Mild exercise improves executive function with increasing neural efficiency in the prefrontal cortex of older adults.

This study examined whether a 3-month mild-exercise intervention could improve executive function in healthy middle-aged and older adults in a randomized control trial. Ultimately, a total of 81 middle-aged and older adults were randomly assigned to either an exercise group or a control group. The exercise group received 3 months of mild cycle exercise intervention (3 sessions/week, 30-50 min/session). The control group was asked to behave as usual for the intervention period. Before and after the intervention, participants did color-word matching Stroop tasks (CWST), and Stroop interference (SI)-related reaction time (RT) was assessed as an indicator of executive function. During the CWST, prefrontal activation was monitored using functional near-infrared spectroscopy (fNIRS). SI-related oxy-Hb changes and SI-related neural efficiency (NE) scores were assessed to examine the underlying neural mechanism of the exercise intervention. Although the mild-exercise intervention significantly decreased SI-related RT, there were no significant effects of exercise intervention on SI-related oxy-Hb changes or SI-related NE scores in prefrontal subregions. Lastly, changes in the effects of mild exercise on NE with advancing age were examined. The 81 participants were divided into two subgroups (younger-aged subgroup [YA], older-aged subgroup [OA], based on median age [68 years.]). Interestingly, SI-related RT significantly decreased, and SI-related NE scores in all ROIs of the prefrontal cortex significantly increased only in the OA subgroup. These results reveal that a long-term intervention of very light-intensity exercise has a positive effect on executive function especially in older adults, possibly by increasing neural efficiency in the prefrontal cortex.

Improvement of mnemonic discrimination with acute light exercise is mediated by pupil-linked arousal in healthy older adults.

Physical exercise has positive impacts on hippocampal memory decline with aging. One of the postulated neurobiological mechanisms of the decline is reduced catecholaminergic projections from the locus coeruleus to the hippocampus. Recent human studies revealed that very light exercise rapidly enhances memory and pupil diameter, which suggests that light exercise may improve memory via neural circuits involved in the ascending arousal system, including the locus coeruleus, even in older adults. Thus, we aimed to clarify the effects of a single bout of light-intensity exercise (60% ventilatory threshold) on mnemonic discrimination performance, an index of hippocampal memory function, in healthy older adults using a randomized crossover design. Pupil diameter was measured during exercise as a physiological marker of the ascending arousal system. Discrimination of highly similar stimuli to the targets improved after exercise when compared to the resting control performance. Importantly, causal mediation analysis showed that pupil dilation during exercise mediated the memory improvement. These results suggest that brief light exercise rapidly enhances memory, possibly by upregulating the ascending arousal system.

Groove Rhythm Enhances Exercise Impact on Prefrontal Cortex Function in Groove Enjoyers.

A positive affective response modulates the effects of aerobic exercise on prefrontal executive function (EF). Groove rhythm (GR), eliciting the feeling of wanting to move to music, is useful for inducing positive affective response during exercise. Three minutes of listening to GR activated the left dorsolateral prefrontal cortex (l-DLPFC) and enhanced EF in participants who had higher psychological responses to GR. This finding prompted us to test the hypothesis that the combination of GR and exercise (GREX) induces positive psychological responses that enhance PFC function through entrainment of body movements and musical beats. 41 participants were administered two experimental conditions: three min of very light-intensity (30% V̇ O2peak) exercise combined with GR and combined with a white-noise metronome (WMEX). Before and after exercise, participants performed a Stroop task and were monitored for l-DLPFC activity with functional near-infrared spectroscopy. GREX enhanced EF and l-DLPFC activity in participants who experienced greater subjective feelings of audiomotor entrainment and increased excitement with GREX. These psychological responses were predictive of the impact of GREX on l-DLPFC activity and EF. These findings, together with previous results, support the hypothesis that GR allows us to boost the cognitive benefits of exercise via l-DLPFC activity only in those who enjoy groove, and suggest that subjective audiomotor entrainment is a key mechanism of this boosting effect.

A possible contribution of the locus coeruleus to arousal enhancement with mild exercise: evidence from pupillometry and neuromelanin imaging.

