Oka Takakazu
Department of Psychosomatic Medicine, International University of Health and Welfare Hospital, Tochigi-ken, Japan.
Handb Clin Neurol. 2018;157:599-621. doi: 10.1016/B978-0-444-64074-1.00035-5.
Stress affects core body temperature (T). Many kinds of stress induce transient, monophasic hyperthermia, which diminishes gradually if the stressor is terminated. Stronger stressors produce a longer-lasting effect. Repeated/chronic stress induces anticipatory hyperthermia, reduces diurnal changes in T, or slightly increases T throughout the day. Animals that are exposed to chronic stress or a cold environment exhibit an enhanced hyperthermic response to a novel stress. These changes persist for several days after cessation of stress exposure. In contrast, long-lasting inescapable stress sometimes induces hypothermia. In healthy humans, psychologic stress induces slight increases in T, which are within the normal range of T or just above it. Some individuals, however, develop extremely high T (up to 41°C) when they are exposed to emotional events or show persistent low-grade high T (37-38°C) during or after chronic stress situations. In addition to the nature of the stressor itself, such stress-induced thermal responses are modulated by sex, age, ambient temperature, cage mates, past stressful experiences and cold exposure, and coping. Stress-induced hyperthermia is driven by mechanisms distinct from infectious fever, which requires inflammatory mediators. However, both stress and infection activate the dorsomedial hypothalamus-rostral medullary raphe region-sympathetic nerve axis to increase T.
应激会影响核心体温（T）。多种应激会引发短暂的单相体温过高，如果应激源终止，体温会逐渐下降。更强的应激源会产生更持久的影响。反复/长期应激会引发预期性体温过高，减少体温的昼夜变化，或使全天体温略有升高。暴露于长期应激或寒冷环境的动物对新的应激表现出增强的体温过高反应。在应激暴露停止后，这些变化会持续数天。相反，长期无法逃避的应激有时会导致体温过低。在健康人类中，心理应激会使体温略有升高，仍在正常体温范围内或略高于正常范围。然而，一些人在经历情绪事件时会出现极高的体温（高达41°C），或在长期应激情况下期间或之后出现持续的低热高温（37 - 38°C）。除了应激源本身的性质外，这种应激诱导的热反应还受到性别、年龄、环境温度、笼伴、过去的应激经历、寒冷暴露和应对方式的调节。应激诱导的体温过高是由与感染性发热不同的机制驱动的，感染性发热需要炎症介质。然而，应激和感染都会激活背内侧下丘脑 - 延髓头端中缝区域 - 交感神经轴来升高体温。
