急性应激影响工作记忆的生理心理机制
The influence of acute stress on working memory: Physiological and psychological mechanisms
通讯作者: 库逸轩, E-mail:kuyixuan@mail.sysu.edu.cn
收稿日期: 2019-10-31 网络出版日期: 2020-09-15
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Received: 2019-10-31 Online: 2020-09-15
急性应激是机体面对外界环境变化所产生的一系列生理和心理反应, 对认知加工, 尤其是核心的工作记忆能力产生深远影响, 然而以往的研究存在大量不一致的结果。从应激诱发方式、工作记忆加工子成分、个体差异等三个方面系统阐释应激影响工作记忆的生理心理机制, 并结合认知神经机制的框架, 可以更好地理解以往的结果。未来研究应综合考虑应激诱发、认知任务和响应个体等方面的差异对应激带来的影响, 并关注急性应激负面影响的干预与调控。
关键词:
Acute stress is a series of physiological and psychological reaction that could help people adjust homeostasis, when their body facing changes and challenges in the external environment. Acute stress has a profound impact on cognitive processing, especially the core function working memory. However, inconsistent behavioral influence by acute stress exists in a plethora of previous studies. We therefore review the empirical results, and systematically summarize the findings. From three perspectives, methods to induce stress, working memory tasks/sub-components, and subjects’ individual differences, we can better explain the physiological and psychological mechanisms underlying the influence of acute stress on working memory. We proposed that the influence could be better understood from views of cognitive neural mechanisms. Future studies should jointly consider these extensive factors of stress and translate findings from basic research into intervention and regulation of negative effects of acute stress.
Keywords:
本文引用格式
李婉如, 库逸轩.
LI Wanru, KU Yixuan.
1 引言
应激(stress)是在机体内稳态受到威胁时, 机体为了保持内稳态平衡而产生的一系列生理和心理上的反应(甄珍, 秦绍正, 朱睿达, 封春亮, 刘超, 2017)。根据持续时间的不同, 应激可分为急性应激(acute stress)和慢性应激(chronic stress) (段海军 等, 2017)。慢性应激通常可由长期、反复的急性应激暴露导致(Smyth, Zawadzki, & Gerin, 2013), 因此对急性应激机制的研究更加关键。更进一步, 急性应激还可能导致相关的精神障碍, 如急性应激障碍(acute stress disorder) (杜建政, 夏冰丽, 2009)、创伤后应激障碍(post-traumatic stress disorder, PTSD) (Bryant, 2010)等, 也是多种精神疾病(如精神分裂症等)的高危因素(Holtzman et al., 2013), 因此研究急性应激的生理心理机制是领域的热点。
日常生活中急性应激源众多, 如各种考试、突发事件等。在这些场景中, 人们必须保持正常的认知表现以及较高水平的认知控制, 从而成功地调节个体的行为和想法以良好地应对这些应激源(Luettgau, Schlagenhauf, & Sjoerds, 2018)。然而在遭遇急性应激事件时, 认知功能往往受到损害, 造成认知灵活性下降(Shields, Trainor, Lam, & Yonelinas, 2016)、记忆提取困难(Smeets, 2011)等负面影响, 可能在学习、工作、生活中导致严重和意外的后果。例如, 民航客机在飞行途中遇到突发情况时, 急性应激状态下的飞行员可能做出错误操作而导致空难。因此, 了解急性应激对不同认知功能的影响及其机制, 进而提出方案以应对其潜在的负面影响, 具有重要的科学价值和现实意义。
在诸多认知能力中, 工作记忆(working memory)是一项核心能力, 是各种高级认知活动如语言、决策、问题解决等的操作空间(Baddeley & Hitch, 1974; Cowan, 2001; Fukuda, Vogel, Mayr, & Awh, 2010)。因此对工作记忆的研究是深入探讨急性应激状态下认知功能变化很好的切入点。工作记忆是指暂时储存信息并用于思考和行动的心理表征和认知操作过程(Cowan, 2017)。它与额顶网络的活动密切相关(Baddeley, 2003; 库逸轩, 2019)。其中, 前额叶(prefrontal cortex, PFC)是长久以来公认的参与工作记忆加工的重要脑区(Goldman-Rakic, 1995), 然而其神经活动对化学环境非常敏感。PFC儿茶酚胺类物质(例如多巴胺)含量的微小变化可对工作记忆等高级认知功能产生较大影响(Arnsten, 2009, 2015)。在急性应激状态下, 一系列快速的机体反应会引起额叶区域化学环境的较大变化, 因而可能对工作记忆产生显著的影响。从临床研究结果来看, 急性应激所造成的PFC功能障碍与许多精神疾病中的PFC功能损伤相似(Mcewen, 2004), 工作记忆的损害也与许多应激相关精神疾病产生共伴的症状(Goldman-Rakic, 1994; Scott et al., 2015)。因此, 对于急性应激引起工作记忆变化的机制研究具有重大的理论和临床意义。
前人在探索急性应激影响工作记忆方面进行了不少研究, 但是所得到的结果并不一致:在大部分研究中, 急性应激状态下的工作记忆任务表现会受到损害, 例如数字广度回忆任务(digit span task) (Elzinga & Roelofs, 2005)、视觉空间任务(corsi block backward) (Bogdanov & Schwabe, 2016)、Sternberg任务(Oei, Everaerd, Elzinga, van Well, & Bermond, 2006)、延迟言语(词汇)回忆任务(delayed verbal recall task) (Olver, Pinney, Maruff, & Norman, 2015)、操作广度任务(operation span task) (Schoofs, Wolf, & Smeets, 2009)、阅读广度任务(Luethi, Meier, & Sandi, 2009)和n-back任务(Schoofs, Preuß, & Wolf, 2008; Schoofs, Pabst, Brand, & Wolf, 2013; van Ast et al., 2014; Lieberman et al., 2016; Jiang & Rau, 2017; Woodcock, Greenwald, Khatib, Diwadkar, & Stanley, 2019)等; 但在一些研究中, 急性应激状态下工作记忆的表现反而提高, 例如在应激状态下, n-back任务(Cornelisse, Joëls, & Smeets, 2011; Cornelisse, van Stegeren, & Joëls, 2011)和Sternberg任务(Duncko, Johnson, Merikangas, & Grillon, 2009)的正确率不变, 反应时加速; 而另一些研究则发现急性应激不影响工作记忆表现, 例如图片记忆任务(Weerda, Muehlhan, Wolf, & Thiel, 2010)和n-back任务(Qin, Hermans, van Marle, Luo, & Fernández, 2009; Luettgau et al., 2018)。
这些不一致的结果可能存在多方面的原因, 我们从输入端、输出端和响应个体三方面进行总结:首先是急性应激的诱发方式存在多样性, 其次是以往研究采用的工作记忆任务和所测量的工作记忆子成分不甚相同, 最后是被试个体间存在差异。本文将总结并分析这三方面的因素, 并提出从认知神经机制的角度分析急性应激对工作记忆的影响, 可能是厘清上述矛盾的行之有效的方式, 基于此我们也提出一些未来可能的研究方向。
2 不同应激诱发方式对工作记忆的影响
急性应激对机体存在生理和心理方面的广泛影响。在生理方面, 应激主要涉及到快反应通路交感神经系统(sympathetic nervous system, SNS)和慢反应通路下丘脑-垂体-肾上腺(hypothalamic- pituitary-adrenal, HPA)轴的激活。SNS的激活是机体对外界应激源的快速反应, 涉及到多巴胺、肾上腺素和去甲肾上腺素分泌的增多, 表现为心跳加速、血压升高和唾液淀粉酶(salivary alpha-amylase, sAA)、多巴胺、去甲肾上腺素等分泌的增多。HPA轴的激活通常在应激诱发后1~2 min发生, 主要表现为皮质醇分泌的增多。在心理方面, 应激可能会改变被试的情绪状态与多种认知过程, 包括情绪加工、情绪体验、学习、记忆和注意等(罗跃嘉, 林婉君, 吴健辉, 秦绍正, 2013)。
不同的应激诱发方式对于两个生理反应系统的激活以及对被试心理过程的影响存在较大差别, 在对应激状态和程度进行测量时, 不同类型应激源造成的生理指标与主观情绪感受方面均存在差异。我们根据应激源的类型, 将急性应激分为心理、物理、药理和混合诱发等4种方式。下面分别介绍这些应激诱发方式及其对工作记忆的影响。
2.1 心理诱发
心理诱发主要通过操纵心理任务来诱发被试的应激状态(段海军 等, 2017)。最常见的方式是特里尔社会应激测试(Trier social stress test, TSST)和观看强烈负性情绪影片。TSST要求被试在面试官面前进行自由演讲或复杂算术任务, 并在此过程中受到面试官的负面评价。此方法被证明可以很好地激活被试的SNS与HPA轴, 且15 min的诱发测试可以保持约70 min的应激状态(Kirschbaum, Pirke, & Hellhammer, 1993)。观看强烈负性情绪影片往往在磁共振脑影像研究中使用。在影片诱发前, 有指导语要求被试想象自己在现场亲眼目睹了影片中的负性情绪事件。这种方式也被证明可以成功地诱发被试的应激状态(Qin et al., 2009; Cousijn, Rijpkema, Qin, van Wingen, & Fernández, 2012; Qin et al., 2012), 但持续时间较短。
然而, TSST诱发的应激状态对工作记忆的影响并不一致。同样是使用n-back范式, 研究者得到了损害工作记忆(Schoofs et al., 2008, 2013; van Ast et al., 2014; Olver et al., 2015; Jiang & Rau, 2017)、提高工作记忆(Cornelisse, van Stegeren et al., 2011; Schoofs et al., 2013)和无效应(Cornelisse, Joëls et al., 2011; Human, Henry, Jacobs, & Thomas, 2018; Ponce, del Arco, & Loprinzi, 2019)的多种结果。这种不一致结果也同样存在于数字序列回忆任务和Sternberg任务中。由于控制了输入端的应激诱发方式, 这些不一致结果可能源自于工作记忆测验子成分的差异, 也可能源自于被试个体间的差异, 我们将在后面的章节展开讨论。
使用强烈负性情绪影片诱发被试应激的一些研究并未发现急性应激对2-back任务(Qin et al., 2009, 2012)和数字序列顺序回忆任务(Renner & Beversdorf, 2010)表现的影响。仅有一项研究发现在观看影片后, 被试的2-back任务表现反而提高, 体现在反应时的加速(Cousijn et al., 2012)。一项使用3-back任务的研究使用了与Qin等人(2009, 2012)以及Cousijn等人(2012)相同的情绪片段材料诱发应激, 发现被试在3-back任务中的辨别力下降, 伴随着任务过程中HPA轴显著激活, 而2-back任务的表现则未受到影响(Gärtner, Rohde- Liebenau, Grimm, & Bajbouj, 2014)。另外, 最近一项研究使用虚拟现实(virtual reality, VR)技术, 给被试呈现一些令人紧张的场景(例如恐高的场景), 引起被试SNS和HPA轴的显著激活, 但也未能影响其2-back和3-back任务的表现(Martens et al., 2019)。这些研究结果提示着, 包含社会性因素(例如强烈负性情绪影片中的暴力场面)的刺激材料可能引起被试轻度到中度的急性应激反应, 这对于记忆负荷较小的2-back任务没有显著影响, 但会造成负荷较高的工作记忆任务(3-back任务)表现的下降。这暗示着, 心理社会性的负性情绪片段造成的应激反应对工作记忆的影响结果可能取决于工作记忆负荷。
与之不同的是, 使用一类能够引起强烈应激状态的心理诱发方式诱发应激, 例如让士兵进行一系列军事训练或演习(Morgan et al., 2000), 这之后进行的工作记忆任务几乎都受到负面的影响。在对士兵进行真实军事训练(睡眠剥夺和户外生存等)的强烈应激状态下, 被试在n-back任务中的表现均下降, 在测试视觉空间工作记忆的样本匹配任务(delayed match-to-sample task)中的表现也受到了损害(Lieberman et al., 2016)。这种损害也出现在其他的强烈应激状态下的多种工作记忆任务中:利用模拟战俘演习(法庭审讯)诱发应激状态, 士兵被试在Rey-Osterrieth复杂图形测试(Rey-Osterrieth complex figure, ROCF)任务中的视觉工作记忆能力受到损害(Morgan, Doran, Steffian, Hazlett, & Southwick, 2006; Taverniers, Van Ruysseveldt, Smeets, & von Grumbkow, 2010), 同时在数字倒序回忆任务中的言语工作记忆能力也受到了损害(Taverniers et al., 2010)。在使用直升机水下疏散训练(HUET)任务诱发应激后进行的测试中, 被试在需要用到工作记忆的减法计算任务中的成绩也显著下降(Robinson, Sünram-Lea, Leach, & Owen-Lynch, 2008)。这些研究均表明, 强烈的急性应激状态很可能使工作记忆受到损害。
尽管如此, 究竟何种心理诱发会造成工作记忆任务表现的改变、以及诱发强度和工作记忆能力增减的关系等, 目前尚无定论。未来可针对这些问题进一步深入探讨。
2.2 物理诱发
物理诱发主要通过施加物理刺激来改变被试的生理状态。最常使用的是冷加压测验(cold pressor test, CPT), 即采用冷刺激(如冷水)诱发应激。这种诱发方式通常引起被试SNS的较强激活(Ishizuka, Hillier, & Beversdorf, 2007), 但是对于HPA轴的激活往往存在较大差异(Schwabe, Haddad, & Schachinger, 2008)。CPT对工作记忆表现的影响也存在许多不一致的结果:在冷刺激的同时进行n-back任务, 发现被试的任务表现不受影响(Ishizuka et al., 2007); 使用其他工作记忆范式, 部分研究发现CPT显著降低了操作广度任务、数字倒序回忆任务(Schoofs et al., 2009)和句子广度任务(sentence span task) (Herrera, Hodis, Mack, & Mather, 2017)的工作记忆容量; 但也有研究发现CPT增强了Sternberg任务的表现(Duncko et al., 2009); 还有一些研究发现CPT对Sternberg任务(Porcelli et al., 2008)、字母-数字顺序测试(letter-number sequencing test)和数字倒序回忆任务没有影响(Hood, Pulvers, Spady, Kliebenstein, & Bachand, 2015)。
这些不一致的结果可能由不同实验研究中HPA轴激活程度的差异造成。在一些CPT影响工作记忆的研究中发现了被试皮质醇含量的变化(Schoofs et al., 2009; Hood, Pulvers, & Spady, 2013; Herrera et al., 2017), 而在一些CPT不影响工作记忆或提高工作记忆的研究中未观察到皮质醇水平的改变(Porcelli et al., 2008; Duncko et al., 2009)。更进一步, 在发现CPT负面影响的研究中, 被试应激状态下的皮质醇增加量和任务表现呈负相关, 即应激诱发后, HPA轴激活程度越高的被试其任务表现也越差(Schoofs et al., 2009)。与此对应, 长期使用雌二醇的绝经后女性, 其皮质醇反应受抑制, 在使用CPT诱发应激后, 皮质醇含量未显著升高, 同时其工作记忆表现未显著变化; 而对照组女性在CPT诱发应激后皮质醇水平显著升高, 工作记忆受损, 即皮质醇含量增加, 任务表现变差(Herrera et al., 2017)。这也显示出皮质醇反应较大的群体, 其工作记忆表现更易受到损害。综合上述发现, 在物理诱发方式下, 同样存在较强程度急性应激损害工作记忆任务表现的情形, 与此同时会伴随较强的HPA轴的激活, 引起皮质醇含量的上升, 这与心理诱发的结果是相似的。而在发现工作记忆表现提高的研究中, 较低强度的CPT可能只激活了SNS, 引起机体唤醒水平的升高, 反而使认知任务表现提升(Duncko et al., 2009)。
