Abstract
BACKGROUND: Internet addiction (IA) poses a significant public health challenge, particularly among college students. Neurocognitive research points to dual inhibitory deficits as core mechanisms: impaired response inhibition drives impulsive loss of control, while deficient interference suppression heightens cue reactivity. While exercise shows potential for cognitive enhancement, its modality-specific effects on these distinct inhibitory subcomponents and underlying neurobiology remain unclear, hindering targeted interventions. METHODS: This study employed a multi-modal intervention design with IA-diagnosed college students. Participants underwent supervised 8-week programs across three exercise modalities: Footbike, swimming, and basketball. Inhibitory control was assessed pre- and post-intervention using standardized cognitive tasks (Go/No-Go for response inhibition, Flanker for interference suppression), with concurrent neurofunctional monitoring via functional near-infrared spectroscopy (fNIRS) focusing on prefrontal subregions-dorsolateral prefrontal cortex (DLPFC), frontopolar cortex (FPC), and orbitofrontal cortex (OFC). RESULTS: Footbike training demonstrated superior efficacy in enhancing inhibitory control compared to other modalities. It yielded significant improvements in both response inhibition (d = -1.67, 95% CI [-2.27, -1.07], p < 0.001) and interference inhibition (d = -0.78, 95% CI [-1.32, -0.25], p = 0.007), with neuroimaging revealing increased activation in associated regions including the DLPFC (d = 0.82, 95% CI [0.28, 1.35], p = 0.008) and FPC (d = 1.77, 95% CI [1.16, 2.38], p < 0.001). For interference inhibition function, basketball intervention showed significant improvement (d = -0.69, 95% CI [-1.22, -0.16], p = 0.005) and most strongly activated the OFC (d = -1.05, 95% CI [-1.06, -0.50], p = 0.004), though its effect on response inhibition was weaker. Swimming failed to demonstrate significant modality-specific benefits for any inhibitory domain. Distinct patterns of neural engagement across exercise types revealed dissociable neurocognitive pathways for inhibitory enhancement. CONCLUSION: Exercise modalities have distinct effects on IA-related inhibitory deficits: Footbike optimally enhances both subcomponents via DLPFC/FPC-mediated executive control, while basketball mainly engages OFC reward pathways with limited transfer. These findings provide a neurobiological basis for precision exercise prescriptions, identifying Footbike as optimal for dual inhibition deficits in IA. We propose a stratified framework using real-time fNIRS neurofeedback to match neurocognitive profiles with tailored exercise, advancing personalized interventions for addiction.