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Accepted for/Published in: JMIR Serious Games

Date Submitted: Sep 5, 2025
Open Peer Review Period: Sep 8, 2025 - Nov 3, 2025
Date Accepted: Nov 14, 2025
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

Effects of Progressive Aerobic Training on Executive-Reward Network Connectivity and Symptoms of Internet Gaming Disorder: Randomized Controlled Trial

Cui S, Xu X, Luo X, Wei M, Dong GH

Effects of Progressive Aerobic Training on Executive-Reward Network Connectivity and Symptoms of Internet Gaming Disorder: Randomized Controlled Trial

JMIR Serious Games 2025;13:e83597

DOI: 10.2196/83597

PMID: 41328449

PMCID: 12669919

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Progressive aerobic training reduces internet gaming disorder by modulating executive-reward network connectivity

  • Shaoyu Cui; 
  • Xuefeng Xu; 
  • Xin Luo; 
  • Meiting Wei; 
  • Guang-Heng Dong

ABSTRACT

Background:

Background:

Internet gaming disorder (IGD) causes neurocognitive deficits and brain functional. Traditional interventions require specialists and incur high costs, while progressive aerobic training (PAT) shows more practical. But its effect on IGD and the underlying neural mechanism remains unclear.

Objective:

This pre-registered, randomized, single-blind study examined the efficacy of a novel non-pharmacological intervention by elucidating the neurocognitive mechanisms in IGD.

Methods:

Methods:

A total of 72 IGD participants were recruited and randomly assigned to a PAT group or a free training (FT) group. Sixty-four participants completed the experiment (PAT:33; FT: 31), which included pre- and post-treatment fMRI scans and 20 PAT sessions in a month. Regional homogeneity and degree centrality are calculated, and the overlapping brain regions were used as seed points for FC analysis. The correlation between FC and behavioral data and neurotransmitters were also evaluated.

Results:

Results:

Compared with the FT group, the PAT group showed decreased addiction severity and craving after the intervention. FC analysis showed that PAT increased the FC within the executive control network (ECN) and between the ECN and the reward network (RN). FC was significantly associated with cannabinoid receptors CB1 and type-5 metabotropic glutamate receptor (mGluR5).

Conclusions:

Conclusions:

This study suggests that PAT is effectively in treating IGD by improving the FC between the ECN and the RN, enhancing the top-down control. These results are supported by the correlation between FC and behavior and neurotransmitters, indicating that PAT is a very promising intervention approach. Clinical Trial: The protocol of the trial had been registered at the Chinese clinical trial registry (http://www.chictr.org.cn; ChiCTR2400090834).


 Citation

Please cite as:

Cui S, Xu X, Luo X, Wei M, Dong GH

Effects of Progressive Aerobic Training on Executive-Reward Network Connectivity and Symptoms of Internet Gaming Disorder: Randomized Controlled Trial

JMIR Serious Games 2025;13:e83597

DOI: 10.2196/83597

PMID: 41328449

PMCID: 12669919

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