From Stress to Neurodegeneration: A New Look at the Pathogenesis of Parkinson's Disease.
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The relationship between stress and Parkinson's disease is regarded as complex and multifaceted, although a direct causal link has not yet been conclusively proven. One prevailing hypothesis is based on the activation of the hypothalamic-pituitary-adrenal (HPA) axis and the consequent elevation of glucocorticoid levels. Prolonged exposure to these hormones may exacerbate oxidative stress, thereby rendering the dopaminergic neurons within the brain's subcortical structures more susceptible to degeneration. Furthermore, stress may intensify neuroinflammation through the activation of microglia-a mechanism that could constitute a significant factor in the pathogenesis of Parkinson's disease. Another important concept concerns the direct interaction of stressors with the dopaminergic system. Physiological and psychological stress can alter dopaminergic transmission by affecting both the synthesis and release of dopamine, as well as the sensitivity of dopamine receptors. Severe or chronic stress may contribute to the disruption of dopaminergic mechanisms and accelerate the onset of clinical symptoms in predisposed individuals. Furthermore, many researchers draw attention to the role of stress-induced aggregation of α-synuclein-a key protein implicated in the pathogenesis of Parkinson's disease. Clinical data suggest a highly probable link between post-traumatic stress disorder and an increased risk of developing Parkinson's disease, although these findings remain inconclusive. It is possible that stress acts not as a primary cause, but rather as a modifying factor that interacts with genetic predisposition, accelerating or triggering neurodegenerative processes. The aim of our narrative review was to examine these concepts and discuss possible directions for future research into the interaction between stress and Parkinson's disease.