Psychiatric disease / en Q&A: How to jump-start new psychiatric and neurological drug development /news/qa-how-jump-start-new-psychiatric-and-neurological-drug-development <span class="field field--name-title field--type-string field--label-hidden"><h1>Q&amp;A: How to jump-start new psychiatric and neurological drug development</h1> </span> <span class="field field--name-uid field--type-entity-reference field--label-hidden"> <span>By Tom Ulrich</span> </span> <span class="field field--name-created field--type-created field--label-hidden"><time datetime="2023-12-18T10:02:23-05:00" class="datetime">December 18, 2023</time> </span> <div class="hero-section container"> <div class="hero-section__row row"> <div class="hero-section__content hero-section__content_left col-6"> <div class="hero-section__breadcrumbs"> <div class="block block-system block-system-breadcrumb-block"> <nav class="breadcrumb" role="navigation" aria-labelledby="system-breadcrumb"> <h2 id="system-breadcrumb" class="visually-hidden">Breadcrumb</h2> <ol> <li> <a href="/">Home</a> </li> <li> <a href="/news">News</a> </li> </ol> </nav> </div> </div> <div class="hero-section__title"> <div class="block block-layout-builder block-field-blocknodelong-storytitle"> <span class="field field--name-title field--type-string field--label-hidden"><h1>Q&amp;A: How to jump-start new psychiatric and neurological drug development</h1> </span> </div> </div> <div class="hero-section__description"> <div class="block block-layout-builder block-field-blocknodelong-storybody"> <div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><p>Stanley Center director Steve Hyman talks about a new report he co-authored that explores the obstacles in developing new treatments and how to overcome them</p> </div> </div> </div> <div class="hero-section__author"> <div class="block block-layout-builder block-extra-field-blocknodelong-storyextra-field-author-custom"> By Tom Ulrich </div> </div> <div class="hero-section__date"> <div class="block block-layout-builder block-field-blocknodelong-storycreated"> <span class="field field--name-created field--type-created field--label-hidden"><time datetime="2023-12-18T10:02:23-05:00" title="Monday, December 18, 2023 - 10:02" class="datetime">December 18, 2023</time> </span> </div> </div> </div> <div class="hero-section__right col-6"> <div class="hero-section__image"> <div class="block block-layout-builder block-field-blocknodelong-storyfield-image"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"> <article class="media media--type-image media--view-mode-multiple-content-types-header"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <picture> <source srcset="/files/styles/multiple_ct_header_desktop_xl/public/SEH%20SC%20II.jpg?itok=AnKU0Ryn 1x" media="all and (min-width: 1921px)" type="image/jpeg" width="754" height="503"> <source srcset="/files/styles/multiple_ct_header_desktop_xl/public/SEH%20SC%20II.jpg?itok=AnKU0Ryn 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/jpeg" width="754" height="503"> <source srcset="/files/styles/multiple_ct_header_desktop/public/SEH%20SC%20II.jpg?itok=Lo__sQt6 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/jpeg" width="736" height="520"> <source srcset="/files/styles/multiple_ct_header_laptop/public/SEH%20SC%20II.jpg?itok=L1JFI3U9 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/jpeg" width="641" height="451"> <source srcset="/files/styles/multiple_ct_header_tablet/public/SEH%20SC%20II.jpg?itok=gKnc95f8 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/jpeg" width="706" height="417"> <source srcset="/files/styles/multiple_ct_header_phone/public/SEH%20SC%20II.jpg?itok=10dB5jF6 1x" media="all and (max-width: 539px)" type="image/jpeg" width="499" height="294"> <img loading="eager" src="/files/styles/multiple_ct_header_phone/public/SEH%20SC%20II.jpg?itok=10dB5jF6" width="499" height="294" alt="Steven Hyman" title="Steven Hyman" typeof="foaf:Image"> </picture> </div> <div class="media-caption"> <div class="media-caption__description"> Steven Hyman </div> </div> </article> </div> </div> </div> </div> </div> </div> <div class="content-section container"> <div class="content-section__main"> <div class="block block-better-social-sharing-buttons block-social-sharing-buttons-block"> <div style="display: none"><link rel="preload" href="/modules/contrib/better_social_sharing_buttons/assets/dist/sprites/social-icons--no-color.svg" as="image" type="image/svg+xml" crossorigin="anonymous"></div> <div class="social-sharing-buttons"> <a href="https://www.facebook.com/sharer/sharer.php?u=/taxonomy/term/1791/feed&amp;title=" target="_blank" title="Share to Facebook" aria-label="Share to Facebook" class="social-sharing-buttons__button 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<div class="block block-layout-builder block-field-blocknodelong-storyfield-content-paragraphs"> <div class="field field--name-field-content-paragraphs field--type-entity-reference-revisions field--label-hidden field__items"> <div class="field__item"> <div class="paragraph paragraph--type--text-with-sidebar text-with-sidebar"> <div class="field field--name-field-sidebar field--type-entity-reference-revisions field--label-hidden field__items"> <div class="field__item"> <div class="paragraph paragraph--type--sidebar-menu sidebar-menu"> <div class="sidebar-menu__col"> <div class="clearfix text-formatted field field--name-field-heading field--type-text field--label-hidden field__item"><p>Related people</p> </div> <div class="field field--name-field-links field--type-link field--label-hidden field__items"> <div class="field__item"><a href="/bios/steven-e-hyman">Steven Hyman</a></div> </div> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--sidebar-menu sidebar-menu"> <div class="sidebar-menu__col"> <div class="clearfix text-formatted field field--name-field-heading field--type-text field--label-hidden field__item"><p>Related programs</p> </div> <div class="field field--name-field-links field--type-link field--label-hidden field__items"> <div class="field__item"><a href="/stanley-center-for-psychiatric-research">Stanley Center for Psychiatric Research</a></div> </div> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--sidebar-articles sidebar-articles"> <div class="sidebar-articles__col"> <div class="clearfix text-formatted field field--name-field-heading field--type-text field--label-hidden field__item"><p>Related News</p> </div> <div class="field field--name-field-content-reference field--type-entity-reference field--label-hidden field__items"> <div class="field__item"><article about="/news/scientists-map-locations-hundreds-thousands-cell-types-across-mammalian-brain" class="node"> <div 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of brain tissue from a mouse model of Alzheimer’s, showing tau tangles (red), amyloid plaques (white), RNA (green), and cell nuclei (blue)." title="Fluorescence microscopy image of brain tissue from a mouse model of Alzheimer’s, showing tau tangles (red), amyloid plaques (white), RNA (green), and cell nuclei (blue)." typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/researchers-map-brain-cell-changes-alzheimers-disease" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Researchers map brain cell changes in Alzheimer’s disease</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/first-large-genetic-study-bipolar-disorder-asian-populations-launches" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/first-large-genetic-study-bipolar-disorder-asian-populations-launches"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=fsfHMyPk 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=fsfHMyPk 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LEt4QTt5 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LEt4QTt5 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=Iudqt44B 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LzxxBlIA 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LzxxBlIA" width="220" height="186" alt="Ricardo Job-Reese, Ó³»­´«Ã½ Communications" typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/first-large-genetic-study-bipolar-disorder-asian-populations-launches" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">First large genetic study of bipolar disorder in Asian populations launches</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/brain-organoids-replicate-key-events-human-brain-development" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/brain-organoids-replicate-key-events-human-brain-development"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=lstySHBC 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=lstySHBC 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=4HlxIV8e 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=4HlxIV8e 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=T0IPiSz3 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=njI3T1Gw 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=njI3T1Gw" width="220" height="186" alt="Human brain organoids showing neurons and their dendrites (green), telencephalic (forebrain) cells (blue), and a kind of cell-cell contact called tight junctions (red)." title="Human brain organoids showing neurons and their dendrites (green), telencephalic (forebrain) cells (blue), and a kind of cell-cell contact called tight junctions (red)." typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/brain-organoids-replicate-key-events-human-brain-development" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Brain organoids replicate key events in human brain development</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/two-large-studies-reveal-genes-and-genome-regions-influence-schizophrenia-risk" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/two-large-studies-reveal-genes-and-genome-regions-influence-schizophrenia-risk"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=xZ24Xgbw 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=xZ24Xgbw 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=ktxABhYV 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=ktxABhYV 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=5mQP8D3T 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=KwBq3Kyz 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=KwBq3Kyz" width="220" height="186" alt="Zayna Sheikh, Ó³»­´«Ã½ Communications" typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/two-large-studies-reveal-genes-and-genome-regions-influence-schizophrenia-risk" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Two large studies reveal genes and genome regions that influence schizophrenia risk</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/researchers-find-first-strong-genetic-risk-factor-bipolar-disorder" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/researchers-find-first-strong-genetic-risk-factor-bipolar-disorder"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=nZYvK0EX 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=nZYvK0EX 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=81f3TsED 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=81f3TsED 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=enlVPy8e 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=pxwXJ6Rv 