Towards a clinical staging for bipolar disorder: Defining patient subtypes based on functional outcome

Reinares, María; Papachristou, Efstathios; Harvey, P. Scott; Bonnín, C.M.; Sánchez-Moreno, José; Torrent, Carla; Ayuso-Mateos, José Luís; Ploubidis, George B.; Vieta, Eduard; Frangou, Sophia

doi:10.1016/j.jad.2012.06.005

Cited by 104 publications

(80 citation statements)

References 41 publications

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“…A possible caveat is related to the neuroprogression hypothesis. At this time, there are data suggesting that the biology of BD may vary according to illness stage (41,42). This may signify that BDNF levels only drop significantly in certain stages.…”

Section: Discussionmentioning

confidence: 99%

Val66Met polymorphism and serum brain‐derived neurotrophic factor in bipolar disorder: an open‐label trial

Grande

Magalhães

Chendo

et al. 2013

Acta Psychiatr Scand

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. Val66Met polymorphism and serum brainderived neurotrophic factor in bipolar disorder: an open-label trial.Objective: Brain-derived neurotrophic factor (BDNF) is consistently associated with acute mood episodes in bipolar disorder, but there is a lack of longitudinal data to support this hypothesis. In this 16-week open-label clinical trial, we tested the predictive role of BDNF Val66Met polymorphism on serum BDNF levels and the relationship of serum BDNF and clinical response in people with bipolar disorder during an acute illness episode. Method: Sixty-four people with bipolar disorder who were medicationfree at baseline and in an acute mood episode were recruited. They were matched with 64 healthy controls. Clinical evaluation, serum BDNF, and BDNF Val66Met polymorphism were determined at baseline, and change in serum BDNF was assessed in patients at weeks 2, 4, 8 and 16. Results: There were no differences between patients and controls in serum BDNF or in frequencies of the BDNF Val66Met polymorphism genotype at baseline. The multivariable model showed that Met carriers had a significantly different change in BDNF levels compared with Val homozygotes. Not achieving a complete remission was also associated with lower prospectively assessed BDNF levels. Conclusion: This study provides the first longitudinal evidence that both the BDNF Val66Met polymorphism and remission status predict change in circulating BDNF levels. Significant Outcomes• People with bipolar disorder had a differential change in peripheral levels of brain-derived neurotrophic factor along the treatment of mood episodes depending on their Val66Met genotype.• Met carriers of Val66Met genotype had a significantly different trajectory and a tendency for a less substantial increase in peripheral levels than Val homozygotes.• Change in brain-derived neurotrophic factor levels was associated with treatment response. Limitations• There were no differences in brain-derived neurotrophic factor levels between patients and controls at baseline; this is possibly due to a floor effect.• Owing to the naturalistic design of the study, we could not control for the effect of each particular treatment.

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Section: Discussionmentioning

confidence: 99%

Val66Met polymorphism and serum brain‐derived neurotrophic factor in bipolar disorder: an open‐label trial

Grande

Magalhães

Chendo

et al. 2013

Acta Psychiatr Scand

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“…Although all studies control for the effects of medication, there are very few studies with medication-free patients (44), and the influence of drugs on cognitive performance may be bimodal, with both positive and negative effects (45,46). The relevance of assessing cognition in patients with bipolar disorder is its high correlation with functional outcome (47)(48)(49)(50)(51). This model, which was initially tested in schizophrenia and subsequently in bipolar disorder, is now being analyzed in patients with unipolar depression (52).…”

Section: Cognition and Functioningmentioning

confidence: 99%

The bipolar maze: a roadmap through translational psychopathology

Vieta

2014

Acta Psychiatr Scand

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“…Within the domain of executive function, there is evidence of cognitive dysfunction in subjects with bipolar disorder (BP) specifically during the performance of tasks requiring response inhibition (Martinez-Aran et al, 2004;Swann et al, 2009a;Sole et al, 2011;Xu et al, 2012;Henry et al, 2013). Impairment in inhibitory control performance has been observed in subjects with bipolar disorder during mania and euthymia, and it has been shown to be a significant predictor of functional outcomes, including disability severity, quality of life and occupational functioning (Swann et al, 2009b;Reinares et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Frontal lobe hypoactivation in medication-free adults with bipolar II depression during response inhibition

Penfold¹,

Vizueta²,

Townsend³

et al. 2015

Psychiatry Research: Neuroimaging

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Towards a clinical staging for bipolar disorder: Defining patient subtypes based on functional outcome

Cited by 104 publications

References 41 publications

Val66Met polymorphism and serum brain‐derived neurotrophic factor in bipolar disorder: an open‐label trial

Val66Met polymorphism and serum brain‐derived neurotrophic factor in bipolar disorder: an open‐label trial

The bipolar maze: a roadmap through translational psychopathology

Frontal lobe hypoactivation in medication-free adults with bipolar II depression during response inhibition

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