Indiana University School of Medicine researchers have developed a new blood test to more accurately diagnose military veterans and other people experiencing post-traumatic stress disorder. The biological test may also potentially provide more precise treatments and prevention for the disorder.
A research team led by psychiatry professor Alexander Niculescu, M.D., Ph.D., tracked more than 250 veterans in over 600 visits at the VA Medical Center in Indianapolis to identify molecules in the blood that can help track stress intensity.
Investigators used a careful four-step approach of discovery, prioritization, validation, and testing. According to Niculescu’s findings, the blood test can accurately identify people who are at risk of stress disorders or are experiencing them severely. Study findings appear in the journal Molecular Psychiatry.
“PTSD is a disorder that affects a lot of veterans, especially those involved in combat. They deserve our gratitude and the very best care, and we are making every effort to deliver that. It’s also an underappreciated and underdiagnosed disorder among the civilian population, whether it be the result of abuse, rape, violence or accidents” said Niculescu.
Niculescu worked with other Department of Psychiatry and VA researchers on the study, as well as collaborators at The Scripps Research Institute and University of California Irvine.
“Countless people are underdiagnosed with stress disorders, which may manifest themselves by drinking more, other addictions, suicide or violence. Our research has broader relevance for not just veterans but the general public,” explains Niculescu.
The decade-long study looked at the expression of genes in the blood, starting with the entire genome, which has over 20,000 genes. Over the course of multiple visits, researchers tested participants in both low- and high-stress states. Their blood was analyzed for detectable changes in expression of genes between those two different states that could serve as biological markers (biomarkers) for stress.
Researchers were able to narrow the study’s focus down to 285 individual biomarkers (related to 269 genes) that can objectively help diagnose patients with PTSD, as well as determine the severity of their stress and predict future hospitalizations.
They also compared these biomarkers with other well-known markers of stress and aging, such as telomer length. The biomarker signature helped identify new potential medications and natural substances to treat stress disorders that could be paired in a personalized way with individuals.
“There are similar tests like this in other fields, like cancer, where a physician can biopsy the affected part of the body to determine the stage of disease. But when it comes to mental health, biopsying the brain isn’t an option,” Niculescu said.
“Our research is applying similar concepts from other areas of medicine, but we’re engineering new ways that will allow us to track mental symptoms objectively, including stress, using blood, or so-called ‘liquid biopsies.'”
Much like with his recent work in developing a blood test to measure pain, and his past work on suicide, Niculescu said this research could be life-changing for individuals who have been exposed to or are about to enter high-stress environments.
Such biomarkers will allow doctors to classify people in terms of their current severity or risk for future stress disorders, which can guide career choices as well as treatment options. Additionally, the biomarkers could measure response to treatment in an objective, quantifiable manner.
“Untreated pain and stress can lead to suicide, that’s how we became interested in these disorders, and decided to move upstream and see if we can better understand, treat and prevent them,” Niculescu said.
With this study, Niculescu said the ultimate goal is prevention; pairing the ability to better predict those predisposed to PTSD with a more targeted approach to medicating those suffering from its affects. It’s preventive medicine done in a precise way, which aligns with the IU Grand Challenge Precision Health Initiative launched in 2016.
“We want to prevent the needless tragedy and suffering in people’s lives. By understanding in a biological way a patient’s illnesses and their mental health challenges, we could treat what they have better, preventing future episodes,” Niculescu said.
Source: Indiana University/EurekAlert
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