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Stress-related cognitive dysfunction as a problem of neuromodulatory regulation
KTH, School of Engineering Sciences in Chemistry, Biotechnology and Health (CBH), Biomedical Engineering and Health Systems, Ergonomics. Division of Surgery and Oncology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.ORCID iD: 0000-0002-6207-1969
2026 (English)In: Neuroscience and Biobehavioral Reviews, ISSN 0149-7634, E-ISSN 1873-7528, Vol. 187, article id 106757Article, review/survey (Refereed) Published
Abstract [en]

Prolonged stress is often followed by persistent cognitive instability, reduced mental endurance, and heightened relapse vulnerability, even after external stressors have been substantially reduced. While many models implicitly assume that recovery is roughly proportional to stress reduction, clinical and experimental observations increasingly suggest non-linear trajectories that are difficult to reconcile with level-based or depletion accounts. Here, we propose a systems-level framework in which stress-related cognitive dysfunction is conceptualized primarily as a problem of neuromodulatory regulation rather than static impairment. Focusing on the locus coeruleus-norepinephrine (LC-NE) system, we argue that prolonged stress can bias neuromodulatory dynamics toward maladaptive operating regimes characterized by elevated tonic activity and reduced phasic responsiveness. Such shifts constrain adaptive gain control and narrow the dynamic range available for context-sensitive regulation of attention, learning, and cognitive stability. This perspective offers a coherent account of multi-domain cognitive symptoms, disproportionate sensitivity to modest cognitive or emotional demands, and the persistence of dysfunction in the absence of overt neuropathology. By emphasizing timing, dynamics, and regulatory flexibility over absolute activation levels, the framework also helps clarify why symptom persistence and recovery plateaus may occur despite substantial reductions in stress exposure. Finally, we discuss methodological implications and outline how neuromodulatory dynamics may be indirectly inferred in humans.

Place, publisher, year, edition, pages
Elsevier BV , 2026. Vol. 187, article id 106757
Keywords [en]
Cognition, Dynamics, Flexibility, Locus coeruleus-norepinephrine system, Neuromodulation, Norepinephrine, Stress
National Category
Psychology (Excluding Applied Psychology) Occupational Health and Environmental Health
Identifiers
URN: urn:nbn:se:kth:diva-382748DOI: 10.1016/j.neubiorev.2026.106757PubMedID: 42142685Scopus ID: 2-s2.0-105039316882OAI: oai:DiVA.org:kth-382748DiVA, id: diva2:2064155
Note

QC 20260601

Available from: 2026-06-01 Created: 2026-06-01 Last updated: 2026-06-01Bibliographically approved

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Ericson, Mats

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