Herman J P, Cullinan W E
Dept of Anatomy and Neurobiology, University of Kentucky Medical Center, Lexington 40536-0084, USA.
Trends Neurosci. 1997 Feb;20(2):78-84. doi: 10.1016/s0166-2236(96)10069-2.
Integration of the hypothalamo-pituitary-adrenal stress response occurs by way of interactions between stress-sensitive brain circuitry and neuroendocrine neurons of the hypothalamic paraventricular nucleus (PVN). Stressors involving an immediate physiologic threat ('systemic' stressors) are relayed directly to the PVN, probably via brainstem catecholaminergic projections. By contrast, stressors requiring interpretation by higher brain structures ('processive' stressors) appear to be channeled through limbic forebrain circuits. Forebrain limbic sites connect with the PVN via interactions with GABA-containing neurons in the bed nucleus of the stria terminalis, preoptic area and hypothalamus. Thus, final elaboration of processive stress responses is likely to involve modulation of PVN GABAergic tone. The functional and neuroanatomical data obtained suggest that disease processes involving inappropriate stress control involve dysfunction of processive stress pathways.
下丘脑 - 垂体 - 肾上腺应激反应的整合是通过应激敏感脑回路与下丘脑室旁核（PVN）的神经内分泌神经元之间的相互作用实现的。涉及直接生理威胁的应激源（“全身性”应激源）可能通过脑干儿茶酚胺能投射直接传递至PVN。相比之下，需要更高脑结构进行解读的应激源（“渐进性”应激源）似乎是通过边缘前脑回路传导的。前脑边缘部位通过与终纹床核、视前区和下丘脑含γ-氨基丁酸（GABA）的神经元相互作用与PVN相连。因此，渐进性应激反应的最终细化可能涉及PVN GABA能张力的调节。所获得的功能和神经解剖学数据表明，涉及不适当应激控制的疾病过程与渐进性应激通路功能障碍有关。
