Neurobiological and emotional impact of occupational stress in frontline police officers: a neuroimaging and neurochemical study

<b>Background:</b> Frontline police work demands continuous vigilance and rapid decision-making. These challenges engage neuroplastic adaptations in brain regions critical for threat processing and emotional regulation. However, the influence of chronic occupational stress on officers' emotional states, brain structure, and neurochemical regulation remains underexplored.<b>Objective:</b> To examine the associations between occupational stress, emotional changes, brain morphology, and neurochemical alterations in frontline police officers compared to healthy controls.<b>Method:</b> Thirty-three frontline police officers (mean age = 42.4 ± 8.3 years, 10 females) and thirty-six demographically matched controls (mean age = 38.0 ± 10.2 years, 13 females) underwent five neuropsychiatric assessments, structural magnetic resonance imaging with voxel-based morphometry (VBM), and proton magnetic resonance spectroscopy (MRS) targeting the dorsal anterior cingulate cortex (dACC) and parieto-occipital cortex (POC). Group comparisons employed <i>p</i> < .005 voxel-wise for VBM and false-discovery-rate (FDR)-corrected <i>p</i> < .05 for MRS. Correlations between burnout scores and neurotransmitter metrics (glutamate [Glu], γ-aminobutyric acid [GABA+], and excitatory/inhibitory [E/I] ratio) were assessed (<i>p</i>_FDR < 0.05, <i>R</i>² > 0.10).<b>Results:</b> Frontline police officers reported significantly higher client-related burnout (CBI_3; <i>p</i>_FDR < 0.05). VBM revealed decreased grey matter volume in the bilateral orbitofrontal cortex and right cerebellum (<i>p</i> < .005). MRS revealed that officers had lower levels of specific excitatory neurotransmitters (Glu/N-acetylaspartate (NAA)+N-acetylaspartylglutamate (NAAG), Gln/NAA + NAAG, and Glx/NAA + NAAG) in the dACC compared to controls (<i>p</i>_FDR < 0.05). Burnout scores correlated inversely with Glu and E/I ratio and positively with GABA + in the dACC (<i>p</i>_FDR < 0.05, <i>R</i>² > 0.10).<b>Conclusions:</b> Occupational stress in frontline police officers is associated with elevated burnout, regional grey matter reductions, and neurochemical imbalances in the dACC. These findings highlight the neurobiological basis of stress-related burnout and may inform targeted interventions to support officer well-being.