Targeting the Cerebellar Circuit: How Exercise Intervention Reshapes White Matter Networks to Alleviate Autism Symptoms

Although exercise interventions have been shown to alleviate core symptoms of Autism Spectrum Disorder (ASD), the neural mechanisms underlying these improvements, particularly those involving the White Matter Network (WMN), remain poorly understood. This study investigated the effects of a Mini-Basketball Training Program (MBTP) on core symptoms and WMN in children with ASD. This study adopted a two-site cluster-Randomized Controlled Trial (cRCT) design. Participants from two special education centers in China were randomly assigned to either an intervention group (MBTP) or a control group (CON). The participants underwent a 12-week MBTP. Core symptom assessments and a Diffusion Tensor Imaging (DTI) scan were conducted before and after the intervention. The individual WMNs were constructed using Deterministic Fiber Tracking (DFT). Graph theoretical analysis was applied to examine changes in WMN topological properties after MBTP. The MBTP significantly improved core symptoms in children with ASD, alongside the decreased normalized clustering coefficient (Gamma, γ), characteristic path length (Lambda, λ), small-world attributes (Sigma, σ), and increased global efficiency (Eglob). The nodal clustering coefficient (NCC) increased in the left cuneus (CUN.L) and left cerebellum 9 (CRBL9.L). Notably, the increased NCC in CRBL9.L was significantly correlated with improvements in core symptoms following the MBTP. The improvement in core symptoms in children with ASD following exercise intervention is associated with the remodeling of the WMN, highlighting the cerebellum as a key node in this neural mechanism.