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Ann. psychophysiol. 
ISSN 2412-3188 (Online) | 2410-1354 (Print) 

 
Review Article                                                                                  

A review of the literature on the impact of 
acute and chronic stress upon brain waves 
Shamoon Noushad1,3 , Sadaf Ahmed2 , Basit Ansari1 , Yusra Saleem2,3  

S. Farah Batool2 & Syeda Farah Batool4 

1Department of Health, Physical Education and Sports Sciences, University of Karachi, 
Karachi-Pakistan.  
2Physchophysiology Research Lab, MAHQ-Biological research Centre- University of 
Karachi, Karachi-Pakistan. 
3Department of Public Health, Malir University of Science and Technology, Karachi-
Pakistan.   
4 Department of Psychology, Malir University of Science and Technology, Karachi-Pakistan.  

Abstract 
Background: The biological responses associated with stress originate in the brain 
and involve different physiological and physical effects. The direct effect of stress 
on cortical responses can be visualized by recording the brain’s electrical waves 
using an encephalograph. These waves are recorded by means of an 
electroencephalogram (EEG). EEG is the most commonly used neuroimaging 
technique to study the patterns of brainwaves and functioning of the brain. It also 
measures the variation of the electric field produced by neuronal activity a 
millisecond at a time. To systematically analyze published studies on the 
difference between brain wave patterns in terms of their frequencies among 
subjects with acute stress, chronic stress, and normal individuals.   
Methodology: The data from published studies was arranged quantitatively and 
qualitatively by producing a planned summary measure. Studies that focused on 
brain wave analysis of the EEG of healthy adult subjects with no history of mental 
illness or head injury were included in the review. The selected literature included 
many types of stressors that are acute or chronic, and that affected the neuronal 
electrical activity. The only electronic database utilized to identify relevant studies 
was PubMed.  
Result: Fifteen studies were included that were based on a variety of acute 
stressors to observe alterations in brain wave activity between stress-free and 
stressed states. These studies showed that stressors could be a causative factor to 
generate fluctuations in neuronal oscillations that also leads to significant 
psychological, physiological and neurobiological deteriorations to some extent. An 
additional sixteen studies were included, which showed the effect of chronic stress 
on the asymmetry of the amplitude in the frequencies of brain waves.  
Conclusion:  The most common change observed was in the alpha frequency (8-
13Hz), followed by changes in beta waves (13-30 Hz) and theta (4-8Hz). Though, 
there is not always the same resultant pattern of waves explored with even the 
same type of stressors due to interpersonal differences in response to a stressful 
situation. 

Keywords 
Chronic Stress, Acute Stress, Brain Waves, Electroencephalography.

Citation: Noushad S, Ahmed S, Ansari B, 
Saleem Y, Batool SF, Batool SF. A review 
of the literature on the impact of acute 
and chronic stress upon brain waves. 
APP.2021; 8(1):49-61 
 
Corresponding Author Email: 
shamoon@aeirc-edu.com 
 
DOI: 10.29052/2412-3188.v8.i1.2021.49-61 
 
Received 20/11/2020 
 
Accepted 07/05/2021 
 
Published 01/06/2021 
 
Copyright © The Author(s). 2021 This  
 is an open access article distributed  
under the terms of the Creative Commons 
Attribution 4.0 International License, 
which permits unrestricted use, 
distribution, and reproduction in any 
medium, provided the original author 
and source are credited.  
 

 

Funding: The author(s) received no 
specific funding for this work. 

