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Hypothalamic-pituitary-adrenal axis targets for the treatment of epilepsy
- Source :
- Neuroscience letters. 746
- Publication Year :
- 2020
-
Abstract
- Stress is a common seizure trigger in persons with epilepsy. The body's physiological response to stress is mediated by the hypothalamic-pituitary-adrenal (HPA) axis and involves a hormonal cascade that includes corticotropin releasing hormone (CRH), adrenocorticotropin releasing hormone (ACTH) and the release of cortisol (in humans and primates) or corticosterone (in rodents). The prolonged exposure to stress hormones may not only exacerbate pre-existing medical conditions including epilepsy, but may also increase the predisposition to psychiatric comorbidities. Hyperactivity of the HPA axis negatively impacts the structure and function of the temporal lobe of the brain, a region that is heavily involved in epilepsy and mood disorders like anxiety and depression. Seizures themselves damage temporal lobe structures, further disinhibiting the HPA axis, setting off a vicious cycle of neuronal damage and increasing susceptibility for subsequent seizures and psychiatric comorbidity. Treatments targeting the HPA axis may be beneficial both for epilepsy and for associated stress-related comorbidities such as anxiety or depression. This paper will highlight the evidence demonstrating dysfunction in the HPA axis associated with epilepsy which may contribute to the comorbidity of psychiatric disorders and epilepsy, and propose treatment strategies that may dually improve seizure control as well as alleviate stress related psychiatric comorbidities.
- Subjects :
- 0301 basic medicine
endocrine system
medicine.medical_specialty
Hypothalamo-Hypophyseal System
Pituitary-Adrenal System
Temporal lobe
03 medical and health sciences
Epilepsy
chemistry.chemical_compound
Corticotropin-releasing hormone
0302 clinical medicine
Adrenocorticotropic Hormone
Corticosterone
Internal medicine
medicine
Animals
Humans
Desoxycorticosterone
Depression (differential diagnoses)
business.industry
General Neuroscience
Mental Disorders
medicine.disease
030104 developmental biology
Endocrinology
medicine.anatomical_structure
Treatment Outcome
chemistry
Mood disorders
Anxiety
Anticonvulsants
medicine.symptom
business
hormones, hormone substitutes, and hormone antagonists
030217 neurology & neurosurgery
Hypothalamic–pituitary–adrenal axis
Subjects
Details
- ISSN :
- 18727972
- Volume :
- 746
- Database :
- OpenAIRE
- Journal :
- Neuroscience letters
- Accession number :
- edsair.doi.dedup.....f3568279c4069527c335f8dea394abbe