然而目前这方面的大部分研究对SNS和HPA轴激活程度的度量并不完备, 上述推测尚需大量实证研究的结果来支持。
2.3 药理诱发
令被试直接服用药物, 以模拟应激状态下的激素水平是从应激诱发结果的层面探究急性应激对工作记忆影响的一种方法。这种诱发方式较为特殊, 它并不直接通过打破内稳态平衡来诱发躯体的内源性应激反应, 而是通过施加外源性应激激素来模拟机体应激反应的后果。药理诱发可以排除物理诱发和心理诱发中的其他因素(如疼痛和社会情绪), 更精确地控制体内的应激激素含量, 因而也是从输入端探究急性应激对工作记忆影响的重要方法。
在心理学、精神病学和生物学研究中, 服药诱发药理应激(pharmacological stress)的方式较为多样:第一种方式是使用氢化可的松(hydrocortisone)直接提高被试皮质醇水平(Yurtsever et al., 2016); 第二种方式是使用氢化可的松和育亨宾(Yohimbine), 提高被试皮质醇水平, 并增强去甲肾上腺素的分泌(Woodcock et al., 2019); 第三种方式是使用促肾上腺皮质素释放激素(corticotrophin releasing hormone)间接提高被试皮质醇水平(Back et al., 2008)。
在对工作记忆的研究中, 第一种方式最为常用。皮质醇含量的升高是急性应激的一个重要的生理标志, 急性应激状态下, 大量内源性皮质醇在大脑外部生成, 而外源性皮质醇也同样是从外周进入中枢神经系统, 因此, 外源性与内源性皮质醇对于神经过程的影响应是类似的(Nelson, 2005a, 2005b), 这使以服药方式模拟应激状态下的皮质醇水平成为可能。然而, 服用氢化可的松诱发的药理应激对工作记忆的影响也存在不一致的结果, 但仔细比较结果发现, 工作记忆任务与服用氢化可的松的间隔时间是一个决定性因素。间隔时间的长短可以产生截然不同的效果。使用n-back任务测试工作记忆表现, 发现当间隔较长时, 工作记忆表现会增强(Henckens, van Wingen, Joels, & Fernandez, 2011); 而间隔较短时, 工作记忆表现则未受影响(Henckens et al., 2011; Wingenfeld, Wolf, Krieg, & Lautenbacher, 2011); 在其他的一些工作记忆任务中, 也发现长间隔时的工作记忆表现提高(Oei, Tollenaar, Spinhoven, & Elzinga, 2009), 但较短间隔后进行的工作记忆任务表现受损(Lupien, Gillin, & Hauger, 1999; Terfehr et al., 2011)。有趣的是, Shields, Bonner和Moons (2015)通过元分析讨论急性皮质醇升高对执行功能的影响, 也发现使用氢化可的松之后的15~73 min内, 工作记忆任务表现会被损害, 而当间隔超过74 min时, 任务表现则会增强。产生这种时间效应的可能原因是皮质醇的短时作用不涉及对基因表达的影响, 而其长时作用则可能影响到某些应答基因(responsive genes)的表达, 从而产生与短时作用截然不同的效应(Joëls, Fernandez, & Roozendaal, 2011)。
第二种方法能够制造最接近于真实应激状态下体内的激素情况。一项研究让被试服用育亨宾和氢化可的松诱发药理应激, 发现短时内(45 min)被试2-back任务表现受损(Woodcock et al., 2019), 这和几项采用心理诱发应激的2-back研究结果是一致的(Lieberman et al., 2016; Jiang & Rau, 2017)。但值得注意的是, 另一项任务条件与Woodcock等人相似、但仅使用氢化可的松的研究却未发现短时内(30 min) 2-back任务表现改变(Henckens et al., 2011), 这一差异提示着, 儿茶酚胺类物质与皮质醇的共同作用可能在急性应激中起着关键的作用。而第三种方式在关于工作记忆的研究还未有使用, 其效果有待检验。
药理诱发仍存在一些问题。首先, 大多数药理诱发研究中所造成的被试体内皮质醇浓度的变化量远高于其他诱发方式, 这使得药理诱发的结果难以完全解释内源性皮质醇变化造成的效应; 其次, 药理诱发只是对机体应激后激素水平的一种模拟, 而由于人体内稳态调节的存在, 药物所引起的生理变化可能与其他方式存在较大差异, 难以与其他方式引发的结果进行直接的比较; 再次, 心理诱发和物理诱发会产生较大的主观感受变化, 而药理诱发则没有或较少, 这也可能导致它们对认知功能影响的不同结果; 最后, 以往的研究大多只考虑提高皮质醇水平对工作记忆的影响, 仅有少量研究使用药物抑制皮质醇水平并考察工作记忆任务表现(Wingenfeld et al., 2011), 将两方面的诱发方式结合起来可能有利于更全面地理解应激相关激素对工作记忆的影响。但由于药理诱发可以较好地避免被试在心理或物理诱发中主观感受的差异, 有助于分离讨论各类激素的作用, 仍存在着广泛的应用。在应用和对此类研究结果进行解读时, 应注意上述问题, 并将研究结果与其他诱发方式进行比较。
2.4 混合诱发
混合诱发方式结合了上述多种应激源, 在实际操作中, 现有范式主要结合心理诱发和物理诱发两种方式, 例如结合心算与冷加压测试的马斯特里赫特急性应激测试(Maastricht acute stress test, MAST)和带社会评价的冷加压测试(socially evaluated cold-pressor test, SECPT)。有趣的是, 不同的心理诱发方式结合同样的物理诱发方式(如冷加压测试)所产生的结果却大不相同:使用冷刺激结合心算的MAST任务诱发应激未能影响被试n-back任务的表现(Hernaus, Quaedflieg, Offermann, Casales Santa, & van Amelsvoort, 2018), 但使用冷刺激与社会评价相结合的SECPT任务诱发应激, 反而使被试对词汇的工作记忆表现提高(Becker & Rohleder, 2019); 类似的, 结合外语演讲和冷加压测试的应激使被试在Sternberg任务中反应时变快(Lai et al., 2014)。这些结果体现出不同混合方式所产生的效果可能大相径庭, 且与单一诱发方式产生的效果可能存在差异。使用SECPT诱发应激的研究中观察到SNS的激活而未观察到HPA轴的激活(未观察到被试皮质醇的显著升高), 因此行为学中表现的提高可能源于被试唤醒度的增加(Becker & Rohleder, 2019), 这与前述单一物理诱发的结果一致; 但是MAST范式虽引起了HPA轴的显著激活, 但仍未改变行为学表现(Hernaus et al., 2018), 这与前述单一物理诱发的结果不一致。这种差异可能是由不同的混合方式(如上述同一物理诱发与不同的心理诱发相结合)所造成的, 但仍需更多的研究以得到稳定可靠的结论。
总结上述研究, 物理、药理等诱发方式产生的急性应激对工作记忆造成的影响较为清晰, 可以较好地被生理系统的激活水平、诱发时间间隔等调节因素所解释, 但心理诱发方式所产生的效应仍存在较多不一致, 尤其是中等强度的心理社会性应激诱发范式(如TSST)。此类急性应激与日常生活紧密联系, 且诱发效果的持续时间较长, 因此成为最常使用的急性应激诱发范式之一, 但这些不一致的结果将限制其广泛应用。更进一步分析这些结果, 前述的另外两大因素“工作记忆加工子成分”以及“被试间个体差异”也可能对工作记忆的变化产生影响。
3 应激对工作记忆加工不同子成分的影响
在考察应激对工作记忆影响的研究中, 存在多种工作记忆范式, 所涉及的感觉模态和加工子成分不尽相同, 急性应激所引起的效果的不一致, 也可能是这些差异所造成的。
急性应激影响长时记忆的大量研究表明, 急性应激对长时记忆的不同加工阶段的影响存在差异。元分析结果显示, 急性应激能够增强长时记忆的编码和巩固, 但是会损害长时记忆的提取(Shields, Sazma, McCullough, & Yonelinas, 2017)。与之相类比, 工作记忆同样也涵盖了不同的加工子成分, 包括对信息的编码(encoding)、保持(maintenance)和操作(manipulation)等(Stauble, Thompson, & Morgan, 2013)。其中, 编码主要涉及对信息的注意与感知(Ranganath, DeGutis, & D’Esposito, 2004), 保持主要包括对信息的存储、复述和匹配, 操作则指的是对记忆内容额外的组织或更新(Veltman, Rombouts, & Dolan, 2003), 也包括对双任务的处理(dual-processing)和转换等(Wager & Smith, 2003)。急性应激对这些子成分可能产生不同的影响。
不同工作记忆任务对于工作记忆加工中不同子成分的考察往往存在差异。例如, 数字顺序回忆任务、词汇序列回忆任务和Sternberg任务主要考察工作记忆的保持, 而数字倒序回忆任务、n-back任务和操作广度任务不仅涉及保持, 还涉及对工作记忆内容的操作。研究者可以采用不同的任务, 探讨急性应激对工作记忆保持和操作能力的不同影响。
3.1 应激对工作记忆编码和保持成分的影响
在工作记忆编码阶段, 急性应激通常会增强感觉信息的表征, 这也与长时记忆研究中增强编码的效应相一致。感觉信息编码常受到注意的调节, 然而急性应激对不同的注意类型可能存在差异化影响。由于急性应激激活SNS, 可以使被试在早期对刺激出现的警觉性(vigilance)增强, 但是对编码晚期或者保持阶段的任务导向(task- directed)的选择性注意和注意分配能力减弱(Wang et al., 2005; Shackman et al., 2011; Qi, Gao, Guan, Liu, & Yang, 2016; Qi, Gao, & Liu, 2018)。利用脑电可以分离注意影响的不同层面, 这些研究结果发现应激产生的表现提升主要是增强了感觉增益(sensory gain), 而不是增强信息选择, 表现为与感知和警觉相关的N1成分振幅增大, 而与注意分配和反馈评价有关的P3成分振幅减小(Shackman et al., 2011; Qi et al., 2018)。当感觉编码过程中存在显著的干扰物时, 急性应激会加剧干扰效应, 降低被试的工作记忆表现, 同时伴有选择性注意相关脑电成分的减弱(Sänger, Bechtold, Schoofs, Blaszkewicz, & Wascher, 2014)。然而值得注意的是, 应激状态下被试可能存在对情绪性刺激的注意增强, 表现在情绪Sternberg任务中, 相对于中性刺激, 被试更难抑制对情绪性刺激的干扰(Oei et al., 2012); 在注意瞬脱(attentional blink)任务中, 在中性词作为T1的情况下, 高皮质醇响应者对情绪性T2引起的注意瞬脱效应也会减弱(Schwabe & Wolf, 2010)。
这些结果的可能原因是应激降低个体前额叶区域自上而下的控制, 使得被试主要受杏仁核和其他与潜在威胁刺激有关的脑区支配(Arnsten, 2009), 因此对凸显的目标刺激的注意能力增强, 但对干扰刺激的选择性抑制能力则减弱。此外, 由于急性应激增加了杏仁核活动的敏感性, 使得被试对于外源性刺激有着更强的探测能力(van Marle, Hermans, Qin, & Fernández, 2009; Shackman et al., 2011), 但内源性注意则反而受到损害(Sänger et al., 2014)。
如果控制同样的编码时间, 而在保持过程中使用部分报告法(partial report)提示部分需要回忆的记忆目标, 并操纵感觉刺激与后置提示之间的延迟时间, 可以考察感觉编码到记忆保持的加工过程(Zylberberg, 2009)。当刺激-提示延迟时间较短时, 感觉信息未巩固到工作记忆中, 仍属于感觉记忆, 存在消退现象; 当刺激-提示延迟时间较长时, 感觉信息则巩固到工作记忆中, 能保持较长时间。研究显示, 应激对未巩固的感觉记忆和巩固后的工作记忆的影响效应可能相反(Weckesser, Alexander, Kirschbaum, Mennigen, & Miller, 2016), 例如, 被试服用氢化可的松后立即进行部分报告任务, 当延迟时间较短时(<150 ms), 被试的记忆成绩下降, 而当延迟时间相对较长时(>300 ms), 被试的记忆表现则会增强(Miller, Weckesser, Smolka, Kirschbaum, & Plessow, 2015)。
单纯考察工作记忆保持成分的范式主要是Sternberg任务, 应激产生的影响和记忆负荷有关。在低负荷条件下, 研究发现使用CPT的物理诱发(Duncko et al., 2009)和使用演讲+冷刺激的混合诱发(Lai et al., 2014)使得被试的反应时加快, 即增强被试工作记忆表现; 而在高负荷条件下, 使用TSST诱发应激后, 被试的反应时变慢, 即降低工作记忆表现(Oei et al., 2006)。
综合来看, 急性应激对工作记忆编码的影响会受到感知觉和多种注意形式的影响, 对保持成分的影响会受到不同记忆负荷的调节作用。因此, 急性应激对工作记忆影响的结果需要综合考虑这多种影响因素, 分析各种因素影响效应的强弱, 从而厘清前述不一致的结果。
3.2 应激对工作记忆操作成分的影响
以往研究中, 数字序列回忆任务被广泛使用, 以讨论工作记忆的保持和操作成分, 因为正序回忆不涉及对记忆内容的额外操作, 倒序回忆比正序回忆多了对记忆内容的重排序(re-ordering), 这属于操作成分的一种子成分(Bopp & Verhaeghen, 2005), 通过比较两种任务的差异可以得出单纯操作成分所受到的影响。使用冷刺激诱发应激导致了被试的重排序能力下降, 即正序回忆不受影响, 而倒序回忆成绩下降(Schoofs et al., 2009)。然而, 在心理诱发条件下, 有研究发现被试的倒序回忆成绩不受影响, 而正序回忆成绩出现下降(Elzinga & Roelofs, 2005)甚至上升(Zandara et al., 2016)的趋势。但也有研究显示两种任务都不受急性应激的影响(Kuhlmann, Piel, & Wolf, 2005; Smeets, Jelicic, & Merckelbach, 2006; Zhao et al., 2010; Quesada, Wiemers, Schoofs, & Wolf, 2012; Zandara et al., 2016), 只有在使用模拟战俘演习诱发强烈应激状态时, 倒序回忆受损而正序回忆不受影响(Taverniers et al., 2010)。这些不一致结果可能存在三方面的原因, 第一, 重排序能力本身可能随着任务条件改变而发生变化, 例如记忆的负荷、材料的复杂度等, 且跟这些条件可能存在非线性的依赖关系, 因此需要更多研究排除这些条件本身的变化所导致的重排序能力的改变; 第二, 工作记忆内容重排序能力的损害可能依赖于HPA轴激活的程度, 而部分未发现工作记忆表现改变的研究中并没有检测到皮质醇含量的显著上升; 第三, 数字的倒序回忆任务的计分方式不敏感, 很难反映工作记忆能力的细微变化, 未来可考虑更精细的探测任务, 例如使用较为复杂的数字-字母序列任务, 以期更准确地检测被试组织记忆内容能力的变化(Wells, Kofler, Soto, Schaefer, & Sarver, 2018)。
除了重排序, 工作记忆的操作还涉及对记忆内容的更新(updating)和转换(switching)。n-back任务能很好地体现工作记忆的更新操作, 也是在急性应激研究中最常被使用的范式。然而, 如前所述, 在心理诱发条件下, 急性应激导致n-back任务表现的改变既有损害(Schoofs et al., 2008, 2013; van Ast et al., 2014; Olver et al., 2015; Jiang & Rau, 2017), 也有提高(Cornelisse, van Stegeren et al., 2011; Schoofs et al., 2013), 还存在无影响的结果(Cornelisse, Joëls et al., 2011; Human et al., 2018; Ponce et al., 2019)。究其原因, n-back任务本身其实也包含了工作记忆的多个子成分, 既有对记忆内容的保持, 也有对记忆内容的更新, 通过调节任务参数, 对比不同负荷情形下的结果, 或许可以得到更纯粹的成分。然而情况远比这复杂, 例如在n-back任务中记忆负荷升高时, 工作记忆的保持难度和操作难度均升高(Itthipuripat, Wessel, & Aron, 2013), 仅通过行为学层面的变化可能难以反映这一问题。未来可以考虑结合认知神经科学研究方法, 以更好地分离工作记忆各个子成分。例如脑电研究的结果显示, 与被试工作记忆更新相关的脑电成分在急性应激状态下受到了损害, 伴随着在3-back任务中的成绩下降(Gärtner et al., 2014), 这暗示着, 在保持和操作负荷均较高的条件下, 工作记忆的操作的确受到了损害。同样的, 工作记忆的转换操作成分也会受到急性应激的影响。在涉及到双任务处理的工作记忆任务中, 使用水下训练的心理诱发方法和冷刺激诱发应激, 被试的任务表现均受到了急性应激的损害(Robinson et al., 2008; Schoofs et al., 2009; Herrera et al., 2017)。总结起来, 工作记忆的不同操作子成分都可能受到急性应激的负面影响。
3.3 应激对不同感觉模态工作记忆的影响
经典的工作记忆模型包含语音环路和视觉空间模板两种不同感觉模态的缓存(Baddeley & Hitch, 1974)。以往的应激研究大部分关注言语工作记忆(verbal working memory), 即记忆项是可以进行言语编码的数字、字母、词汇等内容, 然而值得注意的是, 心理诱发的几种方式主要是视觉的输入(例如观看视频和TSST中特定场景下的面试环节等), 因此输入和输出存在跨模态的影响, 这也可能是前述不一致结果的原因之一, 未来采用视觉工作记忆(visual working memory)范式(Luck & Vogel, 2013), 或者反过来利用听觉模态的应激诱发方式来考察言语工作记忆的结果, 或许能取得更加一致的效果。
