PMID- 17555817
OWN - NLM
STAT- MEDLINE
DCOM- 20071121
LR  - 20220316
IS  - 0149-7634 (Print)
IS  - 0149-7634 (Linking)
VI  - 31
IP  - 6
DP  - 2007
TI  - Kindling and sensitization as models for affective episode recurrence, cyclicity, 
      and tolerance phenomena.
PG  - 858-73
AB  - We use the non-homologous model of sensitization and kindling to help 
      conceptualize processes occurring in the longitudinal course of bipolar disorder. 
      The models help focus on the phenomena of episode recurrence, regression, and 
      cycle acceleration occurring without medication and during treatment, when these 
      progressive processes can re-emerge during tolerance development. The preclinical 
      data suggest that it is the ratio of pathological versus adaptive factors 
      mediated by changes in gene expression that mediate episode recurrence or 
      suppression. During tolerance development, there may be selective loss of some 
      episode-induced adaptive factors that may be re-engendered during a period off 
      that medication. The models reveal long-term molecular changes induced by 
      recurrent stresses, episodes of illness, and substances of abuse that can 
      accumulate and lead to progressive increases in vulnerability to episode 
      recurrence. The clinical and preclinical data converge in emphasizing the 
      importance of prevention and early and sustained prophylaxis. New data also 
      implicate brain-derived neurotrophic factor (BDNF) in genetic and environmental 
      illness vulnerability and progression, as well as in the mechanisms of action of 
      the mood stabilizers and antidepressants. Therapeutic agents may thus not only 
      prevent recurrent affective episodes and their adverse consequences on the brain, 
      behavior, and quality of life, but they may also be able to ameliorate the 
      effects of stressors, and reverse or prevent some of the basic pathological brain 
      mechanisms underlying illness progression.
FAU - Post, Robert M
AU  - Post RM
AD  - Penn State College of Medicine, 3502 Turner Lane, Chevy Chase, MD 20815, USA. 
      robert.post@speakeasy.net
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20070424
PL  - United States
TA  - Neurosci Biobehav Rev
JT  - Neuroscience and biobehavioral reviews
JID - 7806090
RN  - 0 (Brain-Derived Neurotrophic Factor)
SB  - IM
MH  - Affective Symptoms/*chemically induced/physiopathology/therapy
MH  - Animals
MH  - Behavior, Animal/*drug effects
MH  - Bipolar Disorder/chemically induced/*physiopathology/therapy
MH  - Brain-Derived Neurotrophic Factor/physiology
MH  - Disease Models, Animal
MH  - Drug Tolerance/*physiology
MH  - Kindling, Neurologic/*drug effects
MH  - Periodicity
MH  - Recurrence
RF  - 89
EDAT- 2007/06/09 09:00
MHDA- 2007/12/06 09:00
CRDT- 2007/06/09 09:00
PHST- 2007/02/08 00:00 [received]
PHST- 2007/04/16 00:00 [revised]
PHST- 2007/04/18 00:00 [accepted]
PHST- 2007/06/09 09:00 [pubmed]
PHST- 2007/12/06 09:00 [medline]
PHST- 2007/06/09 09:00 [entrez]
AID - S0149-7634(07)00044-9 [pii]
AID - 10.1016/j.neubiorev.2007.04.003 [doi]
PST - ppublish
SO  - Neurosci Biobehav Rev. 2007;31(6):858-73. doi: 10.1016/j.neubiorev.2007.04.003. 
      Epub 2007 Apr 24.