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FDA Begins Cancer Product Review Center

Richard Pazdur

Richard Pazdur (

20 January 2017. The U.S. Food and Drug Administration is reorganizing its review of treatments for cancer into a structure that cuts across its traditional bureaucratic lines. FDA’s Oncology Center of Excellence is led by Richard Pazdur who served as acting director of the unit since June 2016, and also lost his wife to ovarian cancer.

The Oncology Center of Excellence aims to better coordinate evaluations of new therapeutic products for cancer by the FDA’s separate offices for drugs, biologics, and medical devices. While applications and review criteria for new treatments and devices are not expected to change, FDA says the new center plans to draw more on the expertise of scientific and regulatory professionals in these offices, where needed, and encourage more collaboration across the usual hierarchies.

In an agency blog post after his appointment in June, Pazdur noted the oncology center will emulate models from cancer care facilities and the academic world that put more emphasis on multi-disciplinary collaboration to confront the complexities of cancer. The new center also intends to encourage more patients’ perspectives in FDA’s regulatory decision making, an idea that became a personal mission after his wife Mary died from ovarian cancer in November 2015.

Pazdur says that before becoming the oncology center’s acting director, he applied some of these methods to his work as director of FDA’s Office of Hematology and Oncology Products in the agency’s Center for Drug Evaluation and Research. From 2010 to mid-2016, says Pazdur, that office approved 61 new cancer treatments, many times before their review target dates.

One of the oncology center’s tasks is to streamline the clinical trial process for testing new treatments. One approach is to shift away from standard phase 1, 2, and 3 — for early-, intermediate-, and late-stage — clinical trials, when possible. Another step to simplify clinical trials is with a common group of control subjects, usually those given a placebo rather than the test drug, for tests of multiple drugs.

In addition, simplified end-point measures of efficacy make data collection easier and can require smaller numbers of trial participants. Pazdur and colleagues outlined some of these proposals in a New England Journal of Medicine article in May 2016.

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Lilly Acquires Migraine Therapy Company in $960M Deal

Person with migraine

(R. Nial Bradshaw, Flickr)

19 January 2017. Drug maker Eli Lilly and Company is acquiring CoLucid Pharmaceuticals, a developer of treatments for migraine pain and associated symptoms. The deal is expected to bring CoLucid Pharma shareholders a total of $960 million.

CoLucid Pharma’s lead product is lasmiditan, a drug to treat migraine. Migraine is a neurological syndrome causing severe headaches along with nausea, vomiting, and extreme sensitivity to light and sound. In some cases, migraines are preceded by warning episodes called aura including flashes of light, blind spots, or tingling in arms and legs. The web site estimates 37 million people in the U.S. suffer from migraines, and cites World Health Organization data indicating migraines affect 18 percent of American women and 7 percent of men.

Lasmiditan stimulates receptors for the protein 5-HT1F in the trigeminal nerve pathway system in the brain, where activating these receptors blocks migraine pain signals through the pathway. Unlike many other migraine therapies, lasmiditan does not constrict blood vessels, making it potentially more suitable for individuals with cardiovascular conditions. The company notes that migraine is highly correlated with and considered a risk factor for cardiovascular disease.

CoLucid Pharma, in Cambridge, Massachusetts, is testing lasmiditan in clinical trials as a migraine treatment. In September 2016, the company reported results of a late-stage clinical trial among more than 2,200 individuals with migraine experienced either with or without associated aura. The drug was tested in 2 doses against a placebo. The results show more recipients of lasmiditan were likely to achieve a full 2 hours without pain after taking the drug, compared to participants receiving the placebo. Lasmiditan recipients were also more likely to be free of secondary migraine symptoms, such as nausea and sensitivity to light.

The company says 2 other clinical trials are underway or planned for lasmiditan. One trial is a late-stage study at 140 sites in the U.S., U.K., and Germany, where participants will include individuals with risk factors for cardiovascular disease. A second trial is a study of long-term safety and efficacy of lasmiditan, as well as its effects on functional outcomes and disability.

Eli Lilly and Company in Indianapolis is acquiring all shares of CoLucid Pharma and paying its shareholders $46.50 per share, which according to industry newsletter FirstWord Pharma is 33 percent higher than CoLucid’s closing share price on 17 January. The total amount paid in the acquisition is about $960 million.