前人研究部分说明了这种可行性, 例如在军事训练或演习的强烈应激状态下, 被试在复杂图形测试(ROCF)中的成绩都显著下降(Morgan et al., 2006; Taverniers et al., 2010); TSST对于包含操作成分的视觉空间工作记忆任务存在损害(Olver et al., 2015; Bogdanov & Schwabe, 2016)。另一方面, 采用更为敏感的回忆任务度量工作记忆的精度也可能是一大趋势, 例如使用图片变化检测任务(Weerda et al., 2010)和朝向变化探测任务(change- detection for orientations) (Stauble et al., 2013)未发现急性应激对任务表现的影响, 而复杂图形测试的表现则受到了损害(Ishizuka et al., 2007)。
总结这部分的研究结果, 急性应激影响工作记忆的效果, 与工作记忆任务的多种因素有关, 包括感觉模态、注意加工的形式、感觉记忆巩固的时间, 记忆的保持和操作加工、记忆的负荷、刺激的复杂度等等。在考察前述不一致结果的时候, 需要综合考虑这些因素。未来的研究工作, 也需要针对这些因素设计相应的实验来建立这些因素和应激所造成影响之间的量化对应关系。
4 应激影响工作记忆的个体差异
除了上述输入端和输出端的差异外, 被试在应激响应方面的个体差异也可能导致不一致的结果。理解这些个体差异, 将有助于解释以往研究中看似矛盾的结果。
4.1 性别差异
进化心理学认为, 在应激状态下, 男性和女性可能存在着截然不同的反应模式, 男性往往展示出“战斗或逃跑(fight or flight)”的反应, 而女性由于存在更多的亲代投资(parental investment), 其应激反应更倾向于使自我和后代免受伤害, 因此, 女性会进化出对HPA轴激活的下调(down- regulation)机制(Zandara et al., 2016), 这将减少可能会给后代健康带来损害的神经内分泌反应; 并且, 女性会通过与社会群体建立友谊以应对压力(Taylor et al., 2000)。这种反应模式上的差异, 也可能导致急性应激对认知功能的不同影响。
在一些涉及工作记忆的实验中, 的确发现在急性应激状态下, 女性的皮质醇反应低于男性(Qin et al., 2009; Cornelisse, van Stegeren et al., 2011; Cousijn et al., 2012; Schoofs et al., 2013; Zandara et al., 2016; Human et al., 2018), 女性的任务表现也与男性有差异(Qin et al., 2009; Cornelisse, van Stegeren et al., 2011; Cousijn et al., 2012; Schoofs et al., 2013; Zandara et al., 2016)。值得注意的是, 在应激引起的工作记忆受损的研究中, 男性往往涉及到容量和正确率的下降(Schoofs et al., 2008; Oei et al., 2012; Gärtner et al., 2014), 而女性则体现在反应时变慢(Schoofs et al., 2013); 反过来, 应激引起的工作记忆增强的研究中, 男性反映在反应时的加快(Cornelisse, van Stegeren et al., 2011; Cousijn et al., 2012; Schoofs et al., 2013), 而女性则体现在记忆容量和正确率的提高(Becker & Rohleder, 2019)。
这意味着, 在探讨应激影响工作记忆的研究中, 至少应该将性别作为一个变量, 分开探讨男性和女性的结果, 混杂不同性别只会使结果更加复杂。元分析显示, 非药理应激诱发方式对于男性执行功能的损害程度大于女性(Shields, Sazma, & Yonelinas, 2016), 但药理诱发却没有发现性别差异(Shields et al., 2015), 这也提示着, 机体自发的应激反应的调节在男女性被试中的确存在差异, 由此导致了不同的实验结果。
然而, 以往大多数研究针对男性被试, 以避免女性月经周期中激素水平的波动而对实验产生影响, 因此对于性别差异的讨论并不充分。此外雌性激素本身对于行为结果的影响仍不清楚(Shansky, 2019), 这有待于后续研究中纳入更多的女性被试, 并对其性激素水平进行监测, 以更深入地探究性别差异。
4.2 其他人口学因素差异
被试所处的不同社会文化背景也可能造成结果的差异。近年的一项研究显示, TSST并未影响南非被试在n-back任务的表现, 可能是由于其基础皮质醇水平及应激状态下皮质醇增加量较低, 这和被试所处的整体压力较小的社会文化及经济环境是相关的(Human et al., 2018)。另外, 急性应激造成的机体改变也可能存在种族差异, 例如, TSST导致美国白人的皮质醇水平变化要大于美国黑人(Chong et al., 2008)。未来研究可进一步考察先天的种族因素和后天的社会文化因素对应激反应的不同影响。
除此之外, 被试的精神健康状态, 如重度抑郁(Terfehr et al., 2011)、毒瘾(Zhao et al., 2010)等, 都可能影响被试急性应激状态下的皮质醇反应及工作记忆表现, 也有研究发现, 有过创伤性应激经历的被试在急性应激后的工作记忆表现也会受到更大的损害(Morgan et al., 2006)。另外, 人格特质(Elzinga & Roelofs, 2005)和体重(Mujica-Parodi, Renelique, & Taylor, 2009)等差别也可能是潜在的影响因素, 例如在一些急性应激的研究中, 研究者们会收集被试的近期压力状况, 结果发现, 近期的主观压力情况与急性应激对工作记忆造成的影响呈负相关, 近期主观压力越大, 工作记忆能力的下降程度越大(Luettgau et al., 2018)。
4.3 神经递质和激素的基因型差异
儿茶酚胺对于工作记忆系统存在关键的影响, 其中额叶的多巴胺水平与工作记忆能力呈倒U型关系(Arnsten, 2009; 库逸轩, 2019)。在操作性工作记忆任务中, 额叶儿茶酚氧位甲基转移酶(catechol-O-methyl transferase, COMT)的基因型会影响额叶儿茶酚胺的基础含量, 其中, Met纯合子被试(Met/Met基因型)拥有较低的COMT活性, 即较高的基线儿茶酚胺含量(Bruder et al., 2005), 研究显示, 其更易受到急性应激的负面影响, 例如在情绪片段诱发应激的实验中, 该组被试n-back任务的准确率显著下降, 而在携带Val基因型的被试中, 未发现应激对其工作记忆的影响(Qin et al., 2012); 同样的, 在TSST诱发应激时, 也发现Met纯合子被试的2-back表现受到损害(Buckert, Kudielka, Reuter, & Fiebach, 2012)。未来研究可进一步考察应激导致的儿茶酚胺类物质变化量和工作记忆任务引起的儿茶酚胺类物质变化量对结果的影响。
4.4 应激响应者敏感性的差异
不同被试对同样的应激刺激可能产生不同的生理反应, 例如使用SECPT诱发被试应激状态, 有的被试出现了sAA含量的显著升高, 这可以作为SNS激活的生物学标志, 而另一些被试的sAA含量未有显著变化。通常来说, 响应者受应激刺激引起的工作记忆表现变化更为显著, 例如sAA响应者在应激诱发后工作记忆表现提高(Becker & Rohleder, 2019); 另一些研究发现急性应激对工作记忆造成的影响仅发生在皮质醇响应者身上(Elzinga & Roelofs, 2005; Luettgau et al., 2018)。因此, 在研究中要考虑不同个体对应激刺激响应的敏感性。
上述这些个体差异给本领域研究的可重复性带来了很大的争议与挑战。在相似实验条件下, 实验结果的差异也可能与被试的个体差异密切相关, 但多数研究并没有对这些个体差异进行记录和具体分析(Schoofs et al., 2008, 2013), 这提示今后的研究应该更加重视对上述潜在个体影响因素的探讨, 并全面发掘可能影响应激反应的其他因素。除此之外, 工作记忆能力也存在个体差异(例如感知觉层面和工作记忆的容量的差异), 也可能会影响最后的结果(Luck & Vogel, 2013; 刘志英, 库逸轩, 2017), 这些都有待进一步的研究。
综上所述, 无论是从输入端应激诱发的方式的多样性, 还是从输出端工作记忆任务的多样性, 再结合个体特质的复杂性, 要从根本上构建急性应激对工作记忆的影响并非易事。然而从神经生物学角度出发, 可以将人类的脑成像研究更好地与动物的神经生理研究相对照, 或许能更好地理解急性应激影响工作记忆的背后机制。
5 应激影响工作记忆的神经机制
以往的研究使用神经影像学、电生理学和分子生物学等技术, 对人类或动物在急性应激状态下工作记忆的认知神经机制方面进行了一些探讨, 下面分别从相关的脑区、神经振荡和分子机制(库逸轩, 2019)方面进行总结。
5.1 应激对工作记忆相关脑区激活的影响
从脑区层面看, 在工作记忆中, 前额叶在记忆项的编码、维持中均起着关键的作用(Fletcher & Henson, 2001; Miller & Cohen, 2001; Baddeley, 2003), 同时来自前额叶自上而下的信号对于感觉皮层的活动具有调节作用, 从而影响工作记忆加工的各个阶段(Gazzaley & Nobre, 2012)。应激的功能性磁共振成像(fMRI)研究发现, 观看情绪视频诱发的急性应激状态下, 被试在n-back任务中双侧DLPFC (Qin et al., 2009)、尤其是右侧DLPFC (Luettgau et al., 2018)的激活情况均小于正常状态, 但注意到被试的n-back任务表现未受明显影响; 而在TSST诱发更强的应激反应后, 并给被试继续施加社会压力, 将被试在n-back任务中的表现与社会评价相联系时, 被试在n-back任务中(2-back和3-back)的准确率下降, 并伴随着DLPFC、前扣带回(anterior cingulate cortex, ACC)、额下回(inferior frontal gyrus)、顶叶区域例如顶内沟(intraparietal sulcus, IPS)等工作记忆相关脑区激活的下降(van Ast et al., 2014); 使用药物诱发应激, 也发现了n-back任务表现的下降, 同时DLPFC处的谷氨酸(glutamate)调节减弱(Woodcock et al., 2019)。这些研究结果表明, 急性应激所导致的工作记忆能力下降可能与DLPFC区域的活动下降有关。而最近的一项研究为这一假设提供了因果性证据:使用经颅直流电刺激(transcranial direct current stimulation, tDCS)能提高DLPFC的兴奋性, 同时避免了急性应激所造成的视觉空间工作记忆容量的下降(Bogdanov & Schwabe, 2016)。因此, DLPFC在急性应激影响工作记忆加工的脑区机制方面起到关键的作用, 急性应激对工作记忆的影响很可能是通过降低DLPFC的激活造成的。
在这样的框架下理解一些没有发现应激影响工作记忆表现的研究变得非常自然:工作记忆相关脑区需要有更强的激活, 才能维持任务表现的不变。例如, 在CPT范式之后的Sternberg任务中, 被试的DLPFC以及腹外侧前额叶(ventrolateral prefrontal cortex, VLPFC)均有更多体素的激活, 且激活程度被提高(Porcelli et al., 2008); 使用TSST诱发应激, 在对图片的变化检测任务中, 工作记忆保持阶段的左侧DLPFC、右侧VLPFC和后顶叶皮层激活更强(Weerda et al., 2010); 使用情绪视频片段诱发的急性应激状态下, 尽管未观察到工作记忆相关脑激活的增强, 但观察到内侧颞叶(medial temporal lobe, MTL)中任务无关活动(task-irrelevant activity)的减弱, 并且减弱程度越大, n-back任务表现越好(Cousijn et al., 2012)。这些研究结果提示我们或许从脑区激活的程度可以更好地理解前述那些不一致的实验结果, 工作记忆相关脑区激活强度的增加, 可能可以抵消应激所带来的负面影响, 甚至出现反转(增强)的行为表现。然而为何出现增强活动的原因亟待进一步研究揭示, 这也可能涉及到个体层面的差异。
除了工作记忆相关脑网络, 一些研究还探讨了急性应激对其他一些脑网络, 例如默认网络(default mode network, DMN)激活的影响。工作记忆任务常伴随DMN活动的抑制(Hampson et al., 2006), 而急性应激导致DMN抑制程度的减少(Qin et al., 2009; Cousijn et al., 2012; Qin et al., 2012), 且皮质醇反应越高, DMN去抑制程度越大。这种DMN网络活动的去抑制可能与DLPFC的激活程度下降有关, 可以解释为神经资源的一种重新分配, 但也可能是由于应激对DMN网络的直接作用, 这部分机制还有待进一步研究。
5.2 应激对工作记忆相关神经振荡的影响
少量研究利用脑电技术探讨了急性应激状态下工作记忆相关的神经振荡活动的变化, 这种高时间分辨率的记录技术有助于对工作记忆各阶段活动变化进行分离。工作记忆与额叶theta波紧密相关(Mitchell et al., 2008), 且早期的theta活动(刺激呈现后0~1000 ms)与注意过程有关, 晚期的持续反应(刺激呈现后1000~2500 ms)与工作记忆操作加工更相关(Deiber et al., 2007; Itthipuripat et al., 2013; Hsieh & Ranganath, 2014)。使用负性情绪片段诱发应激, 发现被试的n-back任务的辨别力在高负荷情况下(3-back)下降, 并伴随着晚期持续的theta活动的减弱, 这暗示着被试的工作记忆过程, 尤其是操作成分, 受到了急性应激的损害(Gärtner et al., 2014); 同样的, 在需要工作记忆参与的口头计算任务中, 应激状态下被试的反应时显著延长, 同时伴随着theta活动的下降(Gärtner, Grimm, & Bajbouj, 2015); 在涉及工作记忆的任务转换(task-switching)任务中, 急性应激甚至造成了基线theta能量的下降(Lin, King, Fan, Appaji, & Prasad, 2018)。这些研究表明, 急性应激不仅会损害工作记忆任务中相关脑区的活动, 还会影响脑区之间的协同加工机制, 例如theta频段的活动。未来研究可以进一步考察其他频段的活动, 例如alpha频段的同步化活动。
5.3 应激影响工作记忆的分子机制
在人类研究中, 脑区激活和神经振荡变化从宏观角度解释了急性应激对工作记忆相关大脑活动可能的影响机制。但急性应激状态下, 机体激素水平的显著变化会对大脑活动产生怎样的影响?这一问题可能需要借鉴动物研究的结果, 从应激相关激素对特定脑区影响的分子生物学机制进行分析。
在急性应激状态下, 机体SNS快反应通路的激活和HPA轴慢反应通路的激活会导致大量儿茶酚胺类以及糖皮质激素等递质和激素的释放, 这些物质可能作用于工作记忆的相关脑区, 对任务表现产生显著的影响(Arnsten, 2009)。其中, 前额叶区域就是这些儿茶酚胺类递质和糖皮质激素作用的重要靶点。
前额叶区域儿茶酚胺类物质的浓度与工作记忆表现之间可能存在倒U型曲线的关系。前额叶区域的儿茶酚胺类物质浓度处于适中的状态时, 工作记忆表现最好。而急性应激状态下, 儿茶酚胺类物质的增加会打破这种平衡, 从而损害工作记忆(Arnsten, 2009; Hermans et al., 2014)。
糖皮质激素(皮质醇也是其中最重要的一种)对前额叶皮层的功能也存在着深远影响。前额叶区域的糖皮质激素受体众多(Pryce, 2008), 且肾上腺皮质分泌的皮质醇易透过血脑屏障进入中枢神经系统(Nelson, 2005a, 2005b), 这使得进入前额叶区域的皮质醇激活膜上的糖皮质激素受体, 增强去甲肾上腺素的负面影响(Barsegyan et al., 2010; Hermans et al., 2014)。也有研究者认为, 皮质醇是通过阻止神经胶质细胞上的转运体对儿茶酚胺类物质的清除, 来加强儿茶酚胺的作用效果, 从而损害工作记忆(Gründemann et al., 1998; Arnsten, 2009)。
除此之外, 应激还会导致催产素水平的升高, 而催产素可能会减弱皮质醇反应, 尤其是在女性中(Wirth, 2015), 这种激素的单独作用和与其他应激相关激素的共同作用, 会让情况变得非常复杂, 但也可能在急性应激影响工作记忆过程中扮演重要的角色, 尤其是在解释急性应激的性别差异时。但总体来说, 应激影响工作记忆的分子机制目前还不清楚, 仍需大量研究进一步探明。
值得注意的是, 在使用氢化可的松模拟应激状态下的皮质醇水平时, 高剂量的氢化可的松对长时记忆也会产生影响。一项元分析显示, 长时记忆提取前使用氢化可的松会导致记忆表现下降(Het, Ramlow, & Wolf, 2005), 而一些动物研究也发现氢化可的松等糖皮质激素含量的提高损害了长时记忆的提取(Roozendaal et al., 2004)。还有研究发现氢化可的松可增强长时记忆的巩固但损害工作记忆的成绩(Barsegyan et al., 2010)。因此施加氢化可的松有可能直接影响记忆而不需要通过应激状态的改变, 这也可能成为2.3节药理诱发结果的另一种可能解释, 但仍需要未来研究进一步验证。
6 未来研究展望
综上所述, 急性应激影响工作记忆的生理心理机制非常复杂, 从输入端、输出端和个体差异三个层面能让我们更清晰地理解前人研究的结果, 以及不同研究中看似矛盾的发现。未来研究若能更多地结合神经机制方面的探索, 可以让我们更深入地理解行为效应背后的机制, 并在统一的框架下理解那些不一致的研究结果。
6.1 综合多方面因素考察急性应激对工作记忆的影响
急性应激涉及机体的广泛反应, 综合多模态影像和生理数据对急性应激影响工作记忆的过程进行监控, 并全面考察个体差异, 有助于我们深入理解其背后的机制。从测量角度来看, 可以深入考察不同应激诱发方式的异同, 采用多种测量方式更精确地度量SNS和HPA轴的激活, 以及脑活动。
多种应激诱发方式中, 使用药理诱发的方式, 直接服用药物, 产生的结果一致性更强, 能够较好地研究应激相关激素水平的升高对工作记忆产生的影响。但以往的研究较少在同一批被试身上对比不同剂量、服药和任务的时间间隔、以及一天中的不同服药时段等因素的影响, 在未来的研究中, 可以综合考虑这些因素的作用, 也可以作为其他诱发方式产生结果的参照。前述物理诱发如CPT范式可以很好地激活SNS的反应, 但对于HPA轴的激活存在因人而异的情况, 因此可以结合药理诱发的方式, 例如使用地塞米松以抑制被试的皮质醇升高(Wingenfeld & Wolf, 2015), 也可以单独使用育亨宾, 增强去甲肾上腺素的分泌, 由此增强或者减弱物理诱发的效果。同样, 在使用心理诱发方式时, 也可以结合物理诱发或者药理诱发, 增强心理诱发的效果。混合诱发方式常常获得明显的效果, 且操作较为简单(段海军 等, 2017), 但在工作记忆的研究中混合其他方式与单独使用物理应激源得到结果是不同的, 因此, 有必要进一步探究不同的混合方式所带来差异的原因。另外, 最近有一项研究关注了细菌感染等可能引起炎症反应的应激源对人类认知的影响:研究者给重度抑郁(major depressive disorder, MDD)患者被试注射一种能引起免疫反应的伤寒沙门菌疫苗(salmonella typhi vaccine), 发现其在数字倒序回忆中任务表现提高(Niemegeers et al., 2019)。这种由病原体导致认知改变的情况比较复杂, 可能与特定的内稳态平衡状态(例如MDD)有关。未来在伦理许可的范围内应该继续研究这种与人类自身紧密相连的应激因素。
除了应激诱发方式外, 对机体反应的全面监测也是必不可少的, 不仅应包括SNS、HPA轴等生理活动的监测, 还应包括被试主观应激感受的测量(Luettgau et al., 2018)。被试在应激状态下的一些情绪变化也可能会对工作记忆产生影响, 例如, 研究发现应激时焦虑(anxiety)可能会降低工作记忆容量(Moran, 2016)。因此, 除了心率、皮肤电、唾液收集与皮质醇测量等生理指标的检测, 使用有效的量表对被试情绪和心境状态进行测量也是很有必要的。综合这些生理、心理和行为数据的多变量分析将全面地反映急性应激所造成的影响。此外, 对被试个体特质的收集可以更加全面, 例如被试的长期应激状况、人格特质、某些基因型、甚至一段时间内的内源激素水平等, 综合这些数据将更好地理解个体差异以及各种实验发现的不一致结果。
如前所述, 急性应激对工作记忆的编码、保持和操作可能存在不同的作用效果。对这一问题的进一步深入探讨可以从结合多模态研究技术和改进实验范式两方面进行。一方面通过结合时间分辨率较高的技术, 例如脑电、脑磁图等, 使用事件相关设计, 对工作记忆各个阶段的脑活动变化进行记录与分析; 另一方面也可改变实验范式, 将工作记忆的各个阶段分离开来, 探究行为学层面的差异。以往的大量研究围绕言语工作记忆开展, 而未来可加强视觉工作记忆方面的研究, 甚至探讨跨感觉模态应激的影响。此外, 采用更敏感的任务指标, 例如对工作记忆精度的度量, 或许可以发现一些被忽略的问题。
6.2 关注对急性应激负面影响的调控
在全面理解急性应激影响机制的基础上, 可针对性地进行调控, 以减少应激的负面影响。对于啮齿类动物的研究发现, 高剂量的纳曲酮(naltrexone, 一种阿片受体阻滞剂)可以预防短期记忆提取时的损伤(Creswell et al., 2013); 在人类实验中, 绝经后女性长期服用雌二醇可以降低急性应激状态下的皮质醇反应, 从而减少工作记忆表现的下降(Herrera et al., 2017), 这提示着药物可以被用于急性应激反应的调控; 使用一些环境改变策略也可以调控应激带来的影响, 例如, 被试接受包括生理性和心理性的应激诱导, 在薰衣草的香气氛围中, 被试在应激后的工作记忆表现相比对照组有显著提高(Chamine & Oken, 2016)。此外, 未来可以尝试更多心理、生理甚至神经调控的方式, 例如冥想(meditation)能够缓解人对急性应激的反应(Mohan, Sharma, & Bijlani, 2011)。神经反馈被用于长期应激调控中(Subhani et al., 2018), 而无创性经颅直流电刺激能够降低应激后的皮质醇反应(Antal et al., 2014)并避免急性应激造成的工作记忆损伤(Bogdanov & Schwabe, 2016), 这暗示着神经调控技术在应激调控中可能的应用潜力。
随着我们对应激影响工作记忆机制的理解, 相信未来会有更多更有效的调控方法来避免应激所造成的负面影响, 使应激更多地带来帮助而非损害。
参考文献
Transcranial electrical stimulation modifies the neuronal response to psychosocial stress exposure: TDCS Affects Stress Response
DOI:10.1002/hbm.22434
URL
PMID:24382804
[本文引用: 1]
Stress is a constant characteristic of everyday life in our society, playing a role in triggering several chronic disorders. Therefore, there is an ongoing need to develop new methods in order to manage stress reactions. The regulatory function of right medial-prefrontal cortex (mPFC) is frequently reported by imaging studies during psychosocial stress situations. Here, we examined the effects of inhibitory and excitatory preconditioning stimulation via cathodal and anodal transcranial direct current stimulation (tDCS) on psychosocial stress related behavioral indicators and physiological factors, including the cortisol level in the saliva and changes in brain perfusion. Twenty minutes real or sham tDCS was applied over the right mPFC of healthy subjects before the performance of the Trier Social Stress Test (TSST). Regional cerebral blood flow (rCBF) was measured during stimulation and after TSST, using pseudo-continuous arterial spin labeling (pCASL). Comparing the effect of the different stimulation conditions, during anodal stimulation we found higher rCBF in the right mPFC, compared to the sham and in the right amygdala, superior PFC compared to the cathodal condition. Salivary cortisol levels showed a decrease in the anodal and increase in cathodal groups after completion of the TSST. The behavioral stress indicators indicated the increase of stress level, however, did not show any significant differences among groups. In this study we provide the first insights into the neuronal mechanisms mediating psychosocial stress responses by prefrontal tDCS.
Stress signalling pathways that impair prefrontal cortex structure and function
Stress weakens prefrontal networks: Molecular insults to higher cognition
Effects of gender and cigarette smoking on reactivity to psychological and pharmacological stress provocation
Working memory: Looking back and looking forward
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Glucocorticoids in the prefrontal cortex enhance memory consolidation and impair working memory by a common neural mechanism
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DOI:10.1089/acm.2015.0349
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PMID:27355279
[本文引用: 1]
OBJECTIVE: Aromas may improve physiologic and cognitive function after stress, but associated mechanisms remain unknown. This study evaluated the effects of lavender aroma, which is commonly used for stress reduction, on physiologic and cognitive functions. The contribution of pharmacologic, hedonic, and expectancy-related mechanisms of the aromatherapy effects was evaluated. METHODS: Ninety-two healthy adults (mean age, 58.0 years; 79.3% women) were randomly assigned to three aroma groups (lavender, perceptible placebo [coconut], and nonperceptible placebo [water] and to two prime subgroups (primed, with a suggestion of inhaling a powerful stress-reducing aroma, or no prime). Participants' performance on a battery of cognitive tests, physiologic responses, and subjective stress were evaluated at baseline and after exposure to a stress battery during which aromatherapy was present. Participants also rated the intensity and pleasantness of their assigned aroma. RESULTS: Pharmacologic effects of lavender but not placebo aromas significantly benefited post-stress performance on the working memory task (F(2, 86) = 5.41; p = 0.006). Increased expectancy due to positive prime, regardless of aroma type, facilitated post-stress performance on the processing speed task (F(1, 87) = 8.31; p = 0.005). Aroma hedonics (pleasantness and intensity) played a role in the beneficial lavender effect on working memory and physiologic function. CONCLUSIONS: The observable aroma effects were produced by a combination of mechanisms involving aroma-specific pharmacologic properties, aroma hedonic properties, and participant expectations. In the future, each of these mechanisms could be manipulated to produce optimal functioning.
Whites have a more robust hypothalamic-pituitary-adrenal axis response to a psychological stressor than blacks
A randomized trial on mineralocorticoid receptor blockade in men: Effects on stress responses, selective attention, and memory
DOI:10.1038/npp.2011.162
URL
PMID:21881569
[本文引用: 3]
Corticosteroids, released in high amounts after stress, exert their effects via two different receptors in the brain: glucocorticoid receptors (GRs) and mineralocorticoid receptors (MRs). GRs have a role in normalizing stress-induced effects and promoting consolidation, while MRs are thought to be important in determining the threshold for activation of the hypothalamic-pituitary-adrenal (HPA) axis. We investigated the effects of MR blockade on HPA axis responses to stress and stress-induced changes in cognitive function. In a double-blind, placebo-controlled study, 64 healthy young men received 400 mg of the MR antagonist spironolactone or placebo. After 1.5 h, they were exposed to either a Trier Social Stress Test or a non-stressful control task. Responses to stress were evaluated by hormonal, subjective, and physiological measurements. Afterwards, selective attention, working memory, and long-term memory performance were assessed. Spironolactone increased basal salivary cortisol levels as well as cortisol levels in response to stress. Furthermore, spironolactone significantly impaired selective attention, but only in the control group. The stress group receiving spironolactone showed impaired working memory performance. By contrast, long-term memory was enhanced in this group. These data support a role of MRs in the regulation of the HPA axis under basal conditions as well as in response to stress. The increased availability of cortisol after spironolactone treatment implies enhanced GR activation, which, in combination with MR blockade, presumably resulted in a decreased MR/GR activation ratio. This condition influences both selective attention and performance in various memory tasks.
