Stanford Early Life Stress Research Program, Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California 94305, USA.
J Adolesc Health. 2012 Aug;51(2 Suppl):S23-8. doi: 10.1016/j.jadohealth.2012.04.010.
Youth who experience traumatic stress and develop post-traumatic symptoms secrete higher levels of the glucocorticoid cortisol than youth with no trauma history. Animal research suggests that excess corticosterone secretion can lead to neurotoxicity in areas of the brain rich in glucocorticoid receptors such as the hippocampus and the prefrontal cortex (PFC). These two areas of the brain are involved in memory processing and executive function, both critical functions of learning.
In this article, we summarize findings presented at the National Summit for Stress and the Brain conducted at Johns Hopkins University's Department of Public Health in April 2011. The presentation highlighted structural and functional imaging findings in the hippocampus and PFC of youth with post-traumatic stress symptoms (PTSS).
Youth with PTSS have higher levels of cortisol. Prebedtime cortisol levels predict decreases in hippocampal volume longitudinally. Cortisol levels are negatively correlated with volume in the PFC. Functional imaging studies demonstrate reduced hippocampal and PFC activities on tasks of memory and executive function in youth with PTSS when compared with control subjects.
Effective interventions for youth with PTSS should target improved function of frontolimbic networks. Treatment outcome research using these potential markers can help develop more focused interventions that target the impaired learning of vulnerable youth experiencing traumatic stress.
经历创伤性应激并出现创伤后症状的年轻人比没有创伤史的年轻人分泌更高水平的糖皮质激素皮质醇。动物研究表明，过量的皮质酮分泌会导致大脑中富含糖皮质激素受体的区域（如海马体和前额叶皮层）发生神经毒性。这两个大脑区域参与记忆处理和执行功能，这是学习的两个关键功能。
在本文中，我们总结了 2011 年 4 月在约翰霍普金斯大学公共卫生系举行的国家压力与大脑峰会（National Summit for Stress and the Brain）上提出的发现。该演讲强调了创伤后应激症状（PTSS）年轻人中海马体和前额叶皮层的结构和功能成像发现。
患有创伤后应激症状的年轻人皮质醇水平较高。睡前皮质醇水平与纵向海马体体积减少相关。皮质醇水平与前额叶皮层体积呈负相关。功能成像研究表明，与对照组相比，患有创伤后应激症状的年轻人在记忆和执行功能任务上，其海马体和前额叶皮层的活动减少。
针对创伤后应激症状的年轻人的有效干预措施应针对改善额眶网络的功能。使用这些潜在标志物的治疗结果研究可以帮助开发更有针对性的干预措施，针对易受创伤应激影响的脆弱青年的学习障碍。
