Neuroanatomy and Control of the Uncertainty and Stress Process Triggered by Disasters

Abstract

Uncertainty is characterized by the feeling of anxiety experienced in danger. It is an important factor that causes stress. To maintain a state of complete well-being, people need to be confident that they can maintain their physical, mental, and social well-being. When a change occurs external or internal, it is considered which strategy to choose to maintain this well-being. Uncertainty occurs and stress is triggered when hesitant to choose the appropriate strategy. With the hierarchical structure in brain, sensory and interoceptive inputs from the sensorimotor and visceral sensory cortex are transmitted to the lateral prefrontal cortex. Estimation errors between the current situation and what needs to be done are detected. The larger difference, the greater uncertainty about which strategy to choose and the stronger the activation of the amygdala. The indecisiveness of the anterior cingulate cortex in choosing the appropriate strategy increases amygdala activation. To clear uncertainty, the brain goes on alert. The anterior cingulate cortex-amygdala complex activates three systems: attention, learning, and habit. Neuroendocrine responses activated by arousal contribute to learning and synapse formation. Making stress responses a habit is important to create a faster response when faced with similar situations later. In the case of chronic stress, effects on metabolic, cardiovascular, immune systems, cognitive functions, and post-traumatic stress disorders can be seen. Post-traumatic stress disorders are common in disasters where people feel helpless and lose their sense of control. Making contingency plans, and habit processes in mind through exercises and trainings will speed process of choosing appropriate strategy and minimize uncertainty and stress it causes. The aim of this review is to reveal coping methods by addressing the neuroanatomy and control mechanism of the stress process, which is likely to be triggered by disaster-related uncertainties.

Keywords

• Uncertainty
• stress
• trauma
• natural disaster
• earthquake.

Afetlerle Tetiklenen Belirsizlik ve Stres Sürecinin Nöroanatomisi ve Kontrolü

Abstract

Belirsizlik, tehlike altında yaşanan endişe duygusuyla karakterizedir. Strese yol açan önemli bir faktördür. İnsanların tam iyilik halini sürdürebilmesi için fiziksel, zihinsel ve sosyal açılardan iyilik halini koruyabileceklerinden emin olmaları gerekir. Dışsal ya da içsel bir değişiklik meydana geldiğinde bu iyilik halini korumak için hangi stratejinin seçilmesi gerektiği düşünülür. Uygun stratejiyi seçmek konusunda kararsız kalındığında belirsizlik oluşur ve stres duygusu tetiklenir. Beyindeki hiyerarşik yapılanma ile, sensorimotor ve visserosensori kortekse gelen duyusal ve interoseptif girdiler, lateral prefrontal kortekse iletilir. Bu yapılar arasındaki bilgi akışı ile mevcut durum ile yapılması gerekenler arasındaki tahmin hataları tespit edilir. Farklılıklar veya risk ne kadar büyük olursa, hangi stratejinin seçileceğine dair belirsizlik o kadar artar ve amigdalanın aktivasyonu o kadar güçlü olur. Anterior singulat korteksin uygun stratejiyi seçmede kararsız kalması amigdala aktivasyonunu artırır. Belirsizliği gidermek için beyin alarm durumuna geçer ve anterior singulat korteks-amigdala kompleksi üç sistemi aktive eder. Bu sistemler, dikkat, öğrenme ve alışkanlıktır. Uyarılma ile aktive olan nöroendokrin yanıtlar öğrenmeye ve sinaps oluşumuna katkıda bulunur. Bu stres yanıtlarının alışkanlık haline getirilmesi daha sonra benzer durumlarla karşılaşıldığında daha hızlı yanıt oluşturabilmek için önemlidir. Kronik stres durumunda metabolik hastalıklar, kardiyovasküler etkilenimler, immün sistemde zayıflama, bilişsel fonksiyonlarda etkilenimler ve travma sonrası stres bozuklukları görülebilir. Travma sonrası stres bozuklukları, insanların kendini çaresiz hissettikleri ve kontrol hissini kaybettikleri doğal afetlerde sık görülür. Acil durum planlarının yapılması, tatbikatlar ve eğitimlerle, öğrenme ve alışkanlık süreçlerinin önceden hafızada yer etmesi uygun stratejiyi seçme sürecini hızlandırarak belirsizliği ve neden olduğu stresi en aza indirecektir. Bu derlemenin amacı, afet nedenli belirsizliklerle tetiklenme olasılığı olan stres sürecinin nöroanatomisini ve kontrol mekanizmasını ele alarak başa çıkma yöntemlerini ortaya koymaktır.

