The stress-reaction process and the adaptive modification and reorganization of neuronal networks

Cortisol and psychological responses to natural disasters

Natural disasters are an increasing global health issue. Psychological outcomes from traumatic experiences appear linked to the glucocorticoid hormone cortisol. Here we analyze relations among salivary cortisol, traumatic events, and mental health from a 37-year study of a rural community in Dominica. The community has experienced multiple natural disasters. Our investigations of physiological responses to these traumatic experiences and downstream mental health outcomes are exploratory in nature because this research area is in early stages of methodological and theoretical development, and we are applying current biomedical and psychiatric concepts in a non-western culture. Our analyses suggest that temporal profiles of cortisol response are linked to mental health conditions associated with natural disasters including grief, depression, and post-traumatic stress disorders.

COVID-19 Pandemic Impacts on STRESS, PTSD, and Prefrontal Cortical Thickness in Pre-Pandemic Trauma Survivors

Background/Objectives: The COVID-19 pandemic increased psychiatric symptoms in patients with pre-pandemic mental health conditions. However, the effects of pandemic on the brain, stress, and mental illness remain largely conjectural. Our objective was to examine how the pandemic affected prefrontal cortical thicknesses (CTs), stress, and PTSD symptoms in people with pre-pandemic trauma histories. Methods: Fifty-one survivors from a pre-pandemic trauma study who had completed a pre-pandemic PTSD Checklist-5 (PCL) to assess PTSD symptoms and a sMRI scan to measure prefrontal CTs were re-recruited after the pandemic. They subsequently completed the COVID Stress Scale (CSS) to assess stress, the Clinician Administered PTSD Scale-5 (CAPS) to diagnose PTSD, and a second sMRI scan. COVID-19 infection was self-reported. Associations between stress and symptom assessments and post-pandemic CTs, differences in CTs in PTSD vs. non-PTSD groups, and changes in pre- to post-pandemic CTs were examined. Results: Pre-pandemic PCL scores were positively associated with CSS scores which, in turn, were higher in the PTSD group. Thicker IFG-opercularis CTs were associated with COVID-19 infection. Post-pandemic rMFG and IFG-orbitalis CTs were positively associated with CAPS scores. rACC CTs were negatively associated with CSS scores. Pre- to post-pandemic rMFG and frontal pole CTs thickened in the PTSD group but thinned in the non-PTSD group, whereas rACC CTs thinned in the PTSD group but thickened in the non-PTSD group. Conclusions: These findings provide novel evidence that the COVID-19 pandemic had diverse effects involving prefrontal cortex structure, stress, and PTSD symptoms in subjects with pre-pandemic trauma history and suggest that treatments are needed to counter these diverse effects.

Repetitive and Inflexible Active Coping and Addiction-like Neuroplasticity in Stressed Mice of a Helplessness-Resistant Inbred Strain

Dysfunctional coping styles are involved in the development, persistence, and relapse of psychiatric diseases. Passive coping with stress challenges (helplessness) is most commonly used in animal models of dysfunctional coping, although active coping strategies are associated with generalized anxiety disorder, social anxiety disorder, panic, and phobias as well as obsessive-compulsive and post-traumatic stress disorder. This paper analyzes the development of dysfunctional active coping strategies of mice of the helplessness–resistant DBA/2J (D2) inbred strain, submitted to temporary reduction in food availability in an uncontrollable and unavoidable condition. The results indicate that food-restricted D2 mice developed a stereotyped form of food anticipatory activity and dysfunctional reactive coping in novel aversive contexts and acquired inflexible and perseverant escape strategies in novel stressful situations. The evaluation of FosB/DeltaFosB immunostaining in different brain areas of food-restricted D2 mice revealed a pattern of expression typically associated with behavioral sensitization to addictive drugs and compulsivity. These results support the conclusion that an active coping style represents an endophenotype of mental disturbances characterized by perseverant and inflexible behavior.

Cannabis use and posttraumatic stress disorder comorbidity: Epidemiology, biology and the potential for novel treatment approaches

Cannabis use is increasing among some demographics in the United States and is tightly linked to anxiety, trauma, and stress reactivity at the epidemiological and biological level. Stress-coping motives are highly cited reasons for cannabis use. However, with increased cannabis use comes the increased susceptibility for cannabis use disorder (CUD). Indeed, CUD is highly comorbid with posttraumatic stress disorder (PTSD). Importantly, endogenous cannabinoid signaling systems play a key role in the regulation of stress reactivity and anxiety regulation, and preclinical data suggest deficiencies in this signaling system could contribute to the development of stress-related psychopathology. Furthermore, endocannabinoid deficiency states, either pre-existing or induced by trauma exposure, could provide explanatory insights into the high rates of comorbid cannabis use in patients with PTSD. Here we review clinical and preclinical literature related to the cannabis use-PTSD comorbidity, the role of endocannabinoids in the regulation of stress reactivity, and potential therapeutic implications of recent work in this area.

