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Homocysteine as a potential biomarker in bipolar disorders: a critical review and suggestions for improved studies
journal contribution
posted on 2015-04-16, 00:00 authored by A Ghanizadeh, Ajeet SinghAjeet Singh, Michael BerkMichael Berk, M Torabi-NamiINTRODUCTION: Homocysteine levels have been associated with major depression, but associations with bipolar disorder remain less clear. Some data suggest homocysteine levels have potential as a biomarker of treatment response; however the literature is mixed. Areas covered: Oxidized forms of homocysteine can be potentially neurotoxic leading to glutamate toxicity, apoptotic transformation and neurodegenerative processes. High homocysteine may be a risk biomarker for bipolar disorders, but the empirical base remains too weak for firm conclusions. This review discusses the current literature for homocysteine levels as a biomarker. Expert opinion: It is premature to foreclose the utility of homocysteine levels as a biomarker for bipolar disorder due the methodological inadequacies in the existing literature. These methodological design issues include lack of control for the confounding variables of concurrent medication, phase of bipolar disorder, gender, age, nutritional status, thyroid, liver and renal function, smoking or lean body mass. Well-powered association studies with confounder control could help shed more light on the important clinical question of homocysteine's utility as a biomarker in bipolar disorder. Future experiments are needed to examine the outcome of interventions modulating homocysteine for treating bipolar disorder. Only prospective randomized control trials will provide definitive evidence of the utility of homocysteine as a biomarker or therapeutic target.
History
Journal
Expert opinion on therapeutic targetsVolume
19Issue
7Pagination
1 - 13Publisher
Taylor & FrancisLocation
Oxford, Eng.Publisher DOI
ISSN
1744-7631Language
engPublication classification
C Journal article; C1 Refereed article in a scholarly journalCopyright notice
2015, Informa UKUsage metrics
Keywords
biomarkerbipolar disorderfolic acidhomocysteineone-carbonoxidative stress.Science & TechnologyLife Sciences & BiomedicinePharmacology & Pharmacyoxidative stressMAJOR DEPRESSIVE DISORDERMETHYLENETETRAHYDROFOLATE REDUCTASE GENERANDOMIZED CONTROLLED-TRIALSPLASMA HOMOCYSTEINESERUM HOMOCYSTEINESPECTRUM DISORDERSODIUM VALPROATEDNA METHYLATIONMTHFR GENEArtificial Intelligence and Image Processing
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