Glucocorticoids and hippocampal atrophy in neuropsychiatric disorders

Arch Gen Psychiatry. 2000 Oct;57(10):925-35. doi: 10.1001/archpsyc.57.10.925.

Abstract

An extensive literature stretching back decades has shown that prolonged stress or prolonged exposure to glucocorticoids-the adrenal steroids secreted during stress-can have adverse effects on the rodent hippocampus. More recent findings suggest a similar phenomenon in the human hippocampus associated with many neuropsychiatric disorders. This review examines the evidence for hippocampal atrophy in (1) Cushing syndrome, which is characterized by a pathologic oversecretion of glucocorticoids; (2) episodes of repeated and severe major depression, which is often associated with hypersecretion of glucocorticoids; and (3) posttraumatic stress disorder. Key questions that will be examined include whether the hippocampal atrophy arises from the neuropsychiatric disorder, or precedes and predisposes toward it; whether glucocorticoids really are plausible candidates for contributing to the atrophy; and what cellular mechanisms underlie the overall decreases in hippocampal volume. Explicit memory deficits have been demonstrated in Cushing syndrome, depression, and posttraumatic stress disorder; an extensive literature suggests that hippocampal atrophy of the magnitude found in these disorders can give rise to such cognitive deficits.

Publication types

  • Review

MeSH terms

  • Adult
  • Animals
  • Cognition Disorders / diagnosis
  • Cognition Disorders / physiopathology
  • Cushing Syndrome / diagnosis*
  • Cushing Syndrome / physiopathology
  • Dendrites / physiology
  • Depressive Disorder / diagnosis*
  • Depressive Disorder / physiopathology
  • Female
  • Glucocorticoids / physiology*
  • Hippocampus / anatomy & histology*
  • Hippocampus / physiology
  • Hippocampus / physiopathology
  • Humans
  • Magnetic Resonance Imaging / statistics & numerical data
  • Male
  • Memory Disorders / diagnosis
  • Memory Disorders / etiology
  • Memory Disorders / physiopathology
  • Neurons / physiology
  • Stress Disorders, Post-Traumatic / diagnosis*
  • Stress Disorders, Post-Traumatic / physiopathology*

Substances

  • Glucocorticoids