Bipolar Medical and Health News Headlines

Altered lipid metabolism in brain injury and disorders.

Subcell Biochem. 2008;49:241-68

Authors: Adibhatla RM, Hatcher JF

Deregulated lipid metabolism may be of particular importance for CNS injuries and disorders, as this organ has the highest lipid concentration next to adipose tissue. Atherosclerosis (a risk factor for ischemic stroke) results from accumulation of LDL-derived lipids in the arterial wall. Pro-inflammatory cytokines (TNF-alpha and IL-1), secretory phospholipase A(2) IIA and lipoprotein-PLA(2) are implicated in vascular inflammation. These inflammatory responses promote atherosclerotic plaques, formation and release of the blood clot that can induce ischemic stroke. TNF-alpha and IL-1 alter lipid metabolism and stimulate production of eicosanoids, ceramide, and reactive oxygen species that potentiate CNS injuries and certain neurological disorders. Cholesterol is an important regulator of lipid organization and the precursor for neurosteroid biosynthesis. Low levels of neurosteroids were related to poor outcome in many brain pathologies. Apolipoprotein E is the principal cholesterol carrier protein in the brain, and the gene encoding the variant Apolipoprotein E4 is a significant risk factor for Alzheimer's disease. Parkinson's disease is to some degree caused by lipid peroxidation due to phospholipases activation. Niemann-Pick diseases A and B are due to acidic sphingomyelinase deficiency, resulting in sphingomyelin accumulation, while Niemann-Pick disease C is due to mutations in either the NPC1 or NPC2 genes, resulting in defective cholesterol transport and cholesterol accumulation. Multiple sclerosis is an autoimmune inflammatory demyelinating condition of the CNS. Inhibiting phospholipase A(2) attenuated the onset and progression of experimental autoimmune encephalomyelitis. The endocannabinoid system is hypoactive in Huntington's disease. Ethyl-eicosapetaenoate showed promise in clinical trials. Amyotrophic lateral sclerosis causes loss of motorneurons. Cyclooxygenase-2 inhibition reduced spinal neurodegeneration in amyotrophic lateral sclerosis transgenic mice. Eicosapentaenoic acid supplementation provided improvement in schizophrenia patients, while the combination of (eicosapentaenoic acid + docosahexaenoic acid) provided benefit in bipolar disorders. The ketogenic diet where >90% of calories are derived from fat is an effective treatment for epilepsy. Understanding cytokine-induced changes in lipid metabolism will promote novel concepts and steer towards bench-to-bedside transition for therapies.

PMID: 18751914 [PubMed - in process]

[Psychoeducation in the treatment of bipolar disorder]

Tijdschr Psychiatr. 2008;50(8):509-18

Authors: Sienaert P, de Fruyt J

BACKGROUND: There is a increasing interest in psychosocial treatment strategies for bipolar disorder. An essential ingredient of various psychosocial treatment models is psychoeducation (PE), which can also be used on its own as a psychotherapeutic strategy. AIM: To search the literature systematically in order to discover the efficacy of pe for the treatment of bipolar disorder. METHOD: Medline was searched using mesh-terms 'bipolar disorder', 'psychotherapy' and 'patient education', and the search term 'psychoeducation'. results Thirty-four trials on psychoeducation for bipolar patients were found. The studies showed that pe can widen the patient's knowledge about the disorder and its treatment, and increase compliance and prevent relapse when offered to patients in remission. CONCLUSION: PE should be part of the standard treatment for patients with bipolar disorder. Further study should reveal in which phase of the disease, for which subgroup of patients and under what circumstances pe can best be offered.

PMID: 18688775 [PubMed - in process]