Conflicts of Interests: The authors have 
declared that no competing interests 
exist. 
 

https://doi.org/10.29052/2412-3188.v8.i1.2021.
https://orcid.org/0000-0002-8078-4524
https://orcid.org/0000-0002-9635-0202
https://orcid.org/0000-0003-3919-2516
https://orcid.org/0000-0001-7605-1304
http://creativecommons.org/licenses/by/4.0/)
http://creativecommons.org/licenses/by/4.0/)


 
 
 

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Introduction  
Everyone, at least once in their lifetime, faces 
a stressful situation. This stress can be 
beneficial if it motivates a person to do 
challenging tasks to achieve their goals. But 
it can be harmful when it begins to affect the 
physical or mental health of the subject. The 
term stress is defined as; when the 
equilibrium between internal and external 
environment is disturbed, it alters the bodily 
mechanisms1. This scenario casts a bad 
impact on the central, and peripheral 
regulatory systems that leads to deprived 
health and mental wellbeing2. Stress is also 
responsible for the progression of chronic 
disorders. Its long-term exposure is linked 
with several health problems, including 
obesity, peripheral vascular disease, 
diabetes, and depression. Therefore it is 
essential to evaluate stress levels at the early 
stage before they start to interfere with 
everyday routine. Stress can be evaluated 
based on physiological and behavioral 
responses. Traditionally, physicians tend to 
assess stress by using critically designed 
questionnaires3, i.e. a subjective method. 
Stress can also be measured by assessing 
different biological indicators like cortisol4, 
alpha-amylase levels, body vitals namely 
blood pressure5 and skin conductivity6. The 
direct effect of stress on cortical responses 
can be obtained by using a neuroimaging 
technique, electroencephalogram (EEG)7. 
EEG is the electrophysiological technique 
used to assess the electrical activity of the 
brain8. It also measures the variation of the 
electric field produced by neuronal activity 
at the millisecond resolution. 
 
Assessment of Acute and Chronic Stress 
Based on EEG Features 
Biological responses associated with stress 
originate in the brain and involve different 
types of physiological and physical effects. 
Previous studies have investigated the 
variations in EEG signals during stressful 

conditions. The alpha frequency band ranges 
between 8-13 Hz9. Alpha waves are usually 
recorded in a relaxed, calm and tension-free 
condition10, when a subject is exposed to a 
distress in a controlled laboratory setting a 
distinct reduction in power is observed11. 
During the stressful condition, the right 
hemisphere shows more frontal altered 
alpha waves then left hemisphere12,13. Other 
studies discuss the relationship between 
negative emotions, stress or depression with 
alpha frequency12,14. Marshall and Lopez 
Duran suggest a decline in the power of 
alpha frequency in the prefrontal cortex 
during a stressful situation15. As well, there 
is an increase in alpha power in the frontal 
cortex during fatigue16. Yi et al. reported that 
during chronic stress such as social isolation 
there is a decrease in the power of alpha 
frequency17. 
 

Methodology 
Study Characteristics 
This systematic review protocol is based on 
PRISMA guidelines18. The only electronic 
database involved in this study is PubMed 
and the records and data throughout the 
review is managed by M.S. Word. 
 
Inclusion Criteria 
 The studies conducted between 1st 

January 2000 to 31st March 2019. 

 All the full-text original articles 
published in the English language  

 Studies with the subject age range of 19-
44 years. 

 Studies that focus on brain wave analysis 
by EEG.   

 Studies involving healthy subjects, 
without any history of mental illness or 
head injury.  
 

Exclusion Criteria 

 Studies assessed depressive symptoms 
in healthy populations.  



 
 
 

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 Studies on infants (pediatric studies), 
neonates, pregnant women.   

 Studies focused on other 
electrophysiological techniques than 
EEG.  

 Studies used EEG for evaluation other 
than stress.  

 Studies involving diseased subjects.  
 
 

 

Data Synthesis 
The data was arranged quantitatively and 
qualitatively by producing a planned 
summary measure, reviewing original 
articles in the same aspects, extracting and 
screening the citation and studies, handling 
the studies, screening them and combining 
them according to the methods given by the 
following PRISMA flow diagram (Figure 1 & 
2).  

 
 

 
 

 

 

 
 
 
 

 
 

 
Figure 1: PRISMA Diagram for study selection of chronic stressors in systemic review. 

