Department of Psychology, Whitworth University, Spokane, WA, USA.
Curr Top Behav Neurosci. 2022;55:17-40. doi: 10.1007/7854_2020_190.
Epilepsy and stress are each significant concerns in today's society, bearing heavy impacts on mental and physical health and overall quality of life. Unfortunately, the intersection between these is potentially even more concerning, as stress is a frequent trigger of seizures and may contribute to neural hyperexcitability. A growing body of research suggests a connection between early life stress (occurring in the prenatal or postnatal stage) and later development of epilepsy. While the larger part of this literature suggests that early life stress increases vulnerability for epilepsy development, there are a number of interacting factors influencing this relationship. These factors include developmental stage at which both stressor and seizure assessment occur, type of stressor, sex effects, and type of seizure (convulsive or non-convulsive). Additionally, a number of potential mechanisms have been identified, including activation of the hypothalamic-pituitary-adrenal axis, neuroinflammation, altered inhibitory/excitatory balance, and temporal lobe structures. Developing a clearer understanding of this relationship between early life stress and epilepsy, the factors that influence it, and underlying mechanisms that may serve as targets for intervention is crucial to improving quality of life for persons with epilepsy.
癫痫和压力都是当今社会的重大关注点,对身心健康和整体生活质量都有重大影响。不幸的是,这两者之间的交集可能更为令人担忧,因为压力是癫痫发作的常见诱因,并可能导致神经兴奋性过高。越来越多的研究表明,早期生活压力(发生在产前或产后阶段)与日后癫痫的发生之间存在关联。虽然这方面的大部分文献表明,早期生活压力会增加癫痫发生的易感性,但有许多相互作用的因素影响着这种关系。这些因素包括压力源和癫痫发作评估发生的发育阶段、压力源的类型、性别效应以及癫痫发作的类型(惊厥性或非惊厥性)。此外,已经确定了一些潜在的机制,包括下丘脑-垂体-肾上腺轴的激活、神经炎症、抑制/兴奋平衡的改变以及颞叶结构。更清楚地了解早期生活压力与癫痫之间的关系、影响这种关系的因素以及可能作为干预靶点的潜在机制,对于提高癫痫患者的生活质量至关重要。