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=pxwXJ6Rv" width="220" height="186" alt="Susanna Hamilton, Ó³»­´«Ã½ Communications" typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/researchers-find-first-strong-genetic-risk-factor-bipolar-disorder" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Researchers find first strong genetic risk factor for bipolar disorder</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/path-promising-treatments-schizophrenia" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/path-promising-treatments-schizophrenia"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=dxUHBnI1 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=dxUHBnI1 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=iDYg5eit 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=iDYg5eit 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=JSZhwT-E 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=VYKQHFQJ 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=VYKQHFQJ" width="220" height="186" alt="Morgan Sheng, core institute member and co-director of the Stanley Center for Psychiatric Research, is studying the function of genes linked to schizophrenia." title="Morgan Sheng, core institute member and co-director of the Stanley Center for Psychiatric Research, is studying the function of genes linked to schizophrenia." typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/path-promising-treatments-schizophrenia" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">A path to promising treatments for schizophrenia</span> </a> </div> </article> </div> </div> </div> </div> </div> </div> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Psychiatric and neurological disorders are widespread, yet the pace of drug development for these conditions lags far behind that of heart disease, cancer, and other conditions. Brain disorders are difficult to study and many drug candidates have failed in clinical trials, causing pharmaceutical companies to reduce their investments or even exit the field entirely.&nbsp;</p> <p>But a new path for bringing treatments to patients is starting to emerge. In a recent review in <a href="https://www.science.org/doi/10.1126/scitranslmed.adg4775" target="_blank"><em>Science Translational Medicine</em></a>, <a href="/node/7576">Steven Hyman</a>, director of the <a href="/node/8513">Stanley Center for Psychiatric Research</a> at the Ó³»­´«Ã½ of MIT and Harvard, and colleagues in the National Academies of Science, Engineering, and Medicine (NASEM) <a href="https://www.nationalacademies.org/our-work/forum-on-neuroscience-and-nervous-system-disorders" target="_blank">Forum on Neuroscience and Nervous System Disorders</a> — which includes industry — sketched out a six-point framework for re-invigorating psychiatric and neurological drug development that addresses many of the unique challenges this field faces. They wrote that a deeper understanding of the molecular mechanisms driving these disorders will improve diagnosis, enhance patient stratification in clinical trials, and lead to better therapeutics.&nbsp;</p> <p>To achieve this, the authors called for more genetics and longitudinal data types from patients of diverse ancestries, more data- and tool-sharing across sectors, the development of quantitative biomarkers for measuring disease mechanisms, and more.</p> <p>We asked Hyman, who is also a core institute member at Ó³»­´«Ã½, to talk about the new framework and what he thinks are the biggest opportunities.&nbsp;</p> <p>The following conversation was edited for length and clarity.</p> <p><strong>Why did you and your colleagues with the NASEM Forum decide to write this report?</strong></p> <p>One of our long abiding concerns has been the pharmaceutical industry's progressive exit from R&amp;D on treatments for central nervous system disorders apart from Alzheimer's and for large companies a nearly complete exit from new research in psychiatry.&nbsp;</p> <p>We all recognize the vast, unmet medical need. We have no treatments for the disabling cognitive and deficit symptoms of schizophrenia, and no pharmacologic treatments for the core communication difficulties of autism. We do very poorly at treating the depressed phase of bipolar disorder. And we have no pharmacologic treatments for anorexia nervosa, which at approximately 20 percent has the highest long-term mortality rate in psychiatry.&nbsp;</p> <p>So the need and the markets are there. The question becomes, under what circumstances would industry rebuild the infrastructure they need to re-engage in neuroscience and psychiatric development?&nbsp;</p> <p><strong>What do you think it will take for industry to re-engage in this space?&nbsp;</strong></p> <p>The single biggest problem for psychiatric disorders is that we lack the ability to look underneath the surface phenomena such as symptoms and disease course to group or stratify patients according to disease mechanisms.&nbsp;</p> <p>To use the example of depression, there have been many large, costly clinical trials in which drugs fail to separate convincingly from placebo but ultimately prove effective for a subset of patients. The key problem is that there appear to be many different underlying mechanisms that lead to depression. The genetic risk factors are highly complex, and they intersect with environmental risk factors ranging from infections to stress that are also diverse in their nature and effects (and which deserve intensive study).&nbsp;</p> <p>Without robust biomarkers, we cannot account for this mechanistic diversity and appropriately match patients with candidate treatments in clinical trials. Lumping everyone under this umbrella diagnosis of depression ignores the heterogeneous nature of this disorder, dilutes any signal that we might see in a clinical trial, and prevents us from learning from failures.&nbsp;</p> <p>Biomarkers could take many forms. Based on recent success in Alzheimer’s disease and amyotrophic lateral sclerosis, companies are very interested in quantifiable fluid biomarkers, which for neuroscience has meant markers that can be measured initially in CSF [cerebrospinal fluid]. Studies of Alzheimer's disease are teaching us that it's possible to measure some clinically important CSF biomarkers in blood. Some may even be measurable using positron emission tomography, which has the added benefit of providing information about where in the brain a biomarker is present.&nbsp;</p> <p>For some neurologic and psychiatric disorders, perhaps including depression and obsessive-compulsive symptoms, system-level biomarkers — ones that provide functional information about whole circuits instead of individual cells or molecules — appear promising. Thus magnetic resonance imaging or EEG studies may supplement molecular studies in ways that could prove to be highly useful in, for example, stratifying individuals with schizophrenia. At the Stanley Center, we are already gaining powerful evidence for this using EEG.&nbsp;</p> <p><strong>Your review article discussed the need to study genetically diverse patient samples. Can you expand on that?</strong></p> <p>Without a strong commitment to broadening the populations and societal contexts included in research, the promise of precision medicine rings rather hollow. It is becoming quite clear that even when disease mechanisms are alike across populations, polygenic scores and other genetic tools for risk prediction and stratification perform poorly across ancestries. The same may prove true for particular biomarkers.&nbsp;</p> <p>We cannot know — and cannot claim to be making equitable contributions to global public health — without significantly expanding the diversity of the populations we study. The Stanley Center has made it a central goal to increase population diversity in neuropsychiatric genetics l while increasing our sample sizes overall.&nbsp;</p> <p>There is both scientific benefit and a health equity imperative in looking across all of humanity. I see this as a moral necessity.</p> <p><strong>How important will new animal models be?</strong></p> <p>Industry is quite skeptical, and based on long experience rightly so, when it comes to the use of model systems for studying human psychiatric disorders. However, if we are to gain the most benefit from studies of genetics and neurobiology, diverse model systems — including animal models — are critical for investigating candidate disease mechanisms.&nbsp;</p> <p>Human stem cell-derived models and human brain organoids can help address questions arising from human genetics, especially ones related to human polygenic backgrounds. However, organoids are not brains. Animal models, carefully interpreted, are absolutely critical if we are to investigate relevant neurobiology and candidate disease mechanisms in living brains&nbsp;</p> <p><strong>Where do industry and research institutes like the Stanley Center fit into your framework?</strong></p> <p>Our foremost goal at the Stanley Center is to work both "bottom-up" from genetics up and "top down" from phenotypes and systems-level neuroscience to understand disease mechanisms. It's from an understanding of mechanisms that you have the best chance of identifying meaningful biomarkers and therapeutic targets.&nbsp;</p> <p>Academic centers, and certainly the Stanley Center, ultimately want to share the biomarkers that we discover with industry to ensure that these tools are robust and reliable enough for use in clinical trials. And of course industry has a huge role in optimizing compounds and, above all, in designing and running clinical trials that exceed the financial capacities and core capabilities of academic organizations.</p> <p><strong>Do you think the roadmap you've laid out is something the players in the field will find realistic?</strong></p> <p>There's a long way to travel, but it's not a Pollyanna-ish report. Following this path and breathing new life into treatment development is going to be a multi-sector effort. To meet the vast unmet needs of people with brain disorders, we must commit ourselves to moving forward. Thanks to the amazing discoveries that have come out of genetics over the last decade or so, basic research on psychiatric disorders has finally gained its first durable insights into disease mechanisms. There are now important translational opportunities, beginning with biomarkers. Let’s pursue these opportunities effectively and energetically.&nbsp;</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--table-outro paragraph--view-mode--default"> <div class="field field--name-field-paragraph field--type-entity-reference-revisions field--label-hidden field__items"> <div class="field__item"> <div class="paragraph paragraph--type--table-outro-row paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-heading field--type-text field--label-hidden field__item"><p>Paper cited</p> </div> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Koranic D, et al. <a href="https://www.science.org/doi/10.1126/scitranslmed.adg4775" target="_blank">Shifting the trajectory of therapeutic development for neurological and psychiatric disorders</a>. <em>Science Translational Medicine</em>. Online November 1, 2023. DOI: 10.1126/scitranslmed.adg4775.