The physiological effects of exercise on the nervous system: A narrative review

Exercise induces acute neurophysiological responses and long-term adaptations through interconnected cerebrovascular, neurochemical, neurotrophic, metabolic, and autonomic mechanisms. This narrative review summarises the physiological effects of exercise on the nervous system, focusing on cerebral perfusion, neurotransmitter regulation, neuroplasticity, muscle–brain communication, lactate signalling, and autonomic function. Exercise may support cognitive, emotional, and motor functions by modulating neurotransmitter systems and neurotrophic pathways, including those involving brain-derived neurotrophic factor (BDNF). Improvements in cerebral perfusion, endothelial function, and autonomic regulation may further contribute to neural and cerebrovascular health. Emerging evidence also suggests potential roles for skeletal muscle-derived mediators and lactate in peripheral–brain signalling; however, several proposed mechanisms, particularly neurogenesis and myokine-mediated effects, remain supported predominantly by preclinical studies. The magnitude and nature of these responses vary according to exercise characteristics and individual factors. Overall, current evidence supports exercise as a multidimensional stimulus for nervous system adaptation, with potential implications for maintaining neurological function and informing rehabilitation strategies.