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Increased excitotoxicity and neuroinflammatory markers in postmortem frontal cortex from bipolar disorder patients.
Mol Psychiatry. 2009 Jun 2;
Authors: Rao JS, Harry GJ, Rapoport SI, Kim HW
Reports of cognitive decline, symptom worsening and brain atrophy in bipolar disorder (BD) suggest that the disease progresses over time. The worsening neuropathology may involve excitotoxicity and neuroinflammation. We determined protein and mRNA levels of excitotoxicity and neuroinflammatory markers in postmortem frontal cortex from 10 BD patients and 10 age-matched controls. The brain tissue was matched for age, postmortem interval and pH. The results indicated statistically significant lower protein and mRNA levels of the N-methyl-D-aspartate receptors, NR-1 and NR-3A, but significantly higher protein and mRNA levels of interleukin (IL)-1beta, the IL-1 receptor (IL-1R), myeloid differentiation factor 88, nuclear factor-kappa B subunits, and astroglial and microglial markers (glial fibrillary acidic protein, inducible nitric oxide synthase, c-fos and CD11b) in postmortem frontal cortex from BD compared with control subjects. There was no significant difference in mRNA levels of tumor necrosis factor alpha or neuronal nitric oxide synthase in the same region. These data show the presence of excitotoxicity and neuroinflammation in BD frontal cortex, with particular activation of the IL-R cascade. The changes may account for reported evidence of disease progression in BD and be a target for future therapy.Molecular Psychiatry advance online publication, 2 June 2009; doi:10.1038/mp.2009.47.
PMID: 19488045 [PubMed – as supplied by publisher]
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If and when neuroendocrinologic, psychoimmunologic and metabolic pathophysiology is considered in mainstream psychiatry, the more complete pathophysiology of bipolar disorder may be assessed and targetted in treatment. Otherwise, the best current FDA-approved mood stabilizing treatment can do is a 30% reduction in severity of symptoms of illness.