Discovering biomarkers for antidepressant response: protocol from the Canadian biomarker integration network in depression (CAN-BIND) and clinical characteristics of the first patient cohort

Raymond W. Lam, Roumen Milev, Susan Rotzinger, Ana C. Andreazza, Pierre Blier, Colleen Brenner, Zafiris J. Daskalakis, Moyez Dharsee, Jonathan Downar, Kenneth R. Evans, Faranak Farzan, Jane A. Foster, Benicio N. Frey, Joseph Geraci, Peter Giacobbe, Harriet E. Feilotter, Geoffrey B. Hall, Kate L. Harkness, Stefanie Hassel, Zahinoor IsmailFrancesco Leri, Mario Liotti, Glenda M. MacQueen, Mary Pat McAndrews, Luciano Minuzzi, Daniel J. Müller, Sagar V. Parikh, Franca M. Placenza, Lena C. Quilty, Arun V. Ravindran, Tim V. Salomons, Claudio N. Soares, Stephen C. Strother, Gustavo Turecki, Anthony L. Vaccarino, Fidel Vila-Rodriguez, Sidney H. Kennedy*,

*Corresponding author for this work

Research output: Contribution to journalArticle

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.

Original languageEnglish
Article number105
Number of pages13
JournalBMC Psychiatry
Volume16
DOIs
Publication statusPublished - 16 Apr 2016

Bibliographical note

© 2016 Lam et al. Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://​creativecommons.​org/​licenses/​by/​4.​0/​), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://​creativecommons.​org/​publicdomain/​zero/​1.​0/​) applies to the data made available in this article, unless otherwise stated.

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    Lam, R. W., Milev, R., Rotzinger, S., Andreazza, A. C., Blier, P., Brenner, C., Daskalakis, Z. J., Dharsee, M., Downar, J., Evans, K. R., Farzan, F., Foster, J. A., Frey, B. N., Geraci, J., Giacobbe, P., Feilotter, H. E., Hall, G. B., Harkness, K. L., Hassel, S. (2016). 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, 16, [105]. https://doi.org/10.1186/s12888-016-0785-x