TY  - JOUR
A1  - Haenisch, Frieder
A1  - Cooper, Jason D.
A1  - Reif, Andreas
A1  - Kittel-Schneider, Sarah
A1  - Steiner, Johann
A1  - Leweke, F. Markus
A1  - Rothermundt, Matthias
A1  - Beveren, Nico J. M. van
A1  - Crespo-Facorro, Benedicto
A1  - Niebuhr, David W.
A1  - Cowan, David N.
A1  - Weber, Natalya S.
A1  - Yolken, Robert H.
A1  - Penninx, Brenda W. J. H.
A1  - Bahn, Sabine
T1  - Towards a blood-based diagnostic panel for bipolar disorder
T2  - Brain, behavior and immunity
N2  - Highlights
• A panel of 20 biomarkers was identified capable of differentiating BD patients from controls.
• Excellent discrimination between established BD patients and controls.
• Good to excellent discrimination between misdiagnosed BD patients and first onset MDD patients.
• Fair to good discrimination between pre-diagnostic BD patients and controls.
• Study demonstrates the potential utility of a protein biomarker panel as a diagnostic test for BD.
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.
KW  - Bipolar disorder
KW  - Multiplex immunoassay
KW  - Biomarker
KW  - Differential diagnosis
KW  - Diagnostic test
Y1  - 2015
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/77303
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-773033
SN  - 0889-1591
VL  - 52.2016
SP  - 49
EP  - 57
PB  - Elsevier
CY  - Amsterdam
ER  -