</p> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> <div class="content-section container"> <div class="content-section__main"> <div class="block-node-broad-tags block block-layout-builder block-field-blocknodelong-storyfield-broad-tags"> <div class="block-node-broad-tags__row"> <div class="block-node-broad-tags__title">Tags:</div> <div class="field field--name-field-broad-tags field--type-entity-reference field--label-hidden field__items"> <div class="field__item"><a href="/broad-tags/stanley-center-psychiatric-research" hreflang="en">Stanley Center for Psychiatric Research</a></div> <div class="field__item"><a href="/broad-tags/psychiatric-disease-0" hreflang="en">Psychiatric disease</a></div> <div class="field__item"><a href="/broad-tags/psychiatric-disease" hreflang="en">Brain Health</a></div> <div class="field__item"><a href="/broad-tags/steven-hyman" hreflang="en">Steven Hyman</a></div> </div> </div> </div> </div> </div> Mon, 18 Dec 2023 15:02:23 +0000 tulrich@broadinstitute.org 5556201 at First large genetic study of bipolar disorder in Asian populations launches /news/first-large-genetic-study-bipolar-disorder-asian-populations-launches <span class="field field--name-title field--type-string field--label-hidden"><h1>Q&amp;A: How to jump-start new psychiatric and neurological drug development</h1> </span> <span class="field field--name-uid field--type-entity-reference field--label-hidden"> <span>By Tom Ulrich</span> </span> <span class="field field--name-created field--type-created field--label-hidden"><time datetime="2023-12-18T10:02:23-05:00" class="datetime">December 18, 2023</time> </span> <div class="hero-section container"> <div class="hero-section__row row"> <div class="hero-section__content hero-section__content_left col-6"> <div class="hero-section__breadcrumbs"> <div class="block block-system block-system-breadcrumb-block"> <nav class="breadcrumb" role="navigation" aria-labelledby="system-breadcrumb"> <h2 id="system-breadcrumb" class="visually-hidden">Breadcrumb</h2> <ol> <li> <a href="/">Home</a> </li> <li> <a href="/news">News</a> </li> </ol> </nav> </div> </div> <div class="hero-section__title"> <div class="block block-layout-builder block-field-blocknodelong-storytitle"> <span class="field field--name-title field--type-string field--label-hidden"><h1>Q&amp;A: How to jump-start new psychiatric and neurological drug development</h1> </span> </div> </div> <div class="hero-section__description"> <div class="block block-layout-builder block-field-blocknodelong-storybody"> <div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><p>Stanley Center director Steve Hyman talks about a new report he co-authored that explores the obstacles in developing new treatments and how to overcome them</p> </div> </div> </div> <div class="hero-section__author"> <div class="block block-layout-builder block-extra-field-blocknodelong-storyextra-field-author-custom"> By Tom Ulrich </div> </div> <div class="hero-section__date"> <div class="block block-layout-builder block-field-blocknodelong-storycreated"> <span class="field field--name-created field--type-created field--label-hidden"><time datetime="2023-12-18T10:02:23-05:00" title="Monday, December 18, 2023 - 10:02" class="datetime">December 18, 2023</time> </span> </div> </div> </div> <div class="hero-section__right col-6"> <div class="hero-section__image"> <div class="block block-layout-builder block-field-blocknodelong-storyfield-image"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"> <article class="media media--type-image media--view-mode-multiple-content-types-header"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <picture> <source srcset="/files/styles/multiple_ct_header_desktop_xl/public/SEH%20SC%20II.jpg?itok=AnKU0Ryn 1x" media="all and (min-width: 1921px)" type="image/jpeg" width="754" height="503"> <source srcset="/files/styles/multiple_ct_header_desktop_xl/public/SEH%20SC%20II.jpg?itok=AnKU0Ryn 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/jpeg" width="754" height="503"> <source srcset="/files/styles/multiple_ct_header_desktop/public/SEH%20SC%20II.jpg?itok=Lo__sQt6 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/jpeg" width="736" height="520"> <source srcset="/files/styles/multiple_ct_header_laptop/public/SEH%20SC%20II.jpg?itok=L1JFI3U9 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/jpeg" width="641" height="451"> <source srcset="/files/styles/multiple_ct_header_tablet/public/SEH%20SC%20II.jpg?itok=gKnc95f8 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/jpeg" width="706" height="417"> <source 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width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=_khBWxft 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=_khBWxft 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=0DsI2w5k 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=rIgOybCw 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=rIgOybCw" width="220" height="186" alt="Fluorescence microscopy image of brain tissue from a mouse model of Alzheimer’s, showing tau tangles (red), amyloid plaques (white), RNA (green), and cell nuclei (blue)." title="Fluorescence microscopy image of brain tissue from a mouse model of Alzheimer’s, showing tau tangles (red), amyloid plaques (white), RNA (green), and cell nuclei (blue)." typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/researchers-map-brain-cell-changes-alzheimers-disease" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Researchers map brain cell changes in Alzheimer’s disease</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/first-large-genetic-study-bipolar-disorder-asian-populations-launches" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/first-large-genetic-study-bipolar-disorder-asian-populations-launches"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=fsfHMyPk 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=fsfHMyPk 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LEt4QTt5 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LEt4QTt5 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=Iudqt44B 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LzxxBlIA 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LzxxBlIA" width="220" height="186" alt="Ricardo Job-Reese, Ó³»­´«Ã½ Communications" typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/first-large-genetic-study-bipolar-disorder-asian-populations-launches" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">First large genetic study of bipolar disorder in Asian populations launches</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/brain-organoids-replicate-key-events-human-brain-development" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/brain-organoids-replicate-key-events-human-brain-development"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=lstySHBC 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=lstySHBC 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=4HlxIV8e 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=4HlxIV8e 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=T0IPiSz3 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=njI3T1Gw 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=njI3T1Gw" width="220" height="186" alt="Human brain organoids showing neurons and their dendrites (green), telencephalic (forebrain) cells (blue), and a kind of cell-cell contact called tight junctions (red)." title="Human brain organoids showing neurons and their dendrites (green), telencephalic (forebrain) cells (blue), and a kind of cell-cell contact called tight junctions (red)." typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/brain-organoids-replicate-key-events-human-brain-development" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Brain organoids replicate key events in human brain development</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/two-large-studies-reveal-genes-and-genome-regions-influence-schizophrenia-risk" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/two-large-studies-reveal-genes-and-genome-regions-influence-schizophrenia-risk"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=xZ24Xgbw 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=xZ24Xgbw 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=ktxABhYV 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=ktxABhYV 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=5mQP8D3T 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=KwBq3Kyz 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=KwBq3Kyz" width="220" height="186" alt="Zayna Sheikh, Ó³»­´«Ã½ Communications" typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/two-large-studies-reveal-genes-and-genome-regions-influence-schizophrenia-risk" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Two large studies reveal genes and genome regions that influence schizophrenia risk</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/researchers-find-first-strong-genetic-risk-factor-bipolar-disorder" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/researchers-find-first-strong-genetic-risk-factor-bipolar-disorder"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=nZYvK0EX 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=nZYvK0EX 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=81f3TsED 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=81f3TsED 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=enlVPy8e 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=pxwXJ6Rv 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=pxwXJ6Rv" width="220" height="186" alt="Susanna Hamilton, Ó³»­´«Ã½ Communications" typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/researchers-find-first-strong-genetic-risk-factor-bipolar-disorder" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Researchers find first strong genetic risk factor for bipolar disorder</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/path-promising-treatments-schizophrenia" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/path-promising-treatments-schizophrenia"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=dxUHBnI1 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=dxUHBnI1 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=iDYg5eit 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=iDYg5eit 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=JSZhwT-E 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=VYKQHFQJ 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=VYKQHFQJ" width="220" height="186" alt="Morgan Sheng, core institute member and co-director of the Stanley Center for Psychiatric Research, is studying the function of genes linked to schizophrenia." title="Morgan Sheng, core institute member and co-director of the Stanley Center for Psychiatric Research, is studying the function of genes linked to schizophrenia." typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/path-promising-treatments-schizophrenia" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">A path to promising treatments for schizophrenia</span> </a> </div> </article> </div> </div> </div> </div> </div> </div> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Psychiatric and neurological disorders are widespread, yet the pace of drug development for these conditions lags far behind that of heart disease, cancer, and other conditions. Brain disorders are difficult to study and many drug candidates have failed in clinical trials, causing pharmaceutical companies to reduce their investments or even exit the field entirely.&nbsp;</p> <p>But a new path for bringing treatments to patients is starting to emerge. In a recent review in <a href="https://www.science.org/doi/10.1126/scitranslmed.adg4775" target="_blank"><em>Science Translational Medicine</em></a>, <a href="/node/7576">Steven Hyman</a>, director of the <a href="/node/8513">Stanley Center for Psychiatric Research</a> at the Ó³»­´«Ã½ of MIT and Harvard, and colleagues in the National Academies of Science, Engineering, and Medicine (NASEM) <a href="https://www.nationalacademies.org/our-work/forum-on-neuroscience-and-nervous-system-disorders" target="_blank">Forum on Neuroscience and Nervous System Disorders</a> — which includes industry — sketched out a six-point framework for re-invigorating psychiatric and neurological drug development that addresses many of the unique challenges this field faces. They wrote that a deeper understanding of the molecular mechanisms driving these disorders will improve diagnosis, enhance patient stratification in clinical trials, and lead to better therapeutics.&nbsp;</p> <p>To achieve this, the authors called for more genetics and longitudinal data types from patients of diverse ancestries, more data- and tool-sharing across sectors, the development of quantitative biomarkers for measuring disease mechanisms, and more.</p> <p>We asked Hyman, who is also a core institute member at Ó³»­´«Ã½, to talk about the new framework and what he thinks are the biggest opportunities.&nbsp;</p> <p>The following conversation was edited for length and clarity.</p> <p><strong>Why did you and your colleagues with the NASEM Forum decide to write this report?</strong></p> <p>One of our long abiding concerns has been the pharmaceutical industry's progressive exit from R&amp;D on treatments for central nervous system disorders apart from Alzheimer's and for large companies a nearly complete exit from new research in psychiatry.&nbsp;</p> <p>We all recognize the vast, unmet medical need. We have no treatments for the disabling cognitive and deficit symptoms of schizophrenia, and no pharmacologic treatments for the core communication difficulties of autism. We do very poorly at treating the depressed phase of bipolar disorder. And we have no pharmacologic treatments for anorexia nervosa, which at approximately 20 percent has the highest long-term mortality rate in psychiatry.&nbsp;</p> <p>So the need and the markets are there. The question becomes, under what circumstances would industry rebuild the infrastructure they need to re-engage in neuroscience and psychiatric development?&nbsp;</p> <p><strong>What do you think it will take for industry to re-engage in this space?&nbsp;</strong></p> <p>The single biggest problem for psychiatric disorders is that we lack the ability to look underneath the surface phenomena such as symptoms and disease course to group or stratify patients according to disease mechanisms.&nbsp;</p> <p>To use the example of depression, there have been many large, costly clinical trials in which drugs fail to separate convincingly from placebo but ultimately prove effective for a subset of patients. The key problem is that there appear to be many different underlying mechanisms that lead to depression. The genetic risk factors are highly complex, and they intersect with environmental risk factors ranging from infections to stress that are also diverse in their nature and effects (and which deserve intensive study).&nbsp;</p> <p>Without robust biomarkers, we cannot account for this mechanistic diversity and appropriately match patients with candidate treatments in clinical trials. Lumping everyone under this umbrella diagnosis of depression ignores the heterogeneous nature of this disorder, dilutes any signal that we might see in a clinical trial, and prevents us from learning from failures.&nbsp;</p> <p>Biomarkers could take many forms. Based on recent success in Alzheimer’s disease and amyotrophic lateral sclerosis, companies are very interested in quantifiable fluid biomarkers, which for neuroscience has meant markers that can be measured initially in CSF [cerebrospinal fluid]. Studies of Alzheimer's disease are teaching us that it's possible to measure some clinically important CSF biomarkers in blood. Some may even be measurable using positron emission tomography, which has the added benefit of providing information about where in the brain a biomarker is present.&nbsp;</p> <p>For some neurologic and psychiatric disorders, perhaps including depression and obsessive-compulsive symptoms, system-level biomarkers — ones that provide functional information about whole circuits instead of individual cells or molecules — appear promising. Thus magnetic resonance imaging or EEG studies may supplement molecular studies in ways that could prove to be highly useful in, for example, stratifying individuals with schizophrenia. At the Stanley Center, we are already gaining powerful evidence for this using EEG.&nbsp;</p> <p><strong>Your review article discussed the need to study genetically diverse patient samples. Can you expand on that?</strong></p> <p>Without a strong commitment to broadening the populations and societal contexts included in research, the promise of precision medicine rings rather hollow. It is becoming quite clear that even when disease mechanisms are alike across populations, polygenic scores and other genetic tools for risk prediction and stratification perform poorly across ancestries. The same may prove true for particular biomarkers.&nbsp;</p> <p>We cannot know — and cannot claim to be making equitable contributions to global public health — without significantly expanding the diversity of the populations we study. The Stanley Center has made it a central goal to increase population diversity in neuropsychiatric genetics l while increasing our sample sizes overall.&nbsp;</p> <p>There is both scientific benefit and a health equity imperative in looking across all of humanity. I see this as a moral necessity.</p> <p><strong>How important will new animal models be?</strong></p> <p>Industry is quite skeptical, and based on long experience rightly so, when it comes to the use of model systems for studying human psychiatric disorders. However, if we are to gain the most benefit from studies of genetics and neurobiology, diverse model systems — including animal models — are critical for investigating candidate disease mechanisms.&nbsp;</p> <p>Human stem cell-derived models and human brain organoids can help address questions arising from human genetics, especially ones related to human polygenic backgrounds. However, organoids are not brains. Animal models, carefully interpreted, are absolutely critical if we are to investigate relevant neurobiology and candidate disease mechanisms in living brains&nbsp;</p> <p><strong>Where do industry and research institutes like the Stanley Center fit into your framework?</strong></p> <p>Our foremost goal at the Stanley Center is to work both "bottom-up" from genetics up and "top down" from phenotypes and systems-level neuroscience to understand disease mechanisms. It's from an understanding of mechanisms that you have the best chance of identifying meaningful biomarkers and therapeutic targets.&nbsp;</p> <p>Academic centers, and certainly the Stanley Center, ultimately want to share the biomarkers that we discover with industry to ensure that these tools are robust and reliable enough for use in clinical trials. And of course industry has a huge role in optimizing compounds and, above all, in designing and running clinical trials that exceed the financial capacities and core capabilities of academic organizations.</p> <p><strong>Do you think the roadmap you've laid out is something the players in the field will find realistic?</strong></p> <p>There's a long way to travel, but it's not a Pollyanna-ish report. Following this path and breathing new life into treatment development is going to be a multi-sector effort. To meet the vast unmet needs of people with brain disorders, we must commit ourselves to moving forward. Thanks to the amazing discoveries that have come out of genetics over the last decade or so, basic research on psychiatric disorders has finally gained its first durable insights into disease mechanisms. There are now important translational opportunities, beginning with biomarkers. Let’s pursue these opportunities effectively and energetically.&nbsp;</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--table-outro paragraph--view-mode--default"> <div class="field field--name-field-paragraph field--type-entity-reference-revisions field--label-hidden field__items"> <div class="field__item"> <div class="paragraph paragraph--type--table-outro-row paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-heading field--type-text field--label-hidden field__item"><p>Paper cited</p> </div> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Koranic D, et al. <a href="https://www.science.org/doi/10.1126/scitranslmed.adg4775" target="_blank">Shifting the trajectory of therapeutic development for neurological and psychiatric disorders</a>. <em>Science Translational Medicine</em>. Online November 1, 2023. DOI: 10.1126/scitranslmed.adg4775.</p> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> <div class="content-section container"> <div class="content-section__main"> <div class="block-node-broad-tags block block-layout-builder block-field-blocknodelong-storyfield-broad-tags"> <div class="block-node-broad-tags__row"> <div class="block-node-broad-tags__title">Tags:</div> <div class="field field--name-field-broad-tags field--type-entity-reference field--label-hidden field__items"> <div class="field__item"><a href="/broad-tags/stanley-center-psychiatric-research" hreflang="en">Stanley Center for Psychiatric Research</a></div> <div class="field__item"><a href="/broad-tags/psychiatric-disease-0" hreflang="en">Psychiatric disease</a></div> <div class="field__item"><a href="/broad-tags/psychiatric-disease" hreflang="en">Brain Health</a></div> <div class="field__item"><a href="/broad-tags/steven-hyman" hreflang="en">Steven Hyman</a></div> </div> </div> </div> </div> </div> Mon, 31 Oct 2022 16:53:52 +0000 aviveros@broadinstitute.org 1238511 at Ó³»­´«Ã½ Discovery Center in Cambridge opens to the public this October /news/broad-discovery-center-cambridge-opens-public-october <span class="field field--name-title field--type-string field--label-hidden"><h1>Q&amp;A: How to jump-start new psychiatric and neurological drug development</h1> </span> <span class="field field--name-uid field--type-entity-reference field--label-hidden"> <span>By Tom Ulrich</span> </span> <span class="field field--name-created field--type-created field--label-hidden"><time datetime="2023-12-18T10:02:23-05:00" class="datetime">December 18, 2023</time> </span> <div class="hero-section container"> <div class="hero-section__row row"> <div class="hero-section__content hero-section__content_left col-6"> <div class="hero-section__breadcrumbs"> <div class="block