The role of stress in neurodegenerative
diseases and mental disorders
Tobias
Esch
(1,2)
George
B.
Stefano,
(1,3)
Gregory
L.
Fricchione,
(4)
Herbert
Benson,
(1)
1.
The Mind/ Body Medical Institute, CareGroup and Department
of Medicine, Beth Israel Deaconess Medical Center, Harvard
Medical School, Boston MA 02215, U.S.A.
2. Kliniken Essen-Mitte, Department for Internal and Integrative
Medicine, 45276 Essen, GERMANY
3. Neuroscience Research Institute, State University of New
York at Old Westbury, NY 11568, U.S.A.
4. The Carter Center Mental Health Program, Atlanta GA 30307,
U.S.A.
Keywords:
Stress; Alzheimer's disease; Multiple Sclerosis; Anxiety;
Depression; PTSD; Schizophrenia;
Abstract
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?
METHOD:
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).
DISCUSSION/
CONCLUSION: 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.
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