Lilly is no stranger to lasmiditan. The company first discovered the compound, but when its priorities changed in 2005, lasmiditan was licensed to CoLucid Pharma for development. In the 12 years since that licensing deal, Lilly’s corporate strategy changed again, making CoLucid and lasmiditan takeover targets. Lasmiditan is expected to complement Lilly’s other pain drugs in development: galcanezumab in late-stage trials for cluster headache and migraine, and tanezumab for osteoarthritis, lower back and cancer pain, in development with Pfizer.

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Disclosure: The author owns shares in Pfizer.

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UC San Francisco, Intel Partner on Health Analytics

Networked devices

(Gerd Altmann, Pixabay)

19 January 2017. Intel Corporation and University of California in San Francisco are developing a data analytics platform that harnesses artificial intelligence to help front-line clinicians make better decisions for their patients. Financial and intellectual property aspects of the agreement between Intel and UC-San Francisco were not disclosed.

The agreement aims to advance big data analytics for health care to overcome obstacles from medical data stored in complex and diverse data sets, managed on multiple incompatible platforms. In addition, the number, variety, and complexity of data sources are increasing, which include genomic sequencing and mobile devices with wearable sensors, adding further to the data integration challenge. These obstacles, say the parties, slow the process of integrating data into a usable forms for physicians, often making the information they need difficult to access.

Intel and UC-San Francisco say they plan to develop an “information commons” that integrates data sufficiently from these diverse sources to enable the use of artificial intelligence techniques, such as deep learning to gain greater insights. Deep learning is a form of machine learning that makes it possible for systems to discern underlying patterns in relationships, and build those relationships into knowledge bases applied to a number of disciplines.

While deep learning and artificial intelligence are advancing in other fields, such as driverless vehicles, their applications in health care are so far limited. Michael Blum, director of UC-San Francisco’s Center for Digital Health Innovation, notes in a university statement that that these techniques can be applied to critical medical tasks and issues such as analyzing images, predicting health risks, and preventing hospital readmissions.

“Deep learning environments are capable of rapidly analyzing and predicting patient trajectories utilizing vast amounts of multi-dimensional data,” says Blum. “By integrating deep learning capabilities into the care delivered to critically injured patients, providers will have access to real-time decision support that will enable timely decision making in an environment where seconds are the difference between life and death.”

UC-San Francisco and Intel plan to create algorithms adapting deep learning concepts applied to health care decisions. Those models will be written on advanced, but commercially-available technology platforms that support data collection and annotation, and algorithm development and testing. The university expects the platform will accommodate large data sets, and eventually support advancements such as neural network and other complex models simulating human organisms.

Intel aims to gain more insights into health care analytical requirements that can help the company better design technologies for this industry. In addition, the company expects to apply these deep learning algorithms to more complex analytical challenges in health care as well as other industries.

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California Set to Pioneer Blockchain ATMs in MMJ Dispensaries Statewide

– Contributed Content –

19 January 2017. Although more than half the states have already legalized to some degree MMJ (medical marijuana) or at least have decriminalized it, dispensaries around the nation have been losing their cashless ATMs and POS terminals for what is no apparent reason. Many dispensaries in the State of California, for instance, are simply unable to carry out any transactions that aren’t finalized in cash or checks.

Marijuana plant

(Jasper, Pixabay)

This has been going on for more than two years now, and dispensary operators are simply amazed at the revenue these companies are losing. However, there is one revolutionary new payment system that has stepped up to the plate, and California will see a new form of blockchain cryptocurrency POS terminals in key dispensaries around the state.

What exactly is blockchain or cryptocurrency

The whole concept of blockchain cryptocurrency is so new and innovative that the average person has trouble grasping the idea that there is actually no money that changes hands at the retail level. By this time everyone has heard of Bitcoin, which is the original cryptocurrency in the United States and now it is not only being used in online transactions, but there are merchants who are accepting this form of payment in brick-and-mortar shops.

First Bitcoin Capital Corporation in the news

Here is where the news comes in for thousands of medical, and now legal recreation, patients and consumers in the State of California. First Bitcoin Capital Corporation, trading on OTC Pink as BITCF, is offering blockchain and cryptocurrency online for these dispensaries, but announced on January 12, 2017 that they would be installing a new type of check cashing ATM, which users can access to pay for purchases and cash checks in the dispensary of their choice. For those who have need of the healing effects of medical marijuana for such things as joint and bone pain, this is good news indeed.

