The Immediate and sustained benefits of two-week high-frequency aerobic exercise on depressive symptoms and frontal function in subthreshold depression: A randomized controlled trial

AI Summary

Two-week high-frequency aerobic exercise (6 to 7 sessions per week) significantly reduced BDI-II and PHQ-9 scores and increased response and remission rates.
Aerobic exercise reduced activation in DLPFC, FEF, PMC and SMA and decreased functional connectivity with S1 while improving S1 and FEF network efficiency.
Functional enhancement of PMC, SMA and FEF correlated with reductions in somatic symptoms, notably sleep disturbances and fatigue, supporting protocol feasibility and efficacy.

Transl Psychiatry. 2026 Jul 18. doi: 10.1038/s41398-026-04288-9. Online ahead of print.

ABSTRACT

Aerobic exercise (AE) has been shown to improve subthreshold depression (SD). Current interventions typically involve longer durations and a moderate frequency. There is potential to further optimize this approach. This study designed a two-week high-frequency AE program and evaluated its efficacy and neural mechanisms in SD. This single-blind, randomized controlled study randomly assigned 57 female SD participants to AE (n = 29; 6-7 sessions/week) or a sitting control (n = 28). Depression severity and symptoms were assessed using the Beck Depression Inventory-II (BDI-II) and the Patient Health Questionnaire-9 (PHQ-9) at baseline, post-intervention, and two-week follow-up. Functional near-infrared spectroscopy combined with the Verbal Fluency Task was used to assess multiple neural activity metrics in the prefrontal cortex and motor cortex. The AE intervention significantly decreased in BDI-II and PHQ-9 scores, while increasing response and remission rates. Simultaneously, AE significantly reduced activation in the dorsolateral prefrontal cortex (DLPFC), frontal eye field (FEF), and premotor and supplementary motor areas (PMC-and-SMA). Functional connectivity strength decreased between the DLPFC and the FEF, PMC-and-SMA, and the primary somatosensory cortex (S1), and the PMC-and-SMA and S1. Network efficiency improved within the S1 and FEF, including enhanced node efficiency, increased degree centrality, and reduced shortest path. Moreover, the functional enhancement of PMC-and-SMA and FEF was significantly associated with alleviations in somatic symptoms (sleep disturbances and fatigue). The study demonstrates the feasibility and efficacy of the two-week high-frequency AE protocol in improving SD, with benefits comparable to those of previous AE protocols.

PMID:42471308 | DOI:10.1038/s41398-026-04288-9

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