Implications of psychosocial stress on memory formation in a typical male versus female student sample
Phasic deactivation of the medial temporal lobe enables working memory processing under stress
DOI:10.1016/j.neuroimage.2011.09.027
URL
PMID:21983180
[本文引用: 7]
Demanding cognitive tasks are sometimes carried out under stressful conditions. Several studies indicate that whereas severe stress impairs performance, moderate stress can enhance cognitive performance. In this study, we investigated how moderate stress influences the neural systems supporting working memory. We embedded an N-back working memory task in a moderately stressful context, as indicated by our physiological stress measures, and probed phasic and tonic human brain activity using two fMRI-techniques: conventional blood oxygen level dependent fMRI and arterial spin labeling (ASL). The results showed that the stress induction, as compared to the neutral control condition, led to slightly faster reaction times without changes in accuracy. In general, working memory processing was associated with increased activity in a frontoparietal network and reduced activity in the medial temporal lobe (MTL). The stress induction led to enhanced reduction of phasic MTL responses, specifically the hippocampus and amygdala. In addition, ASL showed that stress increased tonic amygdala activity, while tonic hippocampal activity was unaffected. These findings suggest that the influence of stress on MTL deactivation during working memory processing is task-related rather than a general consequence of the stressful state. The temporal suspension of hippocampal processing in favor of more task relevant processes may allow subjects to maintain normal performance levels under moderate stress.
The magical number 4 in short-term memory: A reconsideration of mental storage capacity
DOI:10.1017/s0140525x01003922
URL
PMID:11515286
[本文引用: 1]
Miller (1956) summarized evidence that people can remember about seven chunks in short-term memory (STM) tasks. However, that number was meant more as a rough estimate and a rhetorical device than as a real capacity limit. Others have since suggested that there is a more precise capacity limit, but that it is only three to five chunks. The present target article brings together a wide variety of data on capacity limits suggesting that the smaller capacity limit is real. Capacity limits will be useful in analyses of information processing only if the boundary conditions for observing them can be carefully described. Four basic conditions in which chunks can be identified and capacity limits can accordingly be observed are: (1) when information overload limits chunks to individual stimulus items, (2) when other steps are taken specifically to block the recording of stimulus items into larger chunks, (3) in performance discontinuities caused by the capacity limit, and (4) in various indirect effects of the capacity limit. Under these conditions, rehearsal and long-term memory cannot be used to combine stimulus items into chunks of an unknown size; nor can storage mechanisms that are not capacity-limited, such as sensory memory, allow the capacity-limited storage mechanism to be refilled during recall. A single, central capacity limit averaging about four chunks is implicated along with other, noncapacity-limited sources. The pure STM capacity limit expressed in chunks is distinguished from compound STM limits obtained when the number of separately held chunks is unclear. Reasons why pure capacity estimates fall within a narrow range are discussed and a capacity limit for the focus of attention is proposed.
The many faces of working memory and short-term storage
Self-Affirmation improves problem-solving under stress
Distinction between perceptual and attentional processing in working memory tasks: A study of phase-locked and induced oscillatory brain dynamics
Working memory performance after acute exposure to the cold pressor stress in healthy volunteers
Cortisol-induced impairments of working memory require acute sympathetic activation
Frontal lobes and human memory: Insights from functional neuroimaging
Quantity, not quality: The relationship between fluid intelligence and working memory capacity
Frontal midline theta oscillations during mental arithmetic: Effects of stress
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DOI:10.1016/j.psyneuen.2014.02.009
URL
PMID:24703176
[本文引用: 4]
Acute stress impairs prefrontal cortex (PFC) function and has detrimental effects on working memory (WM) performance. Converging evidence from electrophysiological studies suggests a close link between WM processes and frontal theta (FT) activity (4-8 Hz). However, the effect of stress on WM-related FT activity has not been investigated yet. To shed light on this topic we acquired EEG data from 31 healthy male subjects who underwent a stressful and a neutral control condition. In both conditions, they performed an n-back WM task at two different difficulty levels. Our results showed that WM-related FT activity was decreased under stress. Behaviorally, we found performance impairments under stress in the difficult task condition that were related to FT decreases. Increased cortisol levels indicated a successful moderate stress induction. These findings indicate that FT is a potential neurobiological marker for intact PFC functioning during WM and further supports the recently made assumption that FT acts in the PFC to optimize performance.
Top-down modulation: Bridging selective attention and working memory
Working memory dysfunction in schizophrenia
Cellular basis of working memory
Molecular identification of the corticosterone- sensitive extraneuronal catecholamine transporter
Brain connectivity related to working memory performance
DOI:10.1523/JNEUROSCI.3408-06.2006
URL
PMID:17182784
[本文引用: 1]
Several brain areas show signal decreases during many different cognitive tasks in functional imaging studies, including the posterior cingulate cortex (PCC) and a medial frontal region incorporating portions of the medial frontal gyrus and ventral anterior cingulate cortex (MFG/vACC). It has been suggested that these areas are components in a default mode network that is engaged during rest and disengaged during cognitive tasks. This study investigated the functional connectivity between the PCC and MFG/vACC during a working memory task and at rest by examining temporal correlations in magnetic resonance signal levels between the regions. The two regions were functionally connected in both conditions. In addition, performance on the working memory task was positively correlated with the strength of this functional connection not only during the working memory task, but also at rest. Thus, it appears these regions are components of a network that may facilitate or monitor cognitive performance, rather than becoming disengaged during cognitive tasks. In addition, these data raise the possibility that the individual differences in coupling strength between these two regions at rest predict differences in cognitive abilities important for this working memory task.
Time-dependent corticosteroid modulation of prefrontal working memory processing
Dynamic adaptation of large-scale brain networks in response to acute stressors
Neuroendocrine stress responses predict catecholamine- dependent working memory-related dorsolateral prefrontal cortex activity
DOI:10.1093/scan/nsx122
URL
PMID:29087511
[本文引用: 2]
Estradiol therapy after menopause mitigates effects of stress on cortisol and working memory
DOI:10.1210/jc.2017-00825
URL
PMID:29106594
[本文引用: 5]
Context: Postmenopausal estradiol therapy (ET) can reduce the stress response. However, it remains unclear whether such reductions can mitigate effects of stress on cognition. Objective: Investigate effects of ET on cortisol response to a physical stressor, cold pressor test (CPT), and whether ET attenuates stress effects on working memory. Design: Women completed the CPT or control condition across two sessions and subsequently completed a sentence span task. Setting: General community: Participants were recruited from the Early vs Late Intervention Trial with Estradiol (ELITE). Participants: ELITE participants (mean age = 66, standard deviation age = 6.8) in this study did not suffer from any major chronic illness or use medications known to affect the stress response or cognition. Interventions: Participants had received a median of randomized 4.7 years of estradiol (n = 21) or placebo (n = 21) treatment at time of participation in this study. Main Outcome Measures: Salivary cortisol and sentence span task performance. Results: Women assigned to estradiol exhibited blunted cortisol responses to CPT compared with placebo (P = 0.017) and lesser negative effects of stress on working memory (P = 0.048). Conclusions: We present evidence suggesting ET may protect certain types of cognition in the presence of stress. Such estrogenic protection against stress hormone exposure may prove beneficial to both cognition and the neural circuitry that maintains and propagates cognitive faculties.
A meta-analytic review of the effects of acute cortisol administration on human memory
Stress and neurodevelopmental processes in the emergence of psychosis
DOI:10.1016/j.neuroscience.2012.12.017
URL
PMID:23298853
[本文引用: 1]
The notion that stress plays a role in the etiology of psychotic disorders, especially schizophrenia, is longstanding. However, it is only in recent years that the potential neural mechanisms mediating this effect have come into sharper focus. The introduction of more sophisticated models of the interplay between psychosocial factors and brain function has expanded our opportunities for conceptualizing more detailed psychobiological models of stress in psychosis. Further, scientific advances in our understanding of adolescent brain development have shed light on a pivotal question that has challenged researchers; namely, why the first episode of psychosis typically occurs in late adolescence/young adulthood. In this paper, we begin by reviewing the evidence supporting associations between psychosocial stress and psychosis in diagnosed patients as well as individuals at clinical high risk for psychosis. We then discuss biological stress systems and examine changes that precede and follow psychosis onset. Next, research findings on structural and functional brain characteristics associated with psychosis are presented; these findings suggest that normal adolescent neuromaturational processes may go awry, thereby setting the stage for the emergence of psychotic syndromes. Finally, a model of neural mechanisms underlying the pathogenesis of psychosis is presented and directions for future research strategies are explored.
Timing and gender determine if acute pain impairs working memory performance
Anxiety mediates the effect of acute stress on working memory performance when cortisol levels are high: A moderated mediation analysis
DOI:10.1080/10615806.2014.1000880
URL
PMID:25537070
[本文引用: 1]
BACKGROUND: Anxiety is an aversive emotional state characterized by perceived uncontrollability and hypervigilance to threat that can frequently cause disruptions in higher-order cognitive processes like working memory. The attentional control theory (ACT) predicts that anxiety negatively affects the working memory system. DESIGN: This study tested the association between anxiety and working memory after the addition of stress and measured the glucocorticoid, cortisol. To better understand this relationship, we utilized a moderated mediation model. METHODS: Undergraduate students from a public university (N = 103) self-reported their anxiety levels. Participants first completed a short-term memory test. During and after a forehead cold pressor task (stress vs. control procedure) participants completed a working memory test. Salivary cortisol was taken at baseline and after the last working memory test. RESULTS: Overall, acute stress had no effect on working memory. However, we found that anxiety levels mediated the influence of condition (stressed vs. control) on working memory, but only among those individuals who had high cortisol levels after exposure to acute stress, supporting a moderated mediation model. CONCLUSIONS: These results imply that activation of the hypothalamic-pituitary-adrenal axis was necessary for working memory impairment in anxious individuals. These results provide support for the ACT.
Frontal midline theta oscillations during working memory maintenance and episodic encoding and retrieval
DOI:10.1016/j.neuroimage.2013.08.003
URL
PMID:23933041
[本文引用: 1]
Neural oscillations in the theta band (4-8 Hz) are prominent in the human electroencephalogram (EEG), and many recent electrophysiological studies in animals and humans have implicated scalp-recorded frontal midline theta (FMT) in working memory and episodic memory encoding and retrieval processes. However, the functional significance of theta oscillations in human memory processes remains largely unknown. Here, we review studies in human and animals examining how scalp-recorded FMT relates to memory behaviors and also their possible neural generators. We also discuss models of the functional relevance of theta oscillations to memory processes and suggest promising directions for future research.
Elevated cortisol leaves working memory unaffected in both men and women
Effect of the Cold Pressor Test on memory and cognitive flexibility
Frontal theta is a signature of successful working memory manipulation
Working memory performance impaired after exposure to acute social stress: The evidence comes from ERPs
DOI:10.1016/j.neulet.2017.08.054
URL
PMID:28851617
[本文引用: 3]
Using event-related potentials (ERPs), we examined the time course of 39 healthy novice drivers during a blocked working memory task (numerical N-back) under acute social stress or control conditions, which were induced by the Trier Social Stress Task (TSST) or control procedure. Subjective measures were used to assess stress manipulation throughout the experiment. An elevated negative effect in response to a stress condition indicated a successful stress induction. The behavioral results showed that the stress group had a longer response time and larger differences in accuracy than the control group. On a neural level, the control group had larger P3 amplitude in the 1-back condition than in the 2-back condition; this load effect, however, disappeared in the stress group. These results revealed that acute social stress had a disruptive effect on both working memory behavioral performance and cognitive neural process. These findings provide us with a basis to understand the correlation between acute stress and cognitive processes of working memory at a cognitive neural level.
Stress and emotional memory: A matter of timing
DOI:10.1016/j.tics.2011.04.004
URL
PMID:21571575
[本文引用: 2]
Stressful events activate the amygdala and a network of associated brain regions. Studies in both humans and rodents indicate that noradrenaline has a prominent role in this activation. Noradrenaline induces a hypervigilant state that helps to remember the event. This mnemonic effect is enhanced when the situation is so stressful that substantial amounts of corticosteroids are released and reach the amygdala. The combination of the two hormones leads to optimal strengthening of contacts and thus memory. Yet, rises in corticosteroid levels that are not precisely synchronized with noradrenaline release do not act synergistically but rather prevent or suppress the effect of noradrenaline. This dynamic interaction illustrates the adaptive and potentially protective capacity of corticosteroids regarding traumatic memories.
The ‘Trier social stress test’ - A tool for investigating psychobiological stress responses in a laboratory setting
Impaired memory retrieval after psychosocial stress in healthy young men
A normal intensity level of psycho-physiological stress can benefit working memory performance at high load
DOI:10.1016/j.ergon.2013.11.015 URL [本文引用: 2]
Cognitive function, stress hormones, heart rate and nutritional status during simulated captivity in military survival training
The influence of acute stress on brain dynamics during task switching activities
Visual working memory capacity: From psychophysics and neurobiology to individual differences
DOI:10.1016/j.tics.2013.06.006 URL PMID:23850263 [本文引用: 2]
Stress effects on working memory, explicit memory, and implicit memory for neutral and emotional stimuli in healthy men
DOI:10.3389/neuro.08.005.2008
URL
PMID:19169362
[本文引用: 1]
Stress is a strong modulator of memory function. However, memory is not a unitary process and stress seems to exert different effects depending on the memory type under study. Here, we explored the impact of social stress on different aspects of human memory, including tests for explicit memory and working memory (for neutral materials), as well as implicit memory (perceptual priming, contextual priming and classical conditioning for emotional stimuli). A total of 35 young adult male students were randomly assigned to either the stress or the control group, with stress being induced by the Trier Social Stress Test (TSST). Salivary cortisol levels were assessed repeatedly throughout the experiment to validate stress effects. The results support previous evidence indicating complex effects of stress on different types of memory: A pronounced working memory deficit was associated with exposure to stress. No performance differences between groups of stressed and unstressed subjects were observed in verbal explicit memory (but note that learning and recall took place within 1 h and immediately following stress) or in implicit memory for neutral stimuli. Stress enhanced classical conditioning for negative but not positive stimuli. In addition, stress improved spatial explicit memory. These results reinforce the view that acute stress can be highly disruptive for working memory processing. They provide new evidence for the facilitating effects of stress on implicit memory for negative emotional materials. Our findings are discussed with respect to their potential relevance for psychiatric disorders, such as post traumatic stress disorder.
