期刊
NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS
卷 35, 期 3, 页码 804-817出版社
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.neubiorev.2010.10.001
关键词
Cytokines; Neurotrophins; BDNF; Oxidative stress; Early intervention; Bipolar disorders; Mania; Depression neuroprotection; Neuroprogression; Mitochondria; Lipids
资金
- Stanley Medical Research Foundation
- MBF
- NHMRC
- Beyond Blue
- Geelong Medical Research Foundation
- Australian Rotary Health Research Fund
- Bristol Myers Squibb
- Eli Lilly
- Glaxo SmithKline
- Organon
- Novartis
- Mayne Pharma
- Servier
- INCT-TM
- CNPq
- CAPES
- SMRI
- NARSAD
- Janssen
- Lilly
- Astra Zeneca
- Abbott
- Michael Smith Health Research Foundation
- Marian and E.H. Flack Trust
- CNPq-Universal [477974/2009-0]
- CNPq-INCT-TM
- FIPE-HCPA
- NIH
- Rebecca L Cooper Medical Research Foundation
- Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq), Brazil
- Janssen-Cilag
- Lundbeck
- Pfizer
- Ranbaxy
- Wyeth
There is now strong evidence of progressive neuropathological processes in bipolar disorder (BD). On this basis, the current understanding of the neurobiology of BD has shifted from an initial focus on monoamines, subsequently including evidence of changes in intracellular second messenger systems and more recently to, incorporating changes in inflammatory cytokines, corticosteroids, neurotrophins, mitochondrial energy generation, oxidative stress and neurogenesis into a more comprehensive model capable of explaining some of the clinical features of BD. These features include progressive shortening of the inter-episode interval with each recurrence, occurring in consort with reduced probability of treatment response as the illness progresses. To this end, emerging data shows that these biomarkers may differ between early and late stages of BD in parallel with stage-related structural and neurocognitive alterations. This understanding facilitates identification of rational therapeutic targets, and the development of novel treatment classes. Additionally, these pathways provide a cogent explanation for the efficacy of seemingly diverse therapies used in BD, that appear to share common effects on oxidative, inflammatory and neurotrophic pathways. (C) 2010 Elsevier Ltd. All rights reserved.
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