Stress and the neurotrophic hypothesis
There are relationships between the hypothalamic-pituitary-adrenal (HPA) axis, neurotransmitter systems and some trophic factors on the hippocampal formation integrity in depression, antidepressant treatments and stress.
An alteration of HPA axis regulation in depression could magnify some deleterious effects of stress.
The brain stress systems include HPA axis stress system and extrahypothalamic stress system. HPA axis stress system involves stressful stimuli which increase Corticotrophin-Releasing Factor (CRF), which in turn stimulates adrenocorticotrophic hormone (ACTH) release from the pituitary, which results in enhanced release of glucocorticoids from the adrenal gland.
Extrahypothalamic stress system involves stressful stimuli, which also activate CRF systems in the basal forebrain, notably the bed nucleus of the stria terminalis and the central nucleus of the amygdala, to help mediate behavioural responses to stressors and to mediate sympathetic activation associated with stressors.
Stress can induce neuronal atrophy in some limbic structures, particularly the hippocampus, and a reduced hippocampal volume has been described in depressed clients. Stress and the associated glucocorticoid release decreases neurogenesis in the hippocampus.
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