Sculpting the developing brain: a review of neural mechanisms linking physical activity to executive function and...

Childhood and adolescence are a critical period for brain development, yet global physical inactivity threatens this neurodevelopmental trajectory. This review synthesizes the past decade of evidence on how physical exercise modulates executive function and emotional brain circuitry in youth. Behaviorally, moderate-intensity aerobic exercise may enhance inhibitory control, working memory, and cognitive flexibility. However, effect sizes are consistently small-to-moderate, and not all cognitive domains show uniform benefits, with working memory effects being smaller and more variable, and high-intensity exercise sometimes impairing performance. Neuroimaging findings reveal enhanced prefrontal-amygdala functional connectivity, strengthening top-down emotion regulation. Mechanistically, acute exercise appears to enhance cognition via transient neurochemical and hemodynamic changes, while chronic exercise may induce longer-lasting neuroplasticity through BDNF-related pathways, although these mechanisms remain largely inferred and peripheral BDNF is an imperfect surrogate for central activity. Cognitively engaging activities yield superior benefits, with the most consistently supported protocols involving approximately 45-min sessions, three times weekly, sustained for 12 weeks or longer. These parameters represent modal characteristics of successful interventions rather than precisely established optimal prescriptions, and substantial heterogeneity across studies precludes highly specific, universally applicable recommendations. Notably, neurodevelopmental populations like ADHD exhibit distinct or amplified responsiveness. Key limitations include methodological heterogeneity, fragmented causal inference, small sample sizes in neuroimaging studies, and limited evidence for clinical populations. Future work must advance precision exercise prescriptions based on individual neural profiles and translational research bridging laboratory findings with real-world educational contexts.