Applying precision medicine principles, four-year study at Indiana University School of Medicine advances diagnostics and therapeutics for depression and bipolar disorder
For doctors eager to move beyond trial-and-error diagnoses and treatments in psychiatric medicine, research from Indiana University (IU) School of Medicine brings a potentially significant development in the advancement of precision medicine for mental health conditions.
Recognized for his work in psychiatric genomics, Alexander B. Niculescu, MD, PhD, and a team of researchers at IU report the development of several biomarkers that can indicate unique genetic differences in bipolar disorder and depression. These findings add to previous research by the same team that studied suicidality, pain, post-traumatic stress disorder, and Alzheimer’s disease.
“We have pioneered the area of precision medicine in psychiatry over the last two decades, particularly over the last 10 years. This study represents a current state-of-the-art outcome of our efforts,” Niculescu said in a recent news article.
“Overall, our studies provide objective assessments, targeted therapeutics, and monitoring of response to treatment, that enable precision medicine for mood disorders,” state the authors of “Precision Medicine for Mood Disorders: Objective Assessment, Risk Prediction, Pharmacogenomics, and Repurposed Drugs,” published in the journal Molecular Psychiatry. “We hope that our trait biomarkers for future risk may be useful in preventive approaches, before the full-blown disorder manifests itself (or re-occurs).”
Moving to Blood Testing for Depression and Bipolar Disorder
“Through this work, we wanted to develop blood tests for depression and for bipolar disorder, to distinguish between the two and to match people to the right treatments,” Niculescu continued. “Blood biomarkers are emerging as important tools in disorders where subjective self-report by an individual, or a clinical impression of a health care professional, are not always reliable. These blood tests can open the door to precise, personalized matching with medications, and objective monitoring of response to treatment.”
Niculescu’s team first identified several genetic biomarkers in patients who had depression or bipolar disorder, carefully studying each biomarker and correlating it to various health states. This is significant because these biomarkers can be used to distinguish between psychiatric conditions that are very similar. They can also be used to determine which treatment options work best for specific individuals who have the same condition.
Researchers Also Observe Connection to Circadian Rhythm
One of the interesting findings of Niculescu’s team is that the genes they identified as being connected with psychiatric disorders are also strongly connected with the body’s natural circadian rhythm. “That explains why some patients get worse with seasonal changes, and the sleep alterations that occur in mood disorders,” Niculescu said.
Niculescu expects his team’s findings to have clinical applications.
“Blood biomarkers offer real-world clinical practice advantages,” Niculescu said. “The brain cannot be easily biopsied in live individuals, so we’ve worked hard over the years to identify blood biomarkers for neuropsychiatric disorders. Given the fact that 1 in 4 people will have a clinical mood disorder episode in their lifetime, the need for and importance of efforts such as ours cannot be overstated.”
Psychiatric disorders have lagged behind other medical conditions in terms of understanding, diagnostics, and treatment. Non-biologically based and somewhat subjective classification still play a major role in patient care.
As clinically relevant biomarkers are better understood, hospitals and other healthcare providers will benefit from blood biomarker testing. These tests can be used to identify individual-specific disease processes and allow hospitals the opportunity to provide patient-specific treatments.
—Caleb Williams
Related Information:
Blood test for depression, bipolar disorder offers promise of personalized treatment
Towards precision medicine for stress disorders: diagnostic biomarkers and targeted drugs
Discovery and validation of blood biomarkers for suicidality
Biomarkers as drug development tools: discovery, validation, qualification and use