̽��ֱ�� of Cambridge - Jakub Tomasik

Simple blood test can help diagnose bipolar disorder

sc604 — Wed, 25 Oct 2023 15:00:00 +0000

̽��ֱ��researchers, from the ̽��ֱ�� of Cambridge, used a combination of an online psychiatric assessment and a blood test to diagnose patients with bipolar disorder, many of whom had been misdiagnosed with major depressive disorder.

̽��ֱ��researchers say the blood test on its own could diagnose up to 30% of patients with bipolar disorder, but that it is even more effective when combined with a digital mental health assessment.

Incorporating biomarker testing could help physicians differentiate between major depressive disorder and bipolar disorder, which have overlapping symptoms but require different pharmacological treatments.

Although the blood test is still a proof of concept, the researchers say it could be an effective complement to existing psychiatric diagnosis and could help researchers understand the biological origins of mental health conditions. ̽��ֱ��results are reported in the journal JAMA Psychiatry.

Bipolar disorder affects approximately one percent of the population – as many as 80 million people worldwide – but for nearly 40% of patients, it is misdiagnosed as major depressive disorder.

“People with bipolar disorder will experience periods of low mood and periods of very high mood or mania,” said first author Dr Jakub Tomasik, from Cambridge’s Department of Chemical Engineering and Biotechnology. “But patients will often only see a doctor when they’re experiencing low mood, which is why bipolar disorder frequently gets misdiagnosed as major depressive disorder.”

“When someone with bipolar disorder is experiencing a period of low mood, to a physician, it can look very similar to someone with major depressive disorder,” said Professor Sabine Bahn, who led the research. “However, the two conditions need to be treated differently: if someone with bipolar disorder is prescribed antidepressants without the addition of a mood stabiliser, it can trigger a manic episode.”

̽��ֱ��most effective way to get an accurate diagnosis of bipolar disorder is a full psychiatric assessment. However, patients often face long waits to get these assessments, and they take time to carry out.

“Psychiatric assessments are highly effective, but the ability to diagnose bipolar disorder with a simple blood test could ensure that patients get the right treatment the first time and alleviate some of the pressures on medical professionals,” said Tomasik.

̽��ֱ��researchers used samples and data from the Delta study, conducted in the UK between 2018 and 2020, to identify bipolar disorder in patients who had received a diagnosis of major depressive disorder within the previous five years and had current depressive symptoms. Participants were recruited online through voluntary response sampling.

More than 3000 participants were recruited, and they each completed an online mental health assessment of more than 600 questions. ̽��ֱ��assessment covered a range of topics that may be relevant to mental health disorders, including past or current depressive episodes, generalised anxiety, symptoms of mania, family history or substance abuse.

Of the participants who completed the online assessment, around 1000 were selected to send in a dried blood sample from a simple finger prick, which the researchers analysed for more than 600 different metabolites using mass spectrometry. After completing the Composite International Diagnostic Interview, a fully structured and validated diagnostic tool to establish mood disorder diagnoses, 241 participants were included in the study.

Analysis of the data showed a significant biomarker signal for bipolar disorder, even after accounting for confounding factors such as medication. ̽��ֱ��identified biomarkers were correlated primarily with lifetime manic symptoms and were validated in a separate group of patients who received a new clinical diagnosis of major depressive disorder or bipolar disorder during the study’s one-year follow-up period.

̽��ֱ��researchers found that the combination of patient-reported information and the biomarker test significantly improved diagnostic outcomes for people with bipolar disorder, especially in those where the diagnosis was not obvious.

“ ̽��ֱ��online assessment was more effective overall, but the biomarker test performs well and is much faster,” said Bahn. “A combination of both approaches would be ideal, as they’re complementary.”

“We found that some patients preferred the biomarker test, because it was an objective result that they could see,” said Tomasik. “Mental illness has a biological basis, and it’s important for patients to know it’s not in their mind. It’s an illness that affects the body like any other.”

“In addition to the diagnostic capabilities of biomarkers, they could also be used to identify potential drug targets for mood disorders, which could lead to better treatments,” said Bahn. “It’s an exciting time to be in this area of research.”

A patent has been filed on the research by Cambridge Enterprise, the ̽��ֱ��’s commercialisation arm. ̽��ֱ��research was supported by the Stanley Medical Research Institute and Psyomics, a ̽��ֱ�� spin-out company co-founded by Sabine Bahn.

