Corticosteroids and Cognition: A Meta-Analysis

Salivary Cortisol Levels Are Associated with Craving and Cognitive Performance in Cocaine-Abstinent Subjects: A Pilot Study

“…We observed these cortisol measurements were positively associated with craving levels and negatively with the age of onset of drug consumption. Some studies about this topic have revealed that a deviation of cortisol secretion away from the homeostatic diurnal pattern in cocaine-dependent subjects was associated with reduced success at achieving early abstinence [ 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 ]. This finding suggests a feed-forward cascade of effects of drugs on stress biology [ 58 ].…”

“…Concerning this, some studies have demonstrated the influence of parental history of substance abuse on the risk of early drug abuse in their offspring [ 63 , 64 ], and for instance, higher morning cortisol levels have been found among crack cocaine users with positive family history and lower treatment retention [ 44 ]. Indeed, activation of the HPA response may be an early dysregulation associated with excessive and early drug taking that ultimately sensitizes the extrahypothalamic CRH systems [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , ...…”

“…This measurement could be more related to the executive domain because it requires inhibiting incorrect responses following interference. This domain has been shown to be affected in patients with prolonged corticosteroid treatments [ 31 , 83 , 84 ].…”

“…Concerning to the effectiveness in the d 2 test, we observed that the performance was negatively associated with morning cortisol levels. In general, the literature about this topic suggests a facilitator role for moderate levels of cortisol in studies on arousal, attention and concentration [ 31 , 87 ]. Nevertheless, apart from alterations in the HPA axis, we must consider other potential factors which could be related to the worse cognitive performance observed in the SUD group.…”

“…It is well known that high levels of cortisol (hypercortisolism) are often observed in several disorders characterized by the presence of cognitive deficits, such as in Cushing’s syndrome, major depression, or in some forms of dementia [ 24 , 25 , 26 ]. Furthermore, prolonged glucocorticoid therapy for inflammatory diseases is also associated with deficits in declarative memory and healthy adults also show a decreased cognitive function after exogenous cortisol administration [ 27 , 28 , 29 , 30 , 31 ]. Several hippocampus changes have been identified to explain, at least in part, these mnemonic deficits related to high cortisol levels, such as alterations in the motivation–arousal–emotion systems, modifications in long-term potentiation, structural and functional neuronal and glia changes, and suppression of adult neurogenesis [ 32 , 33 ].…”