Breakthrough in diagnosing mental disorders could offer personalized treatment

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A groundbreaking study has provided new insight into the biological basis of mood disorders, such as depression and bipolar disorder, which offers a promising blood test aimed at a personalized approach to treatment.

The study of Indiana University School of Medicine researchers led by Dr. Alexander Niculescu, professor of psychiatry, build on previous research by Niculescu and his colleagues on blood biomarkers that follow suicidability as well as pain, post-traumatic stress disorder (PTSD) and Alzheimer’s disease.

The team developed a blood test composed of RNA biomarkers that can distinguish the severity of a patient’s depression, their risk of severe depression in the future, and their risk of future bipolar disorder or manic-depressive illness. The test also informs personalized drug choices for patients.

A breakthrough in the diagnosis of mental disorders

The study, funded by the National Institutes of Health and spanning four years with more than 300 participants recruited primarily from the patient population of Richard L. Roudebush VA Medical Center in Indianapolis, used a four-year conservative approach. stages of discovery, prioritization, validation and testing.

“We have been pioneers in the field of precision medicine in psychiatry over the past two decades, particularly over the past 10 years. This study represents a cutting edge result of our efforts, ”said Niculescu. “It’s part of our effort to take psychiatry from the 19th century to the 21st century, to help it become like other contemporary fields such as oncology. Ultimately, the mission is to save and improve lives.

The researchers recorded what changed in terms of biomarkers in the blood of study participants during the period between highs and lows. They then used large databases developed from all previous studies in the field to cross-validate and prioritize their results, validating the 26 best candidate biomarkers in independent cohorts of people with depression or clinically severe mania. . The biomarkers were tested in additional independent cohorts to determine their ability to predict who is sick and who will become ill in the future.

This allowed researchers to demonstrate how to pair patients with medication, including finding a potential new drug to treat depression.
Niculescu said, “Through this work, we wanted to develop blood tests for depression and bipolar disorder, to distinguish between the two and match people with the right treatments.
“Blood biomarkers appear to be important tools in disorders where the subjective self-assessment of an individual or the clinical impression of a healthcare professional are not always reliable. These blood tests can open the door to an accurate, personalized medication match and objective monitoring of response to treatment.

Seasonal changes

Niculescu’s team also found that mood disorders are underlined by genes in the circadian clock – the genes that regulate seasonal, day-night, and sleep-wake cycles.

“This explains why some patients worsen with the seasonal changes and alterations in sleep that occur in mood disorders,” Niculescu said.

The research opened the door to translating their findings into clinical practice, as well as helping in the development of new drugs.

“Blood biomarkers offer benefits in clinical practice in the real world. The brain cannot be easily biopsied from living individuals, so we have worked hard over the years to identify blood biomarkers for neuropsychiatric disorders, ”Niculescu said. “Since one in four people will have a clinical episode of a mood disorder in their lifetime, the need and importance of effort such as ours cannot be overstated. “




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