Effects of aerobic vs. resistance exercise on anxiety reduction and emotional interference in young women with premenstrual syndrome: A randomized controlled fNIRS study

Background Premenstrual syndrome (PMS) involves recurrent luteal-phase symptoms, including anxiety, attentional bias toward negative stimuli, and impaired emotional inhibition. While moderate-intensity aerobic exercise is recommended for PMS and resistance training benefits anxiety and inhibition, their comparative efficacy is unclear. This study examined the effects of 8-week aerobic versus resistance exercise on anxiety and emotional interference inhibition in female university students with PMS, using functional near-infrared spectroscopy (fNIRS) to assess prefrontal hemodynamics. Methods Sixty participants were randomized to aerobic exercise (AE), resistance exercise (RE), or control (CG) groups. AE and RE groups completed 8 weeks of moderate-intensity training. Data from 56 participants (CG = 19, AE = 18, RE = 19) were analyzed. Pre- and post-intervention assessments during the mid-late luteal phase included the Self-Rating Anxiety Scale (SAS), an emotional Stroop task, and fNIRS. Analyses employed repeated-measures ANOVA and Pearson correlation. Results Compared to baseline, both exercise groups showed significant reductions in SAS scores and emotional Stroop reaction times. The RE group also exhibited increased oxyhemoglobin (Oxy-Hb) in prefrontal channels under negative conditions. Compared to CG, both AE and RE groups had lower SAS scores and reaction times. RE demonstrated lower SAS scores and reaction times (positive condition) than AE. Both exercise groups also showed greater Oxy-Hb changes in prefrontal channels versus CG under negative conditions. Conclusion Both 8-week exercise programs improved anxiety, emotional inhibition, and prefrontal activity in students with PMS. Resistance exercise was superior to aerobic exercise in reducing anxiety and was linked to greater left dorsolateral prefrontal cortex activation. © 2026 Elsevier B.V.