Areas of controversy in neuroprogression in bipolar disorder

Objective We aimed to review clinical features and biological underpinnings related to neuroprogression in bipolar disorder (BD). Also, we discussed areas of controversy and future research in the field. Method We systematically reviewed the extant literature pertaining to neuroprogression and BD by...

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Bibliographic Details
Published in:Acta psychiatrica Scandinavica 2016-08, Vol.134 (2), p.91-103
Main Authors: Passos, I. C., Mwangi, B., Vieta, E., Berk, M., Kapczinski, F.
Format: Article
Language:English
Subjects:
Bipolar disorder
Bipolar Disorder - diagnostic imaging
Bipolar Disorder - pathology
Bipolar Disorder - psychology
Brain - diagnostic imaging
Brain - pathology
Cross-Sectional Studies
Disease Progression
functional impairment
Humans
inflammation
Longitudinal Studies
machine learning
Medical imaging
Neuroimaging - methods
neuroprogression
Psychiatry
Risk Factors
treatment refractoriness
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Summary:Objective We aimed to review clinical features and biological underpinnings related to neuroprogression in bipolar disorder (BD). Also, we discussed areas of controversy and future research in the field. Method We systematically reviewed the extant literature pertaining to neuroprogression and BD by searching PubMed and EMBASE for articles published up to March 2016. Results A total of 114 studies were included. Neuroimaging and clinical evidence from cross‐sectional and longitudinal studies show that a subset of patients with BD presents a neuroprogressive course with brain changes and unfavorable outcomes. Risk factors associated with these unfavorable outcomes are number of mood episodes, early trauma, and psychiatric and clinical comorbidity. Conclusion Illness trajectories are largely variable, and illness progression is not a general rule in BD. The number of manic episodes seems to be the clinical marker more robustly associated with neuroprogression in BD. However, the majority of the evidence came from cross‐sectional studies that are prone to bias. Longitudinal studies may help to identify signatures of neuroprogression and integrate findings from the field of neuroimaging, neurocognition, and biomarkers.
ISSN:0001-690X
1600-0447
DOI:10.1111/acps.12581