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

BACKGROUND

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).

METHODS

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.

RESULTS

At baseline, individuals with AFFs showed fewer occurrences and shorter dwell time of the visual-somatosensory-subcortical CAP (VS-SCCAP) than control participants (both ps ≤ .04, ηp2 ≈ 0.04-0.05). Running therapy induced a treatment-specific reorganization of brain dynamics, with decreased default mode CAP (DMCAP) occurrences (F = 8.18, p = .01, ηp2 = 0.13) and dwell time (F = 11.51, p < .001, ηp2 = 0.19) and increased VS-SCCAP occurrences (F = 8.10, p = .01, ηp2 = 0.13) and entries (F = 5.39, p = .03, ηp2 = 0.08). Greater reductions in DMCAP entries and transitions from DMCAP to VS-SCCAP were associated with greater improvement in anxiety- and fear-related symptoms (ρ = -0.54 to -0.45, all q ≤ .03).

CONCLUSIONS

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.