Chapter 11. An Introduction to the Neurobiology of Bipolar Illness Onset, Recurrence and Progression

  1. Lakshmi N. Yatham3 and
  2. Mario Maj4
  1. Robert M. Post1 and
  2. Marcia Kauer-Sant'Anna2

Published Online: 13 AUG 2010

DOI: 10.1002/9780470661277.ch11

Bipolar Disorder

Bipolar Disorder

How to Cite

Post, R. M. and Kauer-Sant'Anna, M. (2010) An Introduction to the Neurobiology of Bipolar Illness Onset, Recurrence and Progression, in Bipolar Disorder (eds L. N. Yatham and M. Maj), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/9780470661277.ch11

Editor Information

  1. 3

    Department of Psychiatry, The University of British Columbia, Vancouver, Canada

  2. 4

    Department of Psychiatry, University of Naples SUN, Naples, Italy

Author Information

  1. 1

    George Washington University Medical School, Bipolar Collaborative Network, 5415 W. Cedar Kabem Suite 201B, Bethesda, MD 20814, USA

  2. 2

    Molecular Psychiatry Laboratory, Department of Psychiatry, Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brazil

Publication History

  1. Published Online: 13 AUG 2010
  2. Published Print: 1 OCT 2010

ISBN Information

Print ISBN: 9780470721988

Online ISBN: 9780470661277



  • neurobiology of bipolar illness onset, recurrence and progression;
  • neurobiology of bipolar illness, precisely delineated and understood;
  • pathophysiological mechanisms – dichotomous, genetic inheritance or environmental alterations;
  • normal processes of learning and memory and responses - to environmental stressors, short- and long-term changes in gene expression;
  • episode-sensitization and stress-sensitization - replicated with few exceptions;
  • multiple reflections of illness progression - idea of using medical staging models in BD;
  • genetic mechanisms - calcium channel (CACNA1C) and neurotransmitter release mechanism (ANK 3), vulnerability to bipolar illness;
  • increases in BDNF in dopaminergic pathway - defeat stress and cocaine sensitization;
  • prefrontal cortical deficits and hypofunctions versus paralimbic hyperfunction;
  • childhood-onset bipolar illness - accelerated rate of illness stage evolution


This chapter contains sections titled:

  • Introduction

  • Clinical evidence for bipolar illness progression

  • Potential neurobiological mechanisms for illness progression

  • Overview of the neurobiology of bipolar disorder

  • Clinical implications for illness progression

  • Neurobiology informing clinical therapeutics

  • An evolving neurobiology of bipolar disorder

  • References