Hypothalamic-pituitary-adrenocortical axis dysfunction in epilepsy

PHYSIOLOGY & BEHAVIOR

卷:166

Review

Wulsin, Aynara C.^1,2,4,5  Solomon, Matia B.^1,2  Privitera, Michael D.³  Danzer, Steve C.^2,4,5  Herman, James P.^1,2,6 

[1] Univ Cincinnati, Coll Med, Dept Psychiat & Behav Neurosci, Cincinnati, OH USA

[2] Univ Cincinnati, Coll Med, Neurosci Program, Cincinnati, OH USA

[3] Univ Cincinnati, Dept Neurol, Neurosci Inst, Cincinnati, OH USA

[4] Cincinnati Childrens Hosp Med Ctr, Dept Anesthesia, Cincinnati, OH USA

[5] Cincinnati Childrens Hosp Med Ctr, Dept Pediat, Cincinnati, OH 45229 USA

[6] Univ Cincinnati, Dept Psychiat & Behav Neurosci, 2170 E Galbraith Rd Bldg A Room 145, Cincinnati, OH 45237 USA

关键词: Stress;    Temporal lobe epilepsy;    Psychopathologies;    Glucocorticoids;    CRH;   

DOI  :  10.1016/j.physbeh.2016.05.015

来源: Elsevier

【 摘 要 】

Epilepsy is a common neurological disease, affecting 2.4 million people in the US. Among the many different forms of the disease, temporal lobe epilepsy (TLE) is one of the most frequent in adults. Recent studies indicate the presence of a hyperactive hypothalamopituitaiy-adrenocortical (HPA) axis and elevated levels of glucocorticoids in TLE patients. Moreover, in these patients, stress is a commonly reported trigger of seizures, and stress related psychopathologies, including depression and anxiety, are highly prevalent. Elevated glucocorticoids have been implicated in the development of stress-related psychopathologies. Similarly, excess glucocorticoids have been found to increase neuronal excitability, epileptiform activity and seizure susceptibility. Thus, patients with TLE may generate abnormal stress responses that both facilitate ictal discharges and increase vulnerability for the development of comorbid psychopathologies. Here, we will examine the evidence that the HPA axis is disrupted in TLE, consider potential mechanisms by which this might occur, and discuss the implications of HPA dysfunction for seizuretriggering and psychiatric comorbidities. (C) 2016 Elsevier Inc. All rights reserved.

【 授权许可】

Free