File(s) under permanent embargo
From neuroprogression to neuroprotection : implications for clinical care
journal contribution
posted on 2010-08-16, 00:00 authored by Michael BerkMichael Berk, P Conus, F Kapczinski, A Andreazza, M Yücel, S Wood, C Pantelis, G Malhi, Seetal DoddSeetal Dodd, A Bechdolf, G Amminger, I Hickie, P McGorry• Bipolar disorder follows a staged trajectory in which persistence of illness is associated with a number of clinical features such as progressive shortening of the inter-episode interval and decreased probability of treatment response.
• This neuroprogressive clinical process is reflected by both progressive neuroanatomical changes and evidence of cognitive decline.
• The biochemical foundation of this process appears to incorporate changes in inflammatory cytokines, cortisone, neurotrophins and oxidative stress. There is a growing body of evidence to suggest that these markers may differ between the early and late stages of the disorder.
• The presence of a series of tangible targets raises the spectre of development of rational neuroprotective strategies, involving judicious use of current therapies and novel agents. Most of the currently used mood stabilisers share effects on oxidative stress and neurotrophins, while novel potentially neuroprotective agents are being developed. These developments need to be combined with service initiatives to maximise the opportunities for early diagnosis and intervention.
• This neuroprogressive clinical process is reflected by both progressive neuroanatomical changes and evidence of cognitive decline.
• The biochemical foundation of this process appears to incorporate changes in inflammatory cytokines, cortisone, neurotrophins and oxidative stress. There is a growing body of evidence to suggest that these markers may differ between the early and late stages of the disorder.
• The presence of a series of tangible targets raises the spectre of development of rational neuroprotective strategies, involving judicious use of current therapies and novel agents. Most of the currently used mood stabilisers share effects on oxidative stress and neurotrophins, while novel potentially neuroprotective agents are being developed. These developments need to be combined with service initiatives to maximise the opportunities for early diagnosis and intervention.
History
Journal
Medical journal of australiaVolume
193Issue
4Pagination
36 - 40Publisher
Australasian Medical Publishing CompanyLocation
Strawberry Hills, N.S.W.ISSN
0025-729XLanguage
engPublication classification
C1.1 Refereed article in a scholarly journalCopyright notice
2010, Australasian Medical Publishing CompanyUsage metrics
Categories
Keywords
Science & TechnologyLife Sciences & BiomedicineMedicine, General & InternalGeneral & Internal MedicineMAGNETIC-RESONANCE SPECTROSCOPYINCREASED OXIDATIVE STRESSBIPOLAR AFFECTIVE-DISORDERANTERIOR CINGULATE CORTEXACUTE MANIC EPISODESN-ACETYL-ASPARTATEIN-VIVO EVIDENCENEUROTROPHIC FACTORPSYCHIATRIC-DISORDERSEUTHYMIC PATIENTS