Kapczinski Natália S, Mwangi Benson, Cassidy Ryan M, Librenza-Garcia Diego, Bermudez Mariane Bagatin, Kauer-Sant'anna Márcia, Kapczinski Flávio, Passos Ives Cavalcante
a Bipolar Disorder Program , Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA) , Porto Alegre , Brazil.
b Graduation Program in Psychiatry and Department of Psychiatry , Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre , Brazil.
Expert Rev Neurother. 2017 Mar;17(3):277-285. doi: 10.1080/14737175.2017.1240615. Epub 2016 Oct 3.
The longitudinal course of bipolar disorder is highly variable, and a subset of patients seems to present a progressive course associated with brain changes and functional impairment. Areas covered: We discuss the theory of neuroprogression in bipolar disorder. This concept considers the systemic stress response that occurs within mood episodes and late-stage deficits in functioning and cognition as well as neuroanatomic changes. We also discuss treatment refractoriness that may take place in some cases of bipolar disorder. We searched PubMed for articles published in any language up to June 4, 2016. We found 315 abstracts and included 87 studies in our review. Expert commentary: We are of the opinion that the use of specific pharmacological strategies and functional remediation may be potentially useful in bipolar patients at late-stages. New analytic approaches using multimodal data hold the potential to help in identifying signatures of subgroups of patients who will develop a neuroprogressive course.
双相情感障碍的病程具有高度变异性，一部分患者似乎呈现出与脑改变和功能损害相关的进行性病程。涵盖领域：我们讨论双相情感障碍的神经进展理论。这一概念将情绪发作期间发生的全身应激反应、后期功能和认知缺陷以及神经解剖学变化考虑在内。我们还讨论双相情感障碍某些病例中可能出现的治疗难治性。我们在PubMed上检索截至2016年6月4日以任何语言发表的文章。我们找到315篇摘要，并在综述中纳入了87项研究。专家评论：我们认为，使用特定的药理学策略和功能修复可能对晚期双相情感障碍患者有潜在帮助。使用多模态数据的新分析方法有潜力帮助识别将发展为神经进行性病程的患者亚组特征。
