A Comprehensive Assessment of Physiological and Neural Changes Underlying Cognitive Performance after Heat Stress: A Randomized Clinical Trial.
6 affiliations
- 1School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health 8 Technology Assessment, Fudan University, Shanghai 200032, China.
- 2Shanghai Key Laboratory of Meteorology and Health, Shanghai 200030, China.
- 3Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
- 4Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai 200032, China.
- 5Department of Epidemiology and Biostatistics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
- 6Human Phenome Institute, Institute of Science and Technology for Brain-Inspired Intelligence, Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Shanghai 200433, China.
Abstract
Heat stress threatens neurological health as a risk factor for cognitive decline. However, deeper understanding of the psychological, cognitive, and neural changes induced by heat stress, with stronger causal inference and biological evidence, is needed. A randomized, crossover, controlled trial was conducted among 30 healthy adults (15 males, 15 females; mean age 21.5 ± 1.5 years) during October-November 2022. Participants were randomly divided into two groups and alternately underwent 2-h exposures to high temperature (32 °C) and moderate temperature (22 °C) at a laboratory in Shanghai, China. Psychological distress was evaluated using a simplified DASS-21 scale. Cognitive function was assessed through neurobehavioral tests (Schulte grid and Stroop tests), with neural activity examined using functional magnetic resonance imaging (fMRI) to assess blood oxygen level-dependent signals. Blood samples were collected for plasma exosome transcriptomics and targeted biomarker analyses. Acute heat exposure significantly increased psychological distress by 27.3%, decreased processing speed by 13.6%, and impaired response inhibition by 3.4%. Heat stress reduced neural activity and synchronization in the precentral gyrus, inferior frontal gyrus, and rostral hippocampus. Functional connectivity was also attenuated in these regions. These alterations might be driven by type I interferon-dominated inflammation, excitotoxicity, and oxidative stress. Conversely, neural regulatory responses were observed, including activation of the lateral occipital cortex and elevated levels of neurotrophic factors. This trial demonstrates the relationship between acute heat exposure and diminished cognitive function. These findings underscore the need for public health strategies to maintain indoor temperatures within a comfortable range and promote active cooling to protect cognitive health.
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BibTeX
@article{zhou2026comprehensive,
title = {{A Comprehensive Assessment of Physiological and Neural Changes Underlying Cognitive Performance after Heat Stress: A Randomized Clinical Trial.}},
author = {Lu Zhou and Zhang Shi and Ye Yao and Xihao Du and Xinlei Zhu and Yixiang Zhu and Shuai Xu and Jiang Lin and Renjie Chen and He Wang and Haidong Kan},
journal = {Environment \& health (Washington, D.C.)},
year = {2026},
month = jun,
doi = {10.1021/envhealth.5c00818},
url = {https://europepmc.org/article/MED/42903426},
note = {CC BY},
}
RIS
TY - JOUR
TI - A Comprehensive Assessment of Physiological and Neural Changes Underlying Cognitive Performance after Heat Stress: A Randomized Clinical Trial.
AU - Lu Zhou
AU - Zhang Shi
AU - Ye Yao
AU - Xihao Du
AU - Xinlei Zhu
AU - Yixiang Zhu
AU - Shuai Xu
AU - Jiang Lin
AU - Renjie Chen
AU - He Wang
AU - Haidong Kan
PY - 2026
DA - 2026/06/25
JO - Environment & health (Washington, D.C.)
DO - 10.1021/envhealth.5c00818
UR - https://europepmc.org/article/MED/42903426
AB - Heat stress threatens neurological health as a risk factor for cognitive decline. However, deeper understanding of the psychological, cognitive, and neural changes induced by heat stress, with stronger causal inference and biological evidence, is needed. A randomized, crossover, controlled trial was conducted among 30 healthy adults (15 males, 15 females; mean age 21.5 ± 1.5 years) during October-November 2022. Participants were randomly divided into two groups and alternately underwent 2-h exposures to high temperature (32 °C) and moderate temperature (22 °C) at a laboratory in Shanghai, China. Psychological distress was evaluated using a simplified DASS-21 scale. Cognitive function was assessed through neurobehavioral tests (Schulte grid and Stroop tests), with neural activity examined using functional magnetic resonance imaging (fMRI) to assess blood oxygen level-dependent signals. Blood samples were collected for plasma exosome transcriptomics and targeted biomarker analyses. Acute heat exposure significantly increased psychological distress by 27.3%, decreased processing speed by 13.6%, and impaired response inhibition by 3.4%. Heat stress reduced neural activity and synchronization in the precentral gyrus, inferior frontal gyrus, and rostral hippocampus. Functional connectivity was also attenuated in these regions. These alterations might be driven by type I interferon-dominated inflammation, excitotoxicity, and oxidative stress. Conversely, neural regulatory responses were observed, including activation of the lateral occipital cortex and elevated levels of neurotrophic factors. This trial demonstrates the relationship between acute heat exposure and diminished cognitive function. These findings underscore the need for public health strategies to maintain indoor temperatures within a comfortable range and promote active cooling to protect cognitive health.
SN - 2833-8278
ER -