Poškození hipokampu glukokortikoidy - Klíčový patogenetický faktor v psychiatrii?

Corticosteroids induced hippocampal atrophy may play an important role in the pathogenesis of a range of neuropsychiatric disorders. Hippocampal impairment leads to hypothalamo-pituitary-adrenal axis deliberation and memory deficit. Signs of HHN dysregulation in combination with memory impairment are present in affective disorders, Alzheimer's disease and in posttraumatic stress disorder. MRI volumetry shows reduced hippocampal volume in these diseases. The findings are consistent with the results of animal experiments. Evidence supporting this hypothesis, putative mechanisms of corticosteroids' neurotoxicity, possible treatment approaches, and implications for clinical practice are reviewed. Controversies concerning causality, reversibility, type of hippocampal changes, factors increasing hippocampal vulnerability, and ambiguous findings in posttraumatic stress disorder are discussed.