Samenvatting

D. HERNAUS, Z. KASANOVA, T. VAN AMELSVOORT, F.M. MOTTAGHY & I. MYIN-GERMEYS
TITLE: STRESS VULNERABILITY AND THE BRAIN: THE ROLE OF THE DOPAMINE SYSTEM.

Background: Although it is well known that stress is a risk factor for psychiatric illness, brain mechanisms related to stress-sensitivity are not well understood. We explored: (1) the association between the dopamine system and stress-sensitivity in daily life (non-clinical sample, n=26) and (2) the association between prolonged stress and the dopamine system (12 controls, 12 individuals with a psychotic disorder).
Methods: Dopamine levels during a control and stress condition of the Montreal Imaging Stress Task were assessed with 18F-fallypride PET. Daily life stress was assessed in a 7-day ambulatory assessment study. Early life stress/trauma was assessed with the CECA.
Results: Stress-related prefrontal dopamine activity correlated negatively with stress-sensitivity in daily life. Early life stress predicted stress-related prefrontal dopamine activity and subjective stress in controls, but not in psychotic disorder.
Conclusion: The dopamine system plays an important role in stress processing and is predictive of psychotic vulnerability to stress. These identifi ed mechanisms can serve as potential targets for pharmacological and psychological stress interventions.

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Waarom zijn sommige mensen stressgevoeliger dan andere en ontwikkelt de één psychische klachten en de ander niet? Dennis Hernaus cs. onderzoeken hoe het dopaminesysteem betrokken is bij stressverwerking en psychische klachten. ‘Alhoewel voorop moet worden gesteld dat de steekproeven voor deze experimenten bescheiden waren en dat replicatie essentieel is, kunnen we stress-specifieke dopamineniveaus in de prefrontale cortex relateren aan subjectieve stressbeleving alsmede kwetsbaarheid voor psychotische stoornissen.’

Introductie

Denk eens terug aan een belangrijke gebeurtenis in uw leven; iets dat grote indruk maakte. Kunt u zich herinneren hoe u zich toen voelde? Het is goed mogelijk dat u gestrest was. Misschien spanden uw spieren zich onbewust aan, ging uw hart tekeer en produceerde uw bijnierschors op volle kracht stresshormonen. Al uw energie en aandacht was waarschijnlijk gericht op die éne belangrijke gebeurtenis. Deze totaalsom aan lichamelijke activiteit staat bekend als de ‘vecht- of vluchtreactie’. Die reactie wordt uitgelokt wanneer een gebeurtenis als ‘stressvol’ of ‘bedreigend’ wordt geïnterpreteerd (Sapolsky, 1998)21. Dit neurobiologische mechanisme speelt een essentiële rol in het faciliteren van onze stressreactie: vluchten, vechten en alles daartussenin. Eén blik op de literatuur is al voldoende om te beseffen dat niet enkel ontzettend grote, maar ook normale, alledaagse, situaties of gebeurtenissen deze stressreactie kunnen uitlokken. Pijn (Vachon-Presseau et al., 2013)23, werkdruk (Eller, Netterstrom & Hansen, 2006)7, en stedelijke omgevingen (Lederbogen et al., 2011)12 zijn…

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