Stress-Induced Cognitive Impairments: A Narrative Systematic Review

Abstract

Stress is multifactorial, acting via the hypothalamo-pituitary-adrenal axis; with its mediator’s receptors present in the brain’s cognition control area. We identified the causative stressors, ameliorating interventions and patho-physiological mechanisms of stress-induced cognitive-impairments in Medline via a systematic review of PubMed™ using search keywords: ‘stress*’, ‘cogniti*’, ‘executive function’, ‘memory’, ‘learning’ and ‘impairment’, limited in time to 2009 and later, yielding 2795 papers on March 23rd, 2017, reduced to 197 after removing duplicates and reviewing the titles for appropriateness, followed by review of the articles using a-priori criteria. Perceived stress showed no gender disparity, although financial stress was significant in women like work-stress in men. Marriage conferred more stress on women. Acute and/or chronic stress affects learning, memory, attention and executive function cognitive domains. Stressors causing cognitive-impairments include prenatal stress, maternal deprivation, childhood maltreatment, anaesthesia, chronic immobilization, chronic social defeat, illness, noise, sleep deprivation and trauma. Exercise, environmental enrichment and NSAIDS reduce stress-induced cognitive-impairment. Implicated patho-physiological mechanisms include cyclo-oxygenase-2, cholinergic muscarinic and µ-opioid receptors. Newer pathophysiologic mechanisms support future research.