Novel Study Shows Physical Activity Reshapes Neural Connectivity and Makes the Brain More Resilient After Childhood Trauma

New research indicates that the long-term neurological impact of childhood trauma is not permanently etched onto the brain. An analysis of brain communication patterns in a group of individuals who have experienced childhood adversity shows that lifetime physical activity can reshape neural connectivity, thereby strengthening the brain’s internal communication and optimizing its response to stress. The findings from the study in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, published by Elsevier, move beyond the idea of a permanently traumatized brain, highlighting physical activity as a modifiable lifestyle factor associated with neurobiological adaptation.

Adverse childhood experiences such as emotional, physical, and/or sexual abuse or neglect have a profound impact on health and are linked to long-term alterations in brain function. These changes in the brain can increase the risk of psychopathologies such as post-traumatic stress disorder, depression, and bipolar disorder.

Physical activity is associated with synaptic plasticity, neurogenesis, and strengthened connectivity within key neural circuits. While the beneficial effects of physical activity are well established for conditions such as depression and anxiety, there is still limited evidence on how physical activity relates to neurobiological outcomes in trauma-exposed populations.

“In our research, we wanted to challenge the idea of ‘scars of the brain’ as a deterministic outcome,” explains co-lead investigator Christian Schmahl, MD, Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, and German Center for Mental Health (DZPG). “We investigated whether adversity-related brain patterns may reflect risk rather than fate, and whether a modifiable resilience-related behavior—physical activity across the lifespan—might help explain individual differences in how adversity is expressed in brain function.”

The investigators studied 75 adults with a history of adversity before the age of 18 and used resting state functional magnetic resonance image (fMRI) to examine functional connectivity patterns of three key regions involved in stress and emotion regulation: the amygdala, hippocampus, and anterior cingulate cortex.

They observed significant interaction effects between adverse childhood experiences and lifetime physical activity in the connection between the anterior cingulate cortex and amygdala. These interactions were most prominent in the subcortical–cerebellar, visual association, and motor-related regions. These regions overlap with emotion- and sensorimotor-related systems.

The study further showed that across clusters, adversity was linked to lower connectivity at low exercise levels, but increased connectivity at higher levels, showing a crossover pattern. This means that physical activity changed how adversity was linked to communication between different brain regions. These effects were most pronounced at lifetime physical activity levels overlapping with World Health Organization (WHO) recommendations of 150 to 390 minutes per week, indicating there may be a “sweet spot” of activity engagement where neural configurations supporting stress adaptation are most likely to emerge.

Co-lead investigator Gabriele Ende, PhD, Department of Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, and German Center for Mental Health (DZPG), points out that, “We expected that physical activity might moderate adversity-related connectivity, but we were surprised by the consistency of the crossover pattern across multiple clusters and by the prominent involvement of subcortical–cerebellar regions. The cerebellum has traditionally been associated with motor functions, but increasing evidence supports its important role in affective and stress-related processes.”

Given the increasing global burden of trauma exposure due to conflict and displacement, accessible and cost-effective resilience-related approaches are urgently needed. Physical activity is a modifiable behavioral factor that can be supported across interdisciplinary healthcare settings, including psychiatry, psychology, primary care, and nursing.

Editor-in-Chief of Biological Psychiatry: Cognitive Neuroscience and Neuroimaging Cameron S. Carter, MD, University of California Irvine School of Medicine, notes, “This study directly examines lifetime physical activity as a moderator of adversity-related brain connectivity, rather than treating physical activity as a secondary variable. By identifying physical activity as a regulator, this work supports a more dynamic and potentially actionable model of resilience beyond traditional deficit-focused views of adversity. Characterizing network-level disruptions in the brain is essential for elucidating adversity-related neurodevelopment and informing targeted intervention strategies.”

Lead author Lemye Zehirlioglu, PhD candidate, Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University concludes, “Childhood adversity can increase vulnerability, but it does not have to define a person’s trajectory. Our findings suggest that physical activity across the lifespan may shape how adversity is reflected in brain connectivity, supporting a more hopeful and dynamic view of resilience.”

Notes for editors

The article is "Lifetime Physical Activity Moderates the Neural Effects of Childhood Adversity on Resting State Functional Connectivity," by Lemye Zehirlioglu, Richard Nkrumah, Traute Demirakca, Gabriele Ende, and Christian Schmahl (https://doi.org/10.1016/j.bpsc.2026.01.006). It appears online in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, published by Elsevier.

The article is openly available at https://www.biologicalpsychiatrycnni.org/article/S2451-9022(26)00024-8/fulltext.

Copies of this paper are also available to credentialed journalists upon request; please contact Rhiannon Bugno at [email protected]. Journalists wishing to interview the study’s authors should contact Torsten Lauer, Office of Communication and Media, Central Institute of Mental Health (CIMH), at [email protected].

The authors’ affiliations and disclosures of financial relationships and conflicts of interest are available in the article.

Cameron S. Carter, MD, is Chair of the Department of Psychiatry & Human Behavior at the University of California Irvine School of Medicine. His disclosures of financial relationships and conflicts of interest are available here.

This work was funded by the German Research Foundation (Deutsche Forschungsgemeinschaft, Graduiertenkolleg GRK2350/2).

About Biological Psychiatry: Cognitive Neuroscience and Neuroimaging

Biological Psychiatry: Cognitive Neuroscience and Neuroimaging is an official journal of the Society of Biological Psychiatry, whose purpose is to promote excellence in scientific research and education in fields that investigate the nature, causes, mechanisms and treatments of disorders of thought, emotion, or behavior. In accord with this mission, this peer-reviewed, rapid-publication, international journal focuses on studies using the tools and constructs of cognitive neuroscience, including the full range of noninvasive neuroimaging and human extra- and intracranial physiological recording methodologies. It publishes both basic and clinical studies, including those that incorporate genetic data, pharmacological challenges, and computational modeling approaches. The 2024 Journal Impact Factor^TM score, from Clarivate, for Biological Psychiatry: Cognitive Neuroscience and Neuroimaging is 4.8.www.sobp.org/bpcnni

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