 



 
 
 

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This method was used as a medium for extractions and simplification of the combined data and 
rate it in its quality and quantity. 
 

 
 

 

 
 

 

 
 
 
 

 
 

Figure 2: PRISMA Diagram for study selection of acute stressors in systemic review. 
 
 
 
 
 
 

 



 
 
 

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Result 
Table 1 summarizes the sample size, gender, included brain 
frequencies, altered oscillations, and type of chronic stressor 
measured. The stressors mentioned in Table 1 discuss the 
disturbance in neuronal oscillations. Many studies discuss 
several reasons for the asymmetry in brain waves that can be a 
result of continuous exposure to a stressful situation. Different 
stressors have been reported; one of the stressors is sleep 
deprivation, which increases alpha waves19. Another stressor is 
isolation; during 520 days, isolation shows the increase in beta 
waves at the frontal region while alpha and delta remain 
unaffected20. Loganovsky et al. found an increase in alpha at the 
temporal and frontal area, delta at the anterior brain, and theta 
at the anterior brain and right temporal region and beta increase 
at anterior brain while decrease at the temporal region due to 

workload21. Jacubowski et al. considers two stressors, one is 
isolation and the other is exercise, and both stressors resulted in 
high alpha and beta waves22. Hu concluded the influence of 
different stressors caused by unemployment, and the frequent 
examination on students and mothers of disabled children23. 
They found alpha, beta and theta frequencies increase 
anteriorly. Luijcks et al. used electro-shocker as a chronic 
stressor and reported an increase in alpha and slow beta waves 
frequency at central and parietal-temporal areas, spectrum of 
gamma wave’s decrease at frontal, central and occipital 
regions24. Vanneste et al. assessed chronic tinnitus and reported 
that alpha 1 and beta are altered25. However, in this condition, 
alpha 1 at the subgenual anterior cingulate cortex, beta 3 at 
dorsal anterior cingulate cortex, delta, theta, alpha 2, beta 1 and 
2 remain unaffected. When extreme isolation was studied by Yi 
et al. they found a decrease in alpha and beta frequency17. 

 

Table 1: Chronic Stressors That Alter Brain Wave Symmetry. 

 

Author Year Sample size Waves Result Brain region Stressor 

Begić et al 26 2000 18 veterans with 
PTSD and 20 
healthy non-
veterans 

delta, theta, alpha 
1, 
alpha 2 beta 1 & 
beta 2 

theta      
beta     
alpha and delta no 
significant change 

Theta: Central region 
Beta: Frontal, central and left 
occipital-al 

PTSD 

Hall et al27 2000 14 subjects with 
primary insomnia 

delta, alpha and 
beta 

During non-REM 
sleep: 
delta 
beta   
alpha 

- Last 6 months 
depression. 

Brady et al28 2000 6 subjects Theta theta Frontal Binaural beat sound 
tape 

Neylan et al29 2003 24 PTSD patients 
and 18 control 

Delta delta - PTSD 



 
 
 

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Hall et al30 2007 30 patients of 
insomnia 

beta and  delta beta 
delta  

- Perceived stress 

Baumeister  
et al31 

2008 16 right-handed 
healthy subjects 

theta alpha1 
alpha2 beta1 and 
beta2 

beta-1 
alpha-1 

Frontal region: 
Alpha 1  
Right 
Hemispheric frontal brain 
beta 1  

Supplementation of 
phosphatidylseri-ne 

Todder et al32 2012 10 right handed 
PTSD patients+ 
10 healthy hospital 
staff member 

Theta qEEG: 
No statistical 
difference between 
PTSD and control 
subjects for theta band 
LORETA: 
Theta band    

Low on right temporal-al lobe, 
higher theta band  patients 
with PTSD showed lower 
activity over both the right and 
left frontal lobes 
 

