Insulin Resistance and Blood-Brain Barrier Dysfunction Underlie Neuroprogression in Bipolar Disorder.

Frontiers in Psychiatry
Cynthia CalkinAlon Friedman

Abstract

Bipolar disorder (BD) often progresses to a more chronic and treatment resistant (neuroprogressive) course. Identifying which patients are at risk could allow for early intervention and prevention. Bipolar disorder is highly comorbid with metabolic disorders including type II diabetes mellitus (T2DM), hypertension, obesity, and dyslipidemia. Our studies have shown that insulin resistance (IR) is present in over 50% of patients with BD and that IR might underlie the progression of BD. While no confirmed predictors exist for identifying which patients with BD are likely to develop a more chronic course, emerging evidence including our own studies suggest that IR and related inflammatory pathways lead to impairments in blood-brain barrier (BBB) functioning. For the first time in living psychiatric patients, we have shown that the severity of BBB leakage is proportional to BD severity and is associated with IR. In this hypothesis paper we (i) highlight the evidence for a key role of IR in BD, (ii) show how IR in BD relates to shared inflammatory pathways, and (iii) hypothesize that these modulations result in BBB leakage and worse outcomes in BD. We further hypothesize that (iv) reversing IR through lifestyle changes or the actions...Continue Reading

References

Apr 30, 1996·Proceedings of the National Academy of Sciences of the United States of America·Y I ShelineM W Vannier
Sep 30, 1999·Journal of Psychiatric Research·J K Rybakowski, K Twardowska
May 16, 2001·Archives of General Psychiatry·A ReichenbergT Pollmächer
Sep 26, 2001·Archives of General Psychiatry·U OsbyP Sparén
Apr 3, 2002·Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology·Lucile CapuronAndrew H Miller
Jun 5, 2002·Archives of General Psychiatry·Lewis L JuddMartin B Keller
Sep 16, 2003·Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie·Martina RuzickovaMartin Alda
Jun 3, 2004·The British Journal of Psychiatry : the Journal of Mental Science·Stuart WatsonAllan H Young
Jul 23, 2004·Expert Opinion on Investigational Drugs·Norbert MüllerMichael Riedel
Oct 19, 2004·Journal of Affective Disorders·Fotini BoufidouGeorge N Christodoulou
May 12, 2006·International Clinical Psychopharmacology·Nicoletta BrunelloJulien Mendlewicz
Feb 13, 2007·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Steven R Ennis, Richard F Keep
Apr 17, 2007·Journal of Affective Disorders·Yong-Ku KimSun-Hwa Park
Oct 4, 2007·The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry·Pia GudmundssonDeborah Gustafson
Nov 10, 2007·Journal of Neurology, Neurosurgery, and Psychiatry·O TomkinsA Friedman
Jun 10, 2008·Journal of Affective Disorders·Ana C AndreazzaLakshmi N Yatham
Jan 20, 2009·Biological Psychiatry·Andrew H MillerCharles L Raison
Feb 21, 2009·Nature Clinical Practice. Endocrinology & Metabolism·Arshag D Mooradian
Mar 3, 2009·Journal of Affective Disorders·Elisa BrietzkeFlávio Kapczinski
Mar 31, 2009·Biomarkers : Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals·Yuval KonstantinoDavid A Fryburg
Jul 17, 2009·The Journal of Neuroscience : the Official Journal of the Society for Neuroscience·Luisa P CacheauxDaniela Kaufer
Aug 12, 2009·Neurobiology of Disease·N Joan AbbottDavid J Begley
Aug 20, 2009·Bipolar Disorders·Cynthia CalkinMartin Alda
Aug 28, 2009·The Journal of Neuroscience : the Official Journal of the Society for Neuroscience·Yaron DavidAlon Friedman
Dec 5, 2009·CNS Drugs·Chaya G BhuvaneswarJonathan E Alpert

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