Department of Psychiatry and Medical Psychology, Faculty of Medicine and Research Institute, Medical University of Plovdiv, Plovdiv, Bulgaria.
Curr Top Med Chem. 2021;21(11):949-963. doi: 10.2174/1568026621666210521144534.
Major Depressive Disorder (MDD) and Bipolar Disorder (BD) have a high prevalence and detrimental socio-economic consequences for the patients and the community. Furthermore, the depressive symptomatology of both disorders is essentially identical, thus rendering the clinical differential diagnosis between the two significantly more difficult considering the concomitant lack of objective biomarkers. Mood disorders are multifactorial disorders the pathophysiology of which includes genetic, epigenetic, neurobiological, neuroimmunological, structural and functional brain alterations, etc. Aberrant genetic variants as well as changed differential expression of microRNAs (miRNAs) and long non-coding RNAs (lncRNAs) have been implicated in the pathophysiology of MDD and BD. MiRNAs as well as lncRNAs have regulatory and modulating functions on protein-- coding gene expression thus influencing the remodeling of the architecture, neurotransmission, immunomodulation, etc. in the Central Nervous System (CNS) which are essential in the development of psychiatric disorders including MDD and BD. Moreover, both shared and distinct structural, connectivity, task-related and metabolic features have been observed via functional magnetic resonance imaging and magnetic resonance spectroscopy, suggesting the possibility of a dimensional continuum between the two disorders instead of a categorical differentiation. Aberrant connectivity within and between the Default Mode Network, the Salience Network, Executive Network, etc. as well as dysfunctional emotion, cognitive and executive processing have been associated with mood disorders. Therefore, the aim of this review is to explore a more multidimensional framework in the scientific research of mood disorders, including epigenetic and neuroimaging data in order to shape an outline for their translational capacity in clinical practice.
重度抑郁症（MDD）和双相情感障碍（BD）的患病率较高，对患者和社区都有不利的社会经济后果。此外，两种疾病的抑郁症状基本相同，因此考虑到缺乏客观的生物标志物，两者之间的临床鉴别诊断更加困难。情绪障碍是一种多因素疾病，其病理生理学包括遗传、表观遗传、神经生物学、神经免疫、结构和功能脑改变等。异常的遗传变异以及 microRNAs（miRNAs）和长非编码 RNA（lncRNAs）的差异表达改变与 MDD 和 BD 的病理生理学有关。miRNAs 和 lncRNAs 对蛋白质编码基因表达具有调节和调节功能，从而影响中枢神经系统（CNS）的结构重塑、神经传递、免疫调节等，这对于包括 MDD 和 BD 在内的精神疾病的发展至关重要。此外，通过功能磁共振成像和磁共振波谱观察到两者之间存在共享和独特的结构、连接、任务相关和代谢特征，这表明这两种疾病之间存在维度连续体的可能性，而不是分类差异。默认模式网络、突显网络、执行网络等内部和之间的连接异常以及情绪、认知和执行处理功能障碍与情绪障碍有关。因此，本综述的目的是探索情绪障碍科学研究中的一个更具多维性的框架，包括表观遗传学和神经影像学数据，以构建其在临床实践中的转化能力的框架。
