Endocrine disease and glucocorticoid treatment: Cognitive and
emotional function
Given the central role that MR and GR play in cognitive and emotional
processes as outlined above, it is not surprising that endocrine
diseases and long-term steroid treatment are associated with alterations
in these processes. While it is often difficult to exactly disentangle
MR vs. GR-mediated effects, it is increasingly becoming clear that the
MR has an important role in these effects. The support for MR directly
effecting mood states stems from the use of potent synthetic
glucocorticoids in the clinic, which are accompanied by adverse
psychological, behavioural, and cognitive effects (Fardet, Petersen and
Nazareth, 2012; Judd et al. , 2014). Dexamethasone (DEX) is an
example of such potent synthetic GCs and is in vivo highly
selective for GR (Reul et al. , 2000). This strong activation of
GR by DEX causes suppression of HPA axis activity leading to a reduction
in cortisol levels and consequently depletes MR of its ligand. As such,
it is thought that this aberrant increase and decrease in GR and MR
activity, respectively, causes disturbances in system homeostasis
regulated by the two receptors (Meijer and de Kloet, 2017).