Acute and past subjective stress influence working memory and related neural substrates
Working memory is more sensitive than declarative memory to the acute effects of corticosteroids: A dose-response study in humans
DOI:10.1037//0735-7044.113.3.420
URL
PMID:10443770
[本文引用: 1]
The effects of various doses (40 microg/kg/hr, 300 microg/kg/hr, 600 microg/kg/hr or placebo) of hydrocortisone on tasks assessing working and declarative memory function were measured in 4 groups of 10 young men. During the infusion, participants were given an item-recognition working memory task, a paired-associate declarative memory task, and a continuous performance task used to control possible concomitant effects of corticosteroids on vigilance. The results revealed significant acute effects of the highest dose of hydrocortisone on working memory function, without any significant effect on declarative memory function or arousal-vigilance performance. These results suggest that working memory is more sensitive than declarative memory to the acute elevations of corticosteroids, which could explain the detrimental effects of corticosteroids on acquisition and consolidation of information, as reported in the literature.
It feels real: Physiological responses to a stressful virtual reality environment and its impact on working memory
DOI:10.1177/0269881119860156
URL
PMID:31294651
[本文引用: 1]
BACKGROUND: Virtual reality (VR) is increasingly used to study and treat psychiatric disorders. Its fidelity depends in part on the extent to which the VR environment provides a convincing simulation, for example whether a putatively stressful VR situation actually produces a stress response. METHODS: We studied the stress response in 28 healthy men exposed either to a stressor VR elevator (which simulated travelling up the outside of a tall building and culminated in the participant being asked to step off the elevator platform), or to a control elevator. We measured psychological and physiological (salivary cortisol and alpha-amylase, blood pressure, pulse, skin conductance) stress indices. We also measured subsequent performance on the N-back task because acute stress has been reported to impact on working memory. RESULTS: Compared to participants in the control elevator, those in the external elevator had increases in skin conductance, pulse and subjective stress and anxiety ratings, altered heart rate variability, and a delayed rise in cortisol. N-back performance was unaffected. CONCLUSIONS: A putatively stressful VR elevator produces a physiological as well as a psychological stress response, supporting its use in the investigation and treatment of stress-related disorders, and its potential value as an experimental laboratory stressor.
Protection and damage from acute and chronic stress: Allostasis and allostatic overload and relevance to the pathophysiology of psychiatric disorders
DOI:10.1196/annals.1314.001 URL [本文引用: 1]
An integrative theory of prefrontal cortex function
Hydrocortisone accelerates the decay of iconic memory traces: On the modulation of executive and stimulus-driven constituents of sensory information maintenance
Frontal-midline theta from the perspective of hippocampal “theta”
Effect of meditation on stress-induced changes in cognitive functions
DOI:10.1089/acm.2010.0142 URL [本文引用: 1]
Anxiety and working memory capacity: A meta-analysis and narrative review
Stress-induced deficits in working memory and visuo-constructive abilities in special operations soldiers
DOI:10.1016/j.biopsych.2006.04.021
URL
PMID:16934776
[本文引用: 3]
BACKGROUND: Pre-clinical and clinical studies have shown acute stress may impair working memory and visuo-spatial ability. This study was designed to clarify the nature of stress-induced cognitive deficits in soldiers and how such deficits may contribute to operational or battlefield errors. METHODS: One hundred eighty-four Special Operations warfighters enrolled in Survival School completed pre-stress measures of dissociation and trauma exposure. Subjects were randomized to one of three assessment groups (Pre-stress, Stress, Post-stress) and were administered the Rey Ostereith Complex Figure (ROCF). All subjects completed post-stress measures of dissociation. RESULTS: ROCF copy and recall were normal in the Pre- and Post-stress groups. ROCF copy and recall were significantly impaired in the Stress Group. Stress group ROCF copy performance was piecemeal, and ROCF recall was impaired. Symptoms of dissociation were negatively associated with ROCF recall in the Stress group. Baseline dissociation and history of traumatic stress predicted cognitive impairment during stress. CONCLUSIONS: Stress exposure impaired visuo-spatial capacity and working memory. In rats, monkeys, and humans, high dopamine and NE turnover in the PFC induce deficits in cognition and spatial working memory. Improved understanding of stress-induced cognitive deficits may assist in identification of soldiers at risk and lead to the development of better countermeasures.
Hormone profiles in humans experiencing military survival training
Higher body fat percentage is associated with increased cortisol reactivity and impaired cognitive resilience in response to acute emotional stress
The endocrine system
In:
Stress
In:
Digging deeper in the differential effects of inflammatory and psychosocial stressors in remitted depression: Effects on cognitive functioning
Psychosocial stress impairs working memory at high loads: An association with cortisol levels and memory retrieval
DOI:10.1080/10253890600965773
URL
PMID:17035163
[本文引用: 2]
Stress and cortisol are known to impair memory retrieval of well-consolidated declarative material. The effects of cortisol on memory retrieval may in particular be due to glucocorticoid (GC) receptors in the hippocampus and prefrontal cortex (PFC). Therefore, effects of stress and cortisol should be observable on both hippocampal-dependent declarative memory retrieval and PFC-dependent working memory (WM). In the present study, it was tested whether psychosocial stress would impair both WM and memory retrieval in 20 young healthy men. In addition, the association between cortisol levels and cognitive performance was assessed. It was found that stress impaired WM at high loads, but not at low loads in a Sternberg paradigm. High cortisol levels at the time of testing were associated with slow WM performance at high loads, and with impaired recall of moderately emotional, but not of highly emotional paragraphs. Furthermore, performance at high WM loads was associated with memory retrieval. These data extend previous results of pharmacological studies in finding WM impairments after acute stress at high workloads and cortisol-related retrieval impairments.
Stress shifts brain activation towards ventral ‘affective’ areas during emotional distraction
Hydrocortisone reduces emotional distracter interference in working memory
Impairments of spatial working memory and attention following acute psychosocial stress
DOI:10.1002/smi.2533
URL
PMID:24395182
[本文引用: 4]
Few studies have investigated the effect of an acute psychosocial stress paradigm on impaired attention and working memory in humans. Further, the duration of any stress-related cognitive impairment remains unclear. The aim of this study was to examine the effect of an acute psychosocial stress paradigm, the Trier Social Stress, on cognitive function in healthy volunteers. Twenty-three healthy male and female subjects were exposed to an acute psychosocial stress task. Physiological measures (salivary cortisol, heart rate and blood pressure) and subjective stress ratings were measured at baseline, in anticipation of stress, immediately post-stress and after a period of rest. A neuropsychological test battery including spatial working memory and verbal memory was administered at each time point. Acute psychosocial stress produced significant increases in cardiovascular and subjective measures in the anticipatory and post-stress period, which recovered to baseline after rest. Salivary cortisol steadily declined over the testing period. Acute psychosocial stress impaired delayed verbal recall, attention and spatial working memory. Attention remained impaired, and delayed verbal recall continued to decline after rest. Acute psychosocial stress is associated with an impairment of a broad range of cognitive functions in humans and with prolonged abnormalities in attention and memory.
Physical activity versus psychological stress: effects on salivary cortisol and working memory performance
DOI:10.3390/medicina55050119 URL [本文引用: 2]
The effects of acute stress on human prefrontal working memory systems
DOI:10.1016/j.physbeh.2008.04.027
URL
PMID:18692209
[本文引用: 3]
We examined the relationship between acute stress and prefrontal-cortex (PFC) based working memory (WM) systems using behavioral (Experiment 1) and functional magnetic resonance imaging (fMRI; Experiment 2) paradigms. Subjects performed a delayed-response item-recognition task, with alternating blocks of high and low WM demand trials. During scanning, participants performed this task under three stress conditions: cold stress (induced by cold-water hand-immersion), a room temperature water control (induced by tepid-water hand-immersion), and no-water control (no hand-immersion). Performance was affected by WM demand, but not stress. Cold stress elicited greater salivary cortisol readings in behavioral subjects, and greater PFC signal change in fMRI subjects, than control conditions. These results suggest that, under stress, increases in PFC activity may be necessary to mediate cognitive processes that maintain behavioral organization.
Postnatal ontogeny of expression of the corticosteroid receptor genes in mammalian brains: Inter- species and intra-species differences
DOI:10.1016/j.brainresrev.2007.08.005
URL
PMID:17916381
[本文引用: 1]
Corticosteroids are important mediators of homeostasis and stress, and exert their effects via two transcription-factor receptors, mineralocorticoid receptor (MR) and glucocorticoid receptor (GR). Both receptors are expressed in the brain in a region-specific manner, and regulate neuroendocrine and behavioral functions. Stress during early development has been demonstrated to lead to long-term alterations in MR and GR levels and in the phenotypes that they mediate. To date, however, nearly all of this evidence has been obtained in rats, and there is actually no clear basis for extrapolation to other species. The current comparative review presents data, as available, on the following aspects of GR and MR gene expression in mouse and rat (Rodentia), tree shrew (Scandentia), common marmoset, squirrel monkey, rhesus macaque and human (Primates): (1) species-typical adult expression of MR mRNA and GR mRNA in hypothalamus, amygdala, hippocampus and neocortex; (2) species-typical neonate, infant, juvenile/adolescent and adult expression of MR mRNA and GR mRNA in hippocampus. (1) and (2) allow for identification of inter-species consistencies and differences in the relative levels of MR and GR expression across brain regions and ontogenetic stages. In addition, data are presented on (3) within-species inter-individual variation in MR and GR expression and causes thereof, including polymorphism and early life stress. Integrating the evidence in (1)-(3), it is noted that, should the expression levels of MR and GR at the time of early-life stress determine the latter's effects on the formers' long-term expression levels and functioning, then the long-term effects of early life stress on corticosteroid receptor expression and function will be species-, brain-region- and receptor-type-specific.
Subjective stress, salivary cortisol, and electrophysiological responses to psychological stress
DOI:10.3389/fpsyg.2016.00229
URL
PMID:26925026
[本文引用: 2]
The present study aimed to investigate the subjective stress, salivary cortisol, and electrophysiological responses to psychological stress induced by a modified version of a mental arithmetic task. Fifteen participants were asked to estimate whether the multiplication product of two-decimal numbers was above 10 or not either with a time limit (the stress condition) or without a time limit (the control condition). The results showed that participants reported higher levels of stress, anxiety, and negative affect in the stress condition than they did in the control condition. Moreover, the salivary cortisol level continued to increase after the stress condition but exhibited a sharp decrease after the control condition. In addition, the electrophysiological data showed that the amplitude of the frontal-central N1 component was larger for the stress condition than it was for the control condition, while the amplitude of the frontal-central P2 component was larger for the control condition than it was for the stress condition. Our study suggests that the psychological stress characteristics of time pressure and social-evaluative threat caused dissociable effects on perception and on the subsequent attentional resource allocation of visual information.
The effect of mild acute psychological stress on attention processing: An ERP study
DOI:10.1007/s00221-018-5283-6
URL
PMID:29748696
[本文引用: 1]
We aimed to investigate the effect of mild acute psychological stress on attention processing by adopting a consecutive task paradigm. In each trial, a probe stimulus (left or right arrow) was presented immediately after a mental arithmetic task (psychological stressor). Participants were asked to estimate whether the product of a multiplication term was above 10 or not, either with (stress block) or without (control block) time pressure and social-evaluative threat. When the probe was presented, participants were asked to judge the direction of the arrows. Increased subjective stress and negative affect were found for the stress versus control trials. For the probe task, reaction times were faster in the stress block than in the control block. Event-related potentials locked to the arrows revealed that (a) fronto-central N1 was enhanced in the stress block compared to the control block. This finding might indicate that stress amplified processes of early perception and that vigilance and sensory intake were augmented. (b) fronto-central N2 was enhanced in the stress block compared to the control block. This finding might reflect increased effort to control selective attention in completing the probe task. (c) less positive P3 was evoked in the stress block than in the control block. This finding potentially reflects the fact that fewer attentional resources were engaged in processing the probe, or that the activity associated with the process of response evaluation was decreased. In sum, mild acute psychological stress exerts a dissociable effect on the neural subprocesses of attention.
The effect of moderate acute psychological stress on working memory- related neural activity is modulated by a genetic variation in catecholaminergic function in humans
Acute psychological stress reduces working memory-related activity in the dorsolateral prefrontal cortex
DOI:10.1016/j.biopsych.2009.03.006
URL
PMID:19403118
[本文引用: 8]
BACKGROUND: Acute psychological stress impairs higher-order cognitive function such as working memory (WM). Similar impairments are seen in various psychiatric disorders that are associated with higher susceptibility to stress and with prefrontal cortical dysfunctions, suggesting that acute stress may play a potential role in such dysfunctions. However, it remains unknown whether acute stress has immediate effects on WM-related prefrontal activity. METHODS: Using functional magnetic resonance imaging (fMRI), we investigated neural activity of 27 healthy female participants during a blocked WM task (numerical N-back) while moderate psychological stress was induced by viewing strongly aversive (vs. neutral) movie material together with a self-referencing instruction. To assess stress manipulation, autonomic and endocrine, as well as subjective, measurements were acquired throughout the experiment. RESULTS: Successfully induced acute stress resulted in significantly reduced WM-related activity in the dorsolateral prefrontal cortex (DLPFC), and was accompanied by less deactivation in brain regions that are jointly referred to as the default mode network. CONCLUSIONS: This study demonstrates that experimentally induced acute stress in healthy volunteers results in a reduction of WM-related DLPFC activity and reallocation of neural resources away from executive function networks. These effects may be explained by supraoptimal levels of catecholamines potentially in conjunction with elevated levels of cortisol. A similar mechanism involving acute stress as a mediating factor may play an important role in higher-order cognitive deficits and hypofrontality observed in various psychiatric disorders.
Psychosocial stress exposure impairs memory retrieval in children
Category-specific modulation of inferior temporal activity during working memory encoding and maintenance
DOI:10.1016/j.cogbrainres.2003.11.017
URL
PMID:15130587
[本文引用: 1]
Findings from neurophysiology have supported the view that visual working memory (WM) relies on modulation of activity in object-selective populations of neurons in inferior temporal cortex. Here, using event-related functional magnetic resonance imaging, we investigated whether similar mechanisms support human visual working memory encoding and maintenance processes. We identified regions in inferior temporal cortex that exhibited category-specific responses during perception of faces (fusiform face area [FFA]) or scenes (parahippocampal place area [PPA]) and investigated whether activity in these regions would be modulated by demands to actively encode and maintain faces and scenes. Results showed that independent of perceptual stimulation, the FFA and PPA exhibited greater encoding- and maintenance-related activity when their favored stimulus was relevant to the recognition task. In contrast, maintenance-related activity in the dorsolateral prefrontal cortex (PFC) was modulated by memory load, regardless of the type of information that was task relevant. These results are consistent with the view that visual working memory encoding and maintenance processes are implemented through modulation of inferior temporal activity by prefrontal cortex.
