스트레스의 두뇌 과학적 이해
Understanding Stress by Neuroscience
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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.
Abstract
Understanding Stress by NeuroscienceSu-Jung Yoon, M.D., Tae-Suk Kim, M.D., Jeong-Ho Chae, M.D., Ph.D.†
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