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压力对大脑影响的潜在机制:基本概念与临床意义。

Mechanisms underlying stress effects on the brain: Basic concepts and clinical implications.

作者信息

Saad Hager Adel, Marzouk Mahmoud, Abdelrahman Hla, Moradikor Nasrollah

机构信息

Faculty of Pharmacy and Biotechnology, German University in Cairo, (GUC), New Cairo, Cairo, Egypt.

Faculty of Pharmacy and Biotechnology, German University in Cairo, (GUC), New Cairo, Cairo, Egypt.

出版信息

Prog Brain Res. 2025;291:21-47. doi: 10.1016/bs.pbr.2025.01.008. Epub 2025 Mar 5.


DOI:10.1016/bs.pbr.2025.01.008
PMID:40222781
Abstract

Chronic stress impacts the brain through complex physiological, neurological, and immunological responses. The stress response involves the activation of the sympathetic-adrenal-medullary (SAM) system and the hypothalamic-pituitary-adrenal (HPA) axis, releasing stress hormones like norepinephrine and cortisol. While these responses are adaptive short-term, chronic stress disrupts homeostasis, increasing the risk of cardiovascular diseases, neurodegenerative disorders, and psychiatric conditions such as depression. This dysregulation is linked to persistent neuroinflammation, oxidative stress, and neurotransmitter imbalances involving dopamine and serotonin, impairing neuroplasticity and leading to structural changes in critical brain areas, such as the hippocampus and prefrontal cortex. Moreover, stress affects gene expression, particularly neuroinflammatory pathways, contributing to long-term cognitive function and emotional regulation alterations. Advancements in neuroimaging and molecular techniques, including MRI, PET, and SPECT, hold promise for identifying biomarkers and better understanding stress-induced brain changes. These insights are critical for developing targeted interventions to mitigate the adverse effects of chronic stress on brain health.

摘要

慢性应激通过复杂的生理、神经和免疫反应影响大脑。应激反应涉及交感-肾上腺髓质(SAM)系统和下丘脑-垂体-肾上腺(HPA)轴的激活,释放去甲肾上腺素和皮质醇等应激激素。虽然这些反应在短期内具有适应性,但慢性应激会破坏体内平衡,增加心血管疾病、神经退行性疾病以及抑郁症等精神疾病的风险。这种失调与持续的神经炎症、氧化应激以及涉及多巴胺和血清素的神经递质失衡有关,损害神经可塑性并导致关键脑区(如海马体和前额叶皮质)的结构变化。此外,应激会影响基因表达,尤其是神经炎症途径,导致长期认知功能和情绪调节改变。神经成像和分子技术的进步,包括磁共振成像(MRI)、正电子发射断层扫描(PET)和单光子发射计算机断层扫描(SPECT),有望识别生物标志物并更好地理解应激引起的大脑变化。这些见解对于开发有针对性的干预措施以减轻慢性应激对大脑健康的不利影响至关重要。

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