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Chancel R, Lopez-Castroman J, Baca-Garcia E, Mateos Alvarez R, Courtet P, Conejero I. Biomarkers of Bipolar Disorder in Late Life: An Evidence-Based Systematic Review. Curr Psychiatry Rep 2024; 26:78-103. [PMID: 38470559 DOI: 10.1007/s11920-024-01483-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/09/2024] [Indexed: 03/14/2024]
Abstract
PURPOSE OF REVIEW Review the current evidence on biomarkers for bipolar disorder in the older adults. We conducted a systematic search of PubMed MEDLINE, PsycINFO, and Web of Science databases using the MeSH search terms "Biomarkers", "Bipolar Disorder", "Aged" and and "Aged, 80 and over". Studies were included if they met the following criteria: (1) the mean age of the study population was 50 years old or older, (2) the study included patients with bipolar disorder, and (3) the study examined one type of biomarkers or more including genetic, neuroimaging, and biochemical biomarkers. Reviews, case reports, studies not in English and studies for which no full text was available were excluded. A total of 26 papers were included in the final analysis. RECENT FINDINGS Genomic markers of bipolar disorder in older adults highlighted the implication of serotonin metabolism, while the expression of genes involved in angiogenesis was dysregulated. Peripheral blood markers were mainly related with low grade inflammation, axonal damage, endothelial dysfunction, and the dysregulation of the HPA axis. Neuroanatomical markers reflected a dysfunction of the frontal cortex, a loss of neurones in the anterior cingulate cortex and a reduction of the hippocampal volume (in patients older than 50 years old). While not necessarily limited to older adults, some of them may be useful for differential diagnosis (neurofilaments), disease staging (homocysteine, BDNF) and the monitoring of treatment outcomes (matrix metalloproteinases). Our review provides a comprehensive overview of the current evidence on biomarkers for bipolar disorder in the older adults. The identification of biomarkers may aid in the diagnosis, treatment selection, and monitoring of bipolar disorder in older adults, ultimately leading to improved outcomes for this population. Further research is needed to validate and further explore the potential clinical utility of biomarkers in this population.
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Affiliation(s)
- R Chancel
- PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, France
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
| | - J Lopez-Castroman
- Department of Psychiatry, Nimes University Hospital, Nimes, France
- Department of Signal Theory and Communications, Carlos III University, Madrid, Spain
- Institut de Génomique Fonctionnelle, University of Montpellier, CNRS-INSERM, Montpellier, France
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - E Baca-Garcia
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
- Universidad Autónoma de Madrid, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Central de Villalba, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Infanta Elena, Valdemoro, Madrid, Spain
- Universidad Católica del Maude, Talca, Chile
- CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - R Mateos Alvarez
- Department of Psychiatry, University of Santiago de Compostela, Santiago de Compostela, Spain
- Psychogeriatric Unit, CHUS University Hospital, Santiago de Compostela, Spain
| | - Ph Courtet
- PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, France
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
| | - I Conejero
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain.
- Universidad Autónoma de Madrid, Madrid, Spain.
- Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.
- Department of Psychiatry, CHU Nîmes, PSNREC, INSERM, University of Montpellier, Nîmes, France.
- Pôle de psychiatrie, CHU Nîmes, Rue du Professeur Robert Debré, 30900, Nîmes, France.
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