PTSD 

Glos et al33 2014 12 healthy young 

volunteer 

Alpha alpha  - Sleep deprivation 

Yi  et al20 2015 6 subjects alpha, beta, and  
delta 

beta   Frontal region Chronic stress burden of 
520-d isolation 

Loganovsk et 
al21 

2015 196 subjects alpha, beta,  theta 
and delta 

alpha  
beta     
theta   
delta     

Anterior brain: 
beta, theta, delta 
Right Temporal: 
theta,  

beta, alpha 
Frontal: 
Alpha 

Work load 
 
 

Jacubowski 
et al22 

2015      6 subjects alpha and 
beta 

post isolation 
alpha, beta    
exercise 
alpha, beta   :  

Limited number of channels, 
no further details of brain 
regions 

Isolation. 

Hu et al 23 2015 18 unemployed,  
Students and 
Mothers of disabled 
children 

alpha, beta and 
theta 

alpha   
beta      
theta    

Anterior and frontal region Unemployment, 
Frequent examination 
and graduation, 
Disabled children 



 
 
 

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Luijcks et al24 2015 69 right handed 
subjects 

delta, theta, 
alpha, slow beta 
and fast beta,  
gamma 

alpha     
fast, slow beta        
gamma  

Central,  parietal- temporal 
area: 
alpha,  slow beta 
Frontal, central , occipital: 
Gamma 

Electro-shocker 

Vanneste et 
al25 

2015 55 patients with 
constant chronic 
tinnitus 

delta, theta, alpha 
1, alpha 2, beta 1, 
beta 2, beta 3 and 
gamma 

Sinificant effect on 
alpha 1  
beta 3 

Subgenual anterior cingulate 
cortex: alpha 1 
Dorsal anterior cingulate 
cortex: 
beta 3 

Tinnitus 

Giannakakis  
et al9 

2015 18 healthy subjects theta, alpha, beta 
and gamma θ,  
alpha 1,2  
beta  1,2,3,4 , low 
and high gamma 

alpha and  
beta feature 

Frontal Video 

Yi et al17 2016 6 healthy subjects alpha and beta beta 
alpha 

No further differentiation due 
to limited no. of channels 

Mars voyage subjects 
lived in extreme social 
isolation 

 
Table 2. Summarizes the sample size, their gender, included brain waves, altered oscillations, and type of acute stressor. The stressors 
mentioned in Table 2 discuss the disturbance in neuronal oscillations. Acute stressors can be beneficial as these stressors make the 
body able to adapt according to their surroundings. Alonso  et al., applied two psychological and physical stressors, a Stroop test and 
sleep deprivation in which the Stroop test resulted in an increase in alpha 1 and beta whereas in sleep deprivation, theta increased and 
there was a decline in alpha 1, finally high alpha decreases and high beta increases in stress responses34. Zambotti et al., applied the 
Trier social stress test on insomniac patients and compared them with a control group, beta 1 increases in the control group showed 
no change in brain wave symmetry35. Acute mental arithmetic tasks cause a decrease in alpha and increase in beta and delta and theta 
stay unchanged36. Allen et al., used a socially evaluated cold presser test (S.E.C.P.T.) and found an increase in theta at the frontal 
midline and that alpha1, 2 and beta 1, 2 and delta did not responded to the stressor37. Banis et al., used the Distressing Video and 
Monetary Incentive Delay Task and found alpha power increase in reward cues, which was unaffected during a stressful situation. 
They also found that theta increased in on reward signal38. In Julien Modolo et al., study, alpha remains unchanged at the occipital 
region in magnetic frequency (60 Hz) stressor39. 



 
 
 

 

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Ann. psychophysiol. 
ISSN 2412-3188 (Online) | 2410-1354 (Print) 

 

Table 2: Acute Stressors That Change Brain Wave Symmetry. 

