Neurobiology of early life stress: clinical studies.
Neurobiology of early life stress: clinical studies.
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DOI：
10.1053/scnp.2002.33127
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发表时间：
2002-04-01
期刊：
影响因子：
--
通讯作者：
Nemeroff, Charles B
中科院分区：
文献类型：
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作者：
Heim, Christine;Nemeroff, Charles B
在过去的几年里，越来越多的临床研究评估了早期发展应激的即刻和长期的神经生物学影响，例如，虐待儿童、忽视或失去父母。本文总结和讨论了神经内分泌(下丘脑-垂体-肾上腺轴，其他神经内分泌轴)、神经化学(儿茶酚胺、5-羟色胺、其他神经递质)、心理生理(自主功能、惊厥反应、脑电活动)和神经影像(脑结构、功能)在有早期生活应激史、有或无精神障碍的儿童或成人中的研究结果。人类早期发育应激似乎与神经生物学改变有关，这些改变与早期生活应激动物模型中的许多发现相似，可能代表了精神病理风险增加的生物学基础。临床研究现在开始探索不同类型的早期生活应激的潜在不同的神经生物学效应，以及可能对特定应激源的神经生物学效应敏感的关键发育期的存在。此外，在确定个体对早期生活应激的神经生物学效应的脆弱性或恢复力方面，应考虑多种调节和中介因素的作用。这类研究的结果可能最终有助于防止现代社会中暴露在早期生活压力下的数量高得令人无法接受的儿童产生有害的神经生物学和精神病理学后果。
A burgeoning number of clinical studies have evaluated the immediate and long-term neurobiological effects of early developmental stress, eg, child abuse and neglect or parental loss, in the past years. This review summarizes and discusses the available findings from neuroendocrine (hypothalamic-pituitary-adrenal axis, other neuroendocrine axes), neurochemical (catecholamines, serotonin, other neurotransmitters), psychophysiological (autonomic function, startle reactivity, brain electrical activity) and neuroimaging studies (brain structure, function) conducted in children or adults with a history of early life stress, with or without psychiatric disorders. Early developmental stress in humans appears to be associated with neurobiological alterations that are similar to many findings in animal models of early life stress, and likely represent the biological basis of an enhanced risk for psychopathology. Clinical studies are now beginning to explore potentially differential neurobiological effects of different types of early life stress and the existence of critical developmental periods, which may be sensitive to the neurobiological effects of specific stressors. In addition, the role of a multitude of moderating and mediating factors in the determination of individual vulnerability or resilience to the neurobiological effects of early life stress should be addressed. Findings from such studies may ultimately help to prevent the deleterious neurobiological and psychopathological consequences in the unacceptably high number of children exposed to early life stress in modern society.