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Poster B in Poster Session B: Tuesday, August 4, 2:00 – 3:45 pm, Kimmel Center, Shorin & Rosenthal Rooms

Oscillation in Motion: Dissociable Periodic and Aperiodic EEG Markers of Baseline Cognition and Treatment Response Following Exercise in Schizophrenia Spectrum Disorders

Deniz Yilmaz¹, Nina Gottschewsky¹, Johanna Spaeth¹, Lena Deller¹, Elif Bengisu Kara¹, Klara Lada¹, Mona Hussain¹, Daniel Keeser¹, Lukas Röll¹, Andrea Schmitt¹, Peter Falkai¹, Isabel Maurus¹, Berkhan Karsli¹, Genc Hasanaj¹; ¹Ludwig-Maximilians-Universität München

Presenter: Deniz Yilmaz

Schizophrenia Spectrum Disorders (SSD) are characterized by pervasive cognitive deficits, negative and positive symptoms, and long-term functional impairments, many of which are refractory to standard pharmacological treatments. These clinical features are mirrored by disruptions in cortical electrophysiology, reflecting a core imbalance in excitation–inhibition (E/I) dynamics. While exercise interventions have emerged as promising adjunctive therapies, capable of modulating cognition and clinical symptoms, the neurophysiological mechanisms underlying treatment response remain largely unclear. In this study, we combined cross-sectional and longitudinal EEG assessments to investigate whether exercise influences periodic and aperiodic neural dynamics and whether these changes track cognitive and clinical recovery in SSD. We recruited 58 individuals with SSD (ICD-10: F2*) and 60 healthy controls (HC). All participants underwent baseline EEG assessments. Patients additionally participated in a 12-week randomized exercise intervention, consisting of either Aerobic Exercise Training (AET) or Strength and Balance Training (SBT), with follow-up EEG recordings conducted post-intervention (n = 42). Both exercise arms were combined a priori to streamline analyses and enhance statistical power, supported by prior evidence showing similar effects on EEG and behavioral outcomes. Cognitive function was assessed using the Brief Assessment of Cognition in Schizophrenia (BACS), and clinical symptoms were quantified using the Positive and Negative Syndrome Scale (PANSS). EEG analyses focused on the aperiodic exponent as a proxy of cortical E/I balance, alongside individual alpha peak frequency (iAPF) and theta-band power as markers of cognitive processing. At baseline, patients exhibited localized occipital hyperexcitability, characterized by a flatter aperiodic exponent compared to HC. However, the higher a patient’s cognitive functioning was, the steeper was their global aperiodic exponent, suggesting that a degree of compensatory inhibitory tone may protect cognitive function. Following the 12-week exercise intervention, longitudinal analyses revealed dissociable EEG changes associated with clinical versus cognitive improvement. General psychopathological recovery, as measured by PANSS general scores, corresponded to a global flattening of the aperiodic exponent, suggesting widespread E/I modulation. In contrast, cognitive gains were specifically related to regionally distinct and condition-specific EEG markers: parietal aperiodic steepening and frontal iAPF increases during eyes-closed rest. Overall, our findings demonstrate that periodic and aperiodic EEG metrics provide complementary, region- and state-specific insights into exercise-related neuroplasticity in SSD. Aperiodic slopes reflect global cortical E/I adaptations tracking clinical symptom improvement, whereas oscillatory markers such as iAPF index cognitive enhancements. This neurophysiological dissociation highlights distinct mechanistic pathways through which exercise confers therapeutic benefit, establishing a framework for monitoring treatment efficacy and guiding individualized interventions in SSD.

Topic Area: Development, Individual Differences & Clinical Populations