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Background Executive functioning (EF) deficits are troubling for adolescents and young adults (AYAs) after cancer treatment. Physical activity (PA) may enhance neural activity underlying EF among older adults affected by cancer. Establishing whether PA enhances neural activity among AYAs is warranted. As part of a two-arm, mixed-methods pilot randomized controlled trial (RCT), this proof-of-concept sub-study sought to answer the following questions: (1) is it feasible to use neuroimaging with EF tasks to assess neural activity changes following a 12-week PA intervention? And (2) is there preliminary evidence that a 12-week PA intervention enhances neural activity among AYAs after cancer treatment? Methods AYAs in the pilot RCT were approached for enrollment into this sub-study. Those who were eligible and enrolled, completed functional magnetic resonance imaging (fMRI) with EF tasks (letter n-back, Go/No Go) pre- and post-PA intervention. Sub-study enrollment, adherence to scheduled fMRI scans, outliers, missing data, and EF task performance data were collected. Data were analyzed with descriptive statistics, blood oxygen level dependent (BOLD) analyses, and paired sample t-tests. Results Nine eligible participants enrolled into this sub-study; six attended scheduled fMRI scans. One outlier was identified and was subsequently removed from the analytical sample. Participants showed no differences in EF task performance from pre- to post-PA intervention. Increases in neural activity in brain regions responsible for motor control, information encoding and processing, and decision-making were observed post-PA intervention (p < 0.05; n = 5). Conclusions Findings  show that fMRI scans during EF tasks detected neural activity changes (as assessed by the BOLD signal) from pre- to post-PA intervention. Results thus suggest future trials confirming that PA enhances neural activity underlying EF are needed, though feasibility issues require careful consideration to ensure trial success. Trial registration clinicaltrials.gov, NCT03016728. Registered January 11, 2017, clinicaltrials.gov/ct2/show/NCT03016728.

Much developmental (and comparative) research has used Tulving's Spoon test (i.e., whether an individual will select an item needed to solve a future problem) as the basis for designing tasks to measure episodic future thinking, defined as the capacity to mentally pre‐experience the future. There is, however, intense debate about whether these tasks successfully do so. Most notably, it has been argued that children may pass (i.e., select an item with future utility) by drawing on non‐episodic, associative processes, rather than on the capacity to represent the future, per se. Although subsequent developmental tasks have sought to address this limitation, we highlight what we argue is a more fundamental shortcoming of Spoon tasks: they prompt future‐directed action making it impossible to determine whether children have used their episodic future thinking to guide their behavior. Accordingly, we know little about children's thought about the future that is independently generated (i.e., without prompting), or autocued, and is subsequently reflected (and measurable) by children's actions. We argue that this capacity is a critical, and heretofore overlooked, transition in future‐oriented cognition that may not occur until middle childhood. We further hypothesize that it is reliant on children developing richer and more detailed future event representations, along with the necessary cognitive control to transform these representations into actions that serve to benefit their future selves. The time is ripe for researchers to explore this aspect of cognitive development and we suggest several novel approaches to do so. This article is categorized under: Cognitive Biology > Cognitive Development

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