Why a check cashing ATM is significant

Many of those who suffer chronic pain are on disability and with a low income, many do not have traditional bank/checking accounts. When their check comes, they are powerless to cash it in many cases and so they rely on retailers to cash it first so they can shop. This has often been the case in California dispensaries, and now with the Exclusive Master Distributor Agreement signed between major dispensaries in the state and BITCF, patients will be able to cash their checks at ATMs located in the store, and the prices for this service are set to be highly competitive.

While the details are yet to be released as to what stores will be contracting with BITCF, it is an amazing step in the direction of paperless money that is not backed in the traditional sense. Those who don’t have a bank account will be able to cash checks (backed by USD) at cryptocurrency ATMs and walk away with pain-relieving medication all in one go. No more going to Walmart first, paying a fee to cash their checks and then going to the dispensary for their medication. It is speculated to benefit both the merchant and the consumer and as these machines roll out, more news will be forthcoming.

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Pharma Firms Start Non-Communicable Disease Initiative

Drug vials

(angelsalamag054, Pixabay)

18 January 2017. A group of 22 pharmaceutical companies is supporting worldwide projects to improve access to prevention and treatments for chronic disorders like cancer and heart disease, in lower-resource regions. The Access Accelerated initiative was announced today at the annual meeting of the World Economic Forum in Davos, Switzerland.

Access Accelerated aims to reduce or remove barriers to drugs that prevent or treat non-communicable diseases, starting with cancer, but including cardiovascular diseases, chronic respiratory disease, diabetes, and mental health disorders. The initiative is targeting low- and medium-resource countries, already burdened by much higher rates of infectious diseases, and organized by International Federation of Pharmaceutical Manufacturers and Associations that acts as its administrator.

The initiative contributes to the United Nation’s Sustainable Development Goals that aim to reduce premature deaths from non-communicable diseases, or NCDs, by one-third by 2030. World Bank, a partner organization in Access Accelerated, will identify financing, regulatory and service delivery barriers to prevention and treatments, and recommend solutions to overcoming those barriers. World Bank will also conduct pilot projects in primary care, beginning in Africa.

“If the current trend in NCDs in low- and lower-middle income countries is not reversed,” says Ian Read, CEO of Pfizer in a statement by Access Accelerated, “there is a real possibility we will undermine the progress we have made in health around the world. To reach our goal, we need to catalyze new partnerships, learn quickly and advance the resources and knowledge that will enable countries to tackle NCDs.” Read is also president of International Federation of Pharmaceutical Manufacturers and Associations.

Access Accelerated plans to collaborate with organizations and efforts addressing non-communicable diseases. Its first partner is a project called C/Can 2025: City Cancer Challenge. This effort is undertaken by UICC, a global coalition of 950 organizations in 150 countries addressing cancer. C/Can 2025, like Access Accelerated, was launched at the World Economic forum, and plans to design and implement improvements in access to cancer treatments at the community level.

By addressing cancer care in communities, C/CAN 2025 believes it can reach its goal of reducing deaths from non-communicable diseases by 25 percent by the year 2025. The project focuses on cities with populations of 1 million or more in low- and middle-income countries, beginning with a small group of what it calls “learning cities” that need international support to provide effective cancer care. The first group of learning cities is Cali, Colombia, Asuncion, Paraguay, and Yangon, Myanmar.

Companies and organizations participating in Access Accelerated include Almirall, Astellas, Bayer, Bristol-Myers Squibb, Celgene, Chugai, Daiichi Sankyo, Eisai, Eli Lilly and Company, EFPIA, GlaxoSmithKline, The International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), Johnson & Johnson, JPMA, Menarini, Merck, MSD, Novartis, Pfizer, PhRMA, Roche, Sanofi, Shionogi, Sumitomo Dainippon, Takeda, and UCB.

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Disclosure: The author owns shares in Pfizer and Johnson & Johnson.

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Mobile App Designed to Study Rare Inflammatory Condition

Sarcoidosis  app

Sarcoidosis research app (University of Pennsylvania)

18 January 2017. Researchers at University of Pennsylvania medical school developed an iPhone app to study sarcoidosis, a rare inflammatory disease where the cause is still unknown. The app is now available for download on the iTunes App Store.

