Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, EURON, School for Mental Health and Neuroscience MHeNS, Maastricht University, The Netherlands.
Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, EURON, School for Mental Health and Neuroscience MHeNS, Maastricht University, The Netherlands.
Neurosci Biobehav Rev. 2015 Sep;56:241-51. doi: 10.1016/j.neubiorev.2015.07.008. Epub 2015 Jul 19.
Previous work in animals has shown that dopamine (DA) in cortex and striatum plays an essential role in stress processing. For the first time, we systematically reviewed the in vivo evidence for DAergic stress processing in health and psychopathology in humans. All studies included (n studies=25, n observations=324) utilized DA D2/3 positron emission tomography and measured DAergic activity during an acute stress challenge. The evidence in healthy volunteers (HV) suggests that physiological, but not psychological, stress consistently increases striatal DA release. Instead, increased medial prefrontal cortex (mPFC) DAergic activity in HV was observed during psychological stress. Across brain regions, stress-related DAergic activity was correlated with the physiological and psychological intensity of the stressor. The magnitude of stress-induced DA release was dependent on rearing conditions, personality traits and genetic variations in several SNPs. In psychopathology, preliminary evidence was found for stress-related dorsal striatal DAergic hyperactivity in psychosis spectrum and a blunted response in chronic cannabis use and pain-related disorders, but results were inconsistent. Physiological stress-induced DAergic activity in striatum in HV may reflect somatosensory properties of the stressor and readiness for active fight-or-flight behavior. DAergic activity in HV in the ventral striatum and mPFC may be more related to expectations about the stressor and threat evaluation, respectively. Future studies with increased sample size in HV and psychopathology assessing the functional relevance of stress-induced DAergic activity, the association between cortical and subcortical DAergic activity and the direct comparison of different stressors are necessary to conclusively elucidate the role of the DA system in the stress response.
先前在动物身上的研究表明，大脑皮层和纹状体中的多巴胺（DA）在应激处理中起着至关重要的作用。我们首次系统地回顾了健康和精神病理学中人类 DA 能应激处理的体内证据。所有纳入的研究（n 研究=25，n 观察=324）均利用 DA D2/3 正电子发射断层扫描（PET），并在急性应激挑战期间测量 DA 能活性。健康志愿者（HV）的证据表明，生理应激而非心理应激一致地增加纹状体 DA 的释放。相反，在心理应激期间，HV 的内侧前额叶皮质（mPFC）的 DA 能活性增加。在不同脑区，应激相关的 DA 能活性与应激源的生理和心理强度相关。应激诱导的 DA 释放的幅度取决于饲养条件、人格特质和几个单核苷酸多态性（SNP）的遗传变异。在精神病理学中，在精神病谱中发现了与应激相关的背侧纹状体 DA 能过度活跃的初步证据，而在慢性大麻使用和与疼痛相关的障碍中发现了反应迟钝，但结果不一致。HV 纹状体中的生理应激诱导的 DA 能活性可能反映了应激源的躯体感觉特性和积极战斗或逃跑行为的准备状态。HV 的腹侧纹状体和 mPFC 中的 DA 能活性可能与对应激源的期望和威胁评估分别更为相关。未来的研究需要增加 HV 和精神病理学的样本量，评估应激诱导的 DA 能活性的功能相关性、皮质和皮质下 DA 能活性之间的关联以及不同应激源的直接比较，以明确 DA 系统在应激反应中的作用。