Physical Stress Induced Reduction of Proliferating Cells and Differentiated Neuroblasts Is Ameliorated by Fermented Laminaria japonica Extract Treatment

Laminaria japonica is widely cultivated in East Asia, including South Korea. Fucoidan, a main component of L. japonica, protects neurons from neurological disorders such as ischemia and traumatic brain injury. In the present study, we examined the effects of extract from fermented L. japonica on the reduction of proliferating cells and neuroblasts in mice that were physically (with electric food shock) or psychologically (with visual, auditory and olfactory sensation) stressed with the help of a communication box. Vehicle (distilled water) or fermented L. japonica extract (50 mg/kg) were orally administered to the mice once a day for 21 days. On the 19th day of the treatment, physical and psychological stress was induced by foot shock using a communication box and thereafter for three days. Plasma corticosterone levels were significantly increased after exposure to physical stress and decreased Ki67 positive proliferating cells and doublecortin immunoreactive neuroblasts. In addition, western blot analysis demonstrated that physical stress as well as psychological stress decreased the expression levels of brain-derived neurotrophic factor (BDNF) and the number of phosphorylated cAMP response element binding protein (pCREB) positive nuclei in the dentate gyrus. Fermentation of L. japonica extract significantly increased the contents of reduced sugar and phenolic compounds. Supplementation with fermented L. japonica extract significantly ameliorated the increases of plasma corticosterone revels and decline in the proliferating cells, neuroblasts, and expression of BDNF and pCREB in the physically stressed mice. These results indicate that fermented L. japonica extract has positive effects in ameliorating the physical stress induced reduction in neurogenesis by modulating BDNF and pCREB expression in the dentate gyrus.

The effect of stress-induced cortisol increase on the sense of ankle proprioception

Objectives

The aim of this study is to analyze the effect of stress-induced cortisol increase on the sense of ankle proprioception.

Patients and methods

Between April 2016 and May 2016, a total of 60 students (30 males, 30 females; mean age: 19.2±1.5 years; range, 19 to 20 years) from İnönü University, Faculty of Medicine, Department of Freshmen were included in the study. Separate measurements were made for the right and left ankle to make ankle proprioception measurements a month before the committee exam during their relaxed period using a device designed with digital inclinometer. The sense of ankle proprioception was measured at 10° dorsiflexion (DF), 11° plantar flexion (PF), and 25° PF angles with open eyes and closed eyes using active reproduction test. Salivary samples were taken for stress assessment and State Trait Anxiety Inventory-I (STAI-I) was conducted. The same tests were repeated on the day of committee exam.

Results

Test results showed no statistically significant difference between the right and left ankle proprioception measurements of 10° DF, 11° PF, and 25° PF angles with open eyes (p>0.05). However, a statistically significant difference was found between the right and left ankle proprioception scores at the same angles with closed eyes (p<0.05). According to the Wilcoxon analysis conducted for the comparison of the relaxed and stressed periods of cortisol and STAI-I inventory, a statistically significant difference was found (p<0.05). The Spearman's Rho analysis showed no significant correlation between the right and left ankle proprioception scores and cortisol and STAI-I with open eyes, while there was a statistically significantly positive direction and low correlation between the same angles with closed eyes.

Conclusion

Our study results show that the increase in the stress-related cortisol is negative for the ankle proprioception sense.

Effect of increase in cortisol level due to stress in healthy young individuals on dynamic and static balance scores

OBJECTIVE:

Stress is a condition caused by various factors and characterized by imbalance in body functioning, impair in nervous system, and tension. The purpose of this study was to examine the effects of cortisol level, which increases in healthy young individuals due to stress, on dynamic and static balance scores as well as to present the results caused by high levels of stress.

METHODS:

In this study, 107 healthy medicine faculty students in their second year (who will take the same committee exam) aged between 19 and 23 years were included. The first balance measurements and saliva samples were taken 40 days before the committee exam, and this period was acknowledged as the relaxed period. The same students were considered for balance measurements again on the day of committee exam; saliva samples were collected, and cortisol concentration was determined. This period was acknowledged as the stressful period. The State-Trait Anxiety Inventory (STAI) was given to the participants in their relaxed and stressful periods. Dynamic balance scores were measured with Star Excursion Balance Test (SEBT). Static balance scores were measured with One Leg Standing Balance Test (OLSBT).