Keywords

• Belirsizlik
• stres
• travma
• afet
• deprem.

References

1. Qiao Z, Pan Dn, Hoid D, van Winkel R, Li X. When the approaching threat is uncertain: Dynamics of defensive motivation and attention in trait anxiety. Psychophysiology. 2022;59(9):e14049.
2. Esterwood E, Saeed SA. Past epidemics, natural disasters, COVID19, and mental health: learning from history as we deal with the present and prepare for the future. Psychiatric quarterly. 2020;91:1121-33.
3. Wu D, Yang T. Late bedtime, uncertainty stress among Chinese college students: impact on academic performance and self-rated health. Psychology, Health & Medicine. 2022:1-12.
4. Peters A, McEwen BS. Stress habituation, body shape and cardiovascular mortality. Neuroscience & Biobehavioral Reviews. 2015;56:139-50.
5. Folkman S. Stress, coping, and hope. Psychological aspects of cancer. 2013:119-27.
6. Matta C. The Stress Response: How Dialectical Behavior Therapy Can Free You from Needless Anxiety, Worry, Anger, and Other Symptom: New Harbinger Publications; 2012.
7. McEwen BS. Protective and damaging effects of stress mediators. New England journal of medicine. 1998;338(3):171-9.
8. Toyabe S, Sagawa T, Ueda M, Muneyuki E, Sano M. Experimental demonstration of information-to-energy conversion and validation of the generalized Jarzynski equality. Nature physics. 2010;6(12):988-92.

