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The Human BNST: Functional Role in Anxiety and Addiction.


Avery SN , Clauss JA , Blackford JU , . Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology. primary| primary| primary 6 24; ().


The consequences of chronic stress on brain structure and function are far reaching. While stress can produce short-term adaptive changes in the brain, chronic stress leads to long-term maladaptive changes that increase vulnerability to psychiatric disorders, such as anxiety and addiction. These two disorders are the most prevalent psychiatric disorders in the United States, and are typically chronic, disabling, and highly comorbid. Emerging evidence implicates a tiny brain region- the bed nucleus of the stria terminalis (BNST)-in the body’s stress response and in anxiety and addiction. Rodent studies provide compelling evidence that the BNST plays a central role in the production of sustained threat monitoring, a form of adaptive anxiety, and in the withdrawal and relapse stages of addiction; however, little is known about the BNST’s role in humans. Here, we review current evidence for BNST function in humans, including evidence for a role in the production of both adaptive and maladaptive anxiety. We also review preliminary evidence of the BNST’s role in addiction in humans. Together these studies provide a foundation of knowledge about the BNST’s role in adaptive anxiety and stress-related disorders. Although the field is in its infancy, future investigations of human BNST function have tremendous potential to illuminate mechanisms underlying stress-related disorders and identify novel neural targets for treatment.Neuropsychopharmacology accepted article preview online, 24 June 2015. doi:10.1038/npp.2015.185.