Emerging Diagnostic Tools

Currently, most mental illnesses are diagnosed based on symptoms alone, creating an urgent need for new approaches to diagnosis. In bipolar disorder, there may be a significant delay in diagnosis due to the complex clinical presentation of the illness. It is often misdiagnosed for years before the patient is given proper treatment. Prolonging the time before the patient receives proper treatment can make their illness outcome less successful. The longer one goes untreated, the less likely they are to be responsive to treatments.


Psychiatric neuroimaging (MRI)

MRI may be an effective way to diagnose mental illnesses such as bipolar disorder, according to experts from the Icahn School of Medicine at Mount Sinai. In a landmark study in 2013, researchers were able to correctly distinguish bipolar patients from healthy individuals based on their brain scans alone. Sophia Frangou, MD, Professor of Psychiatry and Chief of the Psychosis Research Program at the Ichan School of Medicine at Mount Sinai along with Andy Simmons, MD, of the Kings College London and Janaina Mourao-Miranda, MD, of University College London, explored whether brain imaging could help correctly identify patients with bipolar disorder.


fMRI

Functional MRI is a robust research tool for exploring subtle changes in blood flow associated with a variety of activities within the brain. In the clinical arena, however, it is limited for the most part to language lateralization and sensorimotor function brain mapping.

Brain imaging techniques such as MRI, positron emission tomography (PET), and diffusion tensor imaging (DTI) are being used increasingly to directly quantify neural system abnormalities associated with bipolar disorder and UPD.

Potential

Already, neuroradiologists around the world are using fMRI to analyze brain function in affective disorders, schizophrenia, autism, and learning problems, such as dyslexia. If fMRI generates better understanding of neuropsychologic diseases, it likely will move neuroradiologists away from their traditional roles as diagnosticians. What neuroradiologists may offer with fMRI is a means of comprehending the biological processes of psychiatric disease onset and progression. Functional MRI in addition may be able to mark disease activity and therefore trace the effect of drug treatment for psychiatric illnesses. It might show how the medication affects the organization of the brain, revealing the efficiency of certain drugs, he said.

Here is a link to an article that discusses the potential of fMRI in finding the origins of chronic psychiatric diseases.

Here is another article that discusses the use of fMRI as a noninvasive “lab test” for bipolar disorder.


Measuring Brain Vitals (“Brain Thermometer”)

In 2016, the Food and Drug Administration (FDA) approved several new technologies to help assess brain health and detect emotional and cognitive changes earlier.

Brain vitals — a set of tests easily administered on a smartphone or tablet that measure mood, cognition, reaction time, spatial discrimination and memory — have yet to be well integrated into routine medical check-ups. Such tests could change healthcare professionals’ diagnostic powers by allowing them to evaluate and track changes in standardized measurements over time.

Called a “brain thermometer” by the US Army’s Combat Care Research Program, a new FDA-cleared app is proving helpful in military settings to help identify traumatic brain disorders (TBI), concussions, post-traumatic stress disorder (PTSD), and depression in members of the Armed Services. The tech expert, Dr. Corinna Lathan, behind this new software suggests that this tool could also be used in general health care settings as well. Here is a link to the full Huffington Post article that discusses this technology.


Blood Test

For over a decade, scientists from California to Cambridge have been trying to develop diagnostic blood tests for mental illnesses. Professor Sabine Bahn is a psychiatrist who runs the Cambridge Centre for Neuropsychiatric Research. In 2011, her research group developed the basis for the world’s first blood test for schizophrenia. The test was brought to market under the name VeriPsych through her spin-off company Psynova Neurotech and a Texas based biomarker laboratory called Rules-Based Medicine.

In November, her lab announced the discovery of a similar blood test for bipolar disorder, a unique fingerprint of 20 molecules called biomarkers which Bahn believes could be used to assist doctors in diagnosing the disease in patients aged between 18 and 35.

Here is an article that discusses this study and the use of blood tests for bipolar diagnosis.

As of 2016, the company says the test remains on hold while such options are being explored. As a result, so far no blood tests for mental illnesses have managed to gain a permanent