Acute mild exercise has been observed to facilitate executive function and memory. A possible underlying mechanism of this is the upregulation of the ascending arousal system, including the catecholaminergic system originating from the locus coeruleus (LC). Prior work indicates that pupil diameter, as an indirect marker of the ascending arousal system, including the LC, increases even with very light-intensity exercise. However, it remains unclear whether the LC directly contributes to exercise-induced pupil-linked arousal. Here, we examined the involvement of the LC in the change in pupil dilation induced by very light-intensity exercise using pupillometry and neuromelanin imaging to assess the LC integrity. A sample of 21 young males performed 10 min of very light-intensity exercise, and we measured changes in the pupil diameters and psychological arousal levels induced by the exercise. Neuromelanin-weighted magnetic resonance imaging scans were also obtained. We observed that pupil diameter and psychological arousal levels increased during very light-intensity exercise, which is consistent with previous findings. Notably, the LC contrast, a marker of LC integrity, predicted the magnitude of pupil dilation and psychological arousal enhancement with exercise. These relationships suggest that the LC-catecholaminergic system is a potential a mechanism for pupil-linked arousal induced by very light-intensity exercise.

Pupil-linked arousal with very light exercise: pattern of pupil dilation during graded exercise.

Although it has been hypothesized that moderate to vigorous exercise immediately modulates cognition via ascending arousal system activation, such activation during very-light to light exercise has remained uncertain. Here, we aimed to uncover the exact exercise intensity necessary for ascending arousal system activation using pupillometry. The pupil diameter, psychological arousal, and ventilation during graded exercise of 26 young males were analyzed based on %[Formula: see text]. Pupils dilated with very-light exercise compared to rest, stabilized, and then drastically increased again with moderate exercise and above. Pupil dilation with very-light exercise was positively correlated with increases in psychological arousal. Thus, we have shown that there are two phases of pupil dilation during graded exercise: one with very-light exercise coinciding with psychological arousal response, and the other with moderate exercise or above similar to the ventilation increase pattern. This unique pupil dilation pattern provides physiological evidence of ascending arousal system activation with very-light exercise.

Cognitive fatigue due to exercise under normobaric hypoxia is related to hypoxemia during exercise.

We previously found that a 10-min bout of moderate-intensity exercise (50% maximal oxygen uptake) under normobaric and hypoxic conditions (fraction of inspired oxygen [[Formula: see text]] = 0.135) reduced executive performance and neural activity in the left dorsolateral prefrontal cortex (DLPFC). To examine whether this cognitive fatigue is due to a decrease in SpO2 during exercise, we compared executive performance and related prefrontal activation between two experimental conditions, in which the participants inhaled normobaric hypoxic gas ([Formula: see text]= 0.135) (hypoxic exercise [HE]) or hypoxic gas adjusted so that SpO2 during exercise remained at the resting level (milder hypoxic exercise [ME]). ME condition showed that reaction time in executive performance decreased (t[13] = 2.228, P < 0.05, d = 0.34, paired t-test) and left DLPFC activity increased (t[13] = -2.376, P < 0.05, d = 0.63, paired t-test) after exercise compared with HE condition. These results showed that the HE-induced reductions in the left DLPFC activity and executive performance were both suppressed in the ME condition, supporting the hypothesis that exercise-induced cognitive fatigue under hypoxic environment is due to hypoxemia during exercise. This may lead to the development of a method of coping with cognitive fatigue due to exercise that causes hypoxemia.

Groove rhythm stimulates prefrontal cortex function in groove enjoyers.

Hearing a groove rhythm (GR), which creates the sensation of wanting to move to the music, can also create feelings of pleasure and arousal in people, and it may enhance cognitive performance, as does exercise, by stimulating the prefrontal cortex. Here, we examined the hypothesis that GR enhances executive function (EF) by acting on the left dorsolateral prefrontal cortex (l-DLPFC) while also considering individual differences in psychological responses. Fifty-one participants underwent two conditions: 3 min of listening to GR or a white-noise metronome. Before and after listening, participants performed the Stroop task and were monitored for l-DLPFC activity with functional near-infrared spectroscopy. Our results show that GR enhanced EF and l-DLPFC activity in participants who felt a greater groove sensation and a more feeling clear-headed after listening to GR. Further, these psychological responses predict the impact of GR on l-DLPFC activity and EF, suggesting that GR enhances EF via l-DLPFC activity when the psychological response to GR is enhanced.

Comparison Between the Effects of Continuous and Intermittent Light-Intensity Aerobic Dance Exercise on Mood and Executive Functions in Older Adults.

