Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Department of Psychiatry and Forensic Medicine, School of Medicine Bellaterra, Universitat Autònoma de Barcelona, Barcelona, Spain.
Curr Neuropharmacol. 2024;22(5):935-962. doi: 10.2174/1570159X21666230703091435.
Exposure to acute and chronic stress has a broad range of structural effects on the brain. The brain areas commonly targeted in the stress response models include the hippocampus, the amygdala, and the prefrontal cortex. Studies in patients suffering from the so-called stress-related disorders -embracing post-traumatic stress, major depressive and anxiety disorders- have fairly replicated animal models of stress response -particularly the neuroendocrine and the inflammatory models- by finding alterations in different brain areas, even in the early neurodevelopment. Therefore, this narrative review aims to provide an overview of structural neuroimaging findings and to discuss how these studies have contributed to our knowledge of variability in response to stress and the ulterior development of stress-related disorders. There are a gross number of studies available but neuroimaging research of stress-related disorders as a single category is still in its infancy. Although the available studies point at particular brain circuitries involved in stress and emotion regulation, the pathophysiology of these abnormalities -involving genetics, epigenetics and molecular pathways-, their relation to intraindividual stress responses -including personality characteristics, self-perception of stress conditions…-, and their potential involvement as biomarkers in diagnosis, treatment prescription and prognosis are discussed.
急性和慢性应激对大脑有广泛的结构影响。应激反应模型中常见的大脑区域包括海马体、杏仁核和前额叶皮层。在患有所谓应激相关障碍(包括创伤后应激、重度抑郁和焦虑障碍)的患者中进行的研究通过在不同的大脑区域发现改变,甚至在早期神经发育中,相当程度地复制了应激反应的动物模型-特别是神经内分泌和炎症模型。因此,本叙述性综述旨在提供结构神经影像学研究的概述,并讨论这些研究如何促进我们对应激反应变异性和应激相关障碍的发展的了解。有大量的研究可用,但作为单一类别,应激相关障碍的神经影像学研究仍处于起步阶段。尽管现有研究指出了参与应激和情绪调节的特定脑回路,但这些异常的病理生理学(涉及遗传学、表观遗传学和分子途径)、它们与个体内应激反应的关系(包括个性特征、对压力条件的自我感知……),以及它们作为诊断、治疗处方和预后的生物标志物的潜在参与,都在讨论中。