Third-Party Funded Projects on Affective Disorders
Affective Disorders - P4D-Study
With personalized medicine against depression
Speaker, Consortium Coordination: Prof. Dr. med. Helge Frieling, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical SchoolFunding period: 2022-2027In addition to seven German universities (MHH, Leibniz Universität Hannover, TU Braunschweig, University of Greifswald, University of Würzburg, University of Kiel, University of Frankfurt), the Fraunhofer Institute for Toxicology and Experimental Medicine, the German Depression Aid Foundation and the company BioVariance GmbH are involved in the study, which is funded with ten million euros over five years by the Federal Ministry of Education and Research (BMBF).
So far, patients with depression have usually been treated with psychotherapy and/or antidepressants, which, however, only leads to a rapid and significant improvement in symptoms in about half of ALL patients. For example, the first antidepressant that is administered as part of a depression therapy is only effective in every fourth to fifth patient. Antidepressants also often lead to severe side effects. This is due to the fact that different brain dysfunctions are hidden behind the clinical picture 'depression' on a neurobiological level.
As part of the P4D study, these pathological structures are to be identified with the help of biomarkers, but also questionnaires, Magnetic Resonance Imaging, brain current measurements and sleep diagnostics, and based on this, patient-tailored diagnostic and treatment approaches are to be developed.
Instead of trying out different treatment methods as before, it should be possible in the future to determine an optimal treatment approach for each patient right at the beginning of the treatment for depression. This should not only ensure that more people with depression are treated more effectively. The researcher also expect personalized therapy approaches to improve the quality of life more quickly for those affected and hope that this will prevent the depression from becoming chronic.
1,000 depressive patients will be included in the study
Around 1,000 patients are being recruited for P4D at the five participating university hospitals of Hannover, Kiel, Greifswald, Würzburg and Frankfurt. The study is characterized by the fact that ALL probands undergo an comprehensiv examination and many different Parameters are recorded. In addition to Magnetic Resonance Imaging, electroencephalography and sleep analyses, physical examinations, various questionnaires and blood samples are also evaluated. The investigations also include a genome-wide long-read sequencing, enables the detection of almost ALL genetic and epigenetic changes. A patient advisory board put together by the German Depression Aid Foundation for the research project critically monitors P4D and brings in the views of those affected.
In addition to the recruitment and detailed collection of extensive patient data, subproject 5A is mainly focused on pharmacogenomics of depression. The individual effectiveness and tolerability of a certain drug depends not only on phenotypic factors, but also on the genetic disposition. In particular, genetic or epigenetic variations in genes involved in the distribution, metabolism and excretion of a drug play a crucial role. Adapting the dosage of a drug to the patient's underlying drug metabolism can significantly increase the effectiveness of a drug and reduce undesirable side effects.
Within the framework of this subproject, genetic factors in particular that influence the metabolism of antidepressants are to be identified. The subsequent development of a specific treatment assay aims to optimize the selection and dosage of a drug by determining these factors in each individual patient and to reduce undesirable side effects. Within the research network, genetic biomarkers are also to be identified that contribute to various mechanisms of disease development and, within this subproject, enable the development of a diagnostic assay for the precise determination of the disease in each patient.
The personalization of treatment approaches not only contributes to improved diagnosis, effectiveness and safety for patients, but could also counteract the considerable suffering of those affected more quickly by shortening the duration of treatment and reduce the risk of a chronic course of the disease.
Further informations on the P4D study are available on: