Epigenetic Basis of Stress-Induced Central Nervous System Disorders: Therapeutic Approaches

Accumulating evidence indicates that epigenetic and post-transcriptional mechanisms interact to shape stress vulnerability and the adaptive capacity of the central nervous system (CNS). This review aimed to identify molecular markers with potential prognostic value for stress-induced CNS disorders. We analyzed 93 publications (2008–2025) identified in PubMed, Scopus, Web of Science Core Collection, and the Cochrane Library, including 80 original experimental and clinical studies, as well as 13 reviews and meta-analyses addressing epigenetic regulation, hypothalamic–pituitary–adrenal (HPA) axis function, CNS remodeling, and therapeutic or environmental modulation in stress-exposed models and clinical cohorts with stress-related disorders. Across studies, altered methylation of NR3C1, FKBP5, and BDNF, reduced hippocampal histone acetylation, and shifts in microRNA profiles (miR-16, miR-124, miR-132, miR-135a, miR-34c) were repeatedly associated with HPA axis dysregulation, limbic system remodeling, and phenotypes relevant to PTSD and depression. Evidence further suggests that at least some of these signatures show partial reversibility, with modulation reported after pharmacological interventions (e.g., SSRIs, histone deacetylase inhibitors, FKBP51 inhibitors, ketamine) and non-pharmacological approaches (e.g., physical activity, social support) in animal models and, to a lesser extent, in clinical and observational studies. We conclude that targeted modulation of specific epigenetic and post-transcriptional pathways supports the development of candidate biomarkers and may inform stratified prevention and treatment strategies for stress-induced CNS disorders, while acknowledging that further validation in large, well-characterized cohorts is required.