Neurobiological trait abnormalities in bipolar disorder
Langan, C McDonald, C
Langan, C
McDonald, C
Identifiers
http://hdl.handle.net/10379/12376
https://doi.org/10.13025/27670
https://doi.org/10.13025/27670
Repository DOI
Publication Date
2009-05-19
Keywords
bipolar disorder, neurobiology, neurotrophins, magnetic resonance imaging, positron emission tomography, magnetic-resonance-spectroscopy, voxel-based morphometry, term lithium treatment, working-memory task, protein-kinase-a, platelet membrane phosphatidylinositol-4,5-bisphosphate, white-matter hyperintensities, signal-transduction pathways, subgenual prefrontal cortex, neurotrophic factor levels
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Article
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Langan, C; McDonald, C (2009). Neurobiological trait abnormalities in bipolar disorder. Molecular Psychiatry 14 (9), 833-846
Abstract
Dissecting trait neurobiological abnormalities in bipolar disorder ( BD) from those characterizing episodes of mood disturbance will help elucidate the aetiopathogenesis of the illness. This selective review highlights the immunological, neuroendocrinological, molecular biological and neuroimaging abnormalities characteristic of BD, with a focus on those likely to reflect trait abnormalities by virtue of their presence in euthymic patients or in unaffected relatives of patients at high genetic liability for illness. Trait neurobiological abnormalities of BD include heightened pro-inflammatory function and hypothalamic-pituitary-adrenal axis dysfunction. Dysfunction in the intracellular signal transduction pathway is indicated by elevated protein kinase A activity and altered intracellular calcium signalling. Consistent neuroimaging abnormalities include the presence of ventricular enlargement and white matter abnormalities in patients with BD, which may represent intermediate phenotypes of illness. In addition, spectroscopy studies indicate reduced prefrontal cerebral N-acetylaspartate and phosphomonoester concentrations. Functional neuroimaging studies of euthymic patients implicate inherently impaired neural networks subserving emotional regulation, including anterior limbic, ventral and dorsal prefrontal regions. Despite heterogeneous samples and conflicting findings pervading the literature, there is accumulating evidence for the existence of neurobiological trait abnormalities in BD at various scales of investigation. The aetiopathogenesis of BD will be better elucidated by future clinical research studies, which investigate larger and more homogenous samples and employ a longitudinal design to dissect neurobiological abnormalities that are underlying traits of the illness from those related to episodes of mood exacerbation or pharmacological treatment. Molecular Psychiatry (2009) 14, 833-846; doi:10.1038/mp.2009.39; published online 19 May 2009
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Publisher
Springer Nature
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Attribution-NonCommercial-NoDerivs 3.0 Ireland