A Promising Blood Test for Diagnosing Mood Disorders
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Understanding Emotional and Cognitive Experiences
How do we articulate the complex nature of our emotions and thoughts? Unlike physical injuries, such as fractures, which are easy to identify and treat, emotional struggles often remain elusive. For instance, what happens when getting out of bed becomes a daunting task? When feelings of dread and anxiety cloud your daily life? The absence of physical symptoms can make these experiences even more challenging to convey.
When you seek medical advice and receive a diagnosis of depression, it doesn't necessarily clarify the reasons behind your condition. The road to finding effective treatments often requires trying multiple options, making the path to recovery seem unclear.
The waiting period to see if a particular treatment is effective can be frustrating, and the reason for this delay remains largely unknown. However, understanding the right treatments for each individual could save valuable time and lives. The ideal solution would be both accessible and precise, and we are gradually making strides in this direction.
“This is part of our effort to bring psychiatry from the 19th century into the 21st century. To help it become like other contemporary fields such as oncology. Ultimately, the mission is to save and improve lives.” — Alexander B. Niculescu
Exploring Biomarkers for Mood Disorders
Statistics reveal that one in four individuals will encounter some form of mood disorder throughout their life. Yet, the underlying mechanisms of depression, anxiety, and related conditions remain poorly understood. Each disorder encompasses a wide range of symptoms and causes, and individuals may experience them differently, necessitating varied treatments.
To tackle these challenges, the fields of precision genomics and medicine have emerged. Researchers can now identify specific biomarkers that assist in understanding these complexities. A leading figure in this research is Dr. Alexander B. Niculescu, MD, Ph.D., a Professor of Psychiatry at Indiana University, whose recent work was published in Molecular Psychiatry.
Dr. Niculescu's team collected blood samples from over 300 individuals diagnosed with mood disorders. They specifically searched for RNA biomarkers—molecules that provide instructions for protein synthesis within cells. By monitoring these participants' moods, the researchers collected blood samples during both high and low emotional states, typical of those with bipolar disorder. Previous studies on biomarkers allowed them to confirm their findings, ultimately narrowing their focus to 26 specific biomarkers linked to 23 distinct genes.
“This is part of our effort to bring psychiatry from the 19th century into the 21st century. To help it become like other contemporary fields such as oncology. Ultimately, the mission is to save and improve lives.” — Alexander B. Niculescu
The Molecular Indicators of Mood Disorders
Out of the 23 genes identified, eight play a crucial role in regulating mood. Our circadian rhythm—a 24-hour biological clock—affects our physiological functions, and disruptions in sleep are common among individuals with mood disorders. During the validation phase, researchers discovered that the gene NRG1 was more active during periods of low mood, outperforming other low mood biomarkers. This gene not only indicated the likelihood of future hospitalization for depression but was particularly predictive for women within a one-year timeframe.
NRG1 is involved in cell-signaling processes across various cell types and organs. Other studies have linked it to risks for disorders such as pain, suicidality, and psychosis. Conversely, the DOCK10 gene exhibited reduced expression during low mood episodes and was a predictor of future hospitalizations in females. Interestingly, in cases of bipolar disorder, increased expression of this gene was associated with elevated mood states, highlighting its role in immune signaling.
“These blood tests can open the door to precise, personalized matching with medications, and objective monitoring of response to treatment.” — Alexander B. Niculescu
By taking four additional predictive genes into account, the researchers developed an algorithm that correlates these biomarkers with specific therapeutic drugs targeting the identified pathways. Moreover, these findings guide the search for new treatment targets for mood disorders. The biomarkers can identify individuals at risk for hospitalization and predict mood fluctuations. Armed with this information, clinicians can better align patients with suitable medications.
“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.” — Alexander B. Niculescu
This progress is vital, especially since we can't visually assess the internal workings of a human brain. A relatively low-cost method now provides an objective overview of physiological conditions. As we apply these techniques, physicians can receive reports detailing a patient's risk and medication recommendations. The treatment of mood disorders is set to become more efficient and tailored as our understanding deepens.
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The first video delves into the groundbreaking possibility of a blood test for diagnosing depression, raising questions about its current underutilization.
The second video showcases the innovative research by IU scientists, focusing on developing a blood test for both depression and bipolar disorder.