Neuropsychology in ischemic stroke:stress,allostasis and allostatic load

As a complicated cerebrovascular disorder,ischemic stroke involves a series of mind-body connections.The“stress”refers to a state of threatened homeostasis caused by any form of internal or external disturbing forces.The“stress response”is a counteracting force that neutralizes the effects of stressors and re-establish homeostasis,which may cause two different outcomes,the allostasis and allostatic load.The prompt stress system is the autonomic nervous system(ANS)with two branches the sympathetic(SNS)and parasympathetic(PNS)nervous systems that play an important role in regulating stress response.As a typical example and final endpoint of allostatic load,ischemic stroke and its complications are related to stress and autonomic dysfunction.Different clinical tests are described for assessing autonomic function in ischemic stroke.This review may bring possibilities for future study to investigate specific treatment on ANS function and stress management on the context of traditional stroke therapies,and thus help improve the clinical outcomes and prognosis of ischemic stroke.

Physiological roles of activins in the human ovary

Initially discovered in the pituitary as stimulators of follicle stimulating hormone,activins are homo-or heterodimers of inhibin subunits,which belong to the transforming growth factor-b superfamily.Subsequent studies have demonstrated that these growth factors play multifaceted roles in regulating various functions in multiple organs,including the ovary.The spatial and temporal expression of inhibin subunits(a,bA,bB,and bC),their cognate receptors,and activin-binding proteins(inhibins and follistatins)in the principal cells of growing follicles in human ovaries indicates that these activin isoforms are involved in ovarian biology.Information collected from animal studies and clinical samples suggests that these locally produced growth factors are crucial modulators of various ovarian functions,including primordial germ cell development,follicular growth and development,ovarian steroidogenesis,extracellular matrix remodeling,oocyte maturation,ovulation,and luteal function.Along with gonadotropins,intrafollicular activins exert synergistic and complementary effects on growing follicles to help them develop a mature,competent oocyte that is prepared for fertilization.Abnormal activin expression,an imbalanced activin/follistatin ratio,and the dysregulation of the activin signaling pathway have been observed in several ovarian pathologies,such as reproductive aging,polycystic ovary syndrome,and ovarian cancers.Recent advancements in our understanding of the molecular interactions and mechanisms that underlie activins and the development of related ovarian abnormalities have provided insights into disease pathogenesis and increased opportunities to achieve efficient and safe therapies.