The Interplay Between Long-Term Psychiatric Disorders and Age-Related Brain Changes

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Background

The worldwide increase in life expectancy has been accompanied by the increasing occurrence and long-lasting duration of psychiatric disorders (PD). Aging-related biomarkers of PD include epidemiological, genetic, neuropsychological, structural, and functional neuroimaging and molecular techniques (e.g. PET). Bipolar disorder (BD), a condition characterized by marked shifts in mood, energy, activity levels, and ability to carry out everyday functions, affects 1-1.5% of the general population.

Typically, the disorder's onset occurs during young adult life, but cases with the emergence in late-life have been increasingly reported. Compared to early-onset BD (EOD), subjects with late-onset BD (LOD) are more likely to suffer from depressive symptoms and cognitive difficulties, namely processing speed, executive function, and episodic memory impairments. LOD occurrence is associated with white matter lesions (WML), particularly in temporal, limbic, and frontal areas. Major depressive disorder (MDD) may be linked to functional and microstructural changes, including the posterior cingulate and the default network (DMN), a set of brain regions showing enhanced activity during rest than in response to external stimulations (e.g., cognitive tasks).
Growing evidence from functional and structural MRI studies describe disturbances in DMN regions as a possible underlying pathophysiological mechanism shared by MDD, schizophrenia (SZ), Attention Deficit Hyperactivity Disorder (ADHD), obsessive compulsive disorder (OCD) and Alzheimer’s disease. Genetic, experimental, and lifestyle factors seem to have cumulative effects throughout the lifespan, modulating the interaction between PD and age-related cognitive decline.

Therefore, brain structure and mental and behavior changes found in the PD may result from poor succeeded compensatory mechanisms, as posited by the Scaffolding model. The Resource-Modulation Hypothesis assumes that age-related brain changes, such as WML, modulate the effects of common genetic variations, magnifying its impact on cognitive and behavior performance (emotional imbalance) in late adulthood or even late-life .

The aim of this Research Topic is to explore the association between the age-related brain changes and the long-term outcomes of PD. The effects of aging on the neurobiological, clinical, and therapeutic characteristics of PD should be the central topic of investigation. Also, we sought to further understand the interplay between PD and specific components of the aging process, by studying the neuroplasticity, brain network disruption, and compensatory mechanisms, and also the number of psychiatric episodes, time of disease outbreak (late or early-onset), and the occurrence of cognitive decline and dementia.

We will consider Original research, Reviews, Clinical Trials, and Methods addressing the following topics:

• Influence of aging process on the risk of cognitive decline in pre-existent psychiatric disorders;
• Which specific genetic and molecular aspects related to recurrent psychiatric disorders may accelerate the aging process, increasing the risk of cognitive decline or dementia;
• Neuropsychological comparisons between samples with early and late onset presentations of psychiatric disorders such as OCD, MDD, ADHD, BD or SZ.
• Role of personality traits, such as cluster A or B traits, on the onset and outcome of cognitive disorders in elderly.
• Neuropsychological comparisons between samples with early and late-onset presentations of psychiatric disorders such as OCD, MDD, BD, ADHD or SZ;
• To investigate whether the number of psychiatric episodes, the duration of disease, and its severity are related to the risk of cognitive decline.
• Impact of psychotropic medication (lithium, antidepressants, antipsychotics, physical activity) on cognition and on the onset, severity and treatment of cognitive disorders.

Keywords: age, psychiatric disorders, cognitive decline, personality, PD

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