Roda Ângela, Chendo Inês, Kunz Mauricio
Faculdade de Medicina de Lisboa, Lisbon, Portugal.
Faculdade de Medicina de Lisboa, University Clinic, Lisboa, Portugal.
Trends Psychiatry Psychother. 2015 Jan-Mar;37(1):3-11. doi: 10.1590/2237-6089-2014-0002. Epub 2014 Dec 9.
A growing body of evidence suggests that bipolar disorder (BD) is a progressive disease according to clinical, biochemical and neuroimaging findings. This study reviewed the literature on the relationship between specific biomarkers and BD stages.
A comprehensive literature search of MEDLINE and PubMed was conducted to identify studies in English and Portuguese using the keywords biomarker, neurotrophic factors, inflammation, oxidative stress, neuroprogression and staging models cross-referenced with bipolar disorder.
Morphometric studies of patients with BD found neuroanatomic abnormalities, such as ventricular enlargement, grey matter loss in the hippocampus and cerebellum, volume decreases in the prefrontal cortex and variations in the size of the amygdala. Other studies demonstrated that serum concentrations of neurotrophic factors, inflammatory mediators and oxidative stress may be used as BD biomarkers.
The analysis of neurobiological changes associated with BD progression and activity may confirm the existence of BD biomarkers, which may be then included in staging models that will lead to improvements in treatment algorithms and more effective, individually tailored treatment regimens. Biomarkers may also be used to define early interventions to control disease progression.
越来越多的证据表明，根据临床、生化和神经影像学研究结果，双相情感障碍（BD）是一种进行性疾病。本研究回顾了关于特定生物标志物与BD分期之间关系的文献。
对MEDLINE和PubMed进行全面的文献检索，以识别使用生物标志物、神经营养因子、炎症、氧化应激、神经进展和分期模型等关键词，并与双相情感障碍交叉引用的英文和葡萄牙文研究。
对BD患者的形态学研究发现了神经解剖学异常，如脑室扩大、海马体和小脑灰质丢失、前额叶皮质体积减小以及杏仁核大小变化。其他研究表明，神经营养因子、炎症介质和氧化应激的血清浓度可作为BD生物标志物。
对与BD进展和活动相关的神经生物学变化的分析可能会证实BD生物标志物的存在，这些生物标志物随后可能会被纳入分期模型，从而改进治疗算法并制定更有效、个性化的治疗方案。生物标志物还可用于确定控制疾病进展的早期干预措施。
