Biomarkers of Bipolar Disorder in Late Life: An Evidence-Based Systematic Review

IF 5.5 2区 医学 Q1 PSYCHIATRY
R. Chancel, J. Lopez-Castroman, E. Baca-Garcia, R. Mateos Alvarez, Ph. Courtet, I. Conejero
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Abstract

Purpose of Review

Review the current evidence on biomarkers for bipolar disorder in the older adults. We conducted a systematic search of PubMed MEDLINE, PsycINFO, and Web of Science databases using the MeSH search terms "Biomarkers", "Bipolar Disorder", "Aged" and and “Aged, 80 and over”. Studies were included if they met the following criteria: (1) the mean age of the study population was 50 years old or older, (2) the study included patients with bipolar disorder, and (3) the study examined one type of biomarkers or more including genetic, neuroimaging, and biochemical biomarkers. Reviews, case reports, studies not in English and studies for which no full text was available were excluded. A total of 26 papers were included in the final analysis.

Recent Findings

Genomic markers of bipolar disorder in older adults highlighted the implication of serotonin metabolism, while the expression of genes involved in angiogenesis was dysregulated. Peripheral blood markers were mainly related with low grade inflammation, axonal damage, endothelial dysfunction, and the dysregulation of the HPA axis. Neuroanatomical markers reflected a dysfunction of the frontal cortex, a loss of neurones in the anterior cingulate cortex and a reduction of the hippocampal volume (in patients older than 50 years old). While not necessarily limited to older adults, some of them may be useful for differential diagnosis (neurofilaments), disease staging (homocysteine, BDNF) and the monitoring of treatment outcomes (matrix metalloproteinases).

Summary

Our review provides a comprehensive overview of the current evidence on biomarkers for bipolar disorder in the older adults. The identification of biomarkers may aid in the diagnosis, treatment selection, and monitoring of bipolar disorder in older adults, ultimately leading to improved outcomes for this population. Further research is needed to validate and further explore the potential clinical utility of biomarkers in this population.

Abstract Image

晚年双相情感障碍的生物标志物:基于证据的系统性综述
综述目的综述有关老年人双相情感障碍生物标志物的现有证据。我们使用 MeSH 检索词 "生物标志物"、"双相情感障碍"、"老年人 "和 "80 岁及以上老年人 "对 PubMed MEDLINE、PsycINFO 和 Web of Science 数据库进行了系统检索。符合以下标准的研究均被纳入:(1) 研究对象的平均年龄为 50 岁或以上;(2) 研究对象包括双相情感障碍患者;(3) 研究采用了一种或多种生物标记物,包括基因、神经影像和生化生物标记物。综述、病例报告、非英语研究以及没有全文的研究均被排除在外。最新研究结果老年人双相情感障碍的基因组标记强调了血清素代谢的影响,而血管生成相关基因的表达则出现了失调。外周血标志物主要与低度炎症、轴突损伤、内皮功能障碍和 HPA 轴调节失调有关。神经解剖标志物反映了额叶皮层的功能障碍、前扣带回皮层神经元的缺失和海马体积的缩小(50 岁以上的患者)。虽然不一定仅限于老年人,但其中一些生物标志物可能有助于鉴别诊断(神经丝)、疾病分期(同型半胱氨酸、BDNF)和监测治疗效果(基质金属蛋白酶)。生物标志物的确定可能有助于诊断、治疗选择和监测老年人躁郁症,最终改善这一人群的治疗效果。要验证和进一步探索生物标志物在这一人群中的潜在临床效用,还需要进一步的研究。
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来源期刊
CiteScore
11.30
自引率
3.00%
发文量
68
审稿时长
6-12 weeks
期刊介绍: This journal aims to review the most important, recently published research in psychiatry. By providing clear, insightful, balanced contributions by international experts, the journal intends to serve all those involved in the care of those affected by psychiatric disorders. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as anxiety, medicopsychiatric disorders, and schizophrenia and other related psychotic disorders. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
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