Running Therapy Reorganizes Dynamic Brain Networks Linked to Symptom Improvement in Affective Disorders

Exercise therapy reduces depressive and anxiety symptoms, but its neural mechanisms remain unclear. We examined whether running therapy reorganizes dynamic brain functional connectivity in affective disorders (AFFs).

Resting-state functional magnetic resonance imaging was analyzed at baseline in 66 healthy control participants and 50 individuals with AFFs. Coactivation pattern (CAP) analysis identified recurring whole-brain states and their temporal dynamics. After baseline comparisons, patients received 16 weeks of running therapy or antidepressant treatment. Then, we examined treatment-related CAP changes and their associations with symptom improvement.

At baseline, individuals with AFFs showed fewer occurrences and shorter dwell time of the visual-somatosensory-subcortical CAP (VS-SC_CAP) than control participants (both ps ≤ .04, η_p² ≈ 0.04-0.05). Running therapy induced a treatment-specific reorganization of brain dynamics, with decreased default mode CAP (DM_CAP) occurrences (F = 8.18, p = .01, η_p² = 0.13) and dwell time (F = 11.51, p < .001, η_p² = 0.19) and increased VS-SC_CAP occurrences (F = 8.10, p = .01, η_p² = 0.13) and entries (F = 5.39, p = .03, η_p² = 0.08). Greater reductions in DM_CAP entries and transitions from DM_CAP to VS-SC_CAP were associated with greater improvement in anxiety- and fear-related symptoms (ρ = -0.54 to -0.45, all q ≤ .03).

Running therapy was associated with treatment-specific reorganization of large-scale brain dynamics in AFFs. Symptom improvement was linked to changes in DM CAP dynamics and transitions between DM and VS states.