Steroid effects on central neurons and implications for psychiatric and neurological disorders

Ann N Y Acad Sci. 1994 Nov 30:746:345-59; discussion 359-61. doi: 10.1111/j.1749-6632.1994.tb39255.x.

Abstract

Acute and chronic stress as well as a number of psychiatric and neurological disorders are accompanied by profound disturbances of the HPA system. These neuroendocrine alterations act back on the central nervous tissue mainly via corticosteroids-affecting glucocorticoid and mineralocorticoid receptors. The major conclusions drawn from studies probing these receptors in clinical investigations are: (1) In many such conditions central corticosteroid receptors are weakened in their capacity to curtail spontaneous and stress-elevated corticosteroid levels; (2) the combined DEX-CRH test is the best neuroendocrine tool currently available for identifying HPA abnormalities in psychiatric patients; (3) in depression the decreased corticosteroid receptor capacity in transient, and antidepressants act through reinstatement of GR and MR function probably resulting in reduced hypothalamic CRH and AVP production; (4) several neurological disorders such as MS and HIV infection are often accompanied by altered HPA function, which has therapeutic implications; and (5) various corticosteroids, their biosynthetic precursors and their metabolites have differentiable effects on the sleep EEG, which can be attributed to their mode of action; specifically, steroids such as pregnenolone and DHEA most likely are produced in glia cells and act in a paracrine fashion at neurons, thus modifying the sleep EEG in humans in a manner that suggests their potential as memory enhancers.

Publication types

  • Review

MeSH terms

  • Adrenocorticotropic Hormone / physiology
  • Amitriptyline / therapeutic use*
  • Benzamides / therapeutic use*
  • Brain / physiology
  • Brain / physiopathology*
  • Corticotropin-Releasing Hormone
  • Dexamethasone
  • Electroencephalography / drug effects
  • HIV Infections / physiopathology
  • Humans
  • Hydrocortisone / physiology
  • Hypothalamo-Hypophyseal System / physiology
  • Hypothalamo-Hypophyseal System / physiopathology*
  • Moclobemide
  • Mood Disorders / drug therapy*
  • Mood Disorders / physiopathology*
  • Multiple Sclerosis / physiopathology*
  • Neurons / physiology*
  • Pituitary-Adrenal System / physiology
  • Pituitary-Adrenal System / physiopathology*
  • Sleep / drug effects
  • Sleep / physiology
  • Stress Disorders, Post-Traumatic / physiopathology*
  • Stress, Psychological / physiopathology
  • Wounds and Injuries / physiopathology*

Substances

  • Benzamides
  • Amitriptyline
  • Dexamethasone
  • Adrenocorticotropic Hormone
  • Corticotropin-Releasing Hormone
  • Moclobemide
  • Hydrocortisone