Star-Shaped Brain Cells Offer New Hope for Personalized Bipolar Disorder Treatment

Bipolar disorder, commonly known as manic-depressive illness, is a complex mental health condition characterized by recurring episodes of mania and depression. This disorder affects approximately 1% to 2% of the global population and significantly increases the risk of suicide—up to 30 times higher than in the general population. Despite advancements in treatment, responses to the primary medication lithium vary widely among patients, emphasizing the need for personalized treatment approaches.

A pioneering study conducted by researchers at KAIST, led by Professor Jinju Han from the Graduate School of Medical Science and Engineering, has uncovered metabolic differences in astrocytes—star-shaped brain cells—based on how patients respond to lithium. This groundbreaking research suggests that targeting astrocytes could pave the way for more tailored and effective therapies for bipolar disorder.

Traditionally, research has focused predominantly on neurons; however, this study shifts the spotlight onto astrocytes, which constitute about half of the brain's cells. These cells act as crucial support systems for neurons, supplying nutrients and maintaining the brain's environment. By differentiating induced pluripotent stem cells (iPSCs) derived from bipolar disorder patients into astrocytes, the team observed that energy metabolism within these cells differs markedly depending on lithium responsiveness.

In patients who responded well to lithium, treatment decreased lipid droplets—tiny fat storage structures inside the cells—and improved mitochondrial function, the cell's energy generator. Conversely, non-responsive patients exhibited metabolic abnormalities, including excessive lipid droplet accumulation, impaired mitochondrial activity, increased breakdown of glucose, and elevated lactate secretion. These findings highlight that energy metabolism dysfunction plays a key role in bipolar disorder and contributes to the variation in lithium effectiveness.

Furthermore, the study identified that the metabolites produced by astrocytes differed according to patient response, showing disrupted energy pathways in non-responders. These insights suggest that the energy factory within astrocytes malfunctions depending on individual biology, leading to the overuse of alternative pathways and accumulation of metabolic byproducts.

Professor Han emphasized that these discoveries open the possibility of developing new treatments targeting astrocytes to improve therapeutic outcomes, especially for patients who do not respond to existing medications. This research represents a significant step toward personalized medicine in bipolar disorder, offering hope for more effective and tailored interventions.

Source: https://medicalxpress.com/news/2025-09-star-brain-cells-personalized-bipolar.html