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Topic: Neurovascular and neuroinflammation mechanisms

associated with bipolar disorder

Neurovascular and neuroinflammatory

mechanisms associated with mood disorders

Gianfranco Spalletta , Gabriele Sani 3,4
1,2
1 Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, Scientific Institute for Research, Hospitalisation
and Health Care, Santa Lucia Foundation, 00179 Rome, Italy.
2 Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX 77030, USA.
3 Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome, School of Medicine and
Psychology, Sant’Andrea Hospital, 00192 Rome, Italy.
4 Centro Lucio Bini, 00193 Rome, Italy.

According to the World Health Organization, mood IL‑18, tumor necrosis factor‑α (TNF‑α), interferon‑α and
disorders are a major source of morbidity, disability brain‑derived neurotrophic factor]. [5‑8]
and mortality worldwide. In fact, they are the
[1]
[2]
leading cause of suicide. Consistent data have been The advent of the psychopharmacological era, in
collected regarding their epidemiology and clinical, general, and of antidepressants, in particular, led
neurobiological and neuropsychological characteristics clinicians and researchers to concentrate their efforts on
but their etiology and pathophysiology still remain to the monoaminergic hypothesis of mood disorders. This
be elucidated. The dearth of data limits the possibility research line became the standard against which every
of developing new therapeutic strategies aimed at case had to be measured. In fact, bioamine research in
improving patient outcomes. mood disorders attracted the vast majority of resources.
Although this research line helped the scientific
Recently, an increasing number of studies have focused on community gain some insights into the pathophysiology
neuroinflammation as a potential mechanism involved of mood disorders, it did not succeed in dissecting
in the etiopathogenesis of mood disorders. Before the mystery of mood disorder mechanisms. Some
[3]
this, a possible relationship between inflammation and anti‑inflammatory properties of anti‑depressants and
[9]
psychiatric disorders had been hypothesized. Julius mood stabilizers such as serotonin selective reuptake
[10]
Wagner‑Jauregg, the first psychiatrist to be awarded the inhibitors, lithium and valproate have been found, but
Nobel Prize in 1927, started from the observations of studies are still few and results are inconsistent. Thus,
Hippocrates and Galen and noted that patients diagnosed there is a need to explore new pathways to improve our
with psychiatric disorders improved after fever attacks. understanding and develop new treatments.
Thus, he proposed treating them by artificially inducing
fever (pyretotherapy). This treatment strategy implies a Inflammation is a fundamental physiological
[4]
primary role of inflammation in the pathophysiology of homeostatic response of the entire body, which is
psychiatric disorders. More recently, this view received connected to the stress response, making it part of
new impetus from studies that focused on several Selye’s “general adaptation syndrome”. [11] It may
inflammatory biomarkers [e.g. interleukin‑1 (IL‑1), IL‑6, produce beneficial effects if it is working well and is
well‑tuned, or it may produce damage and unintended
consequences if there is something wrong with its
Corresponding Author: Dr. Gianfranco Spalletta,
Neuropsychiatry Laboratory, Department of Clinical and mechanisms, causing it to function inadequately.
Behavioral Neurology, Scientific Institute for Research, Undesired consequences may include alterations of
Hospitalisation and Health Care Santa Lucia Foundation, mood, sleep, food intake, energy, volition and cognition,
Via Ardeatina 306, 00179 Rome, Italy.
E‑mail: g.spalletta@hsantalucia.it
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Cite this article as: Spalletta G, Sani G. Neurovascular and
DOI: neuroinflammatory mechanisms associated with mood disorders.
10.4103/2347-8659.167306 Neuroimmunol Neuroinflammation 2015;2:193-4.
Received: 11-04-2015; Accepted: 20-04-2015

© 2015 Neuroimmunology and Neuroinflammation | Published by Hongkong Partner Publishing Co. Limited 193