RESULTS:

The mean cortisol level was found to increase approximately 9 times in stressful periods compared with that in relaxed periods. STAI, which shows state anxiety, showed an increase supporting this increase. In stressful periods, dynamic balance scores showed obvious decrease in all directions. In addition, in stressful periods, an obvious decrease was observed in static balance scores compared with those in relaxed periods.

CONCLUSION:

This study showed that stress negatively affected dynamic and static balance, even for short periods of time. We believe that our study will form a positive source and basis when correlated with long terms stress and balance measurements.

The lateral habenula interacts with the hypothalamo-pituitary adrenal axis response upon stressful cognitive demand in rats

The lateral habenula (LHb) is involved in emotional and cognitive behaviors. Recently, we have shown in rats that blockade of excitatory inputs to the LHb not only induced deficits of memory retrieval in the water maze, but also altered swim strategies (i.e., induced excessive thigmotaxis). The latter observation, although consistent with the occurrence of memory deficits, could also possibly be the consequence of an excessive level of stress, further suggesting a role for the LHb in the stress response in our behavioral paradigm. To test this hypothesis we performed in rats intra-LHb infusion of 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX, 267 ng/side in 0.3 μL), or vehicle, and assessed the responsiveness of the hypothalamo-pituitary adrenal (HPA) axis to environmental stressful or non-stressful situations. We have measured plasma corticosterone (CORT) concentrations at different time points before and following intra-LHb infusion of CNQX - or of the same volume of vehicle - in three conditions: during the probe test of a water maze experiment; in an anxiety test, the elevated plus maze; and in a home cage condition. Whereas there were no differences in the home cage condition and in the elevated plus maze, in the water maze experiment we observed that CNQX-treated rats presented, along with memory deficits, a higher level of blood CORT than vehicle-treated rats. These results suggest that perturbations of the modulation of the HPA axis are consecutive to the alteration of LHb function, whether it is the result of a defective direct control of the LHb over the HPA axis, or the consequence of memory deficits.

Attending, learning, and socioeconomic disadvantage: developmental cognitive and social neuroscience of resilience and vulnerability

We review current findings associating socioeconomic status (SES), development of neurocognitive functions, and neurobiological pathways. A sizeable interdisciplinary literature was organized through a bifurcated developmental trajectory (BiDeT) framework, an account of the external and internal variables associated with low SES that may lead to difficulties with attention and learning, along with buffers that may protect against negative outcomes. A consistent neurocognitive finding is that low-SES children attend to information nonselectively, and engage in late filtering out of task-irrelevant information. Attentional preferences influence the development of latent inhibition (LI), an aspect of learning that involves reassigning meaningful associations to previously learned but irrelevant stimuli. LI reflects learning processes clarifying the relationship between neurobiological mechanisms related to attention and socioeconomic disadvantage during child development. Notably, changes in both selective attention and typical LI development may occur via the mesocorticolimbic dopamine (MsCL-DA) system. Chaotic environments, social isolation, and deprivation associated with low SES trigger stress responses implicating imbalances in the MsCL-DA and consolidating anxiety traits. BiDeT describes plausible interactions between socioemotional traits and low-SES environments that modify selective attention and LI, predisposing individuals to vulnerability in cognitive development and academic achievement. However, positive role models, parental style, and self-regulation training are proposed as potential promoters of resilience.

Serotonin and stress coping

Coping is the necessary outcome of any stressful situation and the major determinant of stress resilience. Coping strategies can be divided into two broad categories, based on the presence (active) or absence (passive) of attempts to act upon the stressor. The role of brain serotonin (5-hydroxytryptamine, 5-HT) in coping behavior that is emerging from studies in animals and humans is the subject of this article. We have focused attention on studies that consider the coping behavior exhibited when the individual is faced with a new stressful experience. Coping styles characterize different species with different evolutionary histories, from fishes to mammals, and evidence shows that serotonin transmission in the central nervous system, with differences in transporter, receptor types and hormone or neurotransmitter influences is critical in determining coping behavior. Moreover, a major role of environmental challenges throughout the lifespan affects brain systems that control coping outcomes through 5-HT transmission. In particular early experiences, for their long-term effects in adulthood, and social experiences throughout the life span, for the effects on serotonin functioning, received attention in preclinical research because of their parallelism in humans and animals. Based on growing evidence pointing to a medial prefrontal cortex-amygdala system in mediating adaptive and maladaptive stress responses, we propose a brain circuit in which serotonin neurons in the dorsal raphe depending on the CRF (corticotropin releasing factor) regulatory action engage a prefrontal cortical-amygdala pathway through 5-HT1A receptors, GABA and Glutamate to moderate coping behavior.

