A critical overview of the clinical evidence supporting the concept of neuroprogression in bipolar disorder.

MARTINO DJ., SAMAMÉ C., MARENGO E., IGOA A., STREJILEVICH SA.

PSYCHIATRY RESEARCH

ELSEVIER IRELAND LTD

Lugar: Amsterdam; Año: 2016 vol. 235 p. 1 - 6

0165-1781

The aim of this work was to review the clinical evidence about neuroprogression in bipolar disorder (BD). We included studies belonging to 4 clinical domains (episode recurrences, cognitive functioning, functional outcome, and response to treatment) acknowledged as being ?in favor? of the hypothesis of neuroprogression in previous reviews. Additional material was derived by literature searches of relevant publications and with focus on the longitudinal course of BD. Results are not entirely consistent regard if cycle lengths increased or decreased over the course of the disorder. Cycle acceleration could exist in a subgroup among patients with the most severe forms of bipolar disorder. On the other hand, preliminary evidence from longitudinal studies suggests that cognitive impairments might be stable rather than progressive. Results derived from cross-sectional studies comparing patients with many and few previous episodes should be interpreted with caution as they may be merely the result of selection bias. Altogether, the clinical evidence supporting the concept of neuroprogression in BD is scarce and limited. Further longitudinal studies are needed to clarify if BD patients (or a subset of them) have a progressive clinical course or not.