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http://psychcentral.com/news/2014/03/17/new-findings-on-chemical-linked-to-bipolar-psychosis/67218.html
By Associate News Editor Reviewed by John M. Grohol, Psy.D. on March 17, 2014 Researchers have discovered a gene that is likely to play a role in the risk of psychosis in bipolar disorders. The condition involves recurrent episodes of mania and depression, interspersed with euthymic periods with no depressive or manic symptoms. Manic episodes sometimes trigger psychotic symptoms such as hallucinations and delusions that are similar to acute psychosis in schizophrenia. This and other similarities may indicate a partially shared basis or pathophysiology for these disorders. Furthermore, a range of overlapping susceptibility genes for both schizophrenia and bipolar disorder have been identified in large genetic studies. Previous research has shown that a chemical called kynurenic acid (KYNA) is present at higher levels in the cerebrospinal fluid and the prefrontal cortex of people with bipolar disorder with psychosis and people with schizophrenia. Now, a team from the Karolinska Institute in Sweden has confirmed this finding and looked at the reason for the phenomenon. KYNA affects several signalling pathways important to brain function, said researcher Professor Martin Schalling, M.D., Ph.D. It is normally produced during inflammation caused by exposure to stress or infection, for example, which themselves have been linked to psychotic episodes.
related to bipolar disease has a very high degree of heredity, up to 80 percent, but we dont know which genes and which mechanisms are involved, said Schalling, The study gives a new explanation that can be linked to signal systems activated by inflammation, he said. This has consequences for diagnostics, and paves the way for new therapies, since there is a large arsenal of already approved drugs that modulate inflammation.
Other Research
Other teams of researchers have also focused on levels of KYNA in patients with bipolar disorder. Dr. Conny Nordin of Linkoping University, Sweden, and her team saw that KYNA levels are increased in the brain of male bipolar disorder patients in the in-between euthymic state. They also found that KYNA levels rose with age in these patients, but not in men without bipolar disorder. This team also believes that KYNA represents a shared feature of bipolar disorder and schizophrenia. They point out that KYNA is closely linked to dopamine activity in the midbrain, indicating a potential role of this compound in dopamine-related diseases. The functional significance of the observed elevation in brain KYNA levels (about 50 percent) is unclear, they write. But experiments in rats suggest that the same rate of increase is associated with a marked activation of the firing of midbrain dopamine neurons. So this rise in brain KYNA in bipolar disorder likely influences glutamatergic, cholinergic, and dopaminergic neurotransmission in these patients. These dysfunctions are known to progress with the course and severity of the disease, the team adds, because numerous studies have shown an intimate relation between cognitive function and glutamatergic and cholinergic neurotransmission. When rats have drug-induced rises in KYNA, they show symptoms also seen in patients with bipolar disorder during both acute psychotic mania and euthymia, as well as in patients with schizophrenia. In addition, it impairs contextual learning and working memory in rats. Taken together, these findings suggest that KYNA might causally contribute to the development of the decline in cognitive function during the progression of bipolar disorder, the team concluded. References Lavebratt, C., Olsson, S., Backlund, L., Frisen, L., Sellgren, C., Priebe, L., Schalling, M. The KMO allele encoding Arg452 is associated with psychotic features in bipolar disorder type 1, and with increased CSF KYNA level and KMO expression. Molecular Psychiatry , 5 March 2013 doi:10.1038/mp.2013.11 Olsson, S. K., Samuelsson, M., and Landen, M. Elevated levels of kynurenic acid in the cerebrospinal fluid of patients with bipolar disorder. Journal of Psychiatry and Neuroscience , May 2010 doi: 10.1503/jpn.090180 APA Reference Collingwood, J. (2014). New Findings on Chemical Linked to Bipolar Psychosis. Psych Central. Retrieved on March 19, 2014, from http://psychcentral.com/news/2014/03/17/new-findings-on-chemical-linked-to-bipolarpsychosis/67218.html