Hippocampal remodeling and damage by corticosteroids: Implications for mood disorders

Mood disorders are common, recurrent and disabling illnesses which are freq uently associated with hypothalamic-pituitary-adrenal (HPA) axis dysregulat ion and memory loss. The hippocampus provides negative feedback to the HPA axis and has an important role in key aspects of spatial and declarative me mory. Thus, hippocampal dysfunction could account for both the memory impai rment and neuroendocrine abnormalities found in moos disorders. The critica l role of the hippocampus in declarative memory, emotional processing, and vulnerability and human studies. Cellular processes in the hippocampus incl uding long-term potentiation, neurogenesis, and dendritic remodeling are cu rrently areas of intense study. Human studies report cognitive impairment c onsistent with hippocampal dysfunction in depression, bipolar disorder, Cus hing's disease, and in those individuals receiving exogenous corticosteroid s. This review examines the role of the corticosteroids in hippocampal remo deling and atrophy in patients with mood disorders. Interventions to preven t or reverse the damaging effects of corticosteroids on the hippocampus are discussed. (C) 1999 American College of Neuropsychopharmacology. Published by Elsevier Science Inc.