Acute aerobic exercise intensity does not modulate pain potentially due to differences in fitness levels and sex effects: results from a pharmacological fMRI study

Exercise might lead to a release of endogenous opioids, potentially resulting in pain relief. However, the neurobiological underpinnings of this effect remain unclear. Using a pharmacological within-subject functional magnetic resonance imaging (fMRI) study with the opioid antagonist naloxone and di...

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Main Authors: Janne Ina Nold, Tahmine Fadai, Christian Büchel
Format: Article
Language:English
Published: eLife Sciences Publications Ltd 2025-08-01
Series:eLife
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Online Access:https://elifesciences.org/articles/102392
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author Janne Ina Nold
Tahmine Fadai
Christian Büchel
author_facet Janne Ina Nold
Tahmine Fadai
Christian Büchel
author_sort Janne Ina Nold
collection DOAJ
description Exercise might lead to a release of endogenous opioids, potentially resulting in pain relief. However, the neurobiological underpinnings of this effect remain unclear. Using a pharmacological within-subject functional magnetic resonance imaging (fMRI) study with the opioid antagonist naloxone and different levels of aerobic exercise and pain, we investigated exercise-induced hypoalgesia (N = 39, 21 female). Overall, high-intensity (HI) aerobic exercise did not reduce pain as compared to low-intensity aerobic exercise. Accordingly, we observed no significant changes in the descending pain modulatory system. The µ-opioid antagonist naloxone significantly increased overall pain ratings but showed no interaction with exercise intensity. An exploratory analysis suggested an influence of fitness level (as indicated by the functional threshold power) and sex, where males showed greater hypoalgesia after HI exercise with increasing fitness levels. This effect was attenuated by naloxone and mirrored by fMRI signal changes in the medial frontal cortex, where activation also varied with fitness level and sex, and was reversed by naloxone. These results indicate that different aerobic exercise intensities have no differential effect on pain in a mixed population sample, but individual factors such as fitness level and sex might play a role. The current study underscores the need for personalised exercise interventions to enhance pain relief in healthy as well as chronic pain populations, taking into account the sex and fitness status as well as the necessity to further investigate the opioidergic involvement in exercise-induced pain modulation.
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spelling doaj-art-281f17fda06847a6af4ca91d4384adbc2025-08-20T03:40:37ZengeLife Sciences Publications LtdeLife2050-084X2025-08-011410.7554/eLife.102392Acute aerobic exercise intensity does not modulate pain potentially due to differences in fitness levels and sex effects: results from a pharmacological fMRI studyJanne Ina Nold0https://orcid.org/0000-0001-7305-0779Tahmine Fadai1Christian Büchel2https://orcid.org/0000-0003-1965-906XDepartment of Systems Neuroscience, University Medical Centre Hamburg-Eppendorf, Hamburg, GermanyDepartment of Systems Neuroscience, University Medical Centre Hamburg-Eppendorf, Hamburg, GermanyDepartment of Systems Neuroscience, University Medical Centre Hamburg-Eppendorf, Hamburg, GermanyExercise might lead to a release of endogenous opioids, potentially resulting in pain relief. However, the neurobiological underpinnings of this effect remain unclear. Using a pharmacological within-subject functional magnetic resonance imaging (fMRI) study with the opioid antagonist naloxone and different levels of aerobic exercise and pain, we investigated exercise-induced hypoalgesia (N = 39, 21 female). Overall, high-intensity (HI) aerobic exercise did not reduce pain as compared to low-intensity aerobic exercise. Accordingly, we observed no significant changes in the descending pain modulatory system. The µ-opioid antagonist naloxone significantly increased overall pain ratings but showed no interaction with exercise intensity. An exploratory analysis suggested an influence of fitness level (as indicated by the functional threshold power) and sex, where males showed greater hypoalgesia after HI exercise with increasing fitness levels. This effect was attenuated by naloxone and mirrored by fMRI signal changes in the medial frontal cortex, where activation also varied with fitness level and sex, and was reversed by naloxone. These results indicate that different aerobic exercise intensities have no differential effect on pain in a mixed population sample, but individual factors such as fitness level and sex might play a role. The current study underscores the need for personalised exercise interventions to enhance pain relief in healthy as well as chronic pain populations, taking into account the sex and fitness status as well as the necessity to further investigate the opioidergic involvement in exercise-induced pain modulation.https://elifesciences.org/articles/102392exerciseopioidspainneuroimagingnaloxonehypoalgesia
spellingShingle Janne Ina Nold
Tahmine Fadai
Christian Büchel
Acute aerobic exercise intensity does not modulate pain potentially due to differences in fitness levels and sex effects: results from a pharmacological fMRI study
eLife
exercise
opioids
pain
neuroimaging
naloxone
hypoalgesia
title Acute aerobic exercise intensity does not modulate pain potentially due to differences in fitness levels and sex effects: results from a pharmacological fMRI study
title_full Acute aerobic exercise intensity does not modulate pain potentially due to differences in fitness levels and sex effects: results from a pharmacological fMRI study
title_fullStr Acute aerobic exercise intensity does not modulate pain potentially due to differences in fitness levels and sex effects: results from a pharmacological fMRI study
title_full_unstemmed Acute aerobic exercise intensity does not modulate pain potentially due to differences in fitness levels and sex effects: results from a pharmacological fMRI study
title_short Acute aerobic exercise intensity does not modulate pain potentially due to differences in fitness levels and sex effects: results from a pharmacological fMRI study
title_sort acute aerobic exercise intensity does not modulate pain potentially due to differences in fitness levels and sex effects results from a pharmacological fmri study
topic exercise
opioids
pain
neuroimaging
naloxone
hypoalgesia
url https://elifesciences.org/articles/102392
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AT christianbuchel acuteaerobicexerciseintensitydoesnotmodulatepainpotentiallyduetodifferencesinfitnesslevelsandsexeffectsresultsfromapharmacologicalfmristudy