Bipolar disorder staging and the impact it has on its management: an update.

IF 3.4 2区 医学 Q2 CLINICAL NEUROLOGY Expert Review of Neurotherapeutics Pub Date : 2024-06-01 Epub Date: 2024-05-16 DOI:10.1080/14737175.2024.2355264
Bernardo Dell'Osso, Laura Cremaschi, Monica Macellaro, Rita Cafaro, Nicolaja Girone
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Abstract

Introduction: The longitudinal course of bipolar disorder (BD) is associated with an active process of neuroprogression, characterized by structural brain alterations and progressive functional impairment. In the last decades, a growing need of a standardized staging model for BD arose, with the aim of a more appropriate definition of stage-specific clinical manifestations and the identification of more customized therapeutic tools.

Areas covered: The authors review the literature on clinical aspects, neurobiological correlates and treatment issues related to BD progression. Thereafter, they address the definition, constructs, and evolution of the staging concept, focusing on the clinical applications of BD staging models available in literature.

Expert opinion: Although several staging models for BD have been proposed to date, their application in clinical practice is still relatively scant. This may have a detrimental impact on the clinical and therapeutic management of BD, in terms of early and proper diagnosis as well as tailored treatment interventions according to the different stages of illness. Future research efforts should tend to the integration of recent insights on neuroimaging and epigenetic markers, toward a standardized and multidimensional staging model.

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躁郁症分期及其对治疗的影响:最新进展。
简介双相情感障碍(BD)的纵向病程与活跃的神经进展过程有关,其特点是大脑结构改变和进行性功能损害。在过去的几十年中,人们越来越需要为双相情感障碍建立一个标准化的分期模型,以便更恰当地定义特定阶段的临床表现,并确定更加个性化的治疗工具:作者回顾了有关 BD 进展的临床方面、神经生物学相关性和治疗问题的文献。之后,他们讨论了分期概念的定义、构建和演变,重点关注文献中现有 BD 分期模型的临床应用:专家观点:尽管迄今为止已提出了多个 BD 分期模型,但其在临床实践中的应用仍相对较少。这可能会对 BD 的临床和治疗管理产生不利影响,包括早期和正确诊断,以及根据疾病的不同阶段进行有针对性的治疗干预。未来的研究工作应倾向于整合神经影像学和表观遗传学标志物的最新研究成果,以建立一个标准化的多维分期模型。
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来源期刊
Expert Review of Neurotherapeutics
Expert Review of Neurotherapeutics Medicine-Neurology (clinical)
CiteScore
7.00
自引率
2.30%
发文量
61
审稿时长
4-8 weeks
期刊介绍: Expert Review of Neurotherapeutics (ISSN 1473-7175) provides expert reviews on the use of drugs and medicines in clinical neurology and neuropsychiatry. Coverage includes disease management, new medicines and drugs in neurology, therapeutic indications, diagnostics, medical treatment guidelines and neurological diseases such as stroke, epilepsy, Alzheimer''s and Parkinson''s. Comprehensive coverage in each review is complemented by the unique Expert Review format and includes the following sections: Expert Opinion - a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results Article Highlights – an executive summary of the author’s most critical points
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