Review Article
INVOLVEMENT OF HYPOTHALAMIC-PITUITARY-ADRENAL AXIS AND SYMPATHOADRENAL SYSTEM IN THE PATHOGENESIS OF STRESS
Abstract
The central stress circuitry represents a neural network that includes hypothalamic-pituitary-adrenocortical axis, sympathoadrenal system and limbic areas (medial prefrontal cortex, hippocampus and amygdala). Hypothalamic-pituitary-adrenocortical axis and sympathoadrenal system dysregulation are the important features of the pathogenesis of stress. The following review summarizes the relationship of hypothalamic-pituitary-adrenocortical axis, sympathoadrenal system and limbic structures as well as control of glucocorticoid and norepinephrine/epinephrine release. Medial prefrontal cortex projects nerve input to the amygdala and hypothalamus. Amygdala has stimulatory while hippocampus has inhibitory control over hypothalamic-pituitary-adrenocortical axis. Paraventricular nucleus of hypothalamus further projects to the pituitary gland. The final outputs of this central stress circuit are endocrine system and emotional motor system. These result in the release of corticosterone and norepinephrine/epinephrine through hypothalamic-pituitary-adrenocortical axis and sympathoadrenal system, respectively.