Sarcoidosis is a condition marked by growths of granulomas, collections of inflammatory cells that appear in various regions of the body, but most likely the skin, eyes, lungs, and lymph nodes. The cause of the disease is unknown, but is believed to be related to immune-system reactions to irritants in the environment. In most cases, the condition is temporary, requiring little, if any treatment, but for some people the condition becomes chronic and can lead to organ damage. While generally a rare disorder, sarcoidosis affects 34 of 100,000 African-American people, compared to 11 of 100,000 Caucasians.

The team led by Penn dermatology professor Misha Rosenbach seeks to harness mobile technology to get a better understanding of this rare disease from people affected by it. The app and research study ask people with sarcoidosis to complete monthly surveys about flare-ups of the disease, medications taken, and the effect of the disorder on their day-to-day lives. The app can also, with consent of the user, track weather at the individual’s location and the person’s physical activity, which can be correlated to data from the surveys.

In addition, the iPhone app provides information about sarcoidosis, including resources for people with the condition, whether or not they take part in the research. Based on the phone’s GPS, the app can also direct individuals to medical specialists and support groups in their vicinity.

Because of the relatively small numbers of people with sarcoidosis, Rosenbach and colleagues hope the app can answer questions about the disease where traditional research methods have failed so far. A study carried out between 1995 and 2003, says Rosenbach, enrolled some 800 individuals with sarcoidosis but did not provide conclusive findings.

“In traditional research,” says Rosenbach in a university statement, “you can’t see patients every day, but in app-based research you can suddenly get all this information about the disease in real-time and over time, from many different patients all over the world. It gives us the power to do sarcoidosis research in a way that has never been done.”

The app — developed with Penn medical student Daniel O’Connor and Marc Judson, an internist in Albany, New York — is built on the Apple ResearchKit, an open-source app framework designed to collect data for medical studies. ResearchKit provides modules for tracking activity, conducting surveys, and gaining user consent. As reported in Science & Enterprise, ResearchKit is being adopted by a number of research teams, including the consumer genetics company 23andMe.

Rosenbach tells more about the app and study in the following video.

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Experimental Drug Shown to Reduce Tourette’s Symptoms

Brain illustration


17 January 2017. Results from a clinical trial show an experimental drug is effective in reducing the severity of tics in children with Tourette’s syndrome, a neurological disorder. Findings from the trial were released today by Psyadon Pharmaceuticals in Germantown, Maryland, developer of ecopipam, the drug tested.

Tourette’s syndrome is a neurological disorder characterized by motor tics, involuntary movements in the face, head, or other parts of the body as well as vocal tics expressed as sniffs or grunts to loud hoots or recognizable, but often inappropriate words. Tourette Association of America says these spoken-word vocal tics, commonly associated with Tourette syndrome, occur in 10 to 15 percent of cases. The association estimates 1 in 160 children between the ages of 5 and 17 in the U.S. has Tourette’s syndrome.

Ecopipam addresses receptors of dopamine, a neurotransmitter or signaling chemical in the brain that affects a range of motor and cognitive functions, including movements. The company cites evidence showing individuals with Tourette’s syndrome have overactive dopamine systems that contribute to the disorder, with a family of receptors for dopamine, known as D1 receptors playing a key role in the symptoms.

“Ecopipam works,” says Psyadon CEO Richard Chipkin in a company statement, “by blocking the dopamine D1 receptor, which differentiates it from any other drug either on the market or currently in development.”

The intermediate-stage clinical trial tested ecopipam with 40 children, age 7 to 17 having Tourette’s syndrome, exhibiting both motor and vocal tics. The study randomly assigned participants to take ecopipam or a placebo daily, before bedtime for 4 weeks. The main efficacy measure was the Yale Global Tic Severity Scale. a standard rating scale completed by clinicians. The study team also looked for a number of safety measures, including reports of adverse events and psychological effects, such as depression, ADHD, and feelings of suicide.

The results show recipients of ecopipam reported lower scores on the Yale rating scale than their counterparts taking the placebo, both 2 weeks and 4 weeks after the treatments, with the differences large enough to be statistically reliable. The company also says rates of side effects were comparable between the ecopipam and placebo groups, with no statistically reliable changes in clinical lab tests, electrocardiograms, or body weight increases from taking the drug.

