The Link between Refractoriness and Neuroprogression in Treatment-Resistant Bipolar Disorder.
The Link between Refractoriness and Neuroprogression in Treatment-Resistant Bipolar Disorder.
复制标题
DOI：
10.1159/000470803
复制
发表时间：
2017-01-01
期刊：
影响因子：
--
通讯作者：
Meyer, Thomas D
中科院分区：
文献类型：
--
作者：
Bauer, Isabelle E;Soares, Jair C;Meyer, Thomas D
治疗难治性仍然是双相情感障碍 (BD) 领域最大的挑战之一，因为治疗通常不是最理想的或不令人满意。最近的证据表明，BD 的逐渐演变、炎症增加和治疗反应降低之间存在潜在联系。有多种药物和其他躯体治疗方法可供选择，但缓解率较低，而且用药依从性仍然存在问题。心理治疗技术似乎在几种疾病状态和预防复发方面很有希望，但需要进行更多研究来确定谁将从哪种策略中受益最多。目前对 BD 神经进展与不良治疗反应之间联系的认识促进了在 BD 早期阶段使用抗炎和神经保护策略。在双相情感障碍的后期，稳定情绪和坚持用药对于防止大脑发生额外变化和认知储备丧失至关重要。迫切需要进行额外的大规模、纵向和方法学上稳健的研究，以开发针对难治性双相情感障碍的有效治疗干预措施。
Treatment refractoriness remains one of the biggest challenges in the field of bipolar disorder (BD) as treatments are often suboptimal or unsatisfactory. Recent evidence points towards a potential link between the progressively evolving nature of BD, increased inflammation, and reduced treatment response. There are several medications and other somatic treatments available, but remission rates are low, and medication compliance is still problematic. Psychotherapeutic techniques appear to be promising in several disease states and in relapse prevention, but additional research is needed to determine who will benefit from what strategy the most. Current knowledge on the link between neuroprogression in BD and poor treatment response promotes the use of anti-inflammatory and neuroprotective strategies in the early phases of BD. In the later stages of BD, mood stabilization and medication adherence would be essential in preventing additional brain changes and loss of cognitive reserve. Additional large-scale, longitudinal, and methodologically robust studies are urgently needed to develop effective therapeutic interventions for treatment-resistant BD.