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Abstract Sport-related concussion (SRC) is a complex brain injury. By applying graph-theoretical analysis to networks derived from neuroimaging techniques, studies have shown that despite an overall retention of small-world topology, changes in small-world properties occur after brain injury. Less is known about how exercise during athletes’ return to sport (RTS) influences these brain network properties. Therefore, in the present study dense electroencephalography (EEG) datasets were collected pre- and post-moderate aerobic exercise. Small-world properties of whole brain (WB) and the default mode network (DMN) were extracted from the EEG datasets of 21 concussed athletes and 21 healthy matched controls. More specifically, path length (LP), clustering coefficient (CP), and small-world index (SWI) in binary and weighted graphs were calculated in the alpha frequency band (7–13 Hz). Pre-exercise, SRC athletes had higher DMN-CP values compared to controls, while post-exercise SRC athletes had higher WB-LP compared to controls. Weighted WB analysis revealed a significant association between SRC and the absence of small-world topology (SWI ≤ 1) post-exercise. This explorative study provides preliminary evidence that moderate aerobic exercise during athletes’ RTS induces an altered network response. Furthermore, this altered response may be related to the clinical characteristics of the SRC athlete.

Functional neurological disorder (FND) is a common neurologic disorder associated with many comorbid symptoms including fatigue, pain, headache, and orthostasis. These concurrent symptoms lead patients to accumulate multiple diagnoses comorbid with FND, including fibromyalgia, chronic fatigue syndrome, postural orthostatic tachycardia syndrome, persistent post-concussive symptoms, and chronic pain. The role of physical activity and exercise has not been evaluated in FND populations, though has been studied in certain comorbid conditions. In this traditional narrative literature review, we highlight some existing literature on physical activity in FND, then look to comorbid disorders to highlight the therapeutic potential of physical activity. We then consider abnormalities in the autonomic nervous system (ANS) as a potential pathophysiological explanation for symptoms in FND and comorbid disorders and postulate how physical activity and exercise may provide benefit via autonomic regulation.