block-system block-system-breadcrumb-block"> <nav class="breadcrumb" role="navigation" aria-labelledby="system-breadcrumb"> <h2 id="system-breadcrumb" class="visually-hidden">Breadcrumb</h2> <ol> <li> <a href="/">Home</a> </li> <li> <a href="/news">News</a> </li> </ol> </nav> </div> </div> <div class="hero-section__title"> <div class="block block-layout-builder block-field-blocknodelong-storytitle"> <span class="field field--name-title field--type-string field--label-hidden"><h1>Q&amp;A: How to jump-start new psychiatric and neurological drug development</h1> </span> </div> </div> <div class="hero-section__description"> <div class="block block-layout-builder block-field-blocknodelong-storybody"> <div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><p>Stanley Center director Steve Hyman talks about a new report he co-authored that explores the obstacles in developing new treatments and how to overcome them</p> </div> </div> </div> <div class="hero-section__author"> <div class="block block-layout-builder block-extra-field-blocknodelong-storyextra-field-author-custom"> By Tom Ulrich </div> </div> <div class="hero-section__date"> <div class="block block-layout-builder block-field-blocknodelong-storycreated"> <span class="field field--name-created field--type-created field--label-hidden"><time datetime="2023-12-18T10:02:23-05:00" title="Monday, December 18, 2023 - 10:02" class="datetime">December 18, 2023</time> </span> </div> </div> </div> <div class="hero-section__right col-6"> <div class="hero-section__image"> <div class="block block-layout-builder block-field-blocknodelong-storyfield-image"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"> <article class="media media--type-image media--view-mode-multiple-content-types-header"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <picture> <source srcset="/files/styles/multiple_ct_header_desktop_xl/public/SEH%20SC%20II.jpg?itok=AnKU0Ryn 1x" media="all and (min-width: 1921px)" type="image/jpeg" width="754" height="503"> <source srcset="/files/styles/multiple_ct_header_desktop_xl/public/SEH%20SC%20II.jpg?itok=AnKU0Ryn 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/jpeg" width="754" height="503"> <source srcset="/files/styles/multiple_ct_header_desktop/public/SEH%20SC%20II.jpg?itok=Lo__sQt6 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/jpeg" width="736" height="520"> <source srcset="/files/styles/multiple_ct_header_laptop/public/SEH%20SC%20II.jpg?itok=L1JFI3U9 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/jpeg" width="641" height="451"> <source srcset="/files/styles/multiple_ct_header_tablet/public/SEH%20SC%20II.jpg?itok=gKnc95f8 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/jpeg" width="706" height="417"> <source 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width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=_khBWxft 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=_khBWxft 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=0DsI2w5k 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=rIgOybCw 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=rIgOybCw" width="220" height="186" alt="Fluorescence microscopy image of brain tissue from a mouse model of Alzheimer’s, showing tau tangles (red), amyloid plaques (white), RNA (green), and cell nuclei (blue)." title="Fluorescence microscopy image of brain tissue from a mouse model of Alzheimer’s, showing tau tangles (red), amyloid plaques (white), RNA (green), and cell nuclei (blue)." typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/researchers-map-brain-cell-changes-alzheimers-disease" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Researchers map brain cell changes in Alzheimer’s disease</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/first-large-genetic-study-bipolar-disorder-asian-populations-launches" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/first-large-genetic-study-bipolar-disorder-asian-populations-launches"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=fsfHMyPk 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=fsfHMyPk 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LEt4QTt5 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LEt4QTt5 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=Iudqt44B 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LzxxBlIA 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LzxxBlIA" width="220" height="186" alt="Ricardo Job-Reese, Ó³»­´«Ã½ Communications" typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/first-large-genetic-study-bipolar-disorder-asian-populations-launches" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">First large genetic study of bipolar disorder in Asian populations launches</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/brain-organoids-replicate-key-events-human-brain-development" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/brain-organoids-replicate-key-events-human-brain-development"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=lstySHBC 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=lstySHBC 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=4HlxIV8e 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=4HlxIV8e 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=T0IPiSz3 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=njI3T1Gw 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=njI3T1Gw" width="220" height="186" alt="Human brain organoids showing neurons and their dendrites (green), telencephalic (forebrain) cells (blue), and a kind of cell-cell contact called tight junctions (red)." title="Human brain organoids showing neurons and their dendrites (green), telencephalic (forebrain) cells (blue), and a kind of cell-cell contact called tight junctions (red)." typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/brain-organoids-replicate-key-events-human-brain-development" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Brain organoids replicate key events in human brain development</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/two-large-studies-reveal-genes-and-genome-regions-influence-schizophrenia-risk" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/two-large-studies-reveal-genes-and-genome-regions-influence-schizophrenia-risk"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=xZ24Xgbw 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=xZ24Xgbw 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=ktxABhYV 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=ktxABhYV 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=5mQP8D3T 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=KwBq3Kyz 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=KwBq3Kyz" width="220" height="186" alt="Zayna Sheikh, Ó³»­´«Ã½ Communications" typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/two-large-studies-reveal-genes-and-genome-regions-influence-schizophrenia-risk" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Two large studies reveal genes and genome regions that influence schizophrenia risk</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/researchers-find-first-strong-genetic-risk-factor-bipolar-disorder" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/researchers-find-first-strong-genetic-risk-factor-bipolar-disorder"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=nZYvK0EX 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=nZYvK0EX 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=81f3TsED 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=81f3TsED 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=enlVPy8e 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=pxwXJ6Rv 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=pxwXJ6Rv" width="220" height="186" alt="Susanna Hamilton, Ó³»­´«Ã½ Communications" typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/researchers-find-first-strong-genetic-risk-factor-bipolar-disorder" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Researchers find first strong genetic risk factor for bipolar disorder</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/path-promising-treatments-schizophrenia" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/path-promising-treatments-schizophrenia"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=dxUHBnI1 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=dxUHBnI1 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=iDYg5eit 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=iDYg5eit 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=JSZhwT-E 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=VYKQHFQJ 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=VYKQHFQJ" width="220" height="186" alt="Morgan Sheng, core institute member and co-director of the Stanley Center for Psychiatric Research, is studying the function of genes linked to schizophrenia." title="Morgan Sheng, core institute member and co-director of the Stanley Center for Psychiatric Research, is studying the function of genes linked to schizophrenia." typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/path-promising-treatments-schizophrenia" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">A path to promising treatments for schizophrenia</span> </a> </div> </article> </div> </div> </div> </div> </div> </div> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Psychiatric and neurological disorders are widespread, yet the pace of drug development for these conditions lags far behind that of heart disease, cancer, and other conditions. Brain disorders are difficult to study and many drug candidates have failed in clinical trials, causing pharmaceutical companies to reduce their investments or even exit the field entirely.&nbsp;</p> <p>But a new path for bringing treatments to patients is starting to emerge. In a recent review in <a href="https://www.science.org/doi/10.1126/scitranslmed.adg4775" target="_blank"><em>Science Translational Medicine</em></a>, <a href="/node/7576">Steven Hyman</a>, director of the <a href="/node/8513">Stanley Center for Psychiatric Research</a> at the Ó³»­´«Ã½ of MIT and Harvard, and colleagues in the National Academies of Science, Engineering, and Medicine (NASEM) <a href="https://www.nationalacademies.org/our-work/forum-on-neuroscience-and-nervous-system-disorders" target="_blank">Forum on Neuroscience and Nervous System Disorders</a> — which includes industry — sketched out a six-point framework for re-invigorating psychiatric and neurological drug development that addresses many of the unique challenges this field faces. They wrote that a deeper understanding of the molecular mechanisms driving these disorders will improve diagnosis, enhance patient stratification in clinical trials, and lead to better therapeutics.&nbsp;</p> <p>To achieve this, the authors called for more genetics and longitudinal data types from patients of diverse ancestries, more data- and tool-sharing across sectors, the development of quantitative biomarkers for measuring disease mechanisms, and more.</p> <p>We asked Hyman, who is also a core institute member at Ó³»­´«Ã½, to talk about the new framework and what he thinks are the biggest opportunities.&nbsp;</p> <p>The following conversation was edited for length and clarity.