Neurobiological and behavioral mechanisms of circadian rhythm disruption in bipolar disorder: A critical multi-disciplinary literature review and agenda for future research from the ISBD task force on chronobiology

Michael J. McCarthy, John F. Gottlieb, Robert Gonzalez, Colleen A. McClung, Lauren B. Alloy, Sean Cain, Davide Dulcis, Bruno Etain, Benicio N. Frey, Corrado Garbazza, Kyle Ketchesin, Dominic Landgraf, Heon Jeong Lee, Cynthia Marie-Claire, Robin Nusslock, Alessandra Porcu, Richard Porter, Philipp Ritter, Jan Scott, Daniel SmithHolly A. Swartz, Greg Murray*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations

Abstract

Aim: Symptoms of bipolar disorder (BD) include changes in mood, activity, energy, sleep, and appetite. Since many of these processes are regulated by circadian function, circadian rhythm disturbance has been examined as a biological feature underlying BD. The International Society for Bipolar Disorders Chronobiology Task Force (CTF) was commissioned to review evidence for neurobiological and behavioral mechanisms pertinent to BD. Method: Drawing upon expertise in animal models, biomarkers, physiology, and behavior, CTF analyzed the relevant cross-disciplinary literature to precisely frame the discussion around circadian rhythm disruption in BD, highlight key findings, and for the first time integrate findings across levels of analysis to develop an internally consistent, coherent theoretical framework. Results: Evidence from multiple sources implicates the circadian system in mood regulation, with corresponding associations with BD diagnoses and mood-related traits reported across genetic, cellular, physiological, and behavioral domains. However, circadian disruption does not appear to be specific to BD and is present across a variety of high-risk, prodromal, and syndromic psychiatric disorders. Substantial variability and ambiguity among the definitions, concepts and assumptions underlying the research have limited replication and the emergence of consensus findings. Conclusions: Future research in circadian rhythms and its role in BD is warranted. Well-powered studies that carefully define associations between BD-related and chronobiologically-related constructs, and integrate across levels of analysis will be most illuminating.

Original languageEnglish (US)
JournalBipolar Disorders
DOIs
StateAccepted/In press - 2021

Keywords

  • actigraphy
  • animal models
  • biomarker
  • chronobiology
  • circadian
  • clock gene
  • levels of analysis
  • light
  • lithium
  • sleep

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

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