Machado-Vieira Rodrigo, Soeiro-De-Souza Marcio G, Richards Erica M, Teixeira Antonio L, Zarate Carlos A
Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, NIH , Bethesda, MD , USA.
World J Biol Psychiatry. 2014 Feb;15(2):84-95. doi: 10.3109/15622975.2013.830775. Epub 2013 Sep 2.
This paper reviews the neurobiology of bipolar disorder (BD), particularly findings associated with impaired cellular resilience and plasticity.
PubMed/Medline articles and book chapters published over the last 20 years were identified using the following keyword combinations: BD, calcium, cytokines, endoplasmic reticulum (ER), genetics, glucocorticoids, glutamate, imaging, ketamine, lithium, mania, mitochondria, neuroplasticity, neuroprotection, neurotrophic, oxidative stress, plasticity, resilience, and valproate.
BD is associated with impaired cellular resilience and synaptic dysfunction at multiple levels, associated with impaired cellular resilience and plasticity. These findings were partially prevented or even reversed with the use of mood stabilizers, but longitudinal studies associated with clinical outcome remain scarce.
Evidence consistently suggests that BD involves impaired neural plasticity and cellular resilience at multiple levels. This includes the genetic and intra- and intercellular signalling levels, their impact on brain structure and function, as well as the final translation into behaviour/cognitive changes. Future studies are expected to adopt integrated translational approaches using a variety of methods (e.g., microarray approaches, neuroimaging, genetics, electrophysiology, and the new generation of -omics techniques). These studies will likely focus on more precise diagnoses and a personalized medicine paradigm in order to develop better treatments for those who need them most.
本文综述双相情感障碍（BD）的神经生物学，特别是与细胞弹性和可塑性受损相关的研究结果。
使用以下关键词组合检索过去20年发表在PubMed/Medline上的文章和书籍章节：BD、钙、细胞因子、内质网（ER）、遗传学、糖皮质激素、谷氨酸、成像、氯胺酮、锂、躁狂、线粒体、神经可塑性、神经保护、神经营养、氧化应激、可塑性、弹性和丙戊酸盐。
BD与多个层面的细胞弹性受损和突触功能障碍相关，与细胞弹性和可塑性受损有关。使用心境稳定剂可部分预防甚至逆转这些发现，但与临床结局相关的纵向研究仍然很少。
证据一致表明，BD涉及多个层面的神经可塑性和细胞弹性受损。这包括遗传以及细胞内和细胞间信号传导层面、它们对脑结构和功能的影响，以及最终转化为行为/认知变化。未来的研究有望采用综合的转化方法，使用多种方法（如微阵列方法、神经成像、遗传学、电生理学和新一代组学技术）。这些研究可能会聚焦于更精确的诊断和个性化医疗模式，以便为最需要的人开发更好的治疗方法。