Corticolimbic catecholamines in stress: a computational model of the appraisal of controllability

Appraisal of a stressful situation and the possibility to control or avoid it is thought to involve frontal-cortical mechanisms. The precise mechanism underlying this appraisal and its translation into effective stress coping (the regulation of physiological and behavioural responses) are poorly understood. Here, we propose a computational model which involves tuning motivational arousal to the appraised stressing condition. The model provides a causal explanation of the shift from active to passive coping strategies, i.e. from a condition characterised by high motivational arousal, required to deal with a situation appraised as stressful, to a condition characterised by emotional and motivational withdrawal, required when the stressful situation is appraised as uncontrollable/unavoidable. The model is motivated by results acquired via microdialysis recordings in rats and highlights the presence of two competing circuits dominated by different areas of the ventromedial prefrontal cortex: these are shown having opposite effects on several subcortical areas, affecting dopamine outflow in the striatum, and therefore controlling motivation. We start by reviewing published data supporting structure and functioning of the neural model and present the computational model itself with its essential neural mechanisms. Finally, we show the results of a new experiment, involving the condition of repeated inescapable stress, which validate most of the model's predictions.

Stress system dynamics during "life as it is lived": an integrative single-case study on a healthy woman

Little is known about the dynamic characteristics of stress system activity during "life as it is lived". Using as representative a study design as possible, this investigation sought to gain insights into this area. A healthy 25-year-old woman collected her entire urine over a period of 63 days in 12-h intervals (126 measurements) to determine cortisol and neopterin (immune activation marker) levels. In addition, she filled out questionnaires on emotional state and daily routine in 12-h intervals, and was interviewed weekly to identify emotionally negative and positive everyday incidents. Adjusted cross-correlational analyses revealed that stressful incidents were associated with cyclic response patterns in both urinary cortisol and urinary neopterin concentrations. Urinary cortisol levels first decreased 12-24 h after stressful incidents occurred (lag 1: -.178; p = 0.048) and then increased a total of 72-84 h later (lag 6: +.224; p = 0.013). Urinary neopterin levels first increased 0-12 h before the occurrence of stressful incidents (-lag 1: +.185; p = 0.040) and then decreased a total of 48-60 h following such stressors (lag 4: -.181; p = 0.044). Decreases in urinary neopterin levels were also found 24-36 and 48-60 h after increases in pensiveness (lag 2: -.215; p = 0.017) and depressiveness (lag 4: -.221; p = 0.014), respectively. Findings on emotionally positive incidents sharply contrasted with those dealing with negative experiences. Positive incidents were followed first by urinary cortisol concentration increases within 12 h (lag 0: +.290; p = 0.001) and then by decreases after a total of 60-72 h (lag 5: -.186; p = 0.039). Urinary neopterin levels first decreased 12-24 h before positive incidents occurred (-lag 2: -.233; p = 0.010) and then increased a total of 12-24 h following these incidents (lag 1: +.222; p = 0.014). As with previous investigations on patients with systemic lupus erythematosus (SLE), this study showed that stress system response can be considerably longer and more complex and differentiated than findings from conventional group studies have suggested. Further integrative single-case studies will need to be conducted in order to draw firm conclusions about stress system dynamics under real-life conditions.

Identifying key features of early stressful experiences that produce stress vulnerability and resilience in primates

This article examines the complex role of early stressful experiences in producing both vulnerability and resilience to later stress-related psychopathology in a variety of primate models of human development. Two types of models are reviewed: Parental Separation Models (e.g., isolate-rearing, peer-rearing, parental separations, and stress inoculation) and Maternal Behavior Models (e.g., foraging demands, variation in maternal style, and maternal abuse). Based on empirical evidence, it is argued that early life stress exposure does not increase adult vulnerability to stress-related psychopathology as a linear function, as is generally believed, but instead reflects a quadratic function. Features of early stress exposure including the type, duration, frequency, ecological validity, sensory modality, and developmental timing, within and between species, are identified to better understand how early stressful experiences alter neurobiological systems to produce such diverse developmental outcomes. This article concludes by identifying gaps in our current knowledge, providing directions for future research, and discussing the translational implications of these primate models for human development and psychopathology.