Effects of naturalistic stressors on cognitive flexibility and working memory task performance
The effects of exposure to an acute naturalistic stressor on working memory, state anxiety and salivary cortisol concentrations
DOI:10.1080/10253890701559970
URL
PMID:18311600
[本文引用: 2]
Exposure to an acute naturalistic stressor induces both psychological and physiological changes in humans. The two studies reported here explored the impact of exposure to an acute naturalistic stressor on state anxiety, working memory and HPA axis activation (salivary cortisol). In both experiments, ten healthy male participants were exposed to an acute naturalistic stressor, helicopter underwater evacuation training (HUET), and their physiological and behavioural responses before (first study) and after (second study) the stressor were compared to ten non-stressed controls. The results of both experiments showed that working memory performance was preserved during anticipation of an acute stressor, but impairments were observed immediately after stress exposure. Participants reported significantly higher state anxiety levels during anticipation and following stress exposure, whereas significant elevations in cortisol levels were only observed 25 min post exposure to stress, but not before or immediately after stress exposure. The results of both experiments demonstrated a dissociation between behavioural and biochemical measures and provided evidence for a dissociation of the effects of stress on cognitive and physiological measures depending on the time of testing, with cognitive impairments most evident following stress exposure.
Glucocorticoid effects on memory retrieval require concurrent noradrenergic activity in the hippocampus and basolateral amygdala
DOI:10.1523/JNEUROSCI.2574-04.2004
URL
PMID:15371517
[本文引用: 1]
Previous findings indicate that administration of abeta-adrenoceptor antagonist systemically blocks glucocorticoid impairment of memory retrieval. Here, we report that beta-adrenoceptor activation in the hippocampus and the basolateral complex of the amygdala (BLA) is implicated in the impairing effects of glucocorticoids on memory retrieval. The specific glucocorticoid receptor (GR) agonist 11beta,17beta-dihydroxy-6,21-dimethyl-17alpha-pregna-4,6-trien-20yn-3-one (RU 28362) (15 ng) infused into the hippocampus of male Sprague Dawley rats 60 min before water maze retention testing, 24 hr after training, impaired probe trial retention performance, as assessed by quadrant search time and initial latency to cross the platform location. Because we found previously that RU 28362 infused into the hippocampus does not affect water maze acquisition or immediate recall, the findings suggest that the GR agonist-induced retention impairment was attributable to a selective influence on long-term memory retrieval. Likewise, systemic injections of the beta1-adrenoceptor partial agonist xamoterol (3.0 or 10.0 mg/kg, s.c.) 60 min before the probe trial dose-dependently impaired retention performance. The beta-adrenoceptor antagonist propranolol (2.0 mg/kg) administered subcutaneously before retention testing did not affect retention performance alone, but blocked the memory retrieval impairment induced by concurrent intrahippocampal infusions of RU 28362. Pretest infusions of the beta1-adrenoceptor antagonist atenolol into either the hippocampus (1.25 microg in 0.5 microl) or the BLA (0.5 microg in 0.2 microl) also prevented the GR agonist-induced memory retrieval impairment. These findings suggest that glucocorticoids impair retrieval of long-term spatial memory by facilitating noradrenergic mechanisms in the hippocampus, and additionally, that norepinephrine-mediated BLA activity is critical in enabling hippocampal glucocorticoid effects on memory retrieval.
The influence of acute stress on attention mechanisms and its electrophysiological correlates
Working memory is differentially affected by stress in men and women
DOI:10.1016/j.bbr.2012.12.004
URL
PMID:23238042
[本文引用: 10]
Stress has been shown to influence working memory. However, sex differences and the potential impact of stimulus emotionality have not received much attention. In a first experiment the effects of stress on a neutral working memory (WM) paradigm were tested in male and female participants (Experiment 1). Experiment 2 employed the same paradigm but used emotional stimuli. For this purpose, healthy participants were exposed either to a stressful (Trierer Social Stress Test (TSST)) or to a non-stressful control condition. Subsequently, WM performance in an n-back task was assessed. In Experiment 1, single digits were used as stimuli, while in Experiment 2 neutral and negative pictures were additionally employed. Salivary cortisol and Alpha-Amylase (sAA) were measured before and three times after the treatment as a marker of hypothalamus-pituitary-adrenal (HPA) axis- and sympathetic nervous system (SNS) activity. In both experiments, stress caused a substantial cortisol and sAA increase. For WM performance (response time) a stress by sex interaction was apparent. Stress enhanced performance in men, while impairing it in women. In both experiments stress had no effect on response accuracy. No modulating effect of the emotional quality of stimuli on n-back performance was observed (study 2). The results indicate that the effect of acute stress on n-back performance differs between the sexes. In contrast to long-term memory, the influence of stress on WM appears not to be modulated by the emotionality of the employed stimuli if stimuli are potential targets as it is the case in the n-back task.
Psychosocial stress induces working memory impairments in an n-back paradigm
DOI:10.1016/j.psyneuen.2008.02.004
URL
PMID:18359168
[本文引用: 5]
In contrast to the substantial number of studies investigating the effects of stress on declarative memory, effects of stress on working memory have received less attention. We compared working memory (numerical n-back task with single digits) in 40 men exposed either to psychosocial stress (Trier Social Stress Test (TSST)) or a control condition. Task difficulty was varied using two conditions (2-back vs. 3-back). Salivary cortisol (as a marker of hypothalamus-pituitary-adrenal (HPA) activity) and salivary alpha-amylase (sAA as a marker of sympathetic nervous system (SNS) activity) were assessed immediately before and three times after the stress or control condition. As expected stress resulted in an increase in cortisol, sAA, and negative affect. Subjects exposed to stress showed significant working memory impairments in both workload conditions. The analysis of variance indicated a main effect of stress for reaction time as well as accuracy. In addition, for reaction time a stress-block interaction occurred. Follow up tests revealed that only during the first block at each level of difficulty performance was significantly impaired by stress. Thus, the effects of stress became smaller the longer the task was performed. Results provide further evidence for impaired working memory after acute stress and illustrate the time course of this phenomenon.
Cold pressor stress impairs performance on working memory tasks requiring executive functions in healthy young men
DOI:10.1037/a0016980
URL
PMID:19824773
[本文引用: 6]
The current study investigated the effects of cold pressor stress (CPS) on 2 working memory (WM) tasks differing in the demand they put on maintenance and executive processing. For this purpose 72 healthy young men were exposed either to a stress group or a nonstressful control group. Subsequently, WM performance on the O-Span task (Turner & Engle, 1989) and the digit span task was assessed. Salivary cortisol was measured before and 2 times after the treatment as a marker of hypothalamus-pituitary-adrenal (HPA) axis activity. Results revealed a significant performance impairment of the O-Span and the digit span task backward in stressed subjects that correlated negatively with CPS-induced cortisol increases. Digit span forward was neither affected by CPS nor related to the ensuing cortisol increases. These results indicate that acute stress impairs WM performance for tasks requiring executive functions that operate on the stored material but not for WM tasks that only require maintenance.
HPA axis activation by a socially evaluated cold-pressor test
Emotional modulation of the attentional blink: Is there an effect of stress?
DOI:10.1037/a0017751
URL
PMID:20364906
[本文引用: 1]
Individuals are often unable to identify the second target (T2) of two when it is presented within 500 ms after the first target (T1). This
A quantitative meta-analysis of neurocognitive functioning in posttraumatic stress disorder
DOI:10.1037/a0038039
URL
PMID:25365762
[本文引用: 1]
Posttraumatic stress disorder (PTSD) is associated with regional alterations in brain structure and function that are hypothesized to contribute to symptoms and cognitive deficits associated with the disorder. We present here the first systematic meta-analysis of neurocognitive outcomes associated with PTSD to examine a broad range of cognitive domains and describe the profile of cognitive deficits, as well as modifying clinical factors and study characteristics. This report is based on data from 60 studies totaling 4,108 participants, including 1,779 with PTSD, 1,446 trauma-exposed comparison participants, and 895 healthy comparison participants without trauma exposure. Effect-size estimates were calculated using a mixed-effects meta-analysis for 9 cognitive domains: attention/working memory, executive functions, verbal learning, verbal memory, visual learning, visual memory, language, speed of information processing, and visuospatial abilities. Analyses revealed significant neurocognitive effects associated with PTSD, although these ranged widely in magnitude, with the largest effect sizes in verbal learning (d = -.62), speed of information processing (d = -.59), attention/working memory (d = -.50), and verbal memory (d =-.46). Effect-size estimates were significantly larger in treatment-seeking than community samples and in studies that did not exclude participants with attention-deficit/hyperactivity disorder, and effect sizes were affected by between-group IQ discrepancies and the gender composition of the PTSD groups. Our findings indicate that consideration of neuropsychological functioning in attention, verbal memory, and speed of information processing may have important implications for the effective clinical management of persons with PTSD. Results are further discussed in the context of cognitive models of PTSD and the limitations of this literature.
Stress potentiates early and attenuates late stages of visual processing
DOI:10.1523/JNEUROSCI.3384-10.2011
URL
PMID:21248140
[本文引用: 3]
Stress can fundamentally alter neural responses to incoming information. Recent research suggests that stress and anxiety shift the balance of attention away from a task-directed mode, governed by prefrontal cortex, to a sensory-vigilance mode, governed by the amygdala and other threat-sensitive regions. A key untested prediction of this framework is that stress exerts dissociable effects on different stages of information processing. This study exploited the temporal resolution afforded by event-related potentials to disentangle the impact of stress on vigilance, indexed by early perceptual activity, from its impact on task-directed cognition, indexed by later postperceptual activity in humans. Results indicated that threat of shock amplified stress, measured using retrospective ratings and concurrent facial electromyography. Stress also double-dissociated early sensory-specific processing from later task-directed processing of emotionally neutral stimuli: stress amplified N1 (184-236 ms) and attenuated P3 (316-488 ms) activity. This demonstrates that stress can have strikingly different consequences at different processing stages. Consistent with recent suggestions, stress amplified earlier extrastriate activity in a manner consistent with vigilance for threat (N1), but disrupted later activity associated with the evaluation of task-relevant information (P3). These results provide a novel basis for understanding how stress can modulate information processing in everyday life and stress-sensitive disorders.
Are hormones a “female problem” for animal research?
Does cortisol influence core executive functions? A meta-analysis of acute cortisol administration effects on working memory, inhibition, and set-shifting
DOI:10.1016/j.psyneuen.2015.04.017
URL
PMID:25973565
[本文引用: 2]
The hormone cortisol is often believed to play a pivotal role in the effects of stress on human cognition. This meta-analysis is an attempt to determine the effects of acute cortisol administration on core executive functions. Drawing on both rodent and stress literatures, we hypothesized that acute cortisol administration would impair working memory and set-shifting but enhance inhibition. Additionally, because cortisol is thought to exert different nongenomic (rapid) and genomic (slow) effects, we further hypothesized that the effects of cortisol would differ as a function of the delay between cortisol administration and cognitive testing. Although the overall analyses were nonsignificant, after separating the rapid, nongenomic effects of cortisol from the slower, genomic effects of cortisol, the rapid effects of cortisol enhanced response inhibition, g+ = 0.113, p=.016, but impaired working memory, g+ = -0.315, p=.008, although these effects reversed over time. Contrary to our hypotheses, there was no effect of cortisol administration on set-shifting. Thus, although we did not find support for the idea that increases in cortisol influence set-shifting, we found that acute increases in cortisol exert differential effects on working memory and inhibition over time.
The effects of acute stress on episodic memory: A meta-analysis and integrative review
DOI:10.1037/bul0000100
URL
PMID:28368148
[本文引用: 1]
A growing body of research has indicated that acute stress can critically impact memory. However, there are a number of inconsistencies in the literature, and important questions remain regarding the conditions under which stress effects emerge as well as basic questions about how stress impacts different phases of memory. In this meta-analysis, we examined 113 independent studies in humans with 6,216 participants that explored effects of stress on encoding, postencoding, retrieval, or postreactivation phases of episodic memory. The results indicated that when stress occurred prior to or during encoding it impaired memory, unless both the delay between the stressor and encoding was very short and the study materials were directly related to the stressor, in which case stress improved encoding. In contrast, postencoding stress improved memory unless the stressor occurred in a different physical context than the study materials. When stress occurred just prior to or during retrieval, memory was impaired, and these effects were larger for emotionally valenced materials than neutral materials. Although stress consistently increased cortisol, the magnitude of the cortisol response was not related to the effects of stress on memory. Nonetheless, the effects of stress on memory were generally reduced in magnitude for women taking hormonal contraceptives. These analyses indicate that stress disrupts some episodic memory processes while enhancing others, and that the effects of stress are modulated by a number of critical factors. These results provide important constraints on current theories of stress and memory, and point to new questions for future research. (PsycINFO Database Record
The effects of acute stress on core executive functions: A meta-analysis and comparison with cortisol
DOI:10.1016/j.neubiorev.2016.06.038
URL
PMID:27371161
[本文引用: 1]
Core executive functions such as working memory, inhibition, and cognitive flexibility are integral to daily life. A growing body of research has suggested that acute stress may impair core executive functions. However, there are a number of inconsistencies in the literature, leading to uncertainty about how or even if acute stress influences core executive functions. We addressed this by conducting a meta-analysis of acute stress effects on working memory, inhibition, and cognitive flexibility. We found that stress impaired working memory and cognitive flexibility, whereas it had nuanced effects on inhibition. Many of these effects were moderated by other variables, such as sex. In addition, we compared effects of acute stress on core executive functions to effects of cortisol administration and found some striking differences. Our findings indicate that stress works through mechanisms aside from or in addition to cortisol to produce a state characterized by more reactive processing of salient stimuli but greater control over actions. We conclude by highlighting some important future directions for stress and executive function research.
Acute stress impairs cognitive flexibility in men, not women
DOI:10.1080/10253890.2016.1192603
URL
PMID:27230831
[本文引用: 1]
Psychosocial stress influences cognitive abilities, such as long-term memory retrieval. However, less is known about the effects of stress on cognitive flexibility, which is mediated by different neurobiological circuits and could thus be regulated by different neuroendocrine pathways. In this study, we randomly assigned healthy adults to an acute stress induction or control condition and subsequently assessed participants' cognitive flexibility using an open-source version of the Wisconsin Card Sort task. Drawing on work in rodents, we hypothesized that stress would have stronger impairing effects on cognitive flexibility in men than women. As predicted, we found that stress impaired cognitive flexibility in men but did not significantly affect women. Our results thus indicate that stress exerts sex-specific effects on cognitive flexibility in humans and add to the growing body of research highlighting the need to consider sex differences in effects of stress.
Acute stress impairs memory retrieval independent of time of day
DOI:10.1016/j.psyneuen.2010.08.001
URL
PMID:20800361
[本文引用: 1]
It is widely recognized that acute stress and associated glucocorticoid stress responses yield memory-enhancing effects when the memory consolidation phase is targeted, while impairing effects are generally found with regard to memory retrieval performance. While some evidence exists that the memory-enhancing effects of consolidation stress are modulated by time of day, no study to date has investigated whether stress-induced retrieval deficits are also prone to such time of day effects. To address this issue, participants (N=76) were exposed to a stressor or control condition before a retrieval test that probed for neutral and negative words learned 24h before. Results show that stress exposure resulted in impaired retrieval of both neutral and negative words, but that time of day did not moderate this effect. This memory-impairing effect was larger for negative than for neutral information, and was significantly associated with stress-induced cortisol responses. The current findings demonstrate the robustness of stress-induced retrieval deficits throughout the day, in particular for emotional memory material, and further underscore the importance of cortisol reactivity in impairing memory retrieval.
