Research report: Differential default mode network changes following progressive aerobic training and free training in internet gaming disorder

A secondary analysis of a randomized trial in internet gaming disorder (IGD) reports that progressive aerobic training (PAT) was associated with a larger increase in a measure of default mode network (DMN) connectivity than free, self-selected training.

The analysis drew on data from a registered randomized trial (ChiCTR2400090834, registered 14 October 2024). Seventy-two individuals with IGD were randomized to PAT or free training (FT). Behavioral analyses included 63 participants with usable pre- and post-intervention data (33 in PAT, 30 in FT), while resting-state MRI analyses included 59 participants with usable paired scans (29 in PAT, 30 in FT).

PAT participants completed 20 progressively intensified treadmill sessions over one month, whereas FT participants engaged in self-selected exercise. The principal neuroimaging outcome was the area under the PC-versus-sparsity curve (AUC), calculated across a 10%–30% sparsity range, providing a threshold-integrated summary of DMN network participation.

The principal novel finding was a significant TIME × GROUP interaction in DMN PC AUC (F(1, 57) = 9.270, p = .0035, partial η² = 0.140), driven by a larger increase in the PAT group. The PAT pre-post contrast remained significant after Bonferroni adjustment, whereas the FT contrast did not. The interaction result also remained significant after adjustment for change in mean framewise displacement (F(1, 56) = 6.982, p = .0107), indicating it was robust to residual head motion.

Behavioral outcomes were analyzed in the same trial.

Exploratory correlations between change in PC AUC and changes in QGU, DSM-5, and IAT scores were negative in the PAT group but nonsignificant in the FT group. PAT-versus-FT differences for QGU and IAT survived false discovery rate correction but not Bonferroni correction, so the authors characterize these brain-behavior associations as hypothesis-generating rather than established findings.

The authors are careful about interpretation. Because PAT and FT differed across multiple intervention dimensions — intensity, structure, supervision, and progression — the result should be read as a difference between two intervention conditions rather than as evidence of a PAT-specific mechanism. The DMN PC AUC result was robust to threshold-wise analysis and to adjustment for residual head motion, but the study cannot isolate which component of the structured program drove the network change.

Several further limitations frame the findings. This was a secondary neuroimaging analysis, not the trial’s primary report; the sample comprised 59 participants with paired resting-state scans; and the brain-behavior correlations were exploratory and did not survive the most stringent correction. The participation coefficient was computed within a defined sparsity range, and the one-month intervention window limits conclusions about longer-term effects.

Within those constraints, the study adds a network-level observation to the growing literature on exercise-based interventions in gaming disorder: a structured, progressively intensified aerobic program was followed by a larger increase in DMN participation coefficient than self-selected exercise over the same period. Whether that network reconfiguration tracks clinical improvement over longer follow-up, and which feature of structured training accounts for it, remains for future research to determine.

Subject of Research: Effects of progressive aerobic training versus free training on default mode network topology in internet gaming disorder

Article Title: Differential default mode network changes following progressive aerobic training and free training in internet gaming disorder

Article References: Wang, Z., Luo, X., Xu, X., & Dong, G.-H. (2026). Differential default mode network changes following progressive aerobic training and free training in internet gaming disorder. BMC Psychiatry. https://doi.org/10.1186/s12888-026-08815-2

Image Credits: AI Generated

DOI: 10.1186/s12888-026-08815-2

Keywords: internet gaming disorder, progressive aerobic training, default mode network, participation coefficient, resting-state fMRI, randomized trial, graph theory, exercise intervention, BMC Psychiatry, neuroimaging, treadmill training, behavioral outcomes