Lifetime air pollution exposure, cognitive deficits, and brain imaging outcomes: A systematic review

As the amount of air pollution and human exposure has increased, the effects on human health have become an important public health issue. A field of growing interest is how air pollution exposure affects brain structure and function underlying cognitive deficits and if structural and connectivity changes mediate the relationship between the two. We conducted a systematic review to examine the literature on air pollution, brain structure and connectivity, and cognition studies. Eleven studies matched our inclusion criteria and were included in the qualitative analysis. Results suggest significant associations between air pollution and decreased volumes of specific brain structures, cortical thickness and surface area such as in the prefrontal cortex and temporal lobe, as well as the weakening of functional connectivity pathways, largely the Default Mode (DMN) and Frontal Parietal (FPN) networks, as detected by fMRI. Associations between air pollution and cognitive outcomes were found in most of the studies (n = 9), though some studies showed stronger associations than others. For children & adolescents, these deficiencies largely involved heavy reasoning, problem solving, and logic. For young and middle-aged adults, the associations were mostly seen for executive function and visuospatial cognitive domains. To our knowledge, this is the first systematic review to consolidate findings on the associations among air pollution, brain structure, and cognitive function. In the future, it will be important to conduct further longitudinal studies that follow children who have been exposed at a young age and examine associations with brain structure and cognition throughout adulthood. •Air pollution is known to be a detrimental environmental toxin.•Air pollution was associated with brain structural changes in all included studies.•Some studies showed that changes in brain structure mediated cognitive deficits.•The most affected cognitive domains varied between age groups.•Air pollution was associated with disruptions in functional connectivity networks.