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Hope on the horizon
CAMBRIDGE, Mass.—In 2017 alone, about 1.7 million Americans will be diagnosed with a traumatic brain injury (TBI), and 8 million will be diagnosed with post-traumatic stress disorder (PTSD). While these brain disorders are fairly common, few proven tools exist to consistently and accurately diagnose them or determine whether treatment is working.
Trauma-related brain disorders, such as PTSD and TBI, can affect anyone who is exposed to a psychologically or physically traumatic event, including veterans, first responders, terrorist attack survivors, war refugees and those suffering because of human trafficking and domestic abuse. Trauma-related disorders are also a major contributor to risk for suicide—a devastating outcome affecting as many as 20 veterans per day.
Cohen Veterans Bioscience and the U.S. Department of Veterans Affairs (VA) recently announced a new public-private partnership to identify biomarkers and develop diagnostics for trauma-related brain disorders. These organizations are spearheading the Research Alliance for PTSD/TBI Innovation and Discovery Diagnostics (RAPID-Dx) to capitalize on recent advances in brain imaging, genetics and other areas that are bringing the previously unseen impact of PTSD and TBI into focus.
Cohen Veterans Bioscience—a 501(c)(3) non-profit research organization dedicated to fast-tracking the development of diagnostic tests and personalized therapeutics for brain trauma—will lead the public-private partnership alliance to enable different institutions to coordinate efforts and integrate data across dozens of labs and leverage synergistic capabilities for a Big Data team-science approach to discover and support development of first-generation validated biomarkers and diagnostics for PTSD and TBI.
PTSD and TBI are often referred to as “invisible wounds,” subtle shifts in the brain’s structure and function that can devastate a person’s mood, cognition and mental state. Today, first-generation tests still do not exist to diagnose these conditions and make these wounds “visible.”
“We don’t have good ways to diagnose these diseases,” explained Dr. Magali Haas, who serves as president and CEO of Cohen Veterans Bioscience. “It is often done with highly subjective methods, such as interviews, that are not reproducible, so we have a lot of heterogeneity in diagnosis. Even CDC can’t agree on a definition of these diseases.”
She added, “We want to start with developing objective, definitive tests to measure changes in brain functioning and integrity and then create a therapeutic protocol. No drugs have been developed in 15 years, and the existing ones are not very effective. Psychotherapy is not always effective. We have a long way to go to treat these conditions.”
Haas founded Orion Bionetworks in July 2012, which was transformed to Cohen Veterans Bioscience in 2015 to specifically dedicate research to improving the detection and treatment of PTSD and TBI and related co-morbidities so that the burden of these conditions may be lessened on service members, veterans and their families.
Recently, Cohen Veterans Bioscience and the Broad Institute’s Stanley Center for Psychiatric Research along with PTSD researchers from the Psychiatric Genomics Consortium announced initial findings from what is reportedly the largest study of genetic markers for post-traumatic stress disorder to date. Top-line results of a landmark global collaboration of over 80,000 biosamples identified three possible loci or chromosomal points involved in PTSD risk, with some loci being implicated in the genetics of other psychiatric disorders. These data showing the first known genetic markers for PTSD risk were presented at the Society of Biological Psychiatry annual conference in San Diego.
Haas described biomarkers as the basis of developing a diagnostic tool to measure brain disorders in the same way as clinicians measure blood glucose to determine whether a patient is diabetic and how well the treatment is working. She hopes that some form of brain imaging or a wearable device can be used to objectively identify trauma-related brain disorders, whether a disease or a pathological condition, and added that PTSD has a genetic component.
According to Karestan Koenen, principal investigator for the Stanley Center and professor at the Harvard T. H. Chan School of Public Health, “We need a drug discovery revolution in PTSD. Today, the only FDA-approved drugs for treating PTSD are SSRIs, and they are only fully effective for less than a third of patients. Unbiased genetics approaches will provide the basis for new, rational therapeutics, and may eventually help us better match treatments to patients.”
“Now hope is on the horizon. Our public-private partnership has a concerted road map to make progress in advancing diagnostics and therapeutics for trauma-related brain disorders. With millions of veterans and civilians suffering, many of them in silence, we have a responsibility to move forward as efficiently as we can. Working together with partners like the VA, we hope to shape a future of more coordinated research, so that no one who experiences trauma has to suffer the effects for a lifetime,” Haas concluded.