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La puntuación poligénica para la esquizofrenia empeora el efecto del curso del trastorno bipolar en el metabolismo
Marco Paolini1, Andrea Grifoni1, Laura Raffaelli1,2
1IRCCS Ospedale San Raffaele, Division of Neuroscience, Psychiatry and Clinical Psychobiology Unit, Milan, Italy.
Psychiatry and clinical neurosciences
|February 9, 2026
Resumen
Los pacientes con trastorno bipolar con más episodios muestran una reducción del N-acetilaspartato (NAA), especialmente después de los episodios maníacos. Los altos puntajes poligénicos de esquizofrenia (PRS) empeoran los efectos de la duración de la enfermedad en la NAA y la integridad de la sustancia blanca, lo que sugiere una neuroprogesión.
Área de la Ciencia:
- La neurociencia es la neurociencia.
- La psiquiatría es la psiquiatría.
- Genética La genética.
Sus antecedentes:
- El trastorno bipolar (TB) y la esquizofrenia (SCZ) comparten rasgos clínicos y neurobiológicos, lo que sugiere un potencial continuo.
- La neuroprogesión puede ser más probable en pacientes bipolares que exhiben características similares a las de la SCZ.
Objetivo del estudio:
- Investigar los vínculos entre el curso de la enfermedad, la integridad de la materia blanca, los niveles de N-acetilaspartato (NAA) y las puntuaciones de riesgo poligénico SCZ (PRS) en el trastorno bipolar.
- Explorar los marcadores de la neuroprogesión en BD.
Principales métodos:
- Imágenes de tensor de difusión (DTI) y espectroscopia de resonancia magnética (MRS) para evaluar la integridad de la materia blanca y el NAA.
- Genotipización y cálculo de SCZ-PRS en pacientes con trastorno bipolar.
- Análisis de mediación y moderación para explorar los efectos del curso de la enfermedad.
Principales resultados:
- Asociación negativa entre el número de episodios afectivos y los niveles de NAA.
- Los episodios maníacos vinculados a la reducción de la integridad de la materia blanca, con NAA mediando este efecto.
- SCZ-PRS moderó la relación entre la duración de la enfermedad y la NAA; alta SCZ-PRS amplificó los efectos negativos de la duración en la NAA y la materia blanca.
Conclusiones:
- Los hallazgos apoyan la neuroprogesión en la BD, con episodios (especialmente maníacos) que afectan la neuroquímica y la materia blanca.
- SCZ-PRS elevado puede indicar un curso longitudinal parecido a SCZ en algunos pacientes con BD, destacando los riesgos asociados con la duración de la enfermedad.
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