Towards a blood-based diagnostic panel for bipolar disorder
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Haenisch, Frieder; Cooper, Jason D.; Reif, Andreas; Kittel-Schneider, Sarah; Steiner, Johann; Leweke, F. Markus; Rothermundt, Matthias; Beveren, Nico J.M. van; Crespo Facorro, Benedicto
Date
2016Derechos
© The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license
Publicado en
Brain Behav Immun. 2016 Feb;52:49-57
Publisher
Elsevier
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Palabras clave
Bipolar Disorder
Multiplex Immunoassay
Biomarker
Differential Diagnosis
Diagnostic Test
Abstract:
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.
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