The Blood-Brain Barrier in Psychosis

Pollak, T.A., Drndarski, S., Stone, M.J., David, A.S., McGuire, P. and Abbott, N.J. 2018. The Blood-Brain Barrier in Psychosis. The Lancet Psychiatry. 5 (1), pp. 79-92. https://doi.org/10.1016/S2215-0366(17)30293-6

TitleThe Blood-Brain Barrier in Psychosis
TypeJournal article
AuthorsPollak, T.A., Drndarski, S., Stone, M.J., David, A.S., McGuire, P. and Abbott, N.J.
Abstract

Blood-brain barrier pathology is recognised as a central factor in the development of many neurological disorders, but much less is known about the role of the blood-brain barrier in psychiatric disorders. We review post-mortem, serum-biomarker, CSF-biomarker, and neuroimaging studies that have examined blood-brain barrier structure and function in schizophrenia and related psychoses. We consider how blood-brain barrier dysfunction could relate to glutamatergic and inflammatory abnormalities, which are increasingly understood to play a part in the pathogenesis of psychosis. Mechanisms by which the blood-brain barrier and its associated solute transporters moderate CNS availability of antipsychotic drugs are summarised. We conclude that the complex nature of blood-brain barrier dysfunction in psychosis might be relevant to many aspects of disrupted neuronal and synaptic function, increased permeability to inflammatory molecules, disrupted glutamate homoeostasis, impaired action of antipsychotics, and development of antipsychotic resistance. Future research should address the longitudinal course of blood-brain barrier alterations in psychosis, to determine whether blood-brain barrier dysfunction is a cause or consequence of the pathology associated with the disorder.

JournalThe Lancet Psychiatry
Journal citation5 (1), pp. 79-92
ISSN2215-0366
Year2018
PublisherElsevier
Digital Object Identifier (DOI)https://doi.org/10.1016/S2215-0366(17)30293-6
PubMed ID28781208
Web address (URL)https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(17)30293-6/fulltext
Publication dates
Published online03 Aug 2017
Published in print01 Jan 2018

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