Citation

Sigitova E, Fišar Z, Hroudová J, Cikánková T, Raboch J. Psychiatry Clin. Neurosci. 2016; 71(2): 77-103.

Affiliation

Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Ke Karlovu 11, 120 00 Prague 2, Czech Republic.

Copyright

(Copyright © 2016, John Wiley and Sons)

DOI

10.1111/pcn.12476

PMID

27800654

Abstract

The most common mood disorders are major depressive disorders and bipolar disorders. The pathophysiology of bipolar disorder is complex, multifactorial, and not fully understood. Creation of new hypotheses in the field gives impetus for studies and searching new biomarkers of the bipolar disorder. Conversely, new biomarkers facilitate not only diagnosis of a disorder and monitoring of biological effects of treatment, but also formulation of new hypotheses of the causes and pathophysiology of the bipolar disorder. Bipolar disorder is characterized by multiple associations between disturbed brain development, neuroplasticity, and chronobiology, caused by genetic and environmental factors, and defects in apoptotic, immune-inflammatory, neurotransmitter, neurotrophin, and calcium signaling pathways, oxidative and nitrosative stress, cellular bioenergetics, and membrane or vesicular transport. Current biological hypotheses of bipolar disorder are summarized, including related pathophysiological processes and key biomarkers, which have been associated with changes in genetics, systems of neurotransmitter and neurotrophic factors, neuroinflammation, autoimmunity, cytokines, stress axis activity, chronobiology, oxidative stress, and mitochondrial dysfunctions. Therapeutic hypotheses and mechanisms of the switch between depressive and manic state are discussed.

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Language: en