压力神经生物学与精神分裂症易感性的转化研究前景:证据回顾。

The Translational Future of Stress Neurobiology and Psychosis Vulnerability: A Review of the Evidence.

机构信息

Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom.

Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Solna, Sweden.

出版信息

Curr Neuropharmacol. 2024;22(3):350-377. doi: 10.2174/1570159X21666230322145049.

Abstract

Psychosocial stress is a well-established risk factor for psychosis, yet the neurobiological mechanisms underlying this relationship have yet to be fully elucidated. Much of the research in this field has investigated hypothalamic-pituitary-adrenal (HPA) axis function and immuno-inflammatory processes among individuals with established psychotic disorders. However, as such studies are limited in their ability to provide knowledge that can be used to develop preventative interventions, it is important to shift the focus to individuals with increased vulnerability for psychosis (i.e., high-risk groups). In the present article, we provide an overview of the current methods for identifying individuals at high-risk for psychosis and review the psychosocial stressors that have been most consistently associated with psychosis risk. We then describe a network of interacting physiological systems that are hypothesised to mediate the relationship between psychosocial stress and the manifestation of psychotic illness and critically review evidence that abnormalities within these systems characterise highrisk populations. We found that studies of high-risk groups have yielded highly variable findings, likely due to (i) the heterogeneity both within and across high-risk samples, (ii) the diversity of psychosocial stressors implicated in psychosis, and (iii) that most studies examine single markers of isolated neurobiological systems. We propose that to move the field forward, we require well-designed, largescale translational studies that integrate multi-domain, putative stress-related biomarkers to determine their prognostic value in high-risk samples. We advocate that such investigations are highly warranted, given that psychosocial stress is undoubtedly a relevant risk factor for psychotic disorders.

摘要

心理社会压力是精神分裂症的一个公认的风险因素,但这种关系的神经生物学机制尚未完全阐明。该领域的大部分研究都调查了下丘脑-垂体-肾上腺(HPA)轴功能和免疫炎症过程在已确诊精神障碍个体中的作用。然而,由于这些研究在提供可用于开发预防干预措施的知识方面能力有限,因此将重点转移到具有更高精神分裂症易感性的个体(即高风险群体)非常重要。在本文中,我们提供了识别高风险精神分裂症个体的当前方法概述,并回顾了与精神分裂症风险最一致相关的心理社会压力源。然后,我们描述了一个相互作用的生理系统网络,该网络假设介导心理社会压力与精神病表现之间的关系,并批判性地回顾了这些系统异常特征高风险人群的证据。我们发现,高风险群体的研究产生了高度可变的结果,这可能是由于(i)高风险样本内和跨样本的异质性,(ii)精神分裂症中涉及的心理社会压力源的多样性,以及(iii)大多数研究只检查了孤立的神经生物学系统的单一标志物。我们提出,为了推动该领域的发展,我们需要进行精心设计的大规模转化研究,整合多领域、假定与应激相关的生物标志物,以确定它们在高风险样本中的预后价值。我们认为,鉴于心理社会压力无疑是精神障碍的一个相关风险因素,因此进行这种调查是非常有必要的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44ed/10845079/fdc5598ed24d/CN-22-350_F1.jpg

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