Profiling of patients with major psychiatric disorders using electroretinography
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OverviewThis technology, based on electroretinography, will accurately and non-invasively stratify patients with major psychiatric disorders and measure the pharmacological response to specific treatments. |
Psychiatric disorders such as schizophrenia, bipolar disorder and major depression affect millions of individuals in North America. Identification of early risk factors and prevention of the disease for people with genetic predispositions remain the most promising avenues for improving the treatments for these diseases. However, there are different subgroups of patients within a specific mental disease category whose condition is underlain by different pathologies, and there are currently no reliable biomarkers to help establish an early diagnosis and guide the treatment.
Electroretinography (ERG), an accurate, non-invasive measure of retinal function, may represent a novel way to profile patients with neuropsychiatric diseases. The retina is in fact recognized as an extension of the central nervous system and a significant investigation site for understanding brain disorders. Using this tool, Drs. Maziade and Hébert and their team are assessing the dynamic response originating from cones and rods (retinal photoreceptors) following light stimulation in patients with schizophrenia or bipolar disorders. “The first year of this project was impressive, as the team surpassed all of the originally planned milestones,” said Mounia Azzi, Director of Programs at CQDM. The results demonstrate that an ERG profile can be used as a biomarker of the disease since it differentiates between schizophrenic patients and their matched controls while also correlating with both disease severity and cognitive dysfunctions. Building on this sound, valuable data, the second part of this innovative project will assess the specificity of ERG for schizophrenia stratification. Moreover, ERG will also be validated as a diagnostic tool in other neuropsychiatric diseases and as a predictor of responses to psychotropic drugs. The ultimate goal is to use ERG profiling as a biomarker that will provide categories within and across diagnoses with regards to etiology as well as response to treatments.
This project combines different disciplines, such as ophthalmology, clinical and genetic epidemiology, psychiatry, pharmacology and statistical modelling. “Breaking down the diagnostic categories into simpler phenotypes is a crucial step toward patient stratification and response to pharmacological treatment” says Michel Maziade, founder of NDEI Inc. and Scientific Director of the Centre de Recherche Université Laval Robert-Giffard. Michel Maziade and Marc Hébert conclude: “We believe this technology will play a role in biopharmaceutical research, personalized neuroscience medicine and clinical practice to maximize the benefits of medication in terms of both clinical studies and treatment setting. In the short term, we can see how ERG could improve the selection of patients for clinical trials. Moreover, ERG profiling will lead to novel tests in early diagnosis or prognosis. This technology will enable clinicians to adapt the patient’s treatment according to his or her ERG profile in a similar manner to what is already happening for cancer.”
Impact on the drug discovery process
- Stratify patients before inclusion in clinical trials and measure the pharmacological response to specific treatments
- Improve the diagnosis and maximize the benefits of treatments for schizophrenia and other neuropsychiatric disorders
- Improve the power of clinical trials for the development of new drugs targeting neuropsychiatric disorders
Key facts
- Schizophrenia is a neurological brain disorder affecting approximately 2.5 million Americans (1.1% of the adult population)
- Schizophrenia ranks among the top 10 causes of disability in developed countries worldwide
- An estimated 40% of individuals with schizophrenia remain untreated
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