Effect of aerobic exercise on relapse tendency in individuals with methamphetamine use disorder in a virtual social environment: Mediated by cue-induced craving and interoceptive sensibility

Interoceptive sensibility (IS) is a novel therapeutic target in drug relapse prevention. The beneficial mechanisms of exercise on methamphetamine relapse remain unclear. This study assessed the effects of aerobic exercise on cue-induced craving reactivity (including heart rate variability [HRV], methamphetamine-craving, and methamphetamine-using), IS, and relapse tendency in a methamphetamine-related virtual reality environment among individuals with methamphetamine use disorders (MUD). We further examined the role of craving reactivity and IS in aerobic exercise and relapse tendency. Exercise (n = 36) and control (n = 35) groups received eight weeks of aerobic exercise or health education, respectively (5 times/week, 60 minutes/session). HRVcue, methamphetamine-craving, methamphetamine-using, IS, and relapse tendency were measured at pre-test and post-test on the same day. The exercise group exhibited a larger decrease in craving reactivity, IS, and relapse tendency from the pre-test to the post-test compared to the control group. Craving reactivity and IS changes mediated the relationship between exercise intervention and decreased relapse tendency (β = 1.505–2.009, 95% CI: 0.378–3.736). Aerobic exercise improves relapse tendency in individuals with MUD. The underlying mechanisms may include reduced cue-induced craving reactivity and IS.