Neural correlates of acute task-related stress in humans: a systematic review and coordinate-based ALE meta-analysis

Stress is a major risk factor for psychiatric disorders, yet the whole-brain neural signature of acute task-related stress remains incompletely defined, particularly for stress-related decreases in activation. We conducted a PROSPERO-registered systematic review and activation likelihood estimation (ALE) meta-analysis of English-language, peer-reviewed human task-based functional MRI (fMRI) studies published between January 2000 and November 2025. Eligible studies reported whole-brain stereotactic coordinates for stress versus matched non-stress control conditions. Stress > control and control > stress contrasts were analysed separately in GingerALE 3.0.2 using random-effects ALE with cluster-level family-wise error correction. Eighty-nine studies met inclusion criteria. The stress > control analysis included 85 experiments from 84 studies (2,810 participants; 1,350 foci), whereas the control > stress analysis included 25 experiments from 25 studies (922 participants; 263 foci). Stress > control showed convergent activation in a bilateral network including the anterior insula and inferior frontal operculum, dorsal anterior cingulate and supplementary motor area, thalamus, striatum, lateral frontal and parietal cortex, and left amygdala/parahippocampal gyrus. Control > stress yielded a single right parahippocampal-amygdala cluster. Thus, across heterogeneous acute stress-related challenges, the task-based fMRI literature was characterized more by reproducible activation increases across salience, arousal, and action-readiness systems than by consistent deactivation. These findings provide an updated trans-paradigm coordinate-based reference map for stress neurobiology, while acknowledging that the pooled convergence may partly reflect neural responses to salience or task demand that are shared across paradigms.