Korean Journal of Family Medicine (가정의학회지)

The Korean Academy of Family Medicine (대한가정의학회)
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Understanding Stress by Neuroscience

스트레스의 두뇌 과학적 이해

Yoon, Su-Jung;Kim, Tae-Suk;Chae, Jeong-Ho
윤수정;김태석;채정호

  • Published : 20050800
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Abstract

Stress can be defined generally as reponses to stressors on the body or in a definition more focused on the central nervous system, it can be defined as alterations in neuro-psychological homeostatic processes. There is a psychological aspect to stress, related to issues such as memory, emotion, arousal, and also a biological aspect which included activation of specific brain and endocrine circuits. This article reviews a series of neurobiological mechanisms aimed at understanding what are pathways by which stress is perceived, processed, and transduced into a neuroendocrine response. Multiple brain structures are involved in the organization of responses to stressful stimuli. Among them the hypothalamus, septohippocampal structures, amygdala, cingulate and prefrontal cortices, hindbrain regions such as the brainstem catecholamine cell body group (A2/C2 cell groups in the nucleus of the tractus solitaris; A1/C1 cell groups in the ventrolateral medulla; A6 cell groups in the locus ceruleus), the parabrachial nucleus, cuneiform nucleus, and dorsal raphe nucleus are prominent structures. We reviewed with the focus on the classic stress circuits: the limbichypothalamic-pituitary- adrenal axis (LHPA) and locus ceruleus-norepinephrine (LC-NE) system. Our review indicates that the LHPA stress circuit and LC- NE system are the complex systems with multiple control mechanisms and that these mechanisms are altered in pathological states, such as chronic stress and depression. The holistic features described in this reviews can provide insight into the nature and location of brain circuits and neurotransmitter receptors involved in stress and the treatment of stress-related disorders.

개체가 '스트레스 인자(stressor)'에 노출되면 일련의 스트레스 반응이 일어난다. 뇌하수체-부신 축 활성화를 포함하여 내분비계, 자율신경계, 면역계 등의 생리적 변화가 일어나며, 심리적 측면으로 각성수준, 기억, 정서 등이 다양하게 변화한다. 이러한 기저에는 두뇌의 변화가 가장 중심적인 역할을 한다. 본 논문에서는 이러한 스트레스의 행동적, 생리학적 반응을 매개하는 주요 조절자 역할을 하는 두뇌의 변화를 뇌신경과학적 측면에서 고찰하고자 한다. 스트레스 반응에는 시상하부(hypothalamus), 중격-해마 시스템(septohippocamplal system), 편도(amygdala), 대상회 및 전전두엽 피질(cingulate and prefrontal cortex) 등의 전뇌(forebrain) 부위와 뇌간 카테콜라민 세포군(brainstem catecholamine cell body group; nucleus of the tractus solitaris의 A2/C2 세포군, ventrolateral medulla의 A1/C1 세포군, locus coeruleus의 A6 세포군), 방완핵(parabrachial nucleus), 설상핵(cuneiform nucleus), 배측 봉선핵(dorsal raphe nucleus) 등 매우 다양한 뇌 부위가 관여한다. 이러한 뇌의 여러 영역의 활성 변화를 크게 변연계-시상하부-뇌하수체-부신 축(limbic-hypothalamic-pituitary-adrenal axis, LHPA)과 청반-노르에피네프린/자율신경계 (locus ceruleus-norepinephrine, LC-NE/autonomic) 경로로 구분할 수 있다. 본 논문은 스트레스 반응에 있어 중추적인 역할을 한다고 알려진 LPHA와 LC-NE 시스템을 중심으로 하여 스트레스 반응의 신경생물학적 기전과 스트레스 시스템 과활성과 관련된 질환의 발병과의 연관성에 대하여 뇌신경과학적 접근을 통하여 고찰하여 스트레스 상황을 많이 접하는 일차 진료의로서 스트레스에 대한 이해를 심화할 수 있는 목적으로 작성되었다.

Keywords

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