The mesoaccumbens dopamine in coping with stress

Mesoaccumbens dopamine (DA) is involved in the stress response. Although neural mechanisms involved in stress are of paramount importance for both clinical and preclinical research, the results of studies on the stress response by mesoaccumbens DA have received little attention. Therefore, we aimed to review these results and propose a role for mesoaccumbens DA in coping with stress. The data reviewed support the view that fluctuations of tonic levels characterize the mesoaccumbens DA stress response. Stress-induced increase of tonic DA levels in nucleus accumbens (NAc) supports expression of responses aimed at removing and avoiding the stressor through activation of DA D2 receptors, whereas inhibition of DA is associated with cessation of active defensive responses. In novel unescapable/uncontrollable stressful conditions tonic levels of DA in NAc show an initial increase followed by a decrease below pre-stress levels that lasts as long as the stressful situation. This biphasic response fits with the dynamics of the primary and secondary appraisal of a stressor that cannot be removed, escaped or controlled by the organism. In fact, NAc DA fluctuations are controlled by the medial pre-frontal cortex, which is involved in stress appraisal. We propose that enhanced mesoaccumbens DA supports expression of active coping strategies against an event appraised as a stressor and that inhibition of DA is required for passive coping with stressful situations appraised as unescapable/uncontrollable.

Evolutionary functions of early social modulation of hypothalamic-pituitary-adrenal axis development in humans

The hypothalamic-pituitary-adrenal axis (HPAA) is highly responsive to social challenges. Because stress hormones can have negative developmental and health consequences, this presents an evolutionary paradox: Why would natural selection have favored mechanisms that elevate stress hormone levels in response to psychosocial stimuli? Here we review the hypothesis that large brains, an extended childhood and intensive family care in humans are adaptations resulting from selective forces exerted by the increasingly complex and dynamic social and cultural environment that co-evolved with these traits. Variations in the modulation of stress responses mediated by specific HPAA characteristics (e.g., baseline cortisol levels, and changes in cortisol levels in response to challenges) are viewed as phenotypically plastic, ontogenetic responses to specific environmental signals. From this perspective, we discuss relations between physiological stress responses and life history trajectories, particularly the development of social competencies. We present brief summaries of data on hormones, indicators of morbidity and social environments from our long-term, naturalistic studies in both Guatemala and Dominica. Results indicate that difficult family environments and traumatic social events are associated with temporal elevations of cortisol, suppressed reproductive functioning and elevated morbidity. The long-term effects of traumatic early experiences on cortisol profiles are complex and indicate domain-specific effects, with normal recovery from physical stressors, but some heightened response to negative-affect social challenges. We consider these results to be consistent with the hypothesis that developmental programming of the HPAA and other neuroendocrine systems associated with stress responses may facilitate cognitive targeting of salient social challenges in specific environments.

Repeated ferret odor exposure induces different temporal patterns of same-stressor habituation and novel-stressor sensitization in both hypothalamic-pituitary-adrenal axis activity and forebrain c-fos expression in the rat

Repeated exposure to a moderately intense stressor typically produces attenuation of the hypothalamic-pituitary-adrenal (HPA) axis response (habituation) on re-presentation of the same stressor; however, if a novel stressor is presented to the same animals, the HPA axis response may be augmented (sensitization). The extent to which this adaptation is also evident within neural activity patterns is unknown. This study tested whether repeated ferret odor (FO) exposure, a moderately intense psychological stressor for rats, leads to both same-stressor habituation and novel-stressor sensitization of the HPA axis response and neuronal activity as determined by immediate early gene induction (c-fos mRNA). Rats were presented with FO in their home cages for 30 min a day for up to 2 wk and subsequently challenged with FO or restraint. Rats displayed HPA axis activity habituation and widespread habituation of c-fos mRNA expression (in situ hybridization) throughout the brain in as few as three repeated presentations of FO. However, repeated FO exposure led to a more gradual development of sensitized HPA-axis and c-fos mRNA responses to restraint that were not fully evident until after 14 d of prior FO exposure. The sensitized response was evident in many of the same brain regions that displayed habituation, including primary sensory cortices and the prefrontal cortex. The shared spatial expression but distinct temporal development of habituation and sensitization neural response patterns suggests two independent processes with opposing influences across overlapping brain systems.

