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  • What is bipolar disorder? A...
    Mansur, Rodrigo B.; Lee, Yena; McIntyre, Roger S.; Brietzke, Elisa

    Neuroscience and biobehavioral reviews, June 2020, 2020-Jun, 2020-06-00, 20200601, Letnik: 113
    Journal Article

    •Research in BD has been hindered by the lack of a unifying disease model•We propose that dysregulated energy expenditure is a primary cause of BD•We review the evidence on the relevance of energy homeostasis for brain function•The behavioral and mechanistic correlates of energy dysregulation are discussed•We propose the phenotypes and longitudinal progression resulting from this process Advances in the understanding and management of bipolar disorder (BD) have been slow to emerge. Despite notable recent developments in neurosciences, our conceptualization of the nature of this mental disorder has not meaningfully progressed. One of the key reasons for this scenario is the continuing lack of a comprehensive disease model. Within the increasing complexity of modern research methods, there is a clear need for an overarching theoretical framework, in which findings are assimilated and predictions are generated. In this review and hypothesis article, we propose such a framework, one in which dysregulated energy expenditure is a primary, sufficient cause for BD. Our proposed model is centered on the disruption of the molecular and cellular network regulating energy production and expenditure, as well its potential secondary adaptations and compensatory mechanisms. We also focus on the putative longitudinal progression of this pathological process, considering its most likely periods for onset, such as critical periods that challenges energy homeostasis (e.g. neurodevelopment, social isolation), and the resulting short and long-term phenotypical manifestations.