Sabine Bahn is Professor of Neurotechnology at the Department of Chemical Engineering and Biotechnology and is a Fellow of Lucy Cavendish College, Cambridge.

Reference:
Jakub Tomasik et al. ‘Metabolomic Biomarker Signatures for Bipolar and Unipolar Depression.’ JAMA Psychiatry (2023). DOI: 10.1001/jamapsychiatry.2023.4096

Researchers have developed a new way of improving diagnosis of bipolar disorder that uses a simple blood test to identify biomarkers associated with the condition.

̽��ֱ��ability to diagnose bipolar disorder with a simple blood test could ensure that patients get the right treatment the first time

Jakub Tomasik

Cambridge Centre for Neuropsychiatric Research

Providing a drop of blood for a test

̽��ֱ��text in this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Images, including our videos, are Copyright © ̽��ֱ�� of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

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New approach to drug discovery could lead to personalised treatment of neuropsychiatric disorders

erh68 — Wed, 08 May 2019 18:00:00 +0000

Mental health disorders are the leading cause of disability worldwide, accounting for 31% of total years lived with disability. While our understanding of the biology behind these disorders has increased, no new neuropsychiatric drugs with improved treatment effects have been developed in the last few decades, and most existing treatments were found through luck.

This is mainly because doctors can’t take brain tissue samples from patients in the same way that they are able to do a biopsy on a cancer tumour elsewhere in the body for example, so it’s difficult for researchers to understand exactly what to target when designing new neuropsychiatric drugs.

Now, a team of scientists led by the ̽��ֱ�� of Cambridge have shown that live blood cells from patients with mental health disorders can be used to identify potential targets for drug discovery research. Their results are reported in the journal Science Advances.

Human blood cells contain many receptors and proteins involved in signalling that are also found in our central nervous system and have been shown to be linked to neuropsychiatric disorders. Previous research has shown that there is a strong link between cells in our blood and the way our central nervous system operates, for example patients suffering from bacterial infections often show depressive-like symptoms.

This makes blood cells an ideal environment in which to test potential new drugs. There is also significant evidence that using primary cells from patients in drug development leads to a higher success rate for effective drug discovery.

“Psychiatric disorders are increasingly recognised as disorders of the whole body,” said Professor Sabine Bahn from Cambridge’s Department of Chemical Engineering and Biotechnology, who leads the research group behind the work. “This study proposes a shift in the field to directly explore live cellular function as a model for disease.”

Using a high-content single-cell screening process, the researchers analysed cells from 42 schizophrenia patients and screened thousands of potential compounds for new drugs. ̽��ֱ��team have focused on discovering new psychiatric uses for drugs which are routinely prescribed for other conditions, such as high blood pressure.

This drug ‘repurposing’ strategy can reduce the time and cost it takes to bring a new drug to the clinic tenfold. With an average drug development cost of $2-3 billion over 12 years, this represents an efficient alternative to deliver new potential treatments to patients in considerably less time. ̽��ֱ��approach could also lead to a reduction in animal testing.

They can also test existing psychiatric treatments on patient blood cells and may be able to predict how effective those treatments will be for each individual. This overcomes a major hurdle in clinical psychiatry as many patients do not respond to first-line treatments. To accomplish this, the team tested rare blood samples from schizophrenia patients before and after clinical treatment, collected via a network of international collaborators.

As a final step, the team confirmed that the activity of new drugs was shared between blood cells and brain cells, by testing those drug compounds on human nerve cells.

“This is the most in-depth, functional exploration of primary psychiatric patient tissue to date and has the potential to substantially accelerate drug discovery and personalised medicine for neuropsychiatric disorders and other human diseases,” said lead author Dr Santiago Lago, who developed the technology with Dr Jakub Tomasik.

̽��ֱ��research was funded in part by the Stanley Medical Research Institute, the Engineering and Physical Sciences Research Council and the European Union.

Reference:
Santiago G. Lago et al. ‘Drug discovery for psychiatric disorders using high-content single-cell screening of signalling network responses ex vivo.’ Science Advances (2019). DOI: 10.1126/sciadv.aau9093

Researchers have developed a method that could drastically accelerate the search for new drugs to treat mental health disorders such as schizophrenia.

Psychiatric disorders are increasingly recognised as disorders of the whole body

Sabine Bahn

Santiago Lago

Drug target in neurons

̽��ֱ��text in this work is licensed under a Creative Commons Attribution 4.0 International License. Images, including our videos, are Copyright © ̽��ֱ�� of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

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