Background: Affective disorders are associated with an increased occurrence of cognitive deficits and have been linked to cognitive impairment and Alzheimer's disease. The putative molecular mechanisms involved in these associations are however not clear. The aim of this systematic review was to explore clinically founded evidence for amyloid-beta peptides in cerebrospinal fluid and blood as putative biomarkers for affective disorders. Method: Systematic searches in Embase and PubMed databases yielded 23 eligible, observational studies. Results: Despite inconsistencies that were partly ascribed to the application of different assay formats, study results indicate a potentially altered amyloid-beta metabolism in affective disorder. Limitations: Since most studies used a cross-sectional design, causality is difficult to establish. Moreover, methodological rigor of included studies varied and several studies were limited by very low sample numbers. Finally, different assays for amyloid-beta were utilized in the different studies, thus hampering comparisons. Conclusion: To unravel possible risk relations and causalities between affective disorder and Alzheimer's disease and to determine how amyloid-beta concentrations change over time and are associated with cognition as well as affective symptomatology, future research should include prospective, longitudinal studies, implemented in large study populations, where peripheral and central amyloid-p ratios are quantified concomitantly and continuously across various affective phases. Also, to enable inter survey comparisons, the use of standardized pre-analytical/analytical procedures is crucial. (C) 2014 Elsevier B.V. All rights reserved.
Journal of Affective Disorders, 2014, Vol 168, p. 167-183