Quijije Nadia
Massachusetts General Hospital, Gregory Fricchione, MD Massachusetts General Hospital, Boston, Massachusetts, USA.
Curr Opin Endocrinol Diabetes Obes. 2015 Aug;22(4):319-24. doi: 10.1097/MED.0000000000000176.
This review will provide updates on the neurobiology of stress, with specific focus on the transmitting mechanism of stress, the intricacies of integrating stress-related information, variability in response to stressors and clinical interventions.
Neuropeptides have been implicated as a potential modulator for pathological stress via effects on neurogenesis, alterations in functional states of the cortico-limbic circuits and possible neuroprotection. Glucocorticoid receptors and mineralocorticoid receptors have been implicated in limbic modulation of stress and changes in the hypothalamic pituitary adrenal axis activity via corticosteroid signalling and feedback regulation. Chronic stress and genetic susceptibility have been found to promote intracellular mitochondrial and cellular DNA damage resulting in structural and functional alterations of neuroanatomy and neural circuitries.
The interplay of stress and the neuroendocrine system appears to be influenced by alterations in genetic expression, resulting in neurochemical messenger and inflammatory cytokine alterations that impact neuroanatomy and neural circuitries to affect both central nervous system structure and function. These neurobiological contributions have been alluded to as possible contributors to stress-related psychopathologies. Clinical interventions with psychotropics, mind body therapies and behavioural therapies have been found to attenuate and reverse stress-related responses.
本综述将提供应激神经生物学的最新进展，特别关注应激的传递机制、整合应激相关信息的复杂性、对应激源的反应变异性以及临床干预措施。
神经肽被认为是病理性应激的潜在调节因子，其通过对神经发生的影响、皮质-边缘回路功能状态的改变以及可能的神经保护作用来发挥作用。糖皮质激素受体和盐皮质激素受体通过皮质类固醇信号传导和反馈调节参与应激的边缘调节以及下丘脑-垂体-肾上腺轴活动的变化。已发现慢性应激和遗传易感性会促进细胞内线粒体和细胞DNA损伤，导致神经解剖结构和神经回路的结构与功能改变。
应激与神经内分泌系统的相互作用似乎受到基因表达改变的影响，导致神经化学信使和炎性细胞因子的改变，进而影响神经解剖结构和神经回路，影响中枢神经系统的结构和功能。这些神经生物学作用被认为可能是应激相关精神病理学的促成因素。已发现使用精神药物、身心疗法和行为疗法进行临床干预可减轻和逆转应激相关反应。
