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Lam RW, Milev R, Rotzinger S, Andreazza AC, Blier P, Brenner C, Daskalakis ZJ, Dharsee M, Downar J, Evans KR, Farzan F, Foster JA, Frey BN, Geraci J, Giacobbe P, Feilotter HE, Hall GB, Harkness KL, Hassel S, Ismail Z, Leri F, Liotti M, MacQueen GM, McAndrews MP, Minuzzi L, Müller DJ, Parikh SV, Placenza FM, Quilty LC, Ravindran AV, Salomons TV, Soares CN, Strother SC, Turecki G, Vaccarino AL, Vila-Rodriguez F, Kennedy SH. Discovering biomarkers for antidepressant response: protocol from the Canadian biomarker integration network in depression (CAN-BIND) and clinical characteristics of the first patient cohort. BMC Psychiatry 2016; 16:105. [PMID: 27084692 PMCID: PMC4833905 DOI: 10.1186/s12888-016-0785-x] [Citation(s) in RCA: 100] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 03/18/2016] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Major Depressive Disorder (MDD) is among the most prevalent and disabling medical conditions worldwide. Identification of clinical and biological markers ("biomarkers") of treatment response could personalize clinical decisions and lead to better outcomes. This paper describes the aims, design, and methods of a discovery study of biomarkers in antidepressant treatment response, conducted by the Canadian Biomarker Integration Network in Depression (CAN-BIND). The CAN-BIND research program investigates and identifies biomarkers that help to predict outcomes in patients with MDD treated with antidepressant medication. The primary objective of this initial study (known as CAN-BIND-1) is to identify individual and integrated neuroimaging, electrophysiological, molecular, and clinical predictors of response to sequential antidepressant monotherapy and adjunctive therapy in MDD. METHODS CAN-BIND-1 is a multisite initiative involving 6 academic health centres working collaboratively with other universities and research centres. In the 16-week protocol, patients with MDD are treated with a first-line antidepressant (escitalopram 10-20 mg/d) that, if clinically warranted after eight weeks, is augmented with an evidence-based, add-on medication (aripiprazole 2-10 mg/d). Comprehensive datasets are obtained using clinical rating scales; behavioural, dimensional, and functioning/quality of life measures; neurocognitive testing; genomic, genetic, and proteomic profiling from blood samples; combined structural and functional magnetic resonance imaging; and electroencephalography. De-identified data from all sites are aggregated within a secure neuroinformatics platform for data integration, management, storage, and analyses. Statistical analyses will include multivariate and machine-learning techniques to identify predictors, moderators, and mediators of treatment response. DISCUSSION From June 2013 to February 2015, a cohort of 134 participants (85 outpatients with MDD and 49 healthy participants) has been evaluated at baseline. The clinical characteristics of this cohort are similar to other studies of MDD. Recruitment at all sites is ongoing to a target sample of 290 participants. CAN-BIND will identify biomarkers of treatment response in MDD through extensive clinical, molecular, and imaging assessments, in order to improve treatment practice and clinical outcomes. It will also create an innovative, robust platform and database for future research. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT01655706 . Registered July 27, 2012.
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Affiliation(s)
- Raymond W Lam
- University of British Columbia and Vancouver Coastal Health Authority, 2255 Wesbrook Mall, Vancouver, BC, V6T 2A1, Canada
| | - Roumen Milev
- Queen's University, Providence Care, Mental Health Services 752 King Street West, Postal Bag 603, Kingston, ON, K7L 7X3, Canada
| | - Susan Rotzinger
- University Health Network, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada.,Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, ON, M5T 1R8, Canada
| | - Ana C Andreazza
- Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, ON, M5T 1R8, Canada.,Centre for Addiction and Mental Health, 1001 Queen St. W, Toronto, ON, M6J 1A8, Canada
| | - Pierre Blier
- University of Ottawa Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, ON, K1Z 7K4, Canada
| | - Colleen Brenner
- Loma Linda University, 24851 Circle Dr, Loma Linda, CA, 92354, USA
| | - Zafiris J Daskalakis
- Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, ON, M5T 1R8, Canada.,Centre for Addiction and Mental Health, 1001 Queen St. W, Toronto, ON, M6J 1A8, Canada
| | - Moyez Dharsee
- Indoc Research, 258 Adelaide St. East, Suite 200, Toronto, ON, M5A 1N1, Canada
| | - Jonathan Downar
- University Health Network, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada.,Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, ON, M5T 1R8, Canada
| | - Kenneth R Evans
- Indoc Research, 258 Adelaide St. East, Suite 200, Toronto, ON, M5A 1N1, Canada.,Department of Pathology and Molecular Medicine, Queen's University, 88 Stuart Street, Kingston, ON, K7L 3N6, Canada
| | - Faranak Farzan
- Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, ON, M5T 1R8, Canada.,Centre for Addiction and Mental Health, 1001 Queen St. W, Toronto, ON, M6J 1A8, Canada
| | - Jane A Foster
- University Health Network, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada.,McMaster University, and St. Joseph's Healthcare Hamilton, 1280 Main Street West, Hamilton, ON, L8S4L8, Canada
| | - Benicio N Frey
- McMaster University, and St. Joseph's Healthcare Hamilton, 1280 Main Street West, Hamilton, ON, L8S4L8, Canada
| | - Joseph Geraci
- University Health Network, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada
| | - Peter Giacobbe
- University Health Network, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada.,Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, ON, M5T 1R8, Canada
| | - Harriet E Feilotter
- Indoc Research, 258 Adelaide St. East, Suite 200, Toronto, ON, M5A 1N1, Canada.,Department of Pathology and Molecular Medicine, Queen's University, 88 Stuart Street, Kingston, ON, K7L 3N6, Canada
| | - Geoffrey B Hall
- McMaster University, and St. Joseph's Healthcare Hamilton, 1280 Main Street West, Hamilton, ON, L8S4L8, Canada
| | - Kate L Harkness
- Department of Psychology, Queen's University, Kingston, ON, K7L 3N6, Canada
| | - Stefanie Hassel
- Aston University, Aston Triangle, Birmingham, West Midlands, B4 7ET, UK
| | - Zahinoor Ismail
- University of Calgary Hotchkiss Brain Institute, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
| | - Francesco Leri
- University of Guelph, 50 Stone Rd E, Guelph, ON, N1G 2W1, Canada
| | - Mario Liotti
- Simon Fraser University, 8888 University Dr, Burnaby, BC, V5A 1S6, Canada
| | - Glenda M MacQueen
- University of Calgary Hotchkiss Brain Institute, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
| | - Mary Pat McAndrews
- University Health Network, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada
| | - Luciano Minuzzi
- McMaster University, and St. Joseph's Healthcare Hamilton, 1280 Main Street West, Hamilton, ON, L8S4L8, Canada
| | - Daniel J Müller
- Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, ON, M5T 1R8, Canada.,Centre for Addiction and Mental Health, 1001 Queen St. W, Toronto, ON, M6J 1A8, Canada
| | - Sagar V Parikh
- Universisty of Michigan, 500S State St, Ann Arbor, MI, 48109, USA
| | - Franca M Placenza
- University Health Network, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada
| | - Lena C Quilty
- Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, ON, M5T 1R8, Canada.,Centre for Addiction and Mental Health, 1001 Queen St. W, Toronto, ON, M6J 1A8, Canada
| | - Arun V Ravindran
- Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, ON, M5T 1R8, Canada.,Centre for Addiction and Mental Health, 1001 Queen St. W, Toronto, ON, M6J 1A8, Canada
| | - Tim V Salomons
- University of Reading, Earley Gate, Whiteknights, Reading, RG6 6AL, UK
| | - Claudio N Soares
- St. Michael's Hospital, 193 Yonge St, Toronto, ON, M5B 1M4, Canada
| | - Stephen C Strother
- Rotman Research Institute at Baycrest Centre, 3560 Bathurst Street, Toronto, ON, M6A 2E1, Canada
| | - Gustavo Turecki
- McGill University , 845 Rue Sherbrooke O, Montréal, QC, H3A 0G4, Canada.,Douglas Mental Health University Institute Frank B. Common (FBC) F-3145, 6875 LaSalle Boulevard, Montréal, QC, H4H 1R3, Canada
| | - Anthony L Vaccarino
- Indoc Research, 258 Adelaide St. East, Suite 200, Toronto, ON, M5A 1N1, Canada
| | - Fidel Vila-Rodriguez
- University of British Columbia and Vancouver Coastal Health Authority, 2255 Wesbrook Mall, Vancouver, BC, V6T 2A1, Canada
| | - Sidney H Kennedy
- University Health Network, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada. .,Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, ON, M5T 1R8, Canada. .,St. Michael's Hospital, 193 Yonge St, Toronto, ON, M5B 1M4, Canada.
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