9. De Ridder D, Vanneste S, Freeman W. The Bayesian brain: phantom percepts resolve sensory uncertainty. Neuroscience & Biobehavioral Reviews. 2014;44:4-15.
10. Engl E, Attwell D. Non‐signalling energy use in the brain. The Journal of physiology. 2015;593(16):3417-29.
11. van den Heuvel C, Alison L, Power N. Coping with uncertainty: Police strategies for resilient decision-making and action implementation. Cognition, Technology & Work. 2014;16:25-45.
12. Peters A, McEwen BS, Friston K. Uncertainty and stress: Why it causes diseases and how it is mastered by the brain. Progress in Neurobiology. 2017;156:164-88.
13. Clark A. Surfing uncertainty: Prediction, action, and the embodied mind: Oxford University Press; 2015.
14. McEwen BS. Stress, adaptation, and disease: Allostasis and allostatic load. Annals of the New York academy of sciences. 1998;840(1):33-44.
15. Brashers DE, Neidig JL, Haas SM, Dobbs LK, Cardillo LW, Russell JA. Communication in the management of uncertainty: The case of persons living with HIV or AIDS. Communications Monographs. 2000;67(1):63-84.
16. Badcock PB, Friston KJ, Ramstead MJ, Ploeger A, Hohwy J. The hierarchically mechanistic mind: an evolutionary systems theory of the human brain, cognition, and behavior. Cognitive, Affective, & Behavioral Neuroscience. 2019;19:1319-51.
17. Hasson U, Chen J, Honey CJ. Hierarchical process memory: memory as an integral component of information processing. Trends in cognitive sciences. 2015;19(6):304-13.
18. Schwedhelm P, Baldauf D, Treue S. The lateral prefrontal cortex of primates encodes stimulus colors and their behavioral relevance during a match-to-sample task. Sci Rep. 2020;10(1):4216.
19. Schiebener J, Brand M. Decision making under objective risk conditions–a review of cognitive and emotional correlates, strategies, feedback processing, and external influences. Neuropsychology review. 2015;25:171-98.
20. Arnsten AF. Stress signalling pathways that impair prefrontal cortex structure and function. Nature reviews neuroscience. 2009;10(6):410-22.
21. Williams LE, Oler JA, Fox AS, McFarlin DR, Rogers GM, Jesson MA, et al. Fear of the unknown: uncertain anticipation reveals amygdala alterations in childhood anxiety disorders. Neuropsychopharmacology. 2015;40(6):1428-35.
22. Venkatraman V, Huettel SA. Strategic control in decision‐making under uncertainty. European Journal of Neuroscience. 2012;35(7):1075- 82.
23. Weiser MJ, Foradori CD, Handa RJ. Estrogen receptor beta activation prevents glucocorticoid receptor-dependent effects of the central nucleus of the amygdala on behavior and neuroendocrine function. Brain research. 2010;1336:78-88.
24. Andrewes DG, Jenkins LM. The role of the amygdala and the ventromedial prefrontal cortex in emotional regulation: implications for post-traumatic stress disorder. Neuropsychology review. 2019;29:220-43.
25. Hinds JA, Sanchez ER. The Role of the Hypothalamus–Pituitary–Adrenal (HPA) Axis in Test- Induced Anxiety: Assessments, Physiological Responses, and Molecular Details. Stresses. 2022;2(1):146-55.
26. Herman JP, McKlveen JM, Ghosal S, Kopp B, Wulsin A, Makinson R, et al. Regulation of the Hypothalamic-Pituitary-Adrenocortical Stress Response. Compr Physiol. 2016;6(2):603-21.
27. Zieman SJ, Melenovsky V, Kass DA. Mechanisms, pathophysiology, and therapy of arterial stiffness. Arteriosclerosis, thrombosis, and vascular biology. 2005;25(5):932-43.
28. Akbar M, Essa MM, Daradkeh G, Abdelmegeed MA, Choi Y, Mahmood L, et al. Mitochondrial dysfunction and cell death in neurodegenerative diseases through nitroxidative stress. Brain Res. 2016;1637:34-55.
29. Speer K, Upton D, Semple S, McKune A. Systemic low-grade inflammation in post-traumatic stress disorder: a systematic review. Journal of inflammation research. 2018;11:111-21.
30. Orem TR, Wheelock MD, Goodman AM, Harnett NG, Wood KH, Gossett EW, et al. Amygdala and prefrontal cortex activity varies with individual differences in the emotional response to psychosocial stress. Behav Neurosci. 2019;133(2):203-11.
31. Shalev AY. Posttraumatic stress disorder and stress-related disorders. Psychiatr Clin North Am. 2009;32(3):687-704.
32. Burg MM, Soufer R. Post-traumatic Stress Disorder and Cardiovascular Disease. Curr Cardiol Rep. 2016;18(10):94.
33. Golitaleb M, Mazaheri E, Bonyadi M, Sahebi A. Prevalence of Post-traumatic Stress Disorder After Flood: A Systematic Review and Meta- Analysis. Frontiers in psychiatry. 2022;13:890671.
34. Galea S, Nandi A, Vlahov D. The epidemiology of post-traumatic stress disorder after disasters. Epidemiol Rev. 2005;27:78-91.
35. Bromet EJ, Atwoli L, Kawakami N, Navarro-Mateu F, Piotrowski P, King AJ, et al. Post-traumatic stress disorder associated with natural and human-made disasters in the World Mental Health Surveys. Psychol Med. 2017;47(2):227-41.
36. Liang Y, Zeng H, Liu YG, Xu AM, Liu WH. Prevalence of post-traumatic stress disorder after earthquakes among the elderly in China: A meta-analysis. World J Emerg Med. 2021;12(2):137-42.
