The role of stress in neurodegenerative diseases and mental disorders.
OBJECTIVE
Evidence for a connection between stress and selected neurodegenerative diseases as well as mental disorders is analyzed. Does stress cause or exacerbate related pathophysiological disease processes?


METHODS
The stress phenomenon is illustrated and the impact of stress on the nervous system, neurodegenerative diseases, and mental disorders is examined. The connection between stress and the hippocampus - and its association with memory functions - is described. In particular, the pathophysiological significance of stress in Alzheimer's disease, multiple sclerosis, anxiety, depression, posttraumatic stress disorder, and schizophrenia is investigated.


RESULTS
Stress plays a major role in various (patho)physiological processes associated with neurodegenerative diseases and mental disorders. In principle, stress has the potency to exert either ameliorating or detrimental effects. The specific outcome depends on multiple variables. However, the amount of stress experienced in relation to activated physiological processes that aim at successful coping and positive adjustments (i.e., stress response) most often is overwhelming - and may thus become detrimental in the long-term. Moreover, the hippocampus is sensitive to stress, and its involvement in neurodegeneration - in the course of stress-related disease processes - may account for severe clinical disabilities (e.g., memory loss).


CONCLUSIONS
Stress has a major impact upon neurodegenerative diseases and mental disorders. It plays a significant role in susceptibility, progress, and actual outcome. Also, subjective or individual differences have to be taken into account. However, stress - especially 'adequate' acute stress (stress that is not overwhelming) - may even improve performance/biological functions and be beneficial in certain cases.
Esch
Tobias
T
The Mind/Body Medical Institute, CareGroup and Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston MA 02215, USA. tesch@caregroup.harvard.edu
Stefano
George B
GB
Fricchione
Gregory L
GL
Benson
Herbert
H
D006801:Humans; D001523:Mental Disorders / Q000150:complications / Q000503:physiopathology*; D019636:Neurodegenerative Diseases / Q000150:complications / Q000503:physiopathology*; D013312:Stress, Physiological / Q000150:complications / Q000503:physiopathology*