</p> <p><strong>Why did you and your colleagues with the NASEM Forum decide to write this report?</strong></p> <p>One of our long abiding concerns has been the pharmaceutical industry's progressive exit from R&amp;D on treatments for central nervous system disorders apart from Alzheimer's and for large companies a nearly complete exit from new research in psychiatry.&nbsp;</p> <p>We all recognize the vast, unmet medical need. We have no treatments for the disabling cognitive and deficit symptoms of schizophrenia, and no pharmacologic treatments for the core communication difficulties of autism. We do very poorly at treating the depressed phase of bipolar disorder. And we have no pharmacologic treatments for anorexia nervosa, which at approximately 20 percent has the highest long-term mortality rate in psychiatry.&nbsp;</p> <p>So the need and the markets are there. The question becomes, under what circumstances would industry rebuild the infrastructure they need to re-engage in neuroscience and psychiatric development?&nbsp;</p> <p><strong>What do you think it will take for industry to re-engage in this space?&nbsp;</strong></p> <p>The single biggest problem for psychiatric disorders is that we lack the ability to look underneath the surface phenomena such as symptoms and disease course to group or stratify patients according to disease mechanisms.&nbsp;</p> <p>To use the example of depression, there have been many large, costly clinical trials in which drugs fail to separate convincingly from placebo but ultimately prove effective for a subset of patients. The key problem is that there appear to be many different underlying mechanisms that lead to depression. The genetic risk factors are highly complex, and they intersect with environmental risk factors ranging from infections to stress that are also diverse in their nature and effects (and which deserve intensive study).&nbsp;</p> <p>Without robust biomarkers, we cannot account for this mechanistic diversity and appropriately match patients with candidate treatments in clinical trials. Lumping everyone under this umbrella diagnosis of depression ignores the heterogeneous nature of this disorder, dilutes any signal that we might see in a clinical trial, and prevents us from learning from failures.&nbsp;</p> <p>Biomarkers could take many forms. Based on recent success in Alzheimer’s disease and amyotrophic lateral sclerosis, companies are very interested in quantifiable fluid biomarkers, which for neuroscience has meant markers that can be measured initially in CSF [cerebrospinal fluid]. Studies of Alzheimer's disease are teaching us that it's possible to measure some clinically important CSF biomarkers in blood. Some may even be measurable using positron emission tomography, which has the added benefit of providing information about where in the brain a biomarker is present.&nbsp;</p> <p>For some neurologic and psychiatric disorders, perhaps including depression and obsessive-compulsive symptoms, system-level biomarkers — ones that provide functional information about whole circuits instead of individual cells or molecules — appear promising. Thus magnetic resonance imaging or EEG studies may supplement molecular studies in ways that could prove to be highly useful in, for example, stratifying individuals with schizophrenia. At the Stanley Center, we are already gaining powerful evidence for this using EEG.&nbsp;</p> <p><strong>Your review article discussed the need to study genetically diverse patient samples. Can you expand on that?</strong></p> <p>Without a strong commitment to broadening the populations and societal contexts included in research, the promise of precision medicine rings rather hollow. It is becoming quite clear that even when disease mechanisms are alike across populations, polygenic scores and other genetic tools for risk prediction and stratification perform poorly across ancestries. The same may prove true for particular biomarkers.&nbsp;</p> <p>We cannot know — and cannot claim to be making equitable contributions to global public health — without significantly expanding the diversity of the populations we study. The Stanley Center has made it a central goal to increase population diversity in neuropsychiatric genetics l while increasing our sample sizes overall.&nbsp;</p> <p>There is both scientific benefit and a health equity imperative in looking across all of humanity. I see this as a moral necessity.</p> <p><strong>How important will new animal models be?</strong></p> <p>Industry is quite skeptical, and based on long experience rightly so, when it comes to the use of model systems for studying human psychiatric disorders. However, if we are to gain the most benefit from studies of genetics and neurobiology, diverse model systems — including animal models — are critical for investigating candidate disease mechanisms.&nbsp;</p> <p>Human stem cell-derived models and human brain organoids can help address questions arising from human genetics, especially ones related to human polygenic backgrounds. However, organoids are not brains. Animal models, carefully interpreted, are absolutely critical if we are to investigate relevant neurobiology and candidate disease mechanisms in living brains&nbsp;</p> <p><strong>Where do industry and research institutes like the Stanley Center fit into your framework?</strong></p> <p>Our foremost goal at the Stanley Center is to work both "bottom-up" from genetics up and "top down" from phenotypes and systems-level neuroscience to understand disease mechanisms. It's from an understanding of mechanisms that you have the best chance of identifying meaningful biomarkers and therapeutic targets.&nbsp;</p> <p>Academic centers, and certainly the Stanley Center, ultimately want to share the biomarkers that we discover with industry to ensure that these tools are robust and reliable enough for use in clinical trials. And of course industry has a huge role in optimizing compounds and, above all, in designing and running clinical trials that exceed the financial capacities and core capabilities of academic organizations.</p> <p><strong>Do you think the roadmap you've laid out is something the players in the field will find realistic?</strong></p> <p>There's a long way to travel, but it's not a Pollyanna-ish report. Following this path and breathing new life into treatment development is going to be a multi-sector effort. To meet the vast unmet needs of people with brain disorders, we must commit ourselves to moving forward. Thanks to the amazing discoveries that have come out of genetics over the last decade or so, basic research on psychiatric disorders has finally gained its first durable insights into disease mechanisms. There are now important translational opportunities, beginning with biomarkers. Let’s pursue these opportunities effectively and energetically.&nbsp;</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--table-outro paragraph--view-mode--default"> <div class="field field--name-field-paragraph field--type-entity-reference-revisions field--label-hidden field__items"> <div class="field__item"> <div class="paragraph paragraph--type--table-outro-row paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-heading field--type-text field--label-hidden field__item"><p>Paper cited</p> </div> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Koranic D, et al. <a href="https://www.science.org/doi/10.1126/scitranslmed.adg4775" target="_blank">Shifting the trajectory of therapeutic development for neurological and psychiatric disorders</a>. <em>Science Translational Medicine</em>. Online November 1, 2023. DOI: 10.1126/scitranslmed.adg4775.</p> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> <div class="content-section container"> <div class="content-section__main"> <div class="block-node-broad-tags block block-layout-builder block-field-blocknodelong-storyfield-broad-tags"> <div class="block-node-broad-tags__row"> <div class="block-node-broad-tags__title">Tags:</div> <div class="field field--name-field-broad-tags field--type-entity-reference field--label-hidden field__items"> <div class="field__item"><a href="/broad-tags/stanley-center-psychiatric-research" hreflang="en">Stanley Center for Psychiatric Research</a></div> <div class="field__item"><a href="/broad-tags/psychiatric-disease-0" hreflang="en">Psychiatric disease</a></div> <div class="field__item"><a href="/broad-tags/psychiatric-disease" hreflang="en">Brain Health</a></div> <div class="field__item"><a href="/broad-tags/steven-hyman" hreflang="en">Steven Hyman</a></div> </div> </div> </div> </div> </div> Mon, 19 Sep 2022 14:53:09 +0000 kzusi@broadinstitute.org 1195701 at New study shows how microglia are prompted to change their state to adapt to different areas of the brain /news/new-study-shows-how-microglia-are-prompted-change-their-state-adapt-different-areas-brain <span class="field field--name-title field--type-string field--label-hidden"><h1>Q&amp;A: How to jump-start new psychiatric and neurological drug development</h1> </span> <span class="field field--name-uid field--type-entity-reference field--label-hidden"> <span>By Tom Ulrich</span> </span> <span class="field field--name-created field--type-created field--label-hidden"><time datetime="2023-12-18T10:02:23-05:00" class="datetime">December 18, 2023</time> </span> <div class="hero-section container"> <div class="hero-section__row row"> <div class="hero-section__content hero-section__content_left col-6"> <div class="hero-section__breadcrumbs"> <div class="block block-system block-system-breadcrumb-block"> <nav class="breadcrumb" role="navigation" aria-labelledby="system-breadcrumb"> <h2 id="system-breadcrumb" class="visually-hidden">Breadcrumb</h2> <ol> <li> <a href="/">Home</a> </li> <li> <a href="/news">News</a> </li> </ol> </nav> </div> </div> <div class="hero-section__title"> <div class="block block-layout-builder block-field-blocknodelong-storytitle"> <span class="field field--name-title field--type-string field--label-hidden"><h1>Q&amp;A: How to jump-start new psychiatric and neurological drug development</h1> </span> </div> </div> <div class="hero-section__description"> <div class="block block-layout-builder block-field-blocknodelong-storybody"> <div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><p>Stanley Center director Steve Hyman talks about a new report he co-authored that explores the obstacles in developing new treatments and how to overcome them</p> </div> </div> </div> <div class="hero-section__author"> <div class="block block-layout-builder block-extra-field-blocknodelong-storyextra-field-author-custom"> By Tom Ulrich </div> </div> <div class="hero-section__date"> <div class="block block-layout-builder block-field-blocknodelong-storycreated"> <span class="field field--name-created field--type-created field--label-hidden"><time datetime="2023-12-18T10:02:23-05:00" title="Monday, December 18, 2023 - 10:02" class="datetime">December 18, 2023</time> </span> </div> </div> </div> <div class="hero-section__right col-6"> <div class="hero-section__image"> <div class="block block-layout-builder block-field-blocknodelong-storyfield-image"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"> <article class="media media--type-image