The Relationship between the Number of Manic Episodes and Oxidative Stress Indicators in Bipolar Disorder

Abstract

ObjectiveBipolar disorder (BD) is a chronic mood disorder characterized by recurrent episodes that has a lifetime prevalence of 0.4–5.5%. The neurochemical mechanism of BD is not fully understood. Oxidative stress in neurons causes lipid peroxidation in proteins associated with neuronal membranes and intracellular enzymes and it may lead to dysfunction in neurotransmitter reuptake and enzyme activities. These pathological processes are thought to occur in brain regions associated with affective functions and emotions in BD. The relationship between the number of manic episodes and total oxidant-antioxidant capacity was investigated in this study.MethodsEighty-two BD patients hospitalized due to manic symptoms and with no episodes of depression were enrolled in the study. Thirty of the 82 patients had had their first episode of mania, and the other 52 patients had had two or more manic episodes. The control group included 45 socio-demographically matched healthy individuals. Serum total antioxidant capacity (TAC) and total oxidant capacity (TOC) measurements of the participants were performed. The oxidative stress index (OSI) was calculated by TOC/TAC.ResultsThere were no significant differences in OSI scores between BD patients with first-episode mania and BD patients with more than one manic episode. However, OSI scores in both groups were significantly higher than in the control group. TOC levels of BD patients with first-episode mania were found to be significantly higher than TOC levels of BD patients with more than one manic episode and healthy controls. There were no significant differences in TAC levels between BD patients with first-episode mania and BD patients with more than one manic episode. TAC levels in both groups were significantly higher than in the control group.ConclusionSignificant changes in oxidative stress indicators were observed in this study, confirming previous studies. Increased levels of oxidants were shown with increased disease severity rather than with the number of manic episodes. Systematic studies, including of each period of the disorder, are needed for using the findings indicating deterioration of oxidative parameters.

Oxidative stress parameters and antioxidants in patients with bipolar disorder: Results from a meta‐analysis comparing patients, including stratification by polarity and euthymic status, with healthy controls

“…Finally, the combined analysis of SOD + CAT activity, which is a measure of antioxidant status, showed a significant increase in patients with BD vs HCs. A previous study found an elevated total antioxidant capacity in patients with BD vs HCs, irrespective of the number of manic episodes 52 . In our analysis, increased SOD + CAT activity was also observed in patients with a symptomatic affective phase of the disease, but not in those with euthymia, with differences according to manic or depressive polarity.…”

Andrographolide blocks 50-kHz ultrasonic vocalizations, hyperlocomotion and oxidative stress in an animal model of mania

“…Menegas et al (2020), using the methamphetamine administration model of mania, also observed correlations between hyperlocomotion and lipid damage parameters in the striatum of rats. Clinically, a positive correlation between mania severity (Young Mania Rating Scale) and peripheral oxidative stress index was also (Akarsu et al, 2018) observed which supports the relevance of our pre-clinical approach.…”

“…Repeated lithium and ANDRO treatment prevented LDX-induced increases in LPO in rat striatum. Increased generation of reactive oxygen species and free radicals are involved in the pathophysiology of bipolar disorder, as increases in serum/plasma LPO occur in different phases and are associated to illness severity and/or the number of manic episodes (Andreazza et al, 2007;Machado-Vieira et al, 2007;Brown et al, 2014;Sowa--Kućma et al, 2018;Akarsu et al, 2018). In this line, high concentrations of phospholipids make brain tissues more vulnerable to oxidative stress induced by LPO (Banerjee et al, 2012).…”

Therapeutic Interventions to Mitigate Mitochondrial Dysfunction and Oxidative Stress–Induced Damage in Patients with Bipolar Disorder

“…As specified earlier, a frequent finding in patients with BD is the increase in antioxidant marker levels [116], which is likely part of a compensatory response to prevent oxidative damage. Yumru et al found that serum SOD (an antioxidant marker) was significantly elevated in patients with depression and mania compared with controls [73].…”