Hypothalamic Dysfunction and Multiple Sclerosis: Implications for Fatigue and Weight Dysregulation.
Hypothalamic Dysfunction and Multiple Sclerosis: Implications for Fatigue and Weight Dysregulation.
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DOI：
10.1007/s11910-016-0700-3
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发表时间：
2016-11
影响因子：
5.6
通讯作者：
Marks DL
中科院分区：
文献类型：
--
作者：
Burfeind KG;Yadav V;Marks DL
多发性硬化症的体征和症状通常归因于脊髓或大脑皮层的脱髓鞘病变。下丘脑是一个经常被忽视的区域，但它控制着许多重要的稳态功能，包括那些在多发性硬化症中受到干扰的功能。在这篇综述中，我们讨论下丘脑功能障碍如何导致多发性硬化症患者的体征和症状。虽然下丘脑-垂体-肾上腺轴功能障碍在多发性硬化症中很常见，但这种功能障碍的影响和机制尚不清楚。我们讨论多发性硬化症中疲劳的三种下丘脑机制：（1）一般下丘脑-垂体-肾上腺轴过度活跃，（2）食欲素神经传递紊乱，（3）皮质醇分泌异常。然后我们回顾了下丘脑功能障碍引起的体重失调的潜在机制。最后，我们提出未来的研究和治疗方法，以更好地理解和治疗多发性硬化症的下丘脑功能障碍。下丘脑功能障碍似乎在多发性硬化症中很常见，但目前的研究力度不足且相互矛盾。未来的研究应该包含更大的样本量并使激素和神经肽测量标准化。
Signs and symptoms of multiple sclerosis are usually attributed to demyelinating lesions in the spinal cord or cerebral cortex. The hypothalamus is a region that is often overlooked yet controls many important homeostatic functions, including those that are perturbed in multiple sclerosis. In this review we discuss how hypothalamic dysfunction may contribute to signs and symptoms in people with multiple sclerosis. While dysfunction of the hypothalamic-pituitary-adrenal axis is common in multiple sclerosis, the effects and mechanisms of this dysfunction are not well understood. We discuss three hypothalamic mechanisms of fatigue in multiple sclerosis: (1) general hypothalamic-pituitary-adrenal axis hyperactivity, (2) disordered orexin neurotransmission, (3) abnormal cortisol secretion. We then review potential mechanisms of weight dysregulation caused by hypothalamic dysfunction. Lastly, we propose future studies and therapeutics to better understand and treat hypothalamic dysfunction in multiple sclerosis. Hypothalamic dysfunction appears to be common in multiple sclerosis, yet current studies are underpowered and contradictory. Future studies should contain larger sample sizes and standardize hormone and neuropeptide measurements.
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DOI：
10.1084/jem.20111020
发表时间：
2011-11-21
期刊：
The Journal of experimental medicine
影响因子：
--
作者：
Braun TP;Zhu X;Szumowski M;Scott GD;Grossberg AJ;Levasseur PR;Graham K;Khan S;Damaraju S;Colmers WF;Baracos VE;Marks DL
通讯作者：
Marks DL
影响因子：
6.6
作者：
Araki, I;Matsui, M;Kuno, S
通讯作者：
Kuno, S
影响因子：
7.3
作者：
Burfeind KG;Michaelis KA;Marks DL
通讯作者：
Marks DL
影响因子：
4.4
作者：
Constantinescu, Cris S.;Niepel, Graham;Ghatei, Mohammad
通讯作者：
Ghatei, Mohammad
影响因子：
--
作者：
CROFFORD, LJ;PILLEMER, SR;WILDER, RL
通讯作者：
WILDER, RL