There is a growing body of evidence suggesting that one bout of moderate-intensity exercise enhances executive functions in older adults. However, in terms of safety, feasibility, and continuity, older individuals prefer light, easy, and fun exercises to moderate and stressful exercises for improving executive functions. Therefore, light-intensity aerobic dance exercise (LADE) could be suitable if it produces potential benefits related to executive functions. As for continuous vs. intermittent exercise, intermittent exercise has received a lot of attention, as it results in greater effects on mood and executive functions than continuous exercise; however, its effects in older adults remain uncertain. Thus, in this study, we aimed to examine the acute effects of intermittent LADE (I-LADE) in comparison with those of continuous LADE (C-LADE) on mood and executive functions. Fifteen healthy older adults participated in 10-min I-LADE and C-LADE conditions on separate days. Perceived enjoyment following exercise was assessed using the Physical Activity Enjoyment Scale (PACES). The pleasantness of the mood during exercise and pleasure and arousal levels after exercise were assessed using the Feeling Scale and Two-Dimensional Mood Scale, respectively. Executive function was assessed using the Stroop task before and after exercise. As a result, pleasantness of the mood during exercise and exercise enjoyment levels were greater in I-LADE than in C-LADE. Arousal and pleasure levels and Stroop task performance increased after both LADEs and did not differ between the two exercise conditions. These findings suggest that although enhancement of mood and executive functions after exercise did not differ between C-LADE and I-LADE, I-LADE could be more enjoyable and fun than C-LADE. This study will help in the development of exercise conditions that can enable the elderly to enhance their executive functions in a fun way.

Benefit of human moderate running boosting mood and executive function coinciding with bilateral prefrontal activation.

Running, compared to pedaling is a whole-body locomotive movement that may confer more mental health via strongly stimulating brains, although running impacts on mental health but their underlying brain mechanisms have yet to be determined; since almost the mechanistic studies have been done with pedaling. We thus aimed at determining the acute effect of a single bout of running at moderate-intensity, the most popular condition, on mood and executive function as well as their neural substrates in the prefrontal cortex (PFC). Twenty-six healthy participants completed both a 10-min running session on a treadmill at 50%[Formula: see text] and a resting control session in randomized order. Executive function was assessed using the Stroop interference time from the color-word matching Stroop task (CWST) and mood was assessed using the Two-Dimensional Mood Scale, before and after both sessions. Prefrontal hemodynamic changes while performing the CWST were investigated using functional near-infrared spectroscopy. Running resulted in significant enhanced arousal and pleasure level compared to control. Running also caused significant greater reduction of Stroop interference time and increase in Oxy-Hb signals in bilateral PFCs. Besides, we found a significant association among pleasure level, Stroop interference reaction time, and the left dorsolateral PFCs: important brain loci for inhibitory control and mood regulation. To our knowledge, an acute moderate-intensity running has the beneficial of inducing a positive mood and enhancing executive function coinciding with cortical activation in the prefrontal subregions involved in inhibitory control and mood regulation. These results together with previous findings with pedaling imply the specificity of moderate running benefits promoting both cognition and pleasant mood.

Exercise Intervention for Academic Achievement Among Children: A Randomized Controlled Trial.

OBJECTIVES: Physical inactivity is an important health concern worldwide. In this study, we examined the effects of an exercise intervention on children's academic achievement, cognitive function, physical fitness, and other health-related outcomes. METHODS: We conducted a population-based cluster randomized controlled trial among 2301 fourth-grade students from 10 of 11 public primary schools in 1 district of Ulaanbaatar between February and December 2018. Schools were allocated to an intervention or control group with 5 schools each by using urban and mixed residential area stratified block randomization. The intervention group received a 3-minute high-intensity interval exercise program that included jumps, squats, and various steps implemented twice weekly over 10 weeks for 10 to 25 minutes per session. The control group received the usual physical education class. The primary outcome was academic achievement assessed by scores on the national examination. A linear mixed-effects model was applied. The difference between preintervention and post intervention was compared by least-squares means, estimated on the basis of the interaction of group, measurement time point, and school location. Only 1 statistician, responsible for the analysis, was blinded. RESULTS: Of 2301 students, 2101 (1069 intervention; 1032 control) were included in the analysis. Intervention group members in an urban area showed an 8.36-point improvement (95% confidence interval: 6.06 to 10.66) in academic scores when compared with the control group, whereas those in a mixed residential area showed a 9.55-point improvement (95% confidence interval: 6.58 to 12.51). No intervention-associated injuries were observed. CONCLUSIONS: The exercise program significantly improved children's academic achievement.

