Cognitive Function Impairments in Asthma

Asthma is increasingly recognised as a multisystem disorder in which chronic airway inflammation exerts effects beyond the lungs, notably on brain structure and function. Patients with asthma frequently report deficits in attention, executive function, working memory and processing speed. Underlying mechanisms include systemic inflammation, hypoxaemia during exacerbations, oxidative stress and neuroimmune crosstalk through circulating cytokines and chemokines. Neuroimaging studies reveal altered white matter microstructure, particularly reductions in neurite density and increases in mean diffusivity, suggesting accelerated ageing of neural tracts. At the cellular level, activation of microglia and astrocytes in regions such as the prefrontal cortex and hippocampus has been observed in experimental models, correlating with impairments in spatial learning and memory. Moreover, dysregulation of key signalling pathways, including hypoxia‐inducible factors and chemokines like fractalkine, may compromise synaptic plasticity. Behavioural assays in animal studies document anxiety‐like and depression‐like phenotypes alongside cognitive decline, pointing to shared neural circuits governing emotion and cognition. Importantly, effective control of airway inflammation appears to mitigate some of these brain alterations, underscoring the need for integrated management strategies that address both respiratory and cognitive health in people with asthma.

Research from Nature Portfolio

Experimental work in rodent models has demonstrated that allergen‐induced airway inflammation disrupts the medial prefrontal cortex–amygdala circuit, leading to anxiety‐like behaviour and microglial activation. These studies show enhanced delta‐gamma coupling and inverted directional information flow between the amygdala and prefrontal cortex, implicating impaired top‐down regulation of emotional responses as a contributor to cognitive dysfunction. Complementary investigations of the anterior cingulate cortex–basolateral amygdala axis reveal that peripheral allergic inflammation enhances oscillatory synchrony and functional connectivity within this circuit. The degree of connectivity disruption correlates with behavioural measures of anxiety, suggesting that persistent inflammation may recalibrate neural networks involved in both affective regulation and cognitive control.

Cognitive Function Impairments in Asthma publication trend

The graph below shows the total number of articles in cognitive function impairments in asthma across all publications each year (not limited to Nature Index journals).

Technical terms

Neuroimmune crosstalk: Bidirectional communication between the nervous and immune systems via cytokines, chemokines and cellular signalling.
Functional connectivity: Statistical association of neural activity patterns between distinct brain regions.
Neurite density: Measure of the concentration of axons and dendrites within brain tissue, reflecting microstructural integrity.
Synaptic plasticity: Capacity of synapses to strengthen or weaken over time in response to activity and experience.
Hypoxia‐inducible factor (HIF): Transcription factor stabilised under low‐oxygen conditions, regulating genes involved in angiogenesis and metabolism.
Fractalkine: A chemokine that mediates neuron–microglia communication and modulates inflammatory responses in the brain.

References

1. Brain response in asthma: the role of “lung-brain” axis mediated by neuroimmune crosstalk. Frontiers in Immunology (2023).
2. Impact of asthma on the brain: evidence from diffusion MRI, CSF biomarkers and cognitive decline. Brain Communications (2023).
3. Allergen-induced anxiety-like behavior is associated with disruption of medial prefrontal cortex - amygdala circuit. Scientific Reports (2019).
4. ACC-BLA functional connectivity disruption in allergic inflammation is associated with anxiety. Scientific Reports (2022).
5. Allergic Asthma-Induced Cognitive Impairment is Alleviated by Dexamethasone. Frontiers in Pharmacology (2021).
6. Chronic allergic lung inflammation negatively influences neurobehavioral outcomes in mice. Journal of Neuroinflammation (2022).