Center for Studies on Human Stress, Canada; University of Montreal, Department of Neurosciences, Canada; Institut universitaire en santé mentale de Montréal, Research Center, Canada.
Institut universitaire en santé mentale de Montréal, Research Center, Canada; University of Montreal, Department of Psychiatry, Canada.
Prog Neuropsychopharmacol Biol Psychiatry. 2018 Jul 13;85:152-160. doi: 10.1016/j.pnpbp.2017.07.015. Epub 2017 Jul 25.
Early adversity (EA) has been shown to be a potent risk factor for developing a psychopathology in adulthood. Alterations of the stress system in addition to changes in brain development have been suggested to explain some of the psychopathologies associated with EA. The stress response involves the activation of the hypothalamic-pituitary-adrenal (HPA)-axis, which leads to the production of glucocorticoids (GCs; cortisol in humans). Being soluble in lipids, GCs easily cross the blood brain barrier and access GC receptors in the hippocampus, prefrontal cortex and amygdala. These three brain structures do not develop at the same rhythm in humans and recent models suggest that exposition to EA at different times throughout cerebral development can induce a differential vulnerability to diverse mental illnesses. Although these models are of interest, they do not provide any mechanism(s) through which exposition to EA could lead to an increased vulnerability to certain mental illnesses and not others. Interestingly, the main brain structures that are affected by the chronic secretion of stress hormones during childhood (hippocampus, prefrontal cortex and amygdala) are differentially involved in various cognitive functions (memory, emotion regulation, encoding of emotional memories, etc.). It is therefore proposed that exposure to EA, by affecting the development of specific brain structures, might alter the underlying cognitive process of these brain regions, and increase vulnerability to specific mental disorders in adulthood.
早期逆境（EA）已被证明是成年后发展精神病理学的一个强有力的风险因素。除了大脑发育的变化外，应激系统的改变被认为可以解释一些与 EA 相关的精神病理学。应激反应涉及下丘脑-垂体-肾上腺（HPA）轴的激活，导致糖皮质激素（GC；人类中的皮质醇）的产生。GC 具有脂溶性，很容易穿过血脑屏障并进入海马体、前额叶皮层和杏仁核中的 GC 受体。这三个大脑结构在人类中的发育节律不同，最近的模型表明，在大脑发育的不同时间暴露于 EA 可能会导致对各种精神疾病的不同易感性。尽管这些模型很有趣，但它们没有提供任何机制来解释为什么暴露于 EA 会导致对某些精神疾病的易感性增加，而对其他疾病则不会。有趣的是，在儿童时期慢性分泌应激激素会影响的主要大脑结构（海马体、前额叶皮层和杏仁核）在各种认知功能（记忆、情绪调节、情绪记忆编码等）中存在差异。因此，有人提出，暴露于 EA 通过影响特定大脑结构的发育，可能会改变这些大脑区域的潜在认知过程，并增加成年后患特定精神障碍的易感性。
