TY - JOUR
T1 - Towards a blood-based diagnostic panel for bipolar disorder
AU - Haenisch, Frieder
AU - Cooper, Jason D.
AU - Reif, Andreas
AU - Kittel-Schneider, Sarah
AU - Steiner, Johann
AU - Leweke, F. Markus
AU - Rothermundt, Matthias
AU - van Beveren, Nico J.M.
AU - Crespo-Facorro, Benedicto
AU - Niebuhr, David W.
AU - Cowan, David N.
AU - Weber, Natalya S.
AU - Yolken, Robert H.
AU - Penninx, Brenda W.J.H.
AU - Bahn, Sabine
N1 - Funding Information:
We gratefully acknowledge support by the Stanley Medical Research Institute (no. 07R-1888 ). The infrastructure for the NESDA study (www.nesda.nl) has been funded through the Geestkracht program of the Netherlands Organisation for Health Research and Development (Zon-Mw , grant number 10-000-1002 ) and participating universities ( VU University Medical Center , Leiden University Medical Center , University Medical Center Groningen ). DNC, DWN and NSW efforts were funded by the Stanley Medical Research Institute and the US Department of the Army . The funding organizations had no role in the design and conduct of the study; the collection, management, analysis, and interpretation of the data; or the preparation or approval of the manuscript. The views expressed are those of the authors and should not be construed to represent the positions of the funding bodies including the US Department of the Army or Department of Defense.
Publisher Copyright:
© 2015 The Authors.
PY - 2016/2/1
Y1 - 2016/2/1
N2 - Background: Bipolar disorder (BD) is a costly, devastating and life shortening mental disorder that is often misdiagnosed, especially on initial presentation. Misdiagnosis frequently results in ineffective treatment. We investigated the utility of a biomarker panel as a diagnostic test for BD. Methods and findings: We performed a meta-analysis of eight case-control studies to define a diagnostic biomarker panel for BD. After validating the panel on established BD patients, we applied it to undiagnosed BD patients. We analysed 249 BD, 122 pre-diagnostic BD, 75 pre-diagnostic schizophrenia and 90 first onset major depression disorder (MDD) patients and 371 controls. The biomarker panel was identified using ten-fold cross-validation with lasso regression applied to the 87 analytes available across the meta-analysis studies.We identified 20 protein analytes with excellent predictive performance [area under the curve (AUC). ≥. 0.90]. Importantly, the panel had a good predictive performance (AUC 0.84) to differentiate 12 misdiagnosed BD patients from 90 first onset MDD patients, and a fair to good predictive performance (AUC 0.79) to differentiate between 110 pre-diagnostic BD patients and 184 controls. We also demonstrated the disease specificity of the panel. Conclusions: An early and accurate diagnosis has the potential to delay or even prevent the onset of BD. This study demonstrates the potential utility of a biomarker panel as a diagnostic test for BD.
AB - Background: Bipolar disorder (BD) is a costly, devastating and life shortening mental disorder that is often misdiagnosed, especially on initial presentation. Misdiagnosis frequently results in ineffective treatment. We investigated the utility of a biomarker panel as a diagnostic test for BD. Methods and findings: We performed a meta-analysis of eight case-control studies to define a diagnostic biomarker panel for BD. After validating the panel on established BD patients, we applied it to undiagnosed BD patients. We analysed 249 BD, 122 pre-diagnostic BD, 75 pre-diagnostic schizophrenia and 90 first onset major depression disorder (MDD) patients and 371 controls. The biomarker panel was identified using ten-fold cross-validation with lasso regression applied to the 87 analytes available across the meta-analysis studies.We identified 20 protein analytes with excellent predictive performance [area under the curve (AUC). ≥. 0.90]. Importantly, the panel had a good predictive performance (AUC 0.84) to differentiate 12 misdiagnosed BD patients from 90 first onset MDD patients, and a fair to good predictive performance (AUC 0.79) to differentiate between 110 pre-diagnostic BD patients and 184 controls. We also demonstrated the disease specificity of the panel. Conclusions: An early and accurate diagnosis has the potential to delay or even prevent the onset of BD. This study demonstrates the potential utility of a biomarker panel as a diagnostic test for BD.
KW - Biomarker
KW - Bipolar disorder
KW - Diagnostic test
KW - Differential diagnosis
KW - Multiplex immunoassay
UR - http://www.scopus.com/inward/record.url?scp=84953353664&partnerID=8YFLogxK
U2 - 10.1016/j.bbi.2015.10.001
DO - 10.1016/j.bbi.2015.10.001
M3 - Article
C2 - 26441135
AN - SCOPUS:84953353664
SN - 0889-1591
VL - 52
SP - 49
EP - 57
JO - Brain, Behavior, and Immunity
JF - Brain, Behavior, and Immunity
ER -