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This is Dr. Lam and welcome to today's session on the discussion of the
neuroendocrine basis of Adrenal Fatigue Syndrome.
First we need to understand
that stress enters our sphere through a small area of the brain called the locus coeruleus or the LC.
Discovered in the eighteenth century,
this area of the brain stem deals with the physiological responses to stress and panic.
An important homeostatic control center of the body, the LC receives input from a variety of sources
from our senses it is then routed through the hypothalamus, the amygdala,
the cerebellum as well as the prefrontal cortex.
Emotional pain and stressors from the outside world enters our inner world through these pathways.
Once arrived, excitatory signals trigger production and release of norepinephrine from the LC.
Now, norepinephrine has two functions. In the brain, it acts as a central neuro-transmitter
and keeps us aroused: we become alert.
Norepinephrine released from the LC also increases the sympathetic
discharge and inhibits parasympathetic tone in the peripheral nervous system,
which we will go into later. At that point it exerts its excitatory effect directly on
the target organs such as the heart.
So as a result, the heart rate as well as the heartbeat force goes up.
Aside from being the principal production site of the brain norepinephrine,
the LC is also connected on the output side to many parts of the central nervous system;
including the spinal cord, brain stem, cerebellum, hypothalamus, amygdala as well as the cerebral cortex.
So as you can see, it is a two-way street with many many directions and a
collaborative network of information flow, to the LC and out of the LC.
Collectively, the LC and areas of the CNS (or the central nervous system),
affected by the norepinephrine it produces, are described as the LC-NA system,
which stands for locus coeruleus-noradrenergic system.
Noradrenergic is the same as norepinephrine and that is what it connotates here.
Now the distribution as we talked about of the LC-NA system is ubiquitous
and is consistent with the prominent role that norepinephrine plays
in a variety of central nervous system functions,
as well as behavior that includes locomotor functions, cognitive functions, motivation and attention
Now what is important is that once the LC-NA system is activated
it is responsible for much of the psychological effects we see in Adrenal Fatigue Syndrome.
They can include fear, anxiety, alertness, memory changes and REM sleep dysregulation.
Psychiatric research has documented that the role the LC plays in cognitive function
in relation to stress is complex and is multi-modal: there is no one direct link,
multiple factors are involved.
From a neuroendocrinological perspective it is clear
that the body's multiple stress response pathways are all for it
in a redundancy pattern to handle stress in many many cases,
it has ensured the survival of our species for quite some time.
What is confusing clinically is that in Adrenal Fatigue Syndrome,
these pathways can be activated few at a time
all at once, or quickly or slowly as the body sees fit.
The body's truly in control but the symptoms are so convoluted because
it depends on what stage and how the body perceives stress.
Different parts of different systems are being activated all at the same time as necessary.
To fully appreciate the body's heroic effort to rescue us from stress,
it is important to first understand that our brain is in control,
the pathway is through the neuroendocrine system.
What one person perceives as stress may not be for another person.
Based on what is perceived as stress by the mind, the body automatically activates
any or all of the anti-stress mechanisms in place.
In order for us to fully grasp the big picture,
clinicians need to take a step back,
because it is easy to be confused when you look too close.
The picture from afar is quite clear.
We see a body in trouble, unable to maintain homeostasis
and trying to use all its ways and means to recover on its own, using the methods that it knows.
By activating any or all of the built-in stress response systems
modulated by the neurological and endocrine systems working in tandem.
The more severe the stress,the more other systems
such as musculoskeletal, psychiatric, cardiac and immune systems are also affected adversely.
Remember, that the body is a closed system.
Severe dysregulation of one system invariably impacts other systems.
This is inescapable.
Despite this clinical chaos,
we can see a controlled collapse that is logical and systematic from the body's perspective.
Symptoms are simply the messages
or signs the body sends us warning of such impending danger and
thereby alerting us to take appropriate action.
If stress is never really resolved or let go,
then even despite a loosing battle,
The mind continues to be ultimately in charge throughout this ordeal
through its various endocrinological stress response pathways
The neuroendocrine basis of Adrenal Fatigue is quite clear and solid.
Evidence-based scientific research has proven
beyond a doubt that stress can kill.


神經荷爾蒙 (Preview of The Neuroendocrine Basis of Adrenal Fatigue Syndrome)

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鍾佳芳 發佈於 2015 年 11 月 4 日    黃世閔 翻譯    Sally Hsu 審核
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