Similarly, the association between CRH and cognitive impairment observed here suggests that fluctuations in CRH have a significant impact on cognition, as reported in previous studies.29,30 Importantly, despite no correlation with depression and anxiety rating scales, changes in CRH levels may imply a dysregulation of the HPA axis, indicating an inappropriate response to stress, potentially involving neurodegenerative processes. This evidence concerns the gene CRH and major depressive disorder.