37. Dai W, Chen L, Lai Z, Li Y, Wang J, Liu A. The incidence of post-traumatic stress disorder among survivors after earthquakes:a systematic review and meta-analysis. BMC Psychiatry. 2016;16:188.
38. Booth E. Dealing with earthquakes: the practice of seismic engineering ‘as if people mattered’. Bulletin of Earthquake Engineering. 2018;16(4):1661-724.
39. Wood KH, Wheelock MD, Shumen JR, Bowen KH, Ver Hoef LW, Knight DC. Controllability modulates the neural response to predictable but not unpredictable threat in humans. NeuroImage. 2015;119:371-81.
40. Hayes JP, Vanelzakker MB, Shin LM. Emotion and cognition interactions in PTSD: a review of neurocognitive and neuroimaging studies. Front Integr Neurosci. 2012;6:89.
41. Fantl J, McGrath M. Knowledge in an uncertain world: OUP Oxford; 2009.
42. Palego L, Giannaccini G, Betti L. Neuroendocrine response to psychosocial stressors, inflammation mediators and brain-periphery pathways of adaptation. Central Nervous System Agents in Medicinal Chemistry (Formerly Current Medicinal Chemistry-Central Nervous System Agents). 2021;21(1):2-19.
43. Peters A, Schweiger U, Pellerin L, Hubold C, Oltmanns KM, Conrad M, et al. The selfish brain: competition for energy resources. Neurosci Biobehav Rev. 2004;28(2):143-80.
44. Ross JA, Van Bockstaele EJ. The Locus Coeruleus- Norepinephrine System in Stress and Arousal: Unraveling Historical, Current, and Future Perspectives. Frontiers in psychiatry. 2020;11:601519.
45. Atzori M, Cuevas-Olguin R, Esquivel-Rendon E, Garcia-Oscos F, Salgado-Delgado RC, Saderi N, et al. Locus Ceruleus Norepinephrine Release: A Central Regulator of CNS Spatio-Temporal Activation? Front Synaptic Neurosci. 2016;8:25.
46. Chen C, Jiang Z, Fu X, Yu D, Huang H, Tasker JG. Astrocytes amplify neuronal dendritic volume transmission stimulated by norepinephrine. Cell reports. 2019;29(13):4349-61. e4.
47. Humphries P, Pretorius E, Naude H. Direct and indirect cellular effects of aspartame on the brain. European journal of clinical nutrition. 2008;62(4):451-62.
48. Hinton T, Johnston GA. GABA, the major inhibitory neurotransmitter in the brain. 2018.
49. Ueta Y, Ozaki Y, Saito J, Onaka T. Involvement of novel feeding-related peptides in neuroendocrine response to stress. Experimental Biology and Medicine. 2003;228(10):1168-74.
50. Dunlop BW, Wong A. The hypothalamic-pituitary-adrenal axis in PTSD: Pathophysiology and treatment interventions. Progress in Neuro-psychopharmacology and biological psychiatry. 2019;89:361-79.
51. Vyas S, Rodrigues AJ, Silva JM, Tronche F, Almeida OF, Sousa N, et al. Chronic Stress and Glucocorticoids: From Neuronal Plasticity to Neurodegeneration. Neural Plast. 2016;2016:6391686.
52. McEwen BS, Gianaros PJ. Central role of the brain in stress and adaptation: links to socioeconomic status, health, and disease. Ann N Y Acad Sci. 2010;1186:190-222.
53. Anderson EC, Carleton RN, Diefenbach M, Han PK. The relationship between uncertainty and affect. Frontiers in psychology. 2019;10:2504.
54. McGrath RG, MacMillan IC. The entrepreneurial mindset: Strategies for continuously creating opportunity in an age of uncertainty: Harvard Business Press; 2000.
55. Lee K, Pang YC, Lee JAL, Melby JN. A study of adverse childhood experiences, coping strategies, work stress, and self-care in the child welfare profession. Human Service Organizations: Management, Leadership & Governance. 2017;41(4):389-402.
56. Kinateder MT, Kuligowski ED, Reneke PA, Peacock RD. Risk perception in fire evacuation behavior revisited: definitions, related concepts, and empirical evidence. Fire Sci Rev. 2015;4(1):1.
57. Botzen WW, Kunreuther H, Michel-Kerjan EJJoR, Uncertainty. Protecting against disaster risks: Why insurance and prevention may be complements. 2019;59:151-69.
58. Li C, Liang W, Quigley C, Zhao Y, Yu L-F. Earthquake safety training through virtual drills. IEEE transactions on visualization and computer graphics. 2017;23(4):1275-84.
59. Parker G, Lie D, Siskind DJ, Martin-Khan M, Raphael B, Crompton D, et al. Mental health implications for older adults after natural disasters- -a systematic review and meta-analysis. International psychogeriatrics. 2016;28(1):11-20.
60. Heuvel C, Alison L, Power N. Coping with uncertainty: Police strategies for resilient decision-making and action implementation. Cognition, Technology & Work. 2014;16.
61. Al Jowf GI, Ahmed ZT, An N, Reijnders RA, Ambrosino E, Rutten BPF, et al. A Public Health Perspective of Post-Traumatic Stress Disorder. International Journal of Environmental Research and Public Health. 2022;19(11):6474.
62. Bonanno GA, Brewin CR, Kaniasty K, Greca AM. Weighing the Costs of Disaster: Consequences, Risks, and Resilience in Individuals, Families, and Communities. Psychol Sci Public Interest. 2010;11(1):1-49.
63. Thapa V, Pathak S, Pathak N. Psychosocial recovery of earthquake victims: A case study of 2015 Gorkha earthquake. International Journal of Disaster Risk Reduction. 2021;62:102416.