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Semin Thromb Hemost
DOI: 10.1055/s-0044-1788696
Review Article

Antiphospholipid Antibodies in Mental Disorders

Jean-Christophe Gris
1   Department of Hematology, CHU Nîmes, Univ Montpellier, Nîmes, France
2   Debrest Institute of Epidemiology and Public Health, Univ Montpellier, INSERM, Montpellier, France
3   Department of Obstetrics, Gynecology and Perinatal Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
,
Mathias Chéa
1   Department of Hematology, CHU Nîmes, Univ Montpellier, Nîmes, France
2   Debrest Institute of Epidemiology and Public Health, Univ Montpellier, INSERM, Montpellier, France
,
Sylvie Bouvier
1   Department of Hematology, CHU Nîmes, Univ Montpellier, Nîmes, France
2   Debrest Institute of Epidemiology and Public Health, Univ Montpellier, INSERM, Montpellier, France
,
Fabricio R. Pereira
4   Department of Radiology and Medical Imaging, CHU Nîmes, Nîmes, France
5   MIPA, University of Nîmes, Nîmes, France
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Abstract

Thrombotic events striking the central nervous system are clinical criteria for the antiphospholipid syndrome (APS). Besides these, neuropsychiatric non-APS criteria manifestations are increasingly described in patients with persistently positive antiphospholipid antibodies (aPL). Among these are psychiatric manifestations. Animal models mainly describe hyperactive behavior and anxiety associated with hippocampal abnormalities. Cases of associations with psychosis, mood disorders, bipolarity, anxiety, obsessive–compulsive behavior, and depression have been reported but are still rare. Systematic human clinical association studies are concordant with a risk of psychosis, depression (simple to major), and anxiety disorders, but these are limited and of inconstant methodological quality. Brain imaging in patients, also insufficiently investigated, shows early signs of hypoperfusion and of subtle diffuse white matter changes compatible with an alteration of the axonal structure and changes in the myelin sheath. Direct interactions of aPL with the brain cells, both on cell lines and on animal and human brain biopsies, targeting both glial cells, astrocytes, and neurons, can be demonstrated. These clusters of arguments make the association between psychiatric diseases and aPL increasingly plausible. However, a considerable amount of clinical research must still be performed in accordance with the highest standards of methodological quality. The therapeutic management of this association, in terms of both prevention and cure, currently remains unresolved.

Keywords

antiphospholipid antibodies - psychiatry - mental health - psychosis - mood disorders - depression - mania


Publication History

Article published online:
24 July 2024

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