Corticosteroid-Induced Memory Impairment

Mechanism and Effects on the Hippocampus

The hippocampus, a brain region critical for learning and memory, contains a high density of mineralocorticoid and glucocorticoid receptors, which are affected by corticosteroids 1, 2
Dexamethasone has been shown to cause degeneration and necrosis of hippocampal neurons in animal models, as it binds only to glucocorticoid receptors 1, 2, 3
Neonatal dexamethasone treatment alters hippocampal synaptic plasticity and associative memory formation in later life 1, 2, 3
Dexamethasone exposure has been linked to decreased hippocampal volume 1, 2, 3

Not all corticosteroids have equal effects on memory, with hydrocortisone (identical to native cortisol) not showing adverse effects on memory in neonatal studies, unlike dexamethasone 1, 2, 3, 4
Patients should never abruptly discontinue corticosteroids without medical supervision due to the risk of adrenal insufficiency 5