ATF4 and Anxiety: Specifically, the PERK/eIF2α axis exacerbates nociception via ATF4/CHOP [8,9]-mediated synaptic inhibition and dysregulated GABAergic transmission [46,69]—a mechanism corroborated by studies showing that GABA neuron hypofunction in spinal and supraspinal circuits directly facilitates pain persistence and comorbid anxiety [70,71].