Friday, April 5, 2013

Chronic Stress on Cognitive Functioning

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I’m going to take a step back from focusing on the traits of my family to discuss what effects stress can have on our mental capacity. If you’re like me, you have surely had many nights, studying and stressing for hours on end, preparing for a class, a presentation or an exam. But, when the time comes to showcase what you’ve learned, mentally you feel worse off than before you started.

Our lives are inevitably riddled with stressful events that require our optimum alertness and insight to handle. Once again, our biology in that face of chronic stress seems to be more harmful than helpful. Long-term stress can have evitable effects on our cognition and memory in negative ways.

It is helpful to understand a little background information about how our brains allot effort in storing different kinds of memory. There are two important regions in the brain that work in memory storage and retrieval: the cortex and the hippocampus. Without any elaboration, the cortex specializes in storing memories, while the hippocampus places and accesses memories in the cortex.

Memories are stored in patterned displays of excited neurons, called neural networks. This is why all sorts of approximate contextual information, such as a certain smell, can trigger memory recollection. Multiple routes of exciting a certain neural network can extract memory and information.

The cortex and hippocampus make use of a neurotransmitter called glutamate that is critical in creating memory. Glutamate is a uniquely acting neurotransmitter. In glutamatergic synapses, a small amount of glutamate released activates no response. A bit more is released and still nothing happens. It is not until a threshold of glutamate is passed along to the second neuron that an extensive wave of excitation is triggered. This is when we ‘learn’ something. This is when something ‘clicks.’

Once a synapse has experienced a certain number of glutamate-driven excitations, the synapse is strengthened. It becomes persistently more excitable and takes less of a signal the next time to reach that excited state. The strengthened synapse has just been ‘potentiated.’

Time to fit chronic stress back into the picture.

As we move along the stress scale, from no stress, to mild stress, to temporary moderate stress – memory improves. As we continue along to severe and chronic stress, we see a decline in memory. High stress and glucocorticoid levels are certainly the culprits. It could be that these things make for a generally compromised brain altogether, affecting other areas as well, but memory recollection is the most notable.

Interestingly, these conditions seem to more greatly disrupt eliciting prior explicit memory rather than the formation of new memory. Correspondingly however, stress does disrupt what’s called the ‘executive function’ in forming and storing and retrieving new and old memory (Sapolsky, 2004). This concerns what is done with the information, whether it’s organized strategically and how it guides judgments and decisions.

There are several ways that stress evidentially damages the neural networks of the hippocampus. First, the hippocampus neurons do not perform as well. Even in the absence of glucocorticoids, an overactive sympathetic nervous system can disrupt long-term potentiation of the hippocampus; the neurons are not firing as effectively. High and chronic levels of glucocorticoids only elevate the problem.

The hippocampus has two types of receptors for glucocorticoids, one of which is ten times better at accepting the hormone than the other. The low-affinity receptors are only activated by major or long-standing stress, while the high-affinity receptors are activated all the time. These high-affinity receptors enhance potentiation of neural networks; the low-affinity receptors do the opposite. (Sapolsky, 2004)

Second, long-term stress disconnects neural networks. Under prolonged stress and excessive exposure to glucocorticoids, the neural branches – axons and dendrites – begin to atrophy and retract. The good news: it appears that once the stressor is over with these neurons can re-grow or re-strengthen their connections. The memory is still there, you just have to draw from more associative cues to extract it because the neural network is less efficient than before. (Sapolsky, 2004)

Another happy fact: contrary to what you have probably been told, as I was, certain areas in the brain do make new neurons. There are two main areas of the brain that do this - one of them being the hippocampus! And now for the bad news: the third way in which stress detrimentally affects cognition is in inhibiting the creation of new neurons in the hippocampus. Once again the underpinning bullies are glucocorticoids and an overactive sympathetic nervous system. (Sapolsky, 2004)

Fourthly, the neurons in the hippocampus become more susceptible to damage under chronic stress conditions. During a continuous stressor, glucose levels eventually even out to their normal resting levels. As the stressor continues, glucose to the brain is inhibited, specifically to the hippocampus, by about 25 percent less than normal levels due to high glucocorticoids. This would be tolerable for healthy neurons. However, in weak neurons, like those experiencing a severe neurological stressor, the neuron is far liker to just die off. (Sapolsky, 2004)

Moreover, stress can burden cognition simply by allocating more energy to stress-related intrusive thoughts and avoidance behavior, which can furthermore be exacerbated by the perception of stress. In fact, high levels of perceived stress and diagnosed PTSD both equally elicit high occurrences of cognitive failure – meaning forgetfulness and/or lack of attentiveness.  There is much growing research surrounding PTSD and the notion of whether it is the traumatic event or the subjective response to the event that more heavily tips the scale to induce chronic stress and complications with cognition. (Boals & Banks, 2012)

Conclusively, stress isn’t just a pain in your side (sometimes, literally), it’s a pain in your head. We often think of stress as an abstract concept or state of being that comes and goes. In reality, stress is rooted deeply in our biology and can leave its trace (in chronic conditions) even when the stressor has passed.


Reference:
Boals, Adriel & Banks, Jonathan B. (2012): Effects of traumatic stress and perceived
            Stress on everyday cognitive functioning, Cognition & Emotion, 26:7, 1335
            -1343. Doi: http://dx.doi.org/10.1080/02699931.2011.651100.
Sapolsky, Robert M. (2004). Why Zebras Don’t Get Ulcers: The Acclaimed Guide to
            Stress, Stress-Related Diseases, and Coping. New York: St. Martin’s Griffin
            Press.

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