Alizadeh Pahlavani · Behavioural brain research 2024 · narrative review · n=?

Possible role of exercise therapy on depression: Effector neurotransmitters as key players.

Cited 184 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review of biological mechanisms without systematic clinical trial synthesis

PubMed 38048912 · doi:10.1016/j.bbr.2023.114791 · record verified 2026-08-29

What was done

This paper reviewed the neurobiological mechanisms underlying the antidepressant effects of exercise, synthesizing pathways across neurotransmitter systems (serotonin, dopamine, GABA, glutamate, acetylcholine), neuropeptides, myokines (irisin), neurotrophic factors (BDNF, IGF-1), and inflammatory cytokines.

What was found

The abstract reports no empirical numbers or quantitative effect sizes. It qualitatively describes multiple biochemical pathways: exercise increases serotonin levels and receptor sensitivity, enhances dopamine signaling and BDNF/TrkB expression, modulates GABA and glutamate homeostasis via PGC1α, elevates endogenous opioids and irisin, increases the plasma tryptophan-to-competing amino acid ratio, and decreases pro-inflammatory cytokines including TNF-α, IFN-γ, IL-6, and IL-1β.

Why it matters

It provides a consolidated map of the multi-target neurochemical pathways through which physical activity may protect against depression and promote neurogenesis.

Limits

The abstract describes a narrative mechanistic review without primary clinical trial data, systematic search criteria, or quantitative synthesis. Many cited pathways reflect animal or laboratory paradigms, leaving human clinical effect sizes and specific exercise dosing unspecified.

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