ORIGINAL RESEARCH article
Front. Psychol.
Sec. Psychology for Clinical Settings
This article is part of the Research TopicPsychological Factors as Determinants of Medical Conditions, Volume IIIView all 21 articles
The effects of Exercise and rTMS on Depression Symptoms in Adolescents Depression
Provisionally accepted
- 1Capital Institute of Physical Education and Sports, Beijing, China
- 2Beijing Huilonggaun Hospital, Beijing, China
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Background: Depression represents a leading cause of disability among adolescents worldwide, underscoring an urgent need for effective and accessible interventions. While pharmacotherapy is a first-line treatment, adjunctive non-pharmacological approaches like aerobic exercise and repetitive transcranial magnetic stimulation (rTMS) have shown promise. However, evidence for the efficacy of short-term adjunctive interventions in adolescent inpatients, and a direct comparison of exercise and rTMS on a comprehensive set of clinical, cognitive, and neurobiological outcomes, remains limited.Methods: In this randomized controlled trial, 45 adolescent inpatients with moderate-to-severe depression were assigned to one of three groups for 4 weeks: Aerobic Exercise + Medication (n=15), rTMS + Medication (n=15), or Medication-only (control, n=15). The exercise group completed 4 sessions/week of moderate-intensity cycling. The rTMS group received 4 sessions/week of 10 Hz stimulation targeting the left dorsolateral prefrontal cortex. Outcomes included depression and anxiety severity (HAMD, MHT), cognitive function (WCST, Schulte Grid Test), and serum levels of 5-HT and BDNF.Results: A significant time × group interaction was observed for HAMD scores (F=11.859, p < .001, η² = 0.361), alongside significant time main effects (F=506.282, p < .001, η² = 0.923). Similar significant interactions were found for MHT scores ( p < .001, η²=0.361), WCST performance (correct responses: p< .001, η²=0.322), and attention ( p=0.003, η²=0.239). Post-hoc tests revealed that both the exercise and rTMS groups demonstrated significantly greater improvements across all clinical and cognitive outcomes compared to the control group ( p < .05), with no significant difference between the two active interventions ( p > 0.94). Serum 5-HT and BDNF levels showed significant time main effects ( p < .001) and increased significantly within both intervention groups ( p ≤0.002), but not in the control group ( p> 0.45).Conclusions: A 4-week adjunctive intervention of either aerobic exercise or rTMS significantly alleviates depressive and anxiety symptoms, enhances attention and executive function, and modulates serum levels of 5-HT and BDNF in adolescent inpatients. The two modalities demonstrated comparable efficacy across all measures. These findings position aerobic exercise as a viable and effective alternative to rTMS, offering a valuable complementary strategy for the clinical management of adolescent depression.
Keywords: depression1, depression in adolescents2, aerobic exercise3, TMS(repetitivetranscranial magnetic stimulation)4, cognitive function5, BDNF(brain derived neurotrophicfactor)6, 5-HT 7
Received: 14 Sep 2024; Accepted: 20 Nov 2025.
Copyright: © 2025 唐, Jia, li, li, wang and Fu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Quan Fu, fuquan@cupes.edu.cn
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