Glucocorticoids and hippocampal atrophy in neuropsychiatric disorders.
An extensive literature stretching back decades has shown that prolonged stress or prolonged exposure to glucocorticoids-the adrenal steroids secreted during stress-can have adverse effects on the rodent hippocampus. More recent findings suggest a similar phenomenon in the human hippocampus associated with many neuropsychiatric disorders. This review examines the evidence for hippocampal atrophy in (1) Cushing syndrome, which is characterized by a pathologic oversecretion of glucocorticoids; (2) episodes of repeated and severe major depression, which is often associated with hypersecretion of glucocorticoids; and (3) posttraumatic stress disorder. Key questions that will be examined include whether the hippocampal atrophy arises from the neuropsychiatric disorder, or precedes and predisposes toward it; whether glucocorticoids really are plausible candidates for contributing to the atrophy; and what cellular mechanisms underlie the overall decreases in hippocampal volume. Explicit memory deficits have been demonstrated in Cushing syndrome, depression, and posttraumatic stress disorder; an extensive literature suggests that hippocampal atrophy of the magnitude found in these disorders can give rise to such cognitive deficits.
Sapolsky
R M
RM
Departments of Biological Sciences and Neurological Sciences, Stanford University School, Stanford, CA 94305-5020, USA. sapolsky@leland.stanford.edu
D000328:Adult; D000818:Animals; D003072:Cognition Disorders / Q000175:diagnosis / Q000503:physiopathology; D003480:Cushing Syndrome / Q000175:diagnosis* / Q000503:physiopathology; D003712:Dendrites / Q000502:physiology; D003866:Depressive Disorder / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D005938:Glucocorticoids / Q000502:physiology*; D006624:Hippocampus / Q000033:anatomy & histology* / Q000502:physiology / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D009474:Neurons / Q000502:physiology; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000503:physiopathology*
D005938:Glucocorticoids