Researchers have developed a blood test to determine a person's risk of developing anxiety, while also providing insight into its current severity and best course of treatment.
The test, based on biomarkers strongly associated with the mood disorder, can also predict if a person is likely to get more anxious in the future and how other things, like changes in hormones, might affect their anxiety.
And now that the team, led by researchers from the Indiana University School of Medicine, has validated the test, the startup MindX Sciences is already creating the blood tests for physicians to use.
"Many people are suffering from anxiety, which can be very disabling and interfere with daily life," says psychiatric neuroscientist Alexander Niculescu from Indiana University School of Medicine.
"[H]aving something objective like this where we can know what someone's current state is as well as their future risk and what treatment options match their profile is very powerful in helping people."
This recent study made use of techniques that members of the team developed in earlier research, leading to the creation of blood tests for depression, post-traumatic stress disorder, bipolar disorder, and pain.
Testing blood samples is a convenient, objective way to learn about what's going on in our bodies and brains. Diagnoses that rely heavily on self-reporting or observing behaviors can be challenged by difficulties in communication or variations in symptoms. By measuring quantities of a protein, enzyme, hormone, or some other molecule strongly associated with a condition, specialists have one more tool to make an informed decision.
To identify suitable anxiety biomarkers, Niculescu and his colleagues recruited patients at the Indianapolis VA Medical Center and assigned them to one of three groups.
The first group, called the biomarker discovery group, was made up of 58 people (41 males and 17 females) whose anxiety level changed at least once from one visit to the next. This group enabled the team to look for possible biomarkers that might be linked to changes in anxiety.
The top candidate biomarkers found in this 'discovery group' were tested on a second group of volunteers, which was made up of 40 people (32 men and 8 women). This group was called the biomarker validation group. This process of validation was important to make sure that the biomarkers could predict changes in anxiety in a reliable and accurate way.
The validated biomarkers were used in biomarker testing to predict high anxiety states and clinically severe anxiety in a third group. This biomarker testing group consisted of 161 males and 36 females for predicting high anxiety states and 159 males and 36 females for predicting clinically severe anxiety.
Ultimately, using the evidence from all three groups, the researchers found and confirmed 19 blood biomarkers that can be used to predict changes in anxiety.
Anxiety disorders are common, and vastly affect people's quality of life so it's important to try to understand, diagnose, and treat them better.
There are a variety of social and psychological, as well as physiological therapies for anxiety disorders, but it's hard for doctors to find the balance of medications or therapy in the right amounts and at the right times.
"The current approach is to talk to people about how they feel to see if they could be on medications, but some medications can be addictive and create more problems," says Niculescu.
"We wanted to see if our approach to identify blood biomarkers could help us match people to existing medications that will work better and could be a non-addictive choice."
What's more, if doctors can spot specific biomarkers that predict the risk of anxiety disorders in the future, they might be able to start preventing anxiety disorders before they start or come back.
"There are people who have anxiety and it is not properly diagnosed, then they have panic attacks, but think they're having a heart attack and end up in the ER with all sorts of physical symptoms," Niculescu adds.
"If we can know that earlier, then we can hopefully avoid this pain and suffering and treat them earlier with something that matches their profile."
Importantly, the researchers conclude, the fact that not all patients respond to current treatments shows how essential it is to keep doing research to find new and better treatments.
So they hope the new blood biomarker tests can be used to match patients with the right medications, measure how well a treatment is working, and find new uses for old drugs.
"This is something that could be a panel test as part of a patient's regular wellness visits to evaluate their mental health over time and prevent any future distress," Niculescu hopes.
"Prevention is better in the long run."
The research has been published in Molecular Psychiatry.