Acute Exercise Effects on Cognitive Flexibility in Preterm and Full-Term Children: An Event-Related Potential Study

Background: Preterm birth is associated with impairments in executive functions (EFs), particularly in cognitive flexibility, which is essential for adaptive and goal-directed behavior. While acute exercise has been shown to transiently enhance cognitive flexibility in children born full-term, its effects in preterm children remain poorly understood. This study aimed to examine the effects of acute aerobic exercise on cognitive flexibility and its underlying neural mechanisms in preterm children, and to determine whether these effects are comparable to those observed in full-term peers. Methods: Children aged between 10 and 16 years were assigned based on gestational age to either the preterm group (n = 20; born before 37 weeks of gestation) or the full-term group (n = 22; born at or after 37 weeks) to complete two sessions, including a 30-minute aerobic exercise (AE) session and a seated control (CON) session. Cognitive flexibility was assessed immediately after each session using a task-switching paradigm, with concurrent electroencephalographic recording to measure P3b event-related potentials (ERPs). Results: Across both groups, participants exhibited shorter response times in the global and local switch conditions and higher accuracy in the local switch condition following AE compared with CON, although switching costs did not differ significantly between sessions. ERP analyses showed increased P3b amplitudes after AE in both switch conditions, indicating enhanced allocation of attentional resources. No significant group differences were observed, suggesting comparable behavioral and neural patterns between preterm and full-term children. Conclusion: These findings indicate that a single session of moderate-intensity aerobic exercise may transiently enhance cognitive processing in both preterm and full-term children. Although behavioral improvements were not observed in the core index of cognitive flexibility (i.e., switching cost), the ERP results suggest a short-term modulation of neural efficiency following acute exercise.