Raise-Abdullahi Payman, Meamar Morvarid, Vafaei Abbas Ali, Alizadeh Maryam, Dadkhah Masoomeh, Shafia Sakineh, Ghalandari-Shamami Mohadeseh, Naderian Ramtin, Afshin Samaei Seyed, Rashidy-Pour Ali
Research Center of Physiology, Semnan University of Medical Sciences, Semnan, Iran.
Department of Physiology, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran.
Brain Sci. 2023 Jun 29;13(7):1010. doi: 10.3390/brainsci13071010.
Humans have lived in a dynamic environment fraught with potential dangers for thousands of years. While fear and stress were crucial for the survival of our ancestors, today, they are mostly considered harmful factors, threatening both our physical and mental health. Trauma is a highly stressful, often life-threatening event or a series of events, such as sexual assault, war, natural disasters, burns, and car accidents. Trauma can cause pathological metaplasticity, leading to long-lasting behavioral changes and impairing an individual's ability to cope with future challenges. If an individual is vulnerable, a tremendously traumatic event may result in post-traumatic stress disorder (PTSD). The hypothalamus is critical in initiating hormonal responses to stressful stimuli via the hypothalamic-pituitary-adrenal (HPA) axis. Linked to the prefrontal cortex and limbic structures, especially the amygdala and hippocampus, the hypothalamus acts as a central hub, integrating physiological aspects of the stress response. Consequently, the hypothalamic functions have been attributed to the pathophysiology of PTSD. However, apart from the well-known role of the HPA axis, the hypothalamus may also play different roles in the development of PTSD through other pathways, including the hypothalamic-pituitary-thyroid (HPT) and hypothalamic-pituitary-gonadal (HPG) axes, as well as by secreting growth hormone, prolactin, dopamine, and oxytocin. This review aims to summarize the current evidence regarding the neuroendocrine functions of the hypothalamus, which are correlated with the development of PTSD. A better understanding of the role of the hypothalamus in PTSD could help develop better treatments for this debilitating condition.
数千年来，人类一直生活在充满潜在危险的动态环境中。虽然恐惧和压力对我们祖先的生存至关重要，但如今，它们大多被视为有害因素，威胁着我们的身心健康。创伤是一种极具压力、往往危及生命的事件或一系列事件，如性侵犯、战争、自然灾害、烧伤和车祸。创伤会导致病理性可塑性，引发持久的行为变化，并损害个体应对未来挑战的能力。如果个体较为脆弱，一场极其创伤性的事件可能会导致创伤后应激障碍（PTSD）。下丘脑对于通过下丘脑 - 垂体 - 肾上腺（HPA）轴启动对应激刺激的激素反应至关重要。下丘脑与前额叶皮质和边缘结构相连，尤其是杏仁核和海马体，它作为一个中枢枢纽，整合应激反应的生理方面。因此，下丘脑功能被认为与PTSD的病理生理学有关。然而，除了HPA轴的众所周知的作用外，下丘脑还可能通过其他途径在PTSD的发展中发挥不同作用，包括下丘脑 - 垂体 - 甲状腺（HPT）轴和下丘脑 - 垂体 - 性腺（HPG）轴，以及通过分泌生长激素、催乳素、多巴胺和催产素。本综述旨在总结目前关于下丘脑神经内分泌功能的证据，这些功能与PTSD的发展相关。更好地理解下丘脑在PTSD中的作用有助于开发针对这种使人衰弱病症的更好治疗方法。
