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Scott J, Hidalgo-Mazzei D, Strawbridge R, Young A, Resche-Rigon M, Etain B, Andreassen OA, Bauer M, Bennabi D, Blamire AM, Boumezbeur F, Brambilla P, Cattane N, Cattaneo A, Chupin M, Coello K, Cointepas Y, Colom F, Cousins DA, Dubertret C, Duchesnay E, Ferro A, Garcia-Estela A, Goikolea J, Grigis A, Haffen E, Høegh MC, Jakobsen P, Kalman JL, Kessing LV, Klohn-Saghatolislam F, Lagerberg TV, Landén M, Lewitzka U, Lutticke A, Mazer N, Mazzelli M, Mora C, Muller T, Mur-Mila E, Oedegaard KJ, Oltedal L, Pålsson E, Papadopoulos Orfanos D, Papiol S, Perez-Sola V, Reif A, Ritter P, Rossi R, Schulze T, Senner F, Smith FE, Squarcina L, Steen NE, Thelwall PE, Varo C, Vieta E, Vinberg M, Wessa M, Westlye LT, Bellivier F. Prospective cohort study of early biosignatures of response to lithium in bipolar-I-disorders: overview of the H2020-funded R-LiNK initiative. Int J Bipolar Disord 2019; 7:20. [PMID: 31552554 PMCID: PMC6760458 DOI: 10.1186/s40345-019-0156-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 07/24/2019] [Indexed: 01/01/2023] Open
Abstract
Background Lithium 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. Structure The 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. Conclusions The 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. Electronic supplementary material The online version of this article (10.1186/s40345-019-0156-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jan Scott
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.,Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Université Paris Diderot, 75013, Paris, France
| | - Diego Hidalgo-Mazzei
- 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
| | - Rebecca Strawbridge
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Allan Young
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Matthieu Resche-Rigon
- Université Paris Diderot, 75013, Paris, France.,Service de Biostatistique et Information Médicale, Hôpital Saint-Louis, AP-HP, Paris, France.,Inserm, UMR 1153, Equipe ECSTRA, Paris, France
| | - Bruno Etain
- Université Paris Diderot, 75013, Paris, France.,Département de Psychiatrie et de Médecine Addictologique, AP-HP, GH Saint-Louis - Lariboisière - F. Widal, 75475, Paris, France.,Inserm, U1144, Team 1, 75006, Paris, France
| | - Ole A Andreassen
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Djamila Bennabi
- Department of Clinical Psychiatry, Inserm CIC 1431, CHU Besançon, 25000, Besançon, France.,Laboratoire de Neurosciences, Université Bourgogne Franche-Comté, 25000, Besançon, France
| | - Andrew M Blamire
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK.,Newcastle Magnetic Resonance Centre, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - Fawzi Boumezbeur
- NeuroSpin, CEA, Université Paris-Saclay, 91191, Gif-sur-Yvette, France
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.,Department of Psychiatry and Behavioural Neurosciences, University of Texas at Houston, Houston, TX, USA
| | - Nadia Cattane
- IRCCS Istituto Centro San Giovanni di Dio - Fatebenefratelli, Brescia, Italy
| | - Annamaria Cattaneo
- IRCCS Istituto Centro San Giovanni di Dio - Fatebenefratelli, Brescia, Italy
| | - Marie Chupin
- CATI Neuroimaging Platform, ICM, Pitié Salpétrière Hospital, 75013, Paris, France.,Institut du Cerveau et de la Moelle épinière, ICM, 75013, Paris, France.,Inserm, U1127, 75013, Paris, France.,CNRS, UMR 7225, 75013, Paris, France.,Sorbonne Université, 75013, Paris, France
| | - Klara Coello
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Yann Cointepas
- NeuroSpin, CEA, Université Paris-Saclay, 91191, Gif-sur-Yvette, France.,CATI Neuroimaging Platform, ICM, Pitié Salpétrière Hospital, 75013, Paris, France
| | - Francesc Colom
- Mental Health Research Program, IMIM, Hospital del Mar, CIBERSAM, Barcelona, Catalonia, Spain
| | - David A Cousins
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.,Northumberland Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, NE3 3XT, UK
| | - Caroline Dubertret
- Université Paris Diderot, 75013, Paris, France.,APHP; Psychiatry Department, University Hospital Louis Mourier, Colombes, France.,INSERM U894, Institute of Psychiatry and Neurosciences of Paris, Paris, France
| | - Edouard Duchesnay
- NeuroSpin, CEA, Université Paris-Saclay, 91191, Gif-sur-Yvette, France
| | - Adele Ferro
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Aitana Garcia-Estela
- Mental Health Research Program, IMIM, Hospital del Mar, CIBERSAM, Barcelona, Catalonia, Spain
| | - Jose Goikolea
- 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
| | - Antoine Grigis
- NeuroSpin, CEA, Université Paris-Saclay, 91191, Gif-sur-Yvette, France
| | - Emmanuel Haffen
- Department of Clinical Psychiatry, Inserm CIC 1431, CHU Besançon, 25000, Besançon, France.,Laboratoire de Neurosciences, Université Bourgogne Franche-Comté, 25000, Besançon, France
| | - Margrethe C Høegh
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Petter Jakobsen
- NORMENT, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Janos L Kalman
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany.,Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.,International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
| | - Lars V Kessing
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Farah Klohn-Saghatolislam
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany.,Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Trine V Lagerberg
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Mikael Landén
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ute Lewitzka
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Ashley Lutticke
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany.,Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Nicolas Mazer
- APHP; Psychiatry Department, University Hospital Louis Mourier, Colombes, France.,INSERM U894, Institute of Psychiatry and Neurosciences of Paris, Paris, France
| | - Monica Mazzelli
- IRCCS Istituto Centro San Giovanni di Dio - Fatebenefratelli, Brescia, Italy
| | - Cristina Mora
- IRCCS Istituto Centro San Giovanni di Dio - Fatebenefratelli, Brescia, Italy
| | - Thorsten Muller
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Estanislao Mur-Mila
- Mental Health Research Program, IMIM, Hospital del Mar, CIBERSAM, Barcelona, Catalonia, Spain
| | - Ketil Joachim Oedegaard
- NORMENT, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Leif Oltedal
- Department of Clinical Medicine, University of Bergen, Bergen, Norway.,Mohn Medical Imaging and Visualization Centre, Department of Radiology, Haukeland University Hospital, Bergen, Norway
| | - Erik Pålsson
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Sergi Papiol
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany.,Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Victor Perez-Sola
- Mental Health Research Program, IMIM, Hospital del Mar, CIBERSAM, Barcelona, Catalonia, Spain
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Philipp Ritter
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Roberto Rossi
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio - Fatebenefratelli, Brescia, Italy
| | - Thomas Schulze
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Fanny Senner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany.,Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Fiona E Smith
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK.,Newcastle Magnetic Resonance Centre, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - Letizia Squarcina
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Nils Eiel Steen
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Pete E Thelwall
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK.,Newcastle Magnetic Resonance Centre, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - Cristina Varo
- 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
| | - Eduard Vieta
- 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
| | - Maj Vinberg
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Michele Wessa
- Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes Gutenberg-University Mainz, Wallstraße 3, 55122, Mainz, Germany
| | - Lars T Westlye
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Frank Bellivier
- Université Paris Diderot, 75013, Paris, France. .,Département de Psychiatrie et de Médecine Addictologique, AP-HP, GH Saint-Louis - Lariboisière - F. Widal, 75475, Paris, France. .,Inserm, U1144, Team 1, 75006, Paris, France.
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