media--view-mode-multiple-content-types-header"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <picture> <source srcset="/files/styles/multiple_ct_header_desktop_xl/public/SEH%20SC%20II.jpg?itok=AnKU0Ryn 1x" media="all and (min-width: 1921px)" type="image/jpeg" width="754" height="503"> <source srcset="/files/styles/multiple_ct_header_desktop_xl/public/SEH%20SC%20II.jpg?itok=AnKU0Ryn 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/jpeg" width="754" height="503"> <source srcset="/files/styles/multiple_ct_header_desktop/public/SEH%20SC%20II.jpg?itok=Lo__sQt6 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/jpeg" width="736" height="520"> <source srcset="/files/styles/multiple_ct_header_laptop/public/SEH%20SC%20II.jpg?itok=L1JFI3U9 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/jpeg" width="641" height="451"> <source srcset="/files/styles/multiple_ct_header_tablet/public/SEH%20SC%20II.jpg?itok=gKnc95f8 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/jpeg" width="706" height="417"> <source 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width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=_khBWxft 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=_khBWxft 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=0DsI2w5k 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=rIgOybCw 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=rIgOybCw" width="220" height="186" alt="Fluorescence microscopy image of brain tissue from a mouse model of Alzheimer’s, showing tau tangles (red), amyloid plaques (white), RNA (green), and cell nuclei (blue)." title="Fluorescence microscopy image of brain tissue from a mouse model of Alzheimer’s, showing tau tangles (red), amyloid plaques (white), RNA (green), and cell nuclei (blue)." typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/researchers-map-brain-cell-changes-alzheimers-disease" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Researchers map brain cell changes in Alzheimer’s disease</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/first-large-genetic-study-bipolar-disorder-asian-populations-launches" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/first-large-genetic-study-bipolar-disorder-asian-populations-launches"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=fsfHMyPk 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=fsfHMyPk 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LEt4QTt5 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LEt4QTt5 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=Iudqt44B 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LzxxBlIA 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LzxxBlIA" width="220" height="186" alt="Ricardo Job-Reese, Ó³»­´«Ã½ Communications" typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/first-large-genetic-study-bipolar-disorder-asian-populations-launches" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">First large genetic study of bipolar disorder in Asian populations launches</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/brain-organoids-replicate-key-events-human-brain-development" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/brain-organoids-replicate-key-events-human-brain-development"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=lstySHBC 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=lstySHBC 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=4HlxIV8e 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=4HlxIV8e 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=T0IPiSz3 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=njI3T1Gw 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=njI3T1Gw" width="220" height="186" alt="Human brain organoids showing neurons and their dendrites (green), telencephalic (forebrain) cells (blue), and a kind of cell-cell contact called tight junctions (red)." title="Human brain organoids showing neurons and their dendrites (green), telencephalic (forebrain) cells (blue), and a kind of cell-cell contact called tight junctions (red)." typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/brain-organoids-replicate-key-events-human-brain-development" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Brain organoids replicate key events in human brain development</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/two-large-studies-reveal-genes-and-genome-regions-influence-schizophrenia-risk" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/two-large-studies-reveal-genes-and-genome-regions-influence-schizophrenia-risk"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=xZ24Xgbw 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=xZ24Xgbw 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=ktxABhYV 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=ktxABhYV 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=5mQP8D3T 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=KwBq3Kyz 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=KwBq3Kyz" width="220" height="186" alt="Zayna Sheikh, Ó³»­´«Ã½ Communications" typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/two-large-studies-reveal-genes-and-genome-regions-influence-schizophrenia-risk" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Two large studies reveal genes and genome regions that influence schizophrenia risk</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/researchers-find-first-strong-genetic-risk-factor-bipolar-disorder" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/researchers-find-first-strong-genetic-risk-factor-bipolar-disorder"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=nZYvK0EX 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=nZYvK0EX 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=81f3TsED 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=81f3TsED 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=enlVPy8e 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=pxwXJ6Rv 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=pxwXJ6Rv" width="220" height="186" alt="Susanna Hamilton, Ó³»­´«Ã½ Communications" typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/researchers-find-first-strong-genetic-risk-factor-bipolar-disorder" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Researchers find first strong genetic risk factor for bipolar disorder</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/path-promising-treatments-schizophrenia" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/path-promising-treatments-schizophrenia"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=dxUHBnI1 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=dxUHBnI1 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=iDYg5eit 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=iDYg5eit 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=JSZhwT-E 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=VYKQHFQJ 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=VYKQHFQJ" width="220" height="186" alt="Morgan Sheng, core institute member and co-director of the Stanley Center for Psychiatric Research, is studying the function of genes linked to schizophrenia." title="Morgan Sheng, core institute member and co-director of the Stanley Center for Psychiatric Research, is studying the function of genes linked to schizophrenia." typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/path-promising-treatments-schizophrenia" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">A path to promising treatments for schizophrenia</span> </a> </div> </article> </div> </div> </div> </div> </div> </div> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Psychiatric and neurological disorders are widespread, yet the pace of drug development for these conditions lags far behind that of heart disease, cancer, and other conditions. Brain disorders are difficult to study and many drug candidates have failed in clinical trials, causing pharmaceutical companies to reduce their investments or even exit the field entirely.&nbsp;</p> <p>But a new path for bringing treatments to patients is starting to emerge. In a recent review in <a href="https://www.science.org/doi/10.1126/scitranslmed.adg4775" target="_blank"><em>Science Translational Medicine</em></a>, <a href="/node/7576">Steven Hyman</a>, director of the <a href="/node/8513">Stanley Center for Psychiatric Research</a> at the Ó³»­´«Ã½ of MIT and Harvard, and colleagues in the National Academies of Science, Engineering, and Medicine (NASEM) <a href="https://www.nationalacademies.org/our-work/forum-on-neuroscience-and-nervous-system-disorders" target="_blank">Forum on Neuroscience and Nervous System Disorders</a> — which includes industry — sketched out a six-point framework for re-invigorating psychiatric and neurological drug development that addresses many of the unique challenges this field faces. They wrote that a deeper understanding of the molecular mechanisms driving these disorders will improve diagnosis, enhance patient stratification in clinical trials, and lead to better therapeutics.&nbsp;</p> <p>To achieve this, the authors called for more genetics and longitudinal data types from patients of diverse ancestries, more data- and tool-sharing across sectors, the development of quantitative biomarkers for measuring disease mechanisms, and more.</p> <p>We asked Hyman, who is also a core institute member at Ó³»­´«Ã½, to talk about the new framework and what he thinks are the biggest opportunities.&nbsp;</p> <p>The following conversation was edited for length and clarity.</p> <p><strong>Why did you and your colleagues with the NASEM Forum decide to write this report?</strong></p> <p>One of our long abiding concerns has been the pharmaceutical industry's progressive exit from R&amp;D on treatments for central nervous system disorders apart from Alzheimer's and for large companies a nearly complete exit from new research in psychiatry.&nbsp;</p> <p>We all recognize the vast, unmet medical need. We have no treatments for the disabling cognitive and deficit symptoms of schizophrenia, and no pharmacologic treatments for the core communication difficulties of autism. We do very poorly at treating the depressed phase of bipolar disorder. And we have no pharmacologic treatments for anorexia nervosa, which at approximately 20 percent has the highest long-term mortality rate in psychiatry.&nbsp;</p> <p>So the need and the markets are there. The question becomes, under what circumstances would industry rebuild the infrastructure they need to re-engage in neuroscience and psychiatric development?&nbsp;</p> <p><strong>What do you think it will take for industry to re-engage in this space?&nbsp;</strong></p> <p>The single biggest problem for psychiatric disorders is that we lack the ability to look underneath the surface phenomena such as symptoms and disease course to group or stratify patients according to disease mechanisms.&nbsp;</p> <p>To use the example of depression, there have been many large, costly clinical trials in which drugs fail to separate convincingly from placebo but ultimately prove effective for a subset of patients. The key problem is that there appear to be many different underlying mechanisms that lead to depression. The genetic risk factors are highly complex, and they intersect with environmental risk factors ranging from infections to stress that are also diverse in their nature and effects (and which deserve intensive study).