Effect of the neuroinflammatory drug class glucocorticoids on specific cognitive functions

This thesis presents a systematic review of randomized controlled trials (RCTs) investigating the effects of synthetic glucocorticoids (GCs) on human cognitive functions. Based on 33 eligible RCTs, the study critically examines the role of GCs in modulating memory, attention, and executive functioning across different clinical and non-clinical populations. Following PRISMA guidelines and using the Cochrane Risk of Bias 2.0 tool, studies were assessed for methodological quality and categorized by domain (e.g., declarative memory, working memory) and population (e.g., POCD, PTSD, bipolar disorder). The findings suggest dose- and context-dependent cognitive effects of glucocorticoids, with both detrimental and potentially beneficial outcomes depending on dosage, timing, and underlying neurobiological mechanisms. Notably, the results indicate increased cognitive vulnerability in populations with stress-related disorders such as PTSD, where glucocorticoid sensitivity and hippocampal function may play a key role. This work contributes to the understanding of neuroendocrine-cognitive interactions and highlights clinical implications for the use of synthetic GCs. It also identifies limitations in the current literature and provides directions for future research on dosing strategies, long-term effects, and neurobiological pathways.