HIPOTHALAMO-
HIPOFISE-ADRENAL
AXIS
Corteks
Sistem Limbik
Cerebri
Hipothalamus
Hipofise
Kelenjar
Endokrin
CNS-Hipothalamus-Hipofise Antor
Cortisol
• CRTH dan ACTH juga
dihasilkan diluar HT
• ACTH di batang otak,
thalamus dan sistem
limbik berperan untuk
mengatur perhatian,
memori dan learning
Glukokortikoid
• Pada penderita depresi
terjadi peningkatan
hormon ggn
neurogenesis
hipokampus mengecil
HPA Axis
Under stress, the hypothalamus secretes
corticotropin-releasing hormone (CRH), and this
provokes the release of adrenocorticotropic
hormone (ACTH) from the pituitary. ACTH triggers
the secretion of glucocorticoids from the adrenal
cortex
HPA hyperactivity :
1. major depression
2. susceptibility to infectious
diseases
3. cardiovascular problems
Hyporeactivity of the HPA axis
1. autoimmune processes : lupus erythematosis, multiple sclerosis,
neurodermatitis
2. fibromyalgia,
3. Chronic fatigue syndrome, and
4. rheumatoid arthritis
CNS-Hipothalamus-Hipofise
Ant or
Respon terhadap stress dan berperan dalam mengontrol mood
dan perilaku
Kortisol
Diatur oleh corticotropin-releasing hormon dan
adrenocorticotropic hormone
Variasi diurnal, peak : pukul 6 -7
Fungsi :
mempengaruhi sintesis protein dan meningkatkan sintesis
enzim di CNS
Hipercortisolism (cushing’s syndrome)
Gangguan mood (depresi, mania), confusion, psikosis,
Peningkatan dan hilangnya irama sekresi : depresi, mania,
obsesive compulsive disorder
Hipocortisolism (addison’s disease)
Apatis, Kelelahan, Depresi,
HPA axis dysfunction in unmedicated major depressive disorder and its
normalization by pharmacotherapy correlates with alteration of neural
activity in prefrontal cortex and limbic/paralimbic regions
Psychiatry Research: Neuroimaging 155 (2007) 245–256
depressed patients remitted with
antidepressant treatment were
accompanied by resolution of
HPA dysregulation and alteration
of regional glucose metabolism in
the prefrontal cortical, limbic and
paralimbic regions.
Metabolisme Glukosa
♂ dan ♀
1. Numerous studies have
shown that glucocorticoid
levels are higher in females
than in males after HPA axis
stimulation
2. Psychosocial stress ACTH and
free cortisol increases in men were
Gn-RH, LH dan FSH
Gn-RH
struktur mirip TRH
HT, juga di amygdala dan mid brain
Neuromodulator : inhibisi dan eksitasi post synaptic
Berperan dalam sexual behavior dan alertness dan anxiety
Anorexia nervosa : kegagalan sistem pengaturan gonad
penurunan Gn-RH, gagalnya irama sirkadian atau
variasi bulanan kadar Gn-RH
Pubertas : perubahan di pengaturan sistem gonad
metal illnesses
Thyroid
Berperan penting untuk perkembangan
SSP
Hipertiroid :
• Usia muda : anxiety, restlessness dan irritability
• Lanjut : apathetic, depresi
TRH
• HT, Brain stem,medula spinalis, area
periventrikular, amygdala, dan ganglion basalis
• Pada umumnya inhibitor post sinaptik
• Penurunan depresi
Growth Hormon (GH)
Diatur oleh GH-RF dan GH-IF
(somatostatin)
Stress dan aktifitas meningkatkan
GH
Somatostatin
• Konsentrasi tinggi : cortek serebri dan
amygdala
• meningkatkan sedasi dan menurunkan
aktifitas, depresi
• Berperan dalam mengatur Ach
Alzheimer’s disease
Prolaktin
Diatur Prolactin-IH dan Prolactin-RH,
Meningkat pada keadaan : tidur,
excercise, pregnancy dan menyusui
Neuroleptic menyebabkan
peningkatan prolaktin
menghambat reseptor dopamin di
tuberoinfundibular : prolaktin IH
Prolaktin
One of the more important groups of
drug within this class are the
antipsychotics (dopamine
antagonists), which are used in the
treatment of schizophrenia.
Hyperprolactinaemia is thought to be
caused by these agents blocking the
D2 receptors on the lactrotroph cells
and thus preventing inhibition of
prolactin secretion
Peningkatan Prolaktin
In females :
• Irregular menstrual periods (oligomenorrhea) or no menstrual periods
(amenorrhea)
• Milky discharge from the breasts (galactorrhea) when not pregnant or breast-
feeding
• Painful intercourse due to vaginal dryness
• Acne and excessive body and facial hair growth (hirsutism)
In males, prolactinoma can cause:
• Erectile dysfunction
• Decreased body and facial hair
• Uncommonly, enlarged breasts (gynecomastia)
In both sexes, prolactinoma can cause:
• Low bone density
• Loss of interest in sexual activity
• Headaches
• Infertility
• Lethargi, irritability dan haus
Melanocyte Stimulating Hormone
?? memori dan learning
CNS-Hipothalamus-Hipofise Postor
Vasopressin
◦ Attention, memory, learning dan
antidepresan
◦ Meningkat : pain, exercise, morphin,
barbiturat, nicotine
◦ Menurun : alkohol
Melatonin
Disintesa dari serotonin
Diproduksi di kelenjar Pineal
melalui reseptor beta-adrenergik.
Berperan dalam irama sirkadian
dan pematangan sexual
System Peptide
Endogenous Opioid
◦ Berperan pengaturan nyeri, anxiety dan memori, sexual
activity, feeding, suhu, TD
◦ Ggn : schizophrenia, affective illness, eating disorder
Substance P
◦ Pengaturan kontrol motorik dan persepsi nyeri
Cholescystokinin
◦ Bersama dengan dopamin patophysiologi dari
schizophrenia
Vasoactive Intestinal Peptide
◦ ??
Angiostensi II
◦ Meningkatkan rangsang haus
Neurotensin
◦ Nyeri, sensitivitas, suhu
