Evaluation of the transient hypofrontality theory in the context of exercise: A systematic review with meta-analysis

Accumulating research suggests that, as a result of reduced neural activity in the prefrontal cortex (PFC), higher-order cognitive function may be compromised while engaging in high-intensity acute exercise, with this phenomenon referred to as the transient hypofrontality effect. However, findings in this field remain unclear and lack a thorough synthesis of the evidence. Therefore, the purpose of this meta-analysis was to evaluate the effects of in-task acute exercise on cognitive function, and further, to examine whether this effect is moderated by the specific type of cognition (i.e., PFC-dependent vs. non-PFC-dependent). Studies were identified by electronic databases in accordance with the PRISMA guidelines. In total, 22 studies met our inclusion criteria and intercept only meta-regression models with robust variance estimation were used to calculate the weighted average effect sizes across studies. Acute exercise at all intensities did not influence cognitive function (β = -0.16, 95% CI = [-0.58, 0.27], p = .45) when exercise occurred during the cognitive task, and no significant moderation effects emerged. However, there was evidence that cognitive task type (PFC-dependent vs. non-PFC-dependent) moderated the effect of high-intensity acute exercise on a concomitant cognitive performance (β = -0.81, 95% CI = [-1.60, -0.02], p = .04). Specifically, our findings suggest that PFC-dependent cognition is impaired while engaging in an acute bout of high-intensity exercise, providing support for the transient hypofrontality theory. We discuss these findings in the context of reticular-activating and cognitive-energetic perspectives.