Donald Gilbert, director of the Tourette’s Syndrome Clinic at Cincinnati Children’s Hospital Medical Center, who led the research team conducting the trial says, “These results demonstrate the efficacy of D1 antagonism, an entirely new approach that doctors and scientists have speculated about for years. As importantly, the subjects in the study tolerated ecopipam very well, with no weight gain, sedation, or heart problems.”

Psyadon says ecopipam can also treat other movement disorders associated with D1 dopamine receptors, and is recruiting participants for an intermediate- and late-stage clinical trial testing the drug among adults with childhood-onset stuttering.

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Knowledge Bank Tapped for Precision Cancer Treatments

Personal data illustration

(Gerd Altmann, Pixabay)

17 January 2017. An international research team devised techniques for analyzing accumulated clinical trial data to help determine precise treatment strategies for people with cancer. The team headed by researchers from Wellcome Trust Sanger Institute in Cambridge, U.K. published its findings in the 16 January issue of the journal Nature Genetics (paid subscription required).

The Wellcome Trust Sanger Institute researchers led by cancer geneticist Peter Campbell — with colleagues from Europe, the U.S., and New Zealand — are seeking new and better tools to determine precise courses of treatment for cancer patients. Genomic sequencing of cancer cells can identify cancer-causing mutations, but decisions on safe and effective treatments need to take in more information relevant to the patient’s individual conditions. In short, evidence-based treatment decisions need more evidence than just the cancer’s genetic defects.

Campbell’s team looked specifically at patients with acute myeloid leukemia, a cancer of the blood and bone marrow that worsens quickly if left untreated. As the disease develops, bone marrow produces abnormal white blood stem cells called myeloblasts that do not mature into normal functioning white blood cells. The excessive growth of abnormal myeloblasts crowds out healthy white, red, and platelet blood cells, and can spread to other parts of the body. The Globocan project in World Health Organization estimates in 2012 some 352,000 people worldwide had acute myeloid leukemia.

One of the difficulties in determining precise therapies for acute myeloid leukemia is the disease’s multiple sub-types, as well as heterogeneous nature of patient populations. With acute myeloid leukemia in younger patients, the two main treatment strategies are stem cell transplants from bone marrow or chemotherapy. Stem cell transplants generally have a better chance at curing the disease, say the authors, but they also run a higher rate of long-term adverse side effects, with deaths occurring in as many as 1 in 4 cases. More real-world evidence, say the researchers, would help physicians and patients make better informed decisions on these critical questions.

To find that evidence, the team created a knowledge bank of data from clinical trials with patients having acute myeloid leukemia. The trials were held in Germany and Austria, which contributed 1,540 cases. The researchers included analysts from European Bioinformatics Institute who wrote multi-stage statistical models that factored in and matched genomic sequencing results with treatments and clinical outcomes. The models were then validated independently with patient data in the Cancer Genome Atlas, a National Institutes of Health initiative in the U.S.

The results indicate risks and benefits for acute myeloid leukemia patients can be accurately calculated from these clinical trial cases, with different treatments than normally recommended in a large segment of these individuals. The researchers estimate that with this analysis, as many as 1 in 3 patients would receive a different type of treatment compared to current practices. In addition, the number of stem cell transplants could be reduced by 20 to 25 percent, while maintaining current survival rates.

“Current guides use a simple set of rules based on only a few genetic findings,” says Campbell in an institute statement. “For any given patient, using the new tool we can compare the likely future outcomes under a transplant route versus a standard chemotherapy route. This means that we can make a treatment choice that is personally tailored to the unique features of that particular patient.”

The authors point out that this study may have proven the concept, but more testing and validation are still needed before it’s ready for clinical practice. In addition, knowledge banks like the kind created for this study need continuous updating, large numbers of participants, and diverse populations to be effective decision-making tools.

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Tips For Boosting Organic Traffic from Search Engines to Your Medical Blog

– Contributed Content –

Medical appointments

(Darko Stojanovic, Pixabay)

16 January 2017. If you decide to start a medical blog that is designed to provide people with information on how they can improve their health, you want your blog to be highly visible on the internet so it can help as many of those people as possible, right?

This is why your blog must be a magnet for organic traffic, or visitors who naturally come to your website through a search engine. In essence, the higher your blog ranks on a search engine, the more people will find it.

