MR stimulation
Given that MR antagonism rather impairs cognitive performance, MR activation may improve it. Indeed, several studies suggest that a single administration of fludrocortisone acutely enhances verbal learning performance and visuo-spatial memory retrieval (Groch et al. , 2013; Hinkelmann et al. , 2015; Piber et al. , 2016) but not autobiographic memory retrieval (Fleischer et al. , 2015). Notably, visuo-spatial memory is strongly hippocampus-dependent, and the effects of fludrocortisone are likely to be explained by high MR density in this brain region.
The data are less clear regarding other cognitive domains. No effects of MR activation were found with respect to executive function (Grochet al. , 2013; Otte, Wingenfeld, Kuehl, Kaczmarczyk, et al. , 2015), but healthy humans made riskier decisions (Deuter et al. , 2017). Furthermore, an enhanced attentional bias towards negative faces was observed (Schultebraucks K, Wingenfeld K, Otte C, 2016), although unreplicable in a more heterogeneous sample (Nowacki et al. , 2021). These findings are compatible with the hypothesis that MR activation stimulates the brain salience network and suggests involvement in appraisal of novel situations, attentional vigilance to salient information, and behavioural flexibility (Vogel et al. , 2016).
The salience network is also important for social cognition. Humans often must perform complex social tasks whilst stressed, challenged or in emotionally aroused. Accordingly, several studies demonstrated that psychosocial stress enhanced several aspects of social cognition and prosocial behaviours (von Dawans et al. , 2012; Deckers et al. , 2015; Wolf 2017). Additionally, MR stimulation was shown to increase empathy scores (Wingenfeld et al. , 2014; Nowacki, Wingenfeld, Kaczmarczyk, Chae, Abu-Tir, et al. , 2020), adding to a role for MR in adequate and successful social functioning.