Objective To explore the influence of exercise prescription on cognitive function recovery in college students with mild-to-moderate depression.

Methods A retrospective analysis was conducted on clinical data from college students diagnosed with mild-to-moderate depression who received care at The Second Affiliated Hospital of Xinxiang Medical College between January 2022 and June 2024. Depression patients receiving standard drug treatment were enrolled in the control group, while those receiving additional exercise prescription intervention were enrolled in the observation group. Propensity score matching was performed using the 1∶1 nearest-neighbor method to balance confounding factors, and 55 participants were included in each group in the end. Assessments were conducted at baseline and after 3 weeks and 6 weeks of treatment, covering the disease severity measured by the 24-item Hamilton Depression Rating Scale (HAMD-24), depressive symptoms measured by the Self-Rating Depression Scale (SDS), brain cognitive function measured by P300 and fNIRS, neurosecretory system function measured through corticotropin releasing hormone (CRH) and adrenocorticotropic hormone (ACTH), and the levels of neurotrophic factors, including brain-derived neurotrophic factor (BDNF), insulin-like growth factor 1 (IGF-1), and vascular endothelial growth factor (VEGF). Disease severity was the primary research indicator, while the others were secondary research indicators. The primary outcome indicator was the last measurement taken after 6 weeks of treatment.

Results Interaction effects were observed between groups for all measured outcomes before and after treatment (all P < 0.05). After 3 weeks and 6 weeks of treatment, the observation group showed lower HAMD-24 score, SDS score, P300 latency, fNIRS integral, CRH, and ACTH than the control group did (P < 0.05), but higher P300 amplitude, BDNF, IGF-1, and VEGF than the control group did (P < 0.05).

Conclusion Receiving exercise prescription intervention can effectively reduce the severity of depressive symptoms, enhance the recovery of brain cognitive function, and improve the neurosecretory system function recovery and the expressions of neurotrophic factors in college students with mild-to-moderate depression.