Let’s go over some tips you can use to boost organic traffic for your medical blog:

Place your top keywords in your headlines

After coming up with a list of popular keywords, take the most popular of those keywords and place them in the headlines of each of your new posts. The reason why this will improve your blog’s rankings is because search engine algorithms will analyze your headlines before your actual content, so just one popular keyword in each new headline will naturally give your rankings a boost.

Find out which keywords people have used to find your blog

Once your blog has been up and running for a few months and you develop a small reader base, you should find out which medical keywords and phrases those readers used to find your blog on a search engine so you can integrate those keywords into your future content.

An online SEO checker will ultimately be the best tool at your disposal for this because it will generate a list of each of the keywords your existing readers have used to find your blog.

Start link building

Link building is another highly effective SEO strategy that, if done properly, is guaranteed to increase your rankings. This is because search engines will always rank blogs or websites higher that contain quality or relevant links in posts, while lowering the rankings of those that contain irrelevant links or none to begin with.

Write guest posts on other medical blogs

Get in touch with some other popular medical bloggers and ask if you can write a guest post on their blog, and vice versa, if they would be interested in writing one on yours. Guest posting on a popular blog is guaranteed to draw more people to your blog because it immediately gets you noticed by all of the followers of that blog.

Create great content consistently

Finally, all of the above tips will be for nothing if you don’t create great content on a consistent basis. Every post on your blog needs to be high quality, meaning it’s well written and free of spelling/grammar errors, while also providing value to readers. Ultimately, simply creating quality content consistently will be the number one factor behind how well your blog ranks on search engines.

Bringing in new traffic

The success of your medical blog will be entirely dependent on how much organic traffic you can bring in regularly. By applying each of the tips you have learned in this article, you should have no problem getting new people to find your blog each day.

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Grant Funds MRI for Mental Illness Understanding

Functional MRI images of brain

Functional MRI images of brain regions (Human Connectome Project, NIH)

16 January 2017. A psychiatric treatment center received what it calls “a major grant” for a research program on the use of MRI scans to better understand complex mental illnesses. Financial aspects of the award from philanthropists Bill and Deborah Ryan to the Austen Riggs Center in Stockbridge, Massachusetts were not disclosed.

The grant supports a new research program at Austen Riggs Center, called MRI-based Characterization of Complex Psychopathology. The program is expected to explore ways of gaining new detailed insights from magnetic resonance imaging, or MRI, on characteristics of psychiatric disorders, particularly for understanding an individual’s response to psychotherapy. MRI scans are already widely used for diagnosing many brain disorders, such as stroke, aneurysms, tumors, and infections.

Findings from the project are expected to fit in with new directions in mental health research seeking to put psychiatric disorders into a broader context of individual differences in human behavior. The Human Connectome initiative, for example, is mapping neural pathways underlying functions of the brain, with much of the data generated by these studies coming from images of the brain.

The goal of the Human Connectome Project is a comprehensive brain wiring map to navigate neural circuits — from individuals both diagnosed with psychiatric disorders and those with no indications of disease — which can disclose reasons for disorders resulting from misfiring circuits. One of the Human Connectome’s main research initiatives is a collaboration between Massachusetts General Hospital affiliated with Harvard University and UCLA that uses MRI images with advanced analytical software to delineate neural connections in the brain.

The new research will also likely contribute to an emerging framework for understanding individual differences in mental functions and health, known as the Research Domain Criteria matrix, which considers normal and pathological functions on a spectrum, rather than looking at psychiatric diseases as unique conditions. The Austen Riggs Center says many of its patients are admitted with complex disorders, which will enable its medical staff and researchers to take advantage of these and other recent developments in neuroscience and clinical practice.

Aligning research findings and clinical practice in psychiatric disorders is possible but not often easy, according to Andrew Gerber, the Austen Riggs Center’s CEO and medical director. In an essay published on the center’s web site earlier in January, Gerber said advances such as genetics and physiological images “have the potential of adding depth and dimensionality to the understanding of mental illness, and of informing the treatment trajectory.”

He cited, however, a recent study that highlighted the difficulty of linking research in genetics with the diagnosis of depression. The authors, Gerber noted, found “an opportunity to align these new genetic findings with the vast amount of data collected from patients in the clinical setting, including from electronic health records, surveys, and other materials.” The researchers discovered clinicians’ notes were particularly rich sources of insights, which led to identification of 15 genetic markers apparently associated with depression. Identifying these biomarkers can help understand why certain drugs work with some patients and others don’t.

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