The Dose-Response Effect of Aerobic Exercise on Neuroplasticity: An Analysis of The Mechanism of Drug Relapse Intervention Based on RCTs
DOI:
https://doi.org/10.12775/PPS.2025.26.66394Keywords
Aerobic Exercise, Dose-response, Neuroplasticity, Drug Relapse, Randomized Controlled TrialAbstract
Background: Drug relapse involves abnormal synaptic plasticity in reward circuits, including dysregulated glutamatergic signaling and BDNF expression in the nucleus accumbens and prefrontal cortex. Addictive behaviors correlate with hippocampal atrophy, prefrontal inhibition, and disrupted neural oscillations, exacerbating cognitive deficits. Aerobic exercise may modulate neuroplasticity and reduce relapse risk, but its dose-response effects remain unclear.
Methods: This study systematically reviewed RCTs from PubMed, Web of Science, and Elsevier SDOL (2003–2023) on aerobic exercise interventions for drug dependence. Inclusion criteria covered: (1) drug-dependent participants; (2) aerobic exercise as primary or adjunct intervention; (3) neuroplasticity markers (BDNF, hippocampal volume, functional connectivity) and relapse rates. Excluded were non-RCTs or studies lacking dose parameters. Exercise dose was classified by intensity (moderate: 64%–76% HRmax; high: 77%–95%), frequency, and duration.
Results: Moderate-intensity aerobic exercise (3 sessions/week, 30–45 min/session) significantly increased serum BDNF (SMD = 0.47–0.62), expanded anterior hippocampal volume (2%–3%), and enhanced executive function (15%–22% improvement in Go/NoGo accuracy). After 12 weeks, relapse rates decreased by 37%–54%, with males showing greater craving reduction than females (SMD = -2.06 vs. -0.72). Exercise activated AMPAR signaling via lactate pathways and restored cortico-striatal circuitry. High-intensity exercise (>80% HRmax) increased oxidative stress, potentially offsetting neuroprotective benefits.
Conclusion: Aerobic exercise dose-dependently regulates neuroplasticity to mitigate relapse. Moderate-intensity long-term (≥12 weeks) interventions yield optimal risk-benefit profiles. Future studies should combine neuroimaging with ecological assessment to personalize exercise-based rehabilitation.
The funding information.
Project Name: Scientific Research and Innovation Project for Postgraduates of Southwest University.
Project Number: SWUS24042.
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