Exercise as a Promising Adjunct Treatment for Methamphetamine Addiction: Advances in Understanding Neuroplasticity...

Background: Methamphetamine (Meth) addiction, with its high relapse rates, poses a significant global challenge. Conventional therapies remain inadequate, highlighting the need for effective adjunctive treatments. Objective: This review synthesises evidence to propose a novel 'Exercise Modality-Neural Target-Rehabilitation Stage' integration model, elucidating how aerobic, resistance, and mind-body exercises differentially target specific neural pathways to ameliorate cognitive deficits, emotional dysregulation, and craving in Meth use disorder. Methods: A narrative synthesis of 84 studies (up to March 2025) from PubMed, Web of Science, and CNKI was conducted, focusing on the neurobiological basis and clinical application of exercise interventions. Results: The analysis identifies a key overarching neurobiological pattern: different exercise modalities work complementarily to reverse Meth-induced imbalance in glutamate/gamma-aminobutyric acid (Glu/GABA) neurotransmitter homeostasis. Aerobic exercise upregulates prefrontal-striatal BDNF to enhance cognitive control, while resistance training modulates the amygdala-striatal dopamine system to improve emotional stability. Additionally, mind-body exercises help balance the autonomic nervous system, which in turn helps manage cravings. Building on this, we construct a standardised 'screening-assessment-prescription' framework to guide personalised interventions across the various stages of withdrawal. Conclusions: The primary contribution of this review is the integrative model that positions exercise as a precise, evidence-based rehabilitation strategy. The proposed framework provides a practical blueprint for clinical translation, with future research focusing on developing personalised intelligent rehabilitation systems by integrating multimodal exercise with advanced technologies.