The effect of acute stress on memory depends on word valence
DOI:10.1016/j.ijpsycho.2005.11.007
URL
PMID:16388863
[本文引用: 1]
The present study investigated the effect of acute stress on working memory and memory for neutral, emotionally negative, and emotionally positive words in healthy undergraduates. Participants (N=60) were exposed to either the Trier Social Stress Test (stress group) or a non-stressful task (control group). Analyses of salivary cortisol samples taken throughout the study showed elevated glucocorticoid levels after the experimental manipulation in the stress group, but not in the control group. Recall performance was impaired in the stress group, but only so for neutral words. No differences between the stress and control group were found on working memory measures. For the stress group, digit span forward and digit span total scores were associated with correct recall of neutral words. All in all, this study lends further support to the notion that the memory effects of exposure to acute stress depend on the valence of the memory material.
Stress and disease: A structural and functional analysis: Chronic stress and health
DOI:10.1111/spco.2013.7.issue-4 URL [本文引用: 1]
Increases in cortisol are positively associated with gains in encoding and maintenance working memory performance in young men
DOI:10.3109/10253890.2013.780236
URL
[本文引用: 2]
Past studies have demonstrated that increases in cortisol secretion are associated with either enhancements or impairments of long-term memory, depending on the subprocess involved. However, working memory is generally studied as a unified system within the cortisol literature. The present study sought to determine if cortisol increases are positively associated with increases in performance in the encoding subprocess of working memory, and whether increases are positively or negatively associated with performance changes in the maintenance subprocess. Thirty-three young men (M = 19.4 years, SD = 0.89) participated in a change-detection task, consisting of a condition requiring encoding only and a condition requiring both encoding and maintenance. To elicit a cortisol response, participants completed the Trier Social Stress Test (TSST) between two administrations of the task. Cardiovascular measurements and saliva samples were obtained before the TSST (T1), and mid-way between blocks of the second administration of the change-detection task (T2), to measure autonomic and cortisol responses to the TSST evident during the second change-detection task. Cortisol increases between T1 and T2 were positively correlated with both encoding (r(32) = 0.503, p = 0.003) and maintenance (r(32) = 0.463, p = 0.007) performance. This is a novel finding as previous studies have shown an impairing effect of cortisol on working memory. The positive relation between cortisol and working memory has likely been obscured in previous tasks, which did not examine these specific subprocesses in isolation from each other. The beneficial role of cortisol in the stress response is discussed.
Mitigation of stress: New treatment alternatives
DOI:10.1007/s11571-017-9460-2
URL
PMID:29435084
[本文引用: 1]
Complaints of stress are common in modern life. Psychological stress is a major cause of lifestyle-related issues, contributing to poor quality of life. Chronic stress impedes brain function, causing impairment of many executive functions, including working memory, decision making and attentional control. The current study sought to describe newly developed stress mitigation techniques, and their influence on autonomic and endocrine functions. The literature search revealed that the most frequently studied technique for stress mitigation was biofeedback (BFB). However, evidence suggests that neurofeedback (NFB) and noninvasive brain stimulation (NIBS) could potentially provide appropriate approaches. We found that recent studies of BFB methods have typically used measures of heart rate variability, respiration and skin conductance. In contrast, studies of NFB methods have typically utilized neurocomputation techniques employing electroencephalography, functional magnetic resonance imaging and near infrared spectroscopy. NIBS studies have typically utilized transcranial direct current stimulation methods. Mitigation of stress is a challenging but important research target for improving quality of life.
High-intensity stress elicits robust cortisol increases, and impairs working memory and visuo-spatial declarative memory in Special Forces candidates: A field experiment
DOI:10.3109/10253891003642394 URL [本文引用: 4]
Biobehavioral responses to stress in females: Tend-and-befriend, not fight-or-flight
DOI:10.1037/0033-295x.107.3.411
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PMID:10941275
[本文引用: 1]
The human stress response has been characterized, both physiologically and behaviorally, as
Hydrocortisone impairs working memory in healthy humans, but not in patients with major depressive disorder
Brain mechanisms of social threat effects on working memory
From specificity to sensitivity: How acute stress affects amygdala processing of biologically salient stimuli
Maintenance versus manipulation in verbal working memory revisited: An fMRI study
DOI:10.1016/s1053-8119(02)00049-6
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PMID:12595179
[本文引用: 1]
Working memory (WM) is the ability to keep a limited amount of information
Neuroimaging studies of working memory: A meta-analysis
Perfusion functional MRI reveals cerebral blood flow pattern under psychological stress
Hydrocortisone counteracts adverse stress effects on dual-task performance by improving visual sensory processes
Effects of acute psychosocial stress on working memory related brain activity in men
Assessing working memory in children with ADHD: Minor administration and scoring changes may improve digit span backward’s construct validity
DOI:10.1016/j.ridd.2017.10.024
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PMID:29156389
[本文引用: 1]
BACKGROUND: Pediatric ADHD is associated with impairments in working memory, but these deficits often go undetected when using clinic-based tests such as digit span backward. AIMS: The current study pilot-tested minor administration/scoring modifications to improve digit span backward's construct and predictive validities in a well-characterized sample of children with ADHD. METHODS AND PROCEDURES: WISC-IV digit span was modified to administer all trials (i.e., ignore discontinue rule) and count digits rather than trials correct. Traditional and modified scores were compared to a battery of criterion working memory (construct validity) and academic achievement tests (predictive validity) for 34 children with ADHD ages 8-13 (M=10.41; 11 girls). OUTCOMES AND RESULTS: Traditional digit span backward scores failed to predict working memory or KTEA-2 achievement (allns). Alternate administration/scoring of digit span backward significantly improved its associations with working memory reordering (r=.58), working memory dual-processing (r=.53), working memory updating (r=.28), and KTEA-2 achievement (r=.49). CONCLUSIONS AND IMPLICATIONS: Consistent with prior work, these findings urge caution when interpreting digit span performance. Minor test modifications may address test validity concerns, and should be considered in future test revisions. Digit span backward becomes a valid measure of working memory at exactly the point that testing is traditionally discontinued.
Effects of cortisol on cognition in major depressive disorder, posttraumatic stress disorder and borderline personality disorder—2014 Curt Richter Award Winner
Working memory performance and cognitive flexibility after dexamethasone or hydrocortisone administration in healthy volunteers
DOI:10.1007/s00213-011-2286-4
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PMID:21484237
[本文引用: 2]
OBJECTIVE: Several studies have shown that glucocorticoids can impair declarative memory retrieval and working memory (WM) performance. The aim of the present study was to investigate the impact of a high dose of hydrocortisone on WM, as well as to examine the effects of cortisol suppression via treatment with a high dose of dexamethasone (DEX). We hypothesized that hydrocortisone treatment results in an impaired cognitive function compared with placebo. We further expected that dexamethasone treatment is also followed by cognitive impairment, due to the hypothesis that very low levels of cortisol are also associated with alterations in memory performance. METHODS: In a placebo-controlled study with a within-subject design, 16 healthy volunteers received placebo or 120 mg of hydrocortisone (two boluses of 60 mg) directly before neuropsychological testing or 4 mg of DEX the day before testing. RESULTS: We did not find any effect of hydrocortisone on WM and cognitive flexibility, even though cortisol levels were high at the time of testing. Furthermore, we did not find any effect of DEX treatment on WM and reaction time in a cognitive flexibility test. However, cognitive flexibility was negatively correlated with adrenocorticotropin (ACTH) in the DEX condition. CONCLUSIONS: Our results found no clear effect of hydrocortisone and dexamethasone treatment on WM. These results emphasize the need for further research on the association between hypothalamic-pituitary-adrenal axis activity and cognition. These studies should investigate the hypotheses of dose-dependent associations in more detail and should also include analyses on ACTH and cognition.
Hormones, Stress, and Cognition: The Effects of Glucocorticoids and Oxytocin on Memory
Pharmacological stress impairs working memory performance and attenuates dorsolateral prefrontal cortex glutamate modulation
DOI:10.1016/j.neuroimage.2018.11.017
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PMID:30458306
[本文引用: 4]
Working memory processes are associated with the dorsolateral prefrontal cortex (dlPFC). Prior research using proton functional magnetic resonance spectroscopy ((1)H fMRS) observed significant dlPFC glutamate modulation during letter 2-back performance, indicative of working memory-driven increase in excitatory neural activity. Acute stress has been shown to impair working memory performance. Herein, we quantified dlPFC glutamate modulation during working memory under placebo (oral lactose) and acute stress conditions (oral yohimbine 54 mg + hydrocortisone 10 mg). Using a double-blind, randomized crossover design, participants (N = 19) completed a letter 2-back task during left dlPFC (1)H fMRS acquisition (Brodmann areas 45/46; 4.5cm(3)). An automated fitting procedure integrated with LCModel was used to quantify glutamate levels. Working memory-induced glutamate modulation was calculated as percentage change in glutamate levels from passive visual fixation to 2-back levels. Results indicated acute stress significantly attenuated working memory-induced glutamate modulation and impaired 2-back response accuracy, relative to placebo levels. Follow-up analyses indicated 2-back performance significantly modulated glutamate levels relative to passive visual fixation during placebo but not acute stress. Biomarkers, including blood pressure and saliva cortisol, confirmed that yohimbine + hydrocortisone dosing elicited a significant physiological stress response. These findings support a priori hypotheses and demonstrate that acute stress impairs dlPFC function and excitatory activity. This study highlights a neurobiological mechanism through which acute stress may contribute to psychiatric dysfunction and derail treatment progress. Future research is needed to isolate noradrenaline vs. cortisol effects and evaluate anti-stress medications and/or behavioral interventions.
The acute and temporary modulation of PERIOD genes by hydrocortisone in healthy subjects
DOI:10.1080/07420528.2016.1211668
URL
PMID:27485028
[本文引用: 1]
The physiological stress system and the circadian clock system communicate with each other at different signaling levels. The steroid hormone cortisol, the end-effector of the hypothalamus-pituitary-adrenal axis, is released in response to stress and acts as a mediator in circadian rhythms. We determined the effect of escalating cortisol doses on the expression of PERIOD genes (PER1, PER2 and PER3) in healthy subjects and analyzed whether the glucocorticoid receptor (GR) is involved in the cortisol-mediated PERIOD gene expression. Forty participants (50% males and 50% females) were randomly assigned to groups receiving a saline placebo solution or 3 mg, 6 mg, 12 mg and 24 mg of hydrocortisone. Blood was drawn every 15 min to measure quantitative gene expression of PER1, PER2 and PER3. A potential role of the GR was determined by an ex vivo study stimulating whole blood with hydrocortisone and RU486 (a GR antagonist). As a result, moderate doses of hydrocortisone produced an acute and temporary induction of PER1 and PER3 mRNA levels, whereas PER2 was not responsive to the hormone administration. The cortisol-dependent induction of PER1 was blocked by the GR antagonist in whole blood after treatment with hydrocortisone and RU486 ex vivo. In conclusion, acute pharmacological stress modulated the expression of PER1 and PER3 in whole blood temporarily in our short-term sampling design, suggesting that these circadian genes mediate stable molecular mechanisms in the periphery.
Acute stress and working memory: The role of sex and cognitive stress appraisal
DOI:10.1016/j.physbeh.2016.06.022
URL
PMID:27321755
[本文引用: 5]
Sex is considered a moderating factor in the relationship between stress and cognitive performance. However, sex differences and the impact of cognitive stress appraisal on working memory performance have not received much attention. The aim of this study was to investigate the role of physiological responses (heart rate and salivary cortisol) and cognitive stress appraisal in Working Memory (WM) performance in males and females. For this purpose, we subjected a comparable number of healthy young adult males (N=37) and females (N=45) to a modified version of the Trier Social Stress Test (TSST), and we evaluated WM performance before and after the stress task. Females performed better on attention and maintenance after the TSST, but males did not. Moreover, we found that attention and maintenance performance presented a negative relationship with cortisol reactivity in females, but not in males. Nevertheless, we observed that only the females who showed a cortisol decrease after the TSST performed better after the stress task, whereas females and males who showed an increase or no change in cortisol levels, and males who showed a cortisol decrease, did not change their performance over time. In females, we also found that the global indexes of cognitive stress appraisal and cognitive threat appraisal were negatively related to attention and maintenance performance, whereas the Self-concept of Own Competence was positively related to it. However, these relationships were not found in males.
Stress enhances retrieval of drug-related memories in abstinent heroin addicts
DOI:10.1038/npp.2009.179
URL
PMID:19890257
[本文引用: 2]
Stress is associated with relapse to drugs after abstinence, but the mechanisms for this association are unclear. One mechanism may be that stress enhances abstinent addicts' recall of memories of drugs as stress relievers. This study assessed the effects of stress on free recall and cued recall of 10 heroin-related and 10 neutral words learned 24 h earlier by 102 abstinent heroin addicts. These participants were randomly assigned to three experiments that also assessed attention and working memory. Experiment 1 used a psychosocial stressor (Trier social stress test (TSST)) before testing for recall of heroin-related words. Experiment 2 added administration of the beta-adrenoceptor antagonist propranolol 1 h before the psychosocial stressor. Experiment 3 added administration of either cortisol with propranolol, cortisol alone, or propranolol alone 1 h before word recall to determine whether stress enhancement of heroin-related word recall required noradrenergic-glucocorticoid interactions. We found that free recall of heroin-related words in abstinent addicts was enhanced after stress or cortisol administration when compared with a non-stress condition or placebo, respectively, whereas these interventions had no effect on neutral word recall. beta-adrenergic blockade blocked the enhancing effect of stress or cortisol on free recall of heroin-related words. Neither stress nor cortisol affected cued recall, attention, or working memory. The potential of beta-adrenergic blockade to reduce or block stress-induced enhancement of drug-related memory retrieval may be relevant to preventing stress-induced relapse in abstinent heroin addicts.
Neurophysiological bases of exponential sensory decay and top-down memory retrieval: A model
DOI:10.3389/neuro.10.004.2009
URL
PMID:19325713
[本文引用: 1]
Behavioral observations suggest that multiple sensory elements can be maintained for a short time, forming a perceptual buffer which fades after a few hundred milliseconds. Only a subset of this perceptual buffer can be accessed under top-down control and broadcasted to working memory and consciousness. In turn, single-cell studies in awake-behaving monkeys have identified two distinct waves of response to a sensory stimulus: a first transient response largely determined by stimulus properties and a second wave dependent on behavioral relevance, context and learning. Here we propose a simple biophysical scheme which bridges these observations and establishes concrete predictions for neurophsyiological experiments in which the temporal interval between stimulus presentation and top-down allocation is controlled experimentally. Inspired in single-cell observations, the model involves a first transient response and a second stage of amplification and retrieval, which are implemented biophysically by distinct operational modes of the same circuit, regulated by external currents. We explicitly investigated the neuronal dynamics, the memory trace of a presented stimulus and the probability of correct retrieval, when these two stages were bracketed by a temporal gap. The model predicts correctly the dependence of performance with response times in interference experiments suggesting that sensory buffering does not require a specific dedicated mechanism and establishing a direct link between biophysical manipulations and behavioral observations leading to concrete predictions.
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