Mind over matter:

Zusammenfassung. Theoretischer Hintergrund: Neuere Befunde zeigen, dass psychobiologische Prozesse an der Entstehung emotionaler Prozesse beteiligt sind, wobei dysfunktionale Reaktionen neuroendokriner Systeme als mögliche biologische Korrelate psychischer Störungen diskutiert werden. Unklar ist, ob effektive psychotherapeutische Maßnahmen, wie z.B. Expositionstherapie bei Phobien, nicht nur auf Symptomebene, sondern auch physiologische Prozesse beeinflusst. Fragestellung: Hat eine erfolgreiche kognitiv-verhaltenstherapeutische Intervention (Wiederholte Exposition bei Spinnenängstlichen) Auswirkungen auf biologische Parameter und welche Rolle spielen dabei kognitive Prozesse? Methoden: Psychologischen (Bewertung, Angst) und biologischen Reaktionen (Cortisol und Herzrate) von fünfzehn Spinnenängstliche und fünfzehn gesunde Kontrollpersonen wurden während einer Spinnenexposition verglichen. Zusätzlich wurden bei Spinnenängstlichen Veränderungen dieser Parameter über den Verlauf von drei Expositionsterminen erfasst. Ergebnisse: Im Vergleich zu Kontrollpersonen zeigten Spinnenängstliche erhöhte biologische und emotionale Reaktion in der Exposition, welche sich im Verlauf der weiteren Expositionen normalisierten. Das Ausmaß dieser Veränderungen stand im Zusammenhang mit dem Ausmaß der Veränderungen der Bewertungsprozesse. Diskussion: Die Ergebnisse der Untersuchung zeigen, dass erfolgreiche Psychotherapie (auch) biologische Konsequenzen, im Sinne einer Normalisierung der kardiovaskulären und der endokrinen Stressreaktion, hat. Auf dem Hintergrund der physiologischen Bedeutung dieser Reaktionssysteme stellen diese physiologischen Effekte mögliche Voraussetzungen von Neulernen im Sinne einer neuronaler Reorganisation dar.

Estresse, depressão e hipocampo

A exposição a fatores estressantes tem papel importante no desenvolvimento de transtornos depressivos. Os mecanismos envolvidos nesta relação, no entanto, ainda são pouco conhecidos, mas algumas evidências sugerem a participação da formação hipocampal: 1. o estresse pode causar alterações plásticas no hipocampo, que incluem remodelação dendrítica e inibição de neurogênese. Drogas antidepressivas impendem estes efeitos, possivelmente por aumentarem a expressão de fatores neurotróficos; 2. a facilitação da neurotransmissão serotoninérgica no hipocampo atenua conseqüências comportamentais do estresse e produz efeitos antidepressivos em modelos animais; 3. o antagonismo do principal neurotransmissor excitatório no hipocampo, o glutamato, produz efeitos semelhantes; 4. o hipocampo parece estar "hiperativo" em animais mais sensíveis em modelos de depressão e em humanos resistentes à antidepressivos; 5. o hipocampo, em conjunto com o complexo amigdalar, parece ter papel fundamental na consolidação e evocação de memórias aversivas. Não obstante estas evidências, o desafio futuro será o de tentar integrar os resultados destes diferentes campos (farmacológico, molecular, eletrofisiológico, clínico) em uma teoria unificadora sobre o papel do hipocampo na regulação do humor e seus transtornos bem como nos efeitos de tratamentos antidepressivos.

Neurocognitive functioning in subjects with eating disorders: the influence of neuroactive steroids

BACKGROUND

Neuropsychological studies in subjects with eating disorders (EDs) have reported conflicting findings, which might be accounted for by several confounding variables, including neuroendocrine changes.

METHODS

General abilities, executive functions, attention, and noneffortful learning were assessed in 45 patients with EDs and 45 healthy comparison subjects (HCS). Plasma levels of 17beta-estradiol, cortisol, allopregnanolone, dehydroepiandrosterone and its sulfate metabolite (DHEA and DHEAS) were evaluated in a subsample of patients and HCS. The influence of clinical, demographic, and neuroendocrine variables on neurocognitive performance was explored.

RESULTS

Patients were slower than HCS on noneffortful learning and more accurate on a spatial executive task. DHEA and DHEAS were increased and positively correlated with accuracy on the executive task, while cortisol positively correlated with speed of noneffortful learning.

CONCLUSIONS

A subtle impairment of noneffortful learning is the only neuropsychological deficit in patients with EDs. Changes in neuroactive steroids influence neurocognitive performance.