Brain Sciences (Feb 2021)

Neuroprogression as an Illness Trajectory in Bipolar Disorder: A Selective Review of the Current Literature

  • Gianluca Serafini,
  • Matteo Pardini,
  • Fiammetta Monacelli,
  • Beatrice Orso,
  • Nicola Girtler,
  • Andrea Brugnolo,
  • Mario Amore,
  • Flavio Nobili,
  • Disease Management Team on Dementia of the IRCCS Ospedale Policlinico San Martino

DOI
https://doi.org/10.3390/brainsci11020276
Journal volume & issue
Vol. 11, no. 2
p. 276

Abstract

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Bipolar disorder (BD) is a chronic and disabling psychiatric condition that is linked to significant disability and psychosocial impairment. Although current neuropsychological, molecular, and neuroimaging evidence support the existence of neuroprogression and its effects on the course and outcome of this condition, whether and to what extent neuroprogressive changes may impact the illness trajectory is still poorly understood. Thus, this selective review was aimed toward comprehensively and critically investigating the link between BD and neurodegeneration based on the currently available evidence. According to the most relevant findings of the present review, most of the existing neuropsychological, neuroimaging, and molecular evidence demonstrates the existence of neuroprogression, at least in a subgroup of BD patients. These studies mainly focused on the most relevant effects of neuroprogression on the course and outcome of BD. The main implications of this assumption are discussed in light of specific shortcomings/limitations, such as the inability to carry out a meta-analysis, the inclusion of studies with small sample sizes, retrospective study designs, and different longitudinal investigations at various time points.

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