Translational Psychiatry Program Louis A. Faillace, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.
Laboratório de Psiquiatria Translacional, Programa de Pós-Graduação em Ciências da Saúde, Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC, Brazil.
Braz J Psychiatry. 2020 Sep-Oct;42(5):536-551. doi: 10.1590/1516-4446-2019-0732.
Bipolar disorder (BD) is a chronic mental illness characterized by changes in mood that alternate between mania and hypomania or between depression and mixed states, often associated with functional impairment. Although effective pharmacological and non-pharmacological treatments are available, several patients with BD remain symptomatic. The advance in the understanding of the neurobiology underlying BD could help in the identification of new therapeutic targets as well as biomarkers for early detection, prognosis, and response to treatment in BD. In this review, we discuss genetic, epigenetic, molecular, physiological and neuroimaging findings associated with the neurobiology of BD. Despite the advances in the pathophysiological knowledge of BD, the diagnosis and management of the disease are still essentially clinical. Given the complexity of the brain and the close relationship between environmental exposure and brain function, initiatives that incorporate genetic, epigenetic, molecular, physiological, clinical, environmental data, and brain imaging are necessary to produce information that can be translated into prevention and better outcomes for patients with BD.
双相情感障碍（BD）是一种慢性精神疾病，其特征是情绪变化，在躁狂和轻躁狂或抑郁和混合状态之间交替，常伴有功能障碍。尽管有有效的药物和非药物治疗方法，但仍有一些 BD 患者存在症状。对 BD 潜在神经生物学的认识的进步可以帮助确定新的治疗靶点，以及用于早期检测、预后和对 BD 治疗反应的生物标志物。在这篇综述中，我们讨论了与 BD 神经生物学相关的遗传、表观遗传、分子、生理和神经影像学发现。尽管 BD 的病理生理学知识有了进展，但该疾病的诊断和管理仍然主要是临床的。鉴于大脑的复杂性以及环境暴露与大脑功能之间的密切关系，有必要采取包括遗传、表观遗传、分子、生理、临床、环境数据和脑成像在内的综合措施，以产生可转化为预防和改善 BD 患者结局的信息。
