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P E R S P E C T I V E F O C U S O N P SYC H I AT R I C D I S O R D E R S
The search for imaging biomarkers in psychiatric disorders
Anissa Abi-Dargham1,2 & Guillermo Horga1
2016 Nature America, Inc., part of Springer Nature. All rights reserved.
The field of medicine is moving toward the use of biomarkers for the optimization of individualized care. This is a particular challenge for the field of psychiatry, in which diagnosis is based on a descriptive collection of behaviors without the availability of any objective test to stratify patients. Neuroimaging techniques such as molecular imaging with positron-emission tomography (PET) or structural and functional magnetic resonance imaging (MRI) provide an opportunity to bring psychiatry from an era of subjective descriptive classification into objective and tangible brain-based measures. Here we provide steps toward the development of robust, reliable and valid biomarkers. The success of such development is crucial because it will enable the field of psychiatry to move forward into the era of modern medicine.
The search for biomarkersobjective biological measures that can predict clinical outcomesis consistent with the precision-medicine initiative, which gained official support from the White House in January 2015 (ref. 1). The approach, in which treatment and prevention for each person is carried out by taking into account the individuals genes, environment and lifestyle, relies heavily on biomarkers (genetic or otherwise). This personalized stratification approach is already revolutionizing cancer treatment, wherein novel drugs that target specific molecular-signaling pathways related to genetic mutations are currently under development and in testing2, thereby enabling treatments to be tailored to a patients genomic profile3. Treatment of some neurological disorders, such as epilepsy, has been carried out with some success by using similar strategies4. The application of precision medicine to psychiatry, however, is more challenging, because the path from genes to behaviors is influenced by a series of complex interactive links that have yet to be fully understood. Yet, psychiatric disorders are responsible for immense personal, social and financial burden. Medical costs in the USA alone were estimated at $57 billion in 2006 (ref. 5). More importantly, indirect costs resulting from lost earnings, in particular income lost owing to severe mental...