Neuronal Hyperexcitability: Significance, Cause, and Diversity of Clinical Expression

摘要

Although the pathophysiology of psychiatric disorders remains unclear, an emerging hypothesis contends that most of the common psychiatric disorders are rooted in an inherent hyperexcitability of the neurological system. Particularly under the influence of stress, too many neurons fire for too long, resulting in pathologically severe and persistent symptoms such as anxiety, depression, irritability, insomnia, inattention, and obsessional thinking. However, these symptoms are just a small sampling of the many ways that neuronal hyperexcitability can be expressed. According to the Multi-Circuit Neuronal (MCNH) Hypothesis of Psychiatric Disorders, the trait can also be expressed as overly aggressive behavior, disruptive behavior, risky behavior, promiscuous behavior, avoidant behavior, self-injurious behavior, deviant behavior, addictive behavior, and criminal behavior. In essence, any behavioral extreme is likely to be rooted in an inherent hyperexcitability of the neurological system. The importance of recognizing this is that the abnormality, though highly treatable, is commonly overlooked and either mismanaged or poorly managed. Also, there is emerging evidence that the neuronal hyperexcitability trait, which appears to be heritable as a single nucleotide polymorphism, may be detectable by simply measuring one's resting vital signs. If proven to be correct, these findings could incentivize carriers to develop prophylactic strategies early in life. The importance of this is immense, not only because it could reduce the risk of developing psychiatric and substance use disorders but also because it could have a protective effect against developing any of a wide range of general medical conditions, such as diabetes, high blood pressure, heart disease, cancer, and dementia. This article explores the many faces of neuronal hyperexcitability in an effort to increase awareness of this highly prevalent but elusive neurophysiological abnormality.