The circadian system of patients with bipolar disorder differs in episodes of mania and depression
Abstract
OBJECTIVES: Bipolar disorder is a common psychiatric disease characterized by mood disturbances with alternating episodes of mania and depression. Moreover, disturbances in the sleep/wake cycle are prevalent. We tested a hypothesis that the function of the circadian system, which drives the sleep/wake cycle, may differ in patients with bipolar disorder depending on whether they are experiencing an episode of mania or depression. METHODS: To assess the functional state of the central circadian clock, daily profiles of melatonin levels in saliva were determined. The functional state of the peripheral clocks was assessed by determining daily profiles of Per1 and Nr1d1 clock gene expression in buccal mucosa cells. Sixteen patients with bipolar disorder in a manic episode, 22 patients in a depressive episode, and 19 healthy control subjects provided samples at regular intervals during a 24-hour cycle. RESULTS: During episodes of mania, the daily profiles of melatonin differed compared with healthy controls and patients in an episode of depression, mainly due to elevated melatonin levels during the daytime. No difference was found between melatonin profiles of control subjects and patients in depression. The Per1 and Nr1d1 profiles were advanced in patients in mania compared with those in depression. Compared with controls, a trend toward an advance was apparent in the profiles of patients during an episode of mania but not depression. The amplitude of the Nr1d1 expression profile was higher in mania than in depression. CONCLUSIONS: The data revealed differences in the functional state of the circadian system in patients with bipolar disorder depending on whether they were experiencing a manic or a depressive episode.
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State-dependent differences in the timing of wake-onset in this patient are consistent with recent findings in patients who were not specifically identified as rapid-cycling patients.
“In this regard, it is worth noting that state-dependent differences in the timing of wake-onset in this patient are consistent with recent findings in patients who were not specifically identified as rapid-cycling patients24,25.”
From Bipolar mood cycles associated with lunar entrainment of a circadian rhythm (2018) · cites this paper as [24]
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- Authors
- Nováková, M., Praško, J., Látalová, K., Sládek, M., & Sumová, A.
- Affiliations
- Czech Academy of Sciences (CZ)
- University Hospital Olomouc (CZ)
- Corresponding author
- Sumová, Alena
- Venue
- Bipolar Disorders
- Publisher
- Wiley
- Published
- 2014-10-31
- Volume
- 17
- Issue
- 3
- Pages
- 303-314
- ISSN
- 1398-5647 (ISSN-L)
- OpenAlex
- W2037434269
- Cited by
- 123
- References
- 68
- Citations by year
- 2026: 4 · 2025: 11 · 2024: 9 · 2023: 7 · 2022: 17 · 2021: 11 · 2020: 17 · 2019: 6 · 2018: 8 · 2017: 8 · 2016: 15 · 2015: 10
- FWCI
- 5.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Bipolar Disorders (publishedVersion)
- PubMed (publishedVersion)
- ASEP (submittedVersion, public-domain)
- Funders
- Internal Grant Agency of the Ministry of Health of the Czech Republic (NT11474-4/2010)
- Topics
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- bipolar disorder, circadian system, mania, depression, melatonin, saliva melatonin, Per1, NR1D1, clock genes, buccal mucosa, sleep-wake cycle, circadian rhythm
- MeSH terms
- Adult, Bipolar Disorder, Circadian Rhythm, Female, Humans, Male, Melatonin, Middle Aged, Mouth Mucosa, RNA, Messenger, Saliva, Prevalence, Case-Control Studies, Chronobiology Disorders, Period Circadian Proteins, Nuclear Receptor Subfamily 1, Group D, Member 1, Circadian Clocks, Transcriptome
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