&nbsp;</p> <p>Without robust biomarkers, we cannot account for this mechanistic diversity and appropriately match patients with candidate treatments in clinical trials. Lumping everyone under this umbrella diagnosis of depression ignores the heterogeneous nature of this disorder, dilutes any signal that we might see in a clinical trial, and prevents us from learning from failures.&nbsp;</p> <p>Biomarkers could take many forms. Based on recent success in Alzheimer’s disease and amyotrophic lateral sclerosis, companies are very interested in quantifiable fluid biomarkers, which for neuroscience has meant markers that can be measured initially in CSF [cerebrospinal fluid]. Studies of Alzheimer's disease are teaching us that it's possible to measure some clinically important CSF biomarkers in blood. Some may even be measurable using positron emission tomography, which has the added benefit of providing information about where in the brain a biomarker is present.&nbsp;</p> <p>For some neurologic and psychiatric disorders, perhaps including depression and obsessive-compulsive symptoms, system-level biomarkers — ones that provide functional information about whole circuits instead of individual cells or molecules — appear promising. Thus magnetic resonance imaging or EEG studies may supplement molecular studies in ways that could prove to be highly useful in, for example, stratifying individuals with schizophrenia. At the Stanley Center, we are already gaining powerful evidence for this using EEG.&nbsp;</p> <p><strong>Your review article discussed the need to study genetically diverse patient samples. Can you expand on that?</strong></p> <p>Without a strong commitment to broadening the populations and societal contexts included in research, the promise of precision medicine rings rather hollow. It is becoming quite clear that even when disease mechanisms are alike across populations, polygenic scores and other genetic tools for risk prediction and stratification perform poorly across ancestries. The same may prove true for particular biomarkers.&nbsp;</p> <p>We cannot know — and cannot claim to be making equitable contributions to global public health — without significantly expanding the diversity of the populations we study. The Stanley Center has made it a central goal to increase population diversity in neuropsychiatric genetics l while increasing our sample sizes overall.&nbsp;</p> <p>There is both scientific benefit and a health equity imperative in looking across all of humanity. I see this as a moral necessity.</p> <p><strong>How important will new animal models be?</strong></p> <p>Industry is quite skeptical, and based on long experience rightly so, when it comes to the use of model systems for studying human psychiatric disorders. However, if we are to gain the most benefit from studies of genetics and neurobiology, diverse model systems — including animal models — are critical for investigating candidate disease mechanisms.&nbsp;</p> <p>Human stem cell-derived models and human brain organoids can help address questions arising from human genetics, especially ones related to human polygenic backgrounds. However, organoids are not brains. Animal models, carefully interpreted, are absolutely critical if we are to investigate relevant neurobiology and candidate disease mechanisms in living brains&nbsp;</p> <p><strong>Where do industry and research institutes like the Stanley Center fit into your framework?</strong></p> <p>Our foremost goal at the Stanley Center is to work both "bottom-up" from genetics up and "top down" from phenotypes and systems-level neuroscience to understand disease mechanisms. It's from an understanding of mechanisms that you have the best chance of identifying meaningful biomarkers and therapeutic targets.&nbsp;</p> <p>Academic centers, and certainly the Stanley Center, ultimately want to share the biomarkers that we discover with industry to ensure that these tools are robust and reliable enough for use in clinical trials. And of course industry has a huge role in optimizing compounds and, above all, in designing and running clinical trials that exceed the financial capacities and core capabilities of academic organizations.</p> <p><strong>Do you think the roadmap you've laid out is something the players in the field will find realistic?</strong></p> <p>There's a long way to travel, but it's not a Pollyanna-ish report. Following this path and breathing new life into treatment development is going to be a multi-sector effort. To meet the vast unmet needs of people with brain disorders, we must commit ourselves to moving forward. Thanks to the amazing discoveries that have come out of genetics over the last decade or so, basic research on psychiatric disorders has finally gained its first durable insights into disease mechanisms. There are now important translational opportunities, beginning with biomarkers. Let’s pursue these opportunities effectively and energetically.&nbsp;</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--table-outro paragraph--view-mode--default"> <div class="field field--name-field-paragraph field--type-entity-reference-revisions field--label-hidden field__items"> <div class="field__item"> <div class="paragraph paragraph--type--table-outro-row paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-heading field--type-text field--label-hidden field__item"><p>Paper cited</p> </div> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Koranic D, et al. <a href="https://www.science.org/doi/10.1126/scitranslmed.adg4775" target="_blank">Shifting the trajectory of therapeutic development for neurological and psychiatric disorders</a>. <em>Science Translational Medicine</em>. Online November 1, 2023. DOI: 10.1126/scitranslmed.adg4775.</p> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> <div class="content-section container"> <div class="content-section__main"> <div class="block-node-broad-tags block block-layout-builder block-field-blocknodelong-storyfield-broad-tags"> <div class="block-node-broad-tags__row"> <div class="block-node-broad-tags__title">Tags:</div> <div class="field field--name-field-broad-tags field--type-entity-reference field--label-hidden field__items"> <div class="field__item"><a href="/broad-tags/stanley-center-psychiatric-research" hreflang="en">Stanley Center for Psychiatric Research</a></div> <div class="field__item"><a href="/broad-tags/psychiatric-disease-0" hreflang="en">Psychiatric disease</a></div> <div class="field__item"><a href="/broad-tags/psychiatric-disease" hreflang="en">Brain Health</a></div> <div class="field__item"><a href="/broad-tags/steven-hyman" hreflang="en">Steven Hyman</a></div> </div> </div> </div> </div> </div> Wed, 10 Aug 2022 21:47:28 +0000 kzusi@broadinstitute.org 1161661 at Two large studies reveal genes and genome regions that influence schizophrenia risk /news/two-large-studies-reveal-genes-and-genome-regions-influence-schizophrenia-risk <span class="field field--name-title field--type-string field--label-hidden"><h1>Q&amp;A: How to jump-start new psychiatric and neurological drug development</h1> </span> <span class="field field--name-uid field--type-entity-reference field--label-hidden"> <span>By Tom Ulrich</span> </span> <span class="field field--name-created field--type-created field--label-hidden"><time datetime="2023-12-18T10:02:23-05:00" class="datetime">December 18, 2023</time> </span> <div class="hero-section container"> <div class="hero-section__row row"> <div class="hero-section__content hero-section__content_left col-6"> <div class="hero-section__breadcrumbs"> <div class="block block-system block-system-breadcrumb-block"> <nav class="breadcrumb" role="navigation" aria-labelledby="system-breadcrumb"> <h2 id="system-breadcrumb" class="visually-hidden">Breadcrumb</h2> <ol> <li> <a href="/">Home</a> </li> <li> <a href="/news">News</a> </li> </ol> </nav> </div> </div> <div class="hero-section__title"> <div class="block block-layout-builder block-field-blocknodelong-storytitle"> <span class="field field--name-title field--type-string field--label-hidden"><h1>Q&amp;A: How to jump-start new psychiatric and neurological drug development</h1> </span> </div> </div> <div class="hero-section__description"> <div class="block block-layout-builder block-field-blocknodelong-storybody"> <div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><p>Stanley Center director Steve Hyman talks about a new report he co-authored that explores the obstacles in developing new treatments and how to overcome them</p> </div> </div> </div> <div class="hero-section__author"> <div class="block block-layout-builder block-extra-field-blocknodelong-storyextra-field-author-custom"> By Tom Ulrich </div> </div> <div class="hero-section__date"> <div class="block block-layout-builder block-field-blocknodelong-storycreated"> <span class="field field--name-created field--type-created field--label-hidden"><time datetime="2023-12-18T10:02:23-05:00" title="Monday, December 18, 2023 - 10:02" class="datetime">December 18, 2023</time> </span> </div> </div> </div> <div class="hero-section__right col-6"> <div class="hero-section__image"> <div class="block block-layout-builder block-field-blocknodelong-storyfield-image"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"> <article class="media media--type-image media--view-mode-multiple-content-types-header"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <picture> <source srcset="/files/styles/multiple_ct_header_desktop_xl/public/SEH%20SC%20II.jpg?itok=AnKU0Ryn 1x" media="all and (min-width: 1921px)" type="image/jpeg" width="754" height="503"> <source srcset="/files/styles/multiple_ct_header_desktop_xl/public/SEH%20SC%20II.jpg?itok=AnKU0Ryn 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/jpeg" width="754" height="503"> <source srcset="/files/styles/multiple_ct_header_desktop/public/SEH%20SC%20II.jpg?itok=Lo__sQt6 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/jpeg" width="736" height="520"> <source srcset="/files/styles/multiple_ct_header_laptop/public/SEH%20SC%20II.jpg?itok=L1JFI3U9 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/jpeg" width="641" height="451"> <source srcset="/files/styles/multiple_ct_header_tablet/public/SEH%20SC%20II.jpg?itok=gKnc95f8 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/jpeg" width="706" height="417"> <source 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width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=_khBWxft 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=_khBWxft 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=0DsI2w5k 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=rIgOybCw 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=rIgOybCw" width="220" height="186" alt="Fluorescence microscopy image of brain tissue from a mouse model of Alzheimer’s, showing tau tangles (red), amyloid plaques (white), RNA (green), and cell nuclei (blue)." title="Fluorescence microscopy image of brain tissue from a mouse model of Alzheimer’s, showing tau tangles (red), amyloid plaques (white), RNA (green), and cell nuclei (