Prospective cohort study of early biosignatures of response to lithium in bipolar-I-disorders: overview of the H2020-funded R-LiNK initiative View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2019-09-25

AUTHORS

Jan Scott, Diego Hidalgo-Mazzei, Rebecca Strawbridge, Allan Young, Matthieu Resche-Rigon, Bruno Etain, Ole A. Andreassen, Michael Bauer, Djamila Bennabi, Andrew M. Blamire, Fawzi Boumezbeur, Paolo Brambilla, Nadia Cattane, Annamaria Cattaneo, Marie Chupin, Klara Coello, Yann Cointepas, Francesc Colom, David A. Cousins, Caroline Dubertret, Edouard Duchesnay, Adele Ferro, Aitana Garcia-Estela, Jose Goikolea, Antoine Grigis, Emmanuel Haffen, Margrethe C. Høegh, Petter Jakobsen, Janos L. Kalman, Lars V. Kessing, Farah Klohn-Saghatolislam, Trine V. Lagerberg, Mikael Landén, Ute Lewitzka, Ashley Lutticke, Nicolas Mazer, Monica Mazzelli, Cristina Mora, Thorsten Muller, Estanislao Mur-Mila, Ketil Joachim Oedegaard, Leif Oltedal, Erik Pålsson, Dimitri Papadopoulos Orfanos, Sergi Papiol, Victor Perez-Sola, Andreas Reif, Philipp Ritter, Roberto Rossi, Thomas Schulze, Fanny Senner, Fiona E. Smith, Letizia Squarcina, Nils Eiel Steen, Pete E. Thelwall, Cristina Varo, Eduard Vieta, Maj Vinberg, Michele Wessa, Lars T. Westlye, Frank Bellivier

ABSTRACT

BackgroundLithium is recommended as a first line treatment for bipolar disorders. However, only 30% of patients show an optimal outcome and variability in lithium response and tolerability is poorly understood. It remains difficult for clinicians to reliably predict which patients will benefit without recourse to a lengthy treatment trial. Greater precision in the early identification of individuals who are likely to respond to lithium is a significant unmet clinical need.StructureThe H2020-funded Response to Lithium Network (R-LiNK; http://www.r-link.eu.com/) will undertake a prospective cohort study of over 300 individuals with bipolar-I-disorder who have agreed to commence a trial of lithium treatment following a recommendation by their treating clinician. The study aims to examine the early prediction of lithium response, non-response and tolerability by combining systematic clinical syndrome subtyping with examination of multi-modal biomarkers (or biosignatures), including omics, neuroimaging, and actigraphy, etc. Individuals will be followed up for 24 months and an independent panel will assess and classify each participants’ response to lithium according to predefined criteria that consider evidence of relapse, recurrence, remission, changes in illness activity or treatment failure (e.g. stopping lithium; new prescriptions of other mood stabilizers) and exposure to lithium. Novel elements of this study include the recruitment of a large, multinational, clinically representative sample specifically for the purpose of studying candidate biomarkers and biosignatures; the application of lithium-7 magnetic resonance imaging to explore the distribution of lithium in the brain; development of a digital phenotype (using actigraphy and ecological momentary assessment) to monitor daily variability in symptoms; and economic modelling of the cost-effectiveness of introducing biomarker tests for the customisation of lithium treatment into clinical practice. Also, study participants with sub-optimal medication adherence will be offered brief interventions (which can be delivered via a clinician or smartphone app) to enhance treatment engagement and to minimize confounding of lithium non-response with non-adherence.ConclusionsThe paper outlines the rationale, design and methodology of the first study being undertaken by the newly established R-LiNK collaboration and describes how the project may help to refine the clinical response phenotype and could translate into the personalization of lithium treatment. More... »

PAGES

20

Journal

Author Affiliations

  • Université Paris Diderot, 75013, Paris, France
  • Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic de Barcelona, University of Barcelona, IDIBAPS, CIBERSAM, Villaroel 170, 08036, Barcelona, Catalonia, Spain
  • Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
  • Inserm, UMR 1153, Equipe ECSTRA, Paris, France
  • Inserm, U1144, Team 1, 75006, Paris, France
  • Institute of Clinical Medicine, University of Oslo, Oslo, Norway
  • Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
  • Laboratoire de Neurosciences, Université Bourgogne Franche-Comté, 25000, Besançon, France
  • Newcastle Magnetic Resonance Centre, Campus for Ageing and Vitality, Newcastle University, NE4 5PL, Newcastle upon Tyne, UK
  • NeuroSpin, CEA, Université Paris-Saclay, 91191, Gif-sur-Yvette, France
  • Department of Psychiatry and Behavioural Neurosciences, University of Texas at Houston, Houston, TX, USA
  • IRCCS Istituto Centro San Giovanni di Dio - Fatebenefratelli, Brescia, Italy
  • Sorbonne Université, 75013, Paris, France
  • Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, University Hospital of Copenhagen, Copenhagen, Denmark
  • CATI Neuroimaging Platform, ICM, Pitié Salpétrière Hospital, 75013, Paris, France
  • Mental Health Research Program, IMIM, Hospital del Mar, CIBERSAM, Barcelona, Catalonia, Spain
  • Northumberland Tyne and Wear NHS Foundation Trust, NE3 3XT, Newcastle upon Tyne, UK
  • INSERM U894, Institute of Psychiatry and Neurosciences of Paris, Paris, France
  • Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
  • Department of Clinical Medicine, University of Bergen, Bergen, Norway
  • International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
  • Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
  • NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
  • Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
  • Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
  • Mohn Medical Imaging and Visualization Centre, Department of Radiology, Haukeland University Hospital, Bergen, Norway
  • Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
  • Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio - Fatebenefratelli, Brescia, Italy
  • Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes Gutenberg-University Mainz, Wallstraße 3, 55122, Mainz, Germany
  • Department of Psychology, University of Oslo, Oslo, Norway
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1186/s40345-019-0156-x

    DOI

    http://dx.doi.org/10.1186/s40345-019-0156-x

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1121231176

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/31552554


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