Unraveling the Molecular Underpinnings: The Therapeutic Impact of Aerobic Exercise on Anxiety Disorders.

Anxiety disorders, characterized by persistent apprehension, somatic symptoms and fatigue, are leading causes of disability worldwide. The burgeoning therapeutic potential of aerobic exercise has gained prominence as a leading non-pharmacological strategy, with evidence supporting its effectiveness in alleviating anxiety across diverse conditions. This review synthesizes current research to clarify the molecular mechanisms through which aerobic exercise ameliorates anxiety in terms of the effects of exercise on the hypothalamic-pituitary-adrenal (HPA) axis, the hepatic-brain axis and epigenetics; electroencephalographic alterations; inflammatory pathways; the balance between oxidative and nitrogenous stress; various substances, such as brain-derived neurotrophic factor (BDNF), atrial natriuretic peptide (ANP), and opioid peptides; and the 5-HT2C receptor and cannabinoid receptor type-1 (CB1R), among others, reflecting the positive modulatory effects of aerobic exercise on anxiety. As a non-pharmacological intervention, aerobic exercise has been demonstrated to be useful in a variety of medical applications and has considerable potential for ameliorating symptoms of anxiety.