Exercise training and burdock root (Arctium lappa L.) extract independently improve abdominal obesity and sex hormones in elderly women with metabolic syndrome.

The prevalence of metabolic syndrome (MS) is increasing among the elderly, and new lifestyle-based treatment strategies are warranted. We conducted a randomized, double-blind controlled trial of the effects of aquatic exercise (AE) and/or consumption of burdock root extract (BE) on body composition and serum sex hormones, i.e., testosterone, estradiol, sex hormone-binding globulin (SHBG), and dehydroepiandrosterone-sulfate (DHEA-S) in elderly women with MS. The percentage of abdominal fat was decreased in the AE group. Waist circumference was increased in the control (CON) group, but not in the other groups. SHBG and estradiol levels were enhanced by both AE and BE and correlated with changes in fat-related body composition. DHEA-S levels only increased in the BE group, which was consistent with changes in lean body mass. Testosterone levels decreased in the CON group, which correlated with changes in lean body mass, skeletal muscle mass, body fat, and waist circumference. Our findings suggested that the combined AE/BE intervention exerted no synergistic and/or additive effects on any sex-related outcome measures in elderly women with MS.

Spontaneous Eye Blink Rate Connects Missing Link between Aerobic Fitness and Cognition.

PURPOSE: Higher aerobic fitness, a physiological marker of habitual physical activity, is likely to predict higher executive function based on the prefrontal cortex (PFC), according to current cross-sectional studies. The exact biological link between the brain and the brawn remains unclear, but the brain dopaminergic system, which acts as a driving force for physical activity and exercise, can be hypothesized to connect the missing link above. Recently, spontaneous eye blink rate (sEBR) was proposed and has been used as a potential, noninvasive marker of brain dopaminergic activity in the neuroscience field. To address the hypothesis above, we sought to determine whether sEBR is a mediator of the association between executive function and aerobic fitness. METHODS: Thirty-five healthy young males (18-24 yr old) had their sEBR measured while staring at a fixation cross while at rest. They underwent an aerobic fitness assessment using a graded exercise test to exhaustion and performed a color-word Stroop task as an index of executive function. Stroop task-related cortical activation in the left dorsolateral PFC (l-DLPFC) was monitored using functional near-infrared spectroscopy. RESULTS: Correlation analyses revealed significant correlations among higher aerobic fitness, less Stroop interference, and higher sEBR. Moreover, mediation analyses showed that sEBR significantly mediated the association between aerobic fitness and Stroop interference. In addition, higher sEBR was correlated with higher neural efficiency of the l-DLPFC (i.e., executive function was high, and the corresponding l-DLPFC activation was relatively low). CONCLUSION: These results indicate that the sEBR mediates the association between aerobic fitness and executive function through prefrontal neural efficiency, which clearly supports the hypothesis that brain dopaminergic function works to connect, at least in part, the missing link between aerobic fitness and executive function.

Positive Mood while Exercising Influences Beneficial Effects of Exercise with Music on Prefrontal Executive Function: A Functional NIRS Study.

Much attention has been focused on physical exercise benefits to mental health such as mood and cognitive function. Our recent studies have consistently shown that a single bout of exercise elicits increased task-related brain activation mainly in the dorsolateral part of the prefrontal cortex (DLPFC), which results in improved executive performance. As the DLPFC is associated with the modulation of mood as well as executive function, it is tempting to hypothesize that exercising while in a positive mood would facilitate the beneficial effects of exercise on executive function via DLPFC activation. Thus, we conceived an experiment that used music to elicit a positive mood during exercise. Thirty-three young adults performed ten minutes of moderate-intensity (50% V.O2peak) pedaling exercise with two experimental conditions: listening to music and listening to beeps at a steady tempo. Mood and executive function were respectively assessed using the Two-Dimensional Mood Scale and a color-word-matching Stroop task before and after the exercise sessions. Prefrontal activation during the Stroop task was monitored using functional near-infrared spectroscopy. Exercise with music elicited greater enhancement of a positive mood (vitality) than did exercise with beeps. Contrary to our hypothesis, there were no significant differences between conditions in improvement in Stroop task performance and task-related cortical activation in the left-DLPFC. The correlation analyses, however, revealed significant correlations among increased vitality, shortened Stroop interference time and increased activation in the left-DLPFC. These results support the hypothesis that positive mood while exercising influences the benefit of exercise on prefrontal activation and executive performance.

The effectiveness of exercise intervention for academic achievement, cognitive function, and physical health among children in Mongolia: a cluster RCT study protocol.

BACKGROUND: Many studies have demonstrated positive effects of physical activity on children's health such as improved cardiorespiratory function and decreased obesity. Physical activity has also been found to have positive effects on academic achievement and cognitive function. However, there are few high quality RCT studies on this topic at present and the findings remain controversial. METHODS: This protocol describes cluster randomized controlled trials assessing the impact of school-based exercise intervention among children in Mongolia. The intervention consists of 3-min sessions of high intensity interval training combined with music implemented two times a week at school during study periods. The participants are children in the fourth grade in public elementary schools in the Sukhbaatar district in Ulaanbaatar, Mongolia. The participants are cluster randomized by school and allocated either to the intervention or control group. The primary outcome is academic achievement. Secondary outcomes are obesity/overweight, physical fitness function, lifestyle, mental health, and cognitive function. DISCUSSION: This cluster-RCT is designed and implemented to assess the effectiveness of exercise intervention on academic achievement, cognitive function, and physical and mental health among school-age children in Mongolia. This study will provide evidence to promote physical activities among children in low- and middle- income countries. TRIAL REGISTRATION: UMIN: UMIN000031062 . Registered on 1st February 2018.

Acute Sprint Interval Exercise Increases Both Cognitive Functions and Peripheral Neurotrophic Factors in Humans: The Possible Involvement of Lactate.

There is increasing attention to sprint interval exercise (SIE) training as a time-efficient exercise regime. Recent studies, including our own (Kujach et al., 2018), have shown that acute high-intensity intermittent exercise can improve cognitive function; however, the neurobiological mechanisms underlying the effect still remain unknown. We thus examined the effects of acute SIE on cognitive function by monitoring the peripheral levels of growth and neurotrophic factors as well as blood lactate (LA) as potential mechanisms. Thirty-six young males participated in the current study and were divided into two groups: SIE (n = 20; mean age: 21.0 ± 0.9 years) and resting control (CTR) (n = 16; mean age: 21.7 ± 1.3 years). The SIE session consisted of 5 min of warm-up exercise and six sets of 30 s of all-out cycling exercise followed by 4.5 min of rest on a cycling-ergometer. Blood samples to evaluate the changes of serum concentrations of brain-derived neurotrophic factor (BDNF), insulin-like growth factor-1 (IGF-1), vascular endothelial growth factor (VEGF), and blood LA were obtained at three time points: before, immediately after, and 60 min after each session. A Stroop task (ST) and trail making test (TMT) parts A and B were used to assess cognitive functions. Acute SIE shortened response times for both the ST and TMT A and B. Meanwhile, the peripheral levels of BDNF, IGF-1, and VEGF were significantly increased after an acute bout of SIE compared to those in CTR. In response to acute SIE, blood LA levels significantly increased and correlated with increased levels of BDNF, IGF-1, and VEGF. Furthermore, cognitive function and BDNF are found to be correlated. The current results suggest that SIE could have beneficial effects on cognitive functions with increased neuroprotective factors along with peripheral LA concentration in humans.

Rapid stimulation of human dentate gyrus function with acute mild exercise.

Physical exercise has beneficial effects on neurocognitive function, including hippocampus-dependent episodic memory. Exercise intensity level can be assessed according to whether it induces a stress response; the most effective exercise for improving hippocampal function remains unclear. Our prior work using a special treadmill running model in animals has shown that stress-free mild exercise increases hippocampal neuronal activity and promotes adult neurogenesis in the dentate gyrus (DG) of the hippocampus, improving spatial memory performance. However, the rapid modification, from mild exercise, on hippocampal memory function and the exact mechanisms for these changes, in particular the impact on pattern separation acting in the DG and CA3 regions, are yet to be elucidated. To this end, we adopted an acute-exercise design in humans, coupled with high-resolution functional MRI techniques, capable of resolving hippocampal subfields. A single 10-min bout of very light-intensity exercise (30%[Formula: see text]) results in rapid enhancement in pattern separation and an increase in functional connectivity between hippocampal DG/CA3 and cortical regions (i.e., parahippocampal, angular, and fusiform gyri). Importantly, the magnitude of the enhanced functional connectivity predicted the extent of memory improvement at an individual subject level. These results suggest that brief, very light exercise rapidly enhances hippocampal memory function, possibly by increasing DG/CA3-neocortical functional connectivity.

Hypoxia-induced lowered executive function depends on arterial oxygen desaturation.

Although it has been traditionally thought that decreasing SpO2 with ascent to high altitudes not only induces acute mountain sickness but also can decrease executive function, the relationship between decreased SpO2 levels and hypoxia-induced lowered executive function is still unclear. Here we aimed to clarify whether hypoxia-induced lowered executive function was associated with arterial oxygen desaturation, using 21 participants performing the color-word Stroop task under normoxic and three hypoxic conditions (FIO2 = 0.165, 0.135, 0.105; corresponding to altitudes of 2000, 3500, and 5000 m, respectively). Stroop interference significantly increased under severe hypoxic condition (FIO2 = 0.105) compared with the other conditions. Moreover, there was a negative correlation between Stroop interference and SpO2. In conclusion, acute exposure to severe hypoxic condition decreased executive function and this negative effect was associated with decreased SpO2. We initially implicated an arterial oxygen desaturation as a potential physiological factor resulting in hypoxia-induced lowered executive function.

Neural basis for reduced executive performance with hypoxic exercise.

While accumulating evidence suggests positive effects of exercise on executive function, such effects vary with environment. In particular, exercise in a hypoxic environment (hypobaric or normobaric hypoxia), leading to decreased oxygen supply, may dampen or cancel such effects. Thus, we further explore the relation between the effects of hypoxic exercise on executive function and their underlying neural mechanisms by monitoring changes of cortical activation patterns using functional near-infrared spectroscopy (fNIRS). Fifteen healthy participants performed color-word Stroop tasks (CWST) before and after a 10 min bout of moderate-intensity exercise (50%V̇O2peak) under normoxic and hypoxic conditions (fraction of inspired oxygen (FIO2) = 0.135). During the CWST, we monitored prefrontal activation using fNIRS. CWST performance under hypoxic conditions decreased compared with normoxic conditions. In addition, CWST-related activation in the left dorsolateral prefrontal cortex (DLPFC) was reduced after a bout of hypoxic exercise. There was statistically significant association between decreased CWST performance and activation in the left DLPFC. These results suggest that moderate exercise under normobaric hypoxic conditions has negative effects on executive function by reducing task-related activations in the DLPFC.

A transferable high-intensity intermittent exercise improves executive performance in association with dorsolateral prefrontal activation in young adults.

Although growing attention has been drawn to attainable, high-intensity intermittent exercise (HIE)-based intervention, which can improve cardiovascular and metabolic health, for sedentary individuals, there is limited information on the impact and potential benefit of an easily attainable HIE intervention for cognitive health. We aimed to reveal how acute HIE affects executive function focusing on underlying neural substrates. To address this issue, we examined the effects of acute HIE on executive function using the color-word matching Stroop task (CWST), which produces a cognitive conflict in the decision-making process, and its neural substrate using functional near infrared spectroscopy (fNIRS). Twenty-five sedentary young adults (mean age: 21.0 ± 1.6 years; 9 females) participated in two counter-balanced sessions: HIE and resting control. The HIE session consisted of two minutes of warm-up exercise (50 W load at 60 rpm) and eight sets of 30 s of cycling exercise at 60% of maximal aerobic power (mean: 127 W ± 29.5 load at 100 rpm) followed by 30 s of rest on a recumbent-ergometer. Participants performed a CWST before and after the 10-minute exercise session, during both of which cortical hemodynamic changes in the prefrontal cortex were monitored using fNIRS. Acute HIE led to improved Stroop performance reflected by a shortening of the response time related to Stroop interference. It also evoked cortical activation related to Stroop interference on the left-dorsal-lateral prefrontal cortex (DLPFC), which corresponded significantly with improved executive performance. These results provide the first empirical evidence using a neuroimaging method, to our knowledge, that acute HIE improves executive function, probably mediated by increased activation of the task-related area of the prefrontal cortex including the left-DLPFC.