 

Author Year Sample size Waves Result Brain region Stressor 

Muttray et 
al40 

2000 12 subjects Alpha 1, 
Alpha 2, 
Beta 1, 
Beta 2, 
Theta And 
Delta 

alpha 1 : 
alpha 2 :  
beta 1  : 
beta 2: no change 

Tempor-o-parieto-occipital: 
Alpha 1 and beta 1 
Temporooccipital: 
Delta 
Parietal & temporal regions: 
Theta 

200 ppm 1,1,1-
trichloroethane + 
Color Word Stress test 

Tops et al41 2004 11  subjects Alpha alpha  : Frontal activity Acute cortisol 

Hewig et 
al42 

2008 37 subjects Alpha alpha  : Frontal Exam 

Master et 
al43 

2009 54 subjects Alpha alpha asymmetery Frontal EEG.  
Asymmetry 

Trier social stress test 

Rozhkov et 
al44 

2009 11 subjects Theta & 
Delta 

theta  :  
delta  :  

Temporospatial Hypoxia 

Scholey et 
al45 

2012 31 subjects Theta, Alpha 
And 
Beta 

theta   :  
alpha  : 
beta    :   

Midline frontal and central 
region 

Epigallocatechin gallate 
(E.G.C.G.) 

Lithari et 
al46 

2012 26 right handed 
healthy subjects 

Alpha Beta, 
Gamma, Delta 
Theta 

theta   :  
alpha  : 
beta    :  

Regions not mentioned Alcohol intake 

Quaeflieg 
et al47 

2014 70 subjects Alpha alpha not effected Frontal Maastricht acute stress 
test 

https://doi.org/10.29052/2412-3188.v8.i1.2021.


 
 
 

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Alonso et 
al34 

2015 30 subjects Delta 
Theta 
Alpha And 
Beta 

Stroop test:  
alpha1     beta    :  
sleep deprivation: 
theta   :  
alpha 1: 
stress response 
high alpha:   
high beta:  
 

- Stroop color word test 
chronic: 
Sleep deprivation 

de 
Zambotti et 
al35 
 

2015 22 subjects with 
insomnia & 18 
without insomnia 

Alpha Beta1 
Beta2 Delta 
Theta And Sigma 

Insomniac subjects: 
beta1: 
Control: 
beta 1 no change 

- Trier social stress test. 

Al-Shargie 
et al35 

2016 22 healthy right 
handed subjects 

Delta 
Alpha 
Beta And 
Theta 

beta    :  
alpha  :  
alpha waves 
responded more 
significantly to stress 

- Mental arithmetic task 

Allen et al37 2016 22 subjects Alpha1 
Alpha 2  
Beta 1 Beta 2 
Delta & Theta 

theta  :  Frontal midline 
representing prefrontal 
cortical activity. 

Socially evaluated cold 
presser test (S.E.C.P.T.) 

Banis et al40 2017 17 subjects Alpha & Theta alpha :  
in reward cues 
No effect in stressed 
condition 
theta  :  
in non reward cue. 

- Distressing video+ 
Monetary Incentive 
Delay Task 
 
 
 

Modolo et 
al39 

2017 25 subjects Alpha alpha not effected Occipital region Magnetic frequency 60 
Hz 



 
 
 

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Discussion 
The conditions that are associated with stress 
produce significant psychological, 
physiological and neurobiological 
deteriorations. Distress affects neuronal 
circuits that further disturb the normal 
propagation of brain waves; these 
interruptions can be analyzed by EEG with 
precision and efficacy. 
 
This review reveals how the different 
stressors could be a causative factor in 
generating fluctuations in neuronal 
oscillations. It should be noted that gamma 
is the least observed wave in the above-
included studies. Above all, only Luijcks et 
al. reported a decrease in gamma waves at 
the frontal, central and occipital regions 
while others reported no change 9,24,25. Slow-
wave delta least shows the deflection when 
influenced by chronic stressors; in many 
studies, delta waves remain unchanged 
before and after the stressor applied20,24-26. 
Few studies mentioned the increase in delta 
waves during chronic stress9, 12, 21. However, 
Neylan et al. and Hall et al. suggested a 
decrease in delta waves29,30. Like delta, theta 
also in some studies reported to not be a 
respondent of a stressor 9,24,25,31. While Begic 
et al.26, Brady et al. 28 and Hu et al. 23 observed 
a decrease in theta rhythms at central, frontal 
and anterior regions, respectively. However, 
Todder et al.32 use QEEG and Low 
Resolution Electromagnetic Tomographis 
Analysis (LORETA) techniques and report 
that there is no difference observed. At the 
same time, LORETA reveals some other 
results; they distributed the theta band into 
higher and lower frequency band, both 
bands show low activity at different brain 
sites,  the low band found at right temporal 
lobe while the higher band at the right and 
left frontal lobe. Now, beta waves are more 
involved in brain-specific tasks. Most of the 
studies reported an increase in beta 

oscillations at frontal, central, left occipital, 
anterior, right temporal and parietal 
temporal regions of the brain 18,20,21-23,26,30. 
Some detect a decline in this rhythm at the 
frontal and right hemispheric frontal site of 
the brain8,9,17. Also, Vanneste et al. observed 
alteration in frequency bands of beta 3 waves 
at the dorsal, anterior cingulate cortex25. 
Finally, the alpha wave remains unchanged 
in very few cases 20, 26. Mainly, the alpha 
oscillations were reported to be increased 
during or after chronic stressors were 
applied, and the regions indicated were 
frontal, right temporal, parietal temporal, 
central and anterior18,22,25,28,29,31. 
 
On the contrary, Giannakakis et al. 9 and Yi 
et al. 17 suggested the decline in beta 
frequency in the frontal region of the brain. 
Additionally, Vanneste et al. found 
fluctuations in alpha 1 waves after the 
extensive exposure to stress25. Acute 
stressors are the second parameters in this 
review. Lithari et al. 46 included gamma 
wave in his study, but the rhythms remain 
un-deflected. Now, the delta waves mostly 
reported being unchanged during acute 
stress34-37,46. Whereas, Muttray et al. 40 and 
Rozhkov et al. 44 observed an increase in the 
frequency of the delta waves at temporo-
occipital and temporospatial regions of the 
brain. Theta oscillations are not respondents 
of acute stressors observed by Massimiliano 
de Zambotti35 and Al Shargie et al.36 But most 
of the studies mentioned an increase in theta 
wave and the regions are parietal and 
temporal, temporospatial, midline frontal 
and central part of the brain34,40,44,46. Allen et 
al.,37 suggested no change in the beta wave. 
Though, Muttray et al.40 mentioned a 
decrease in beta rhythm at the 
temporoparietal occipital. On the other 
hand, most of the studies reported an 
increase in the beta wave at midline frontal 
and central regions34-36,46. Lastly, the alpha 



 
 
 

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waves are the most considered wave to 
study stress. Some studies reported that 
alpha remains unchanged27,35,37,47. In acute 
stress, it is reported that alpha wave 
increases at frontal, midline frontal and 
central sites34,38,43,46, while other studies 
reported a decline in alpha waves at 
temporoparietal-occipital and frontal 
regions of the brain41,42.  
 

Conclusion 
The literature reviewed for this study shows 

the effect of numerous stressors on brain 

oscillations that change their frequency, 

affecting normal functions of the brain. 

These fluctuations in the power of brain 

waves could lead to some severe 

consequences if persisted for too long. 

Multiple interventions and therapies 

especially biofeedback techniques are 

making the mark and are now being tested 

and successfully applied to train the subject 

to revert the effect of stress. Most significant 

one amongst these were biofeedback and 

behavioral structuring techniques with high 

efficacy rates. Awareness in this regard is 

highly recommended. 

 

Acknowledgment  
The authors are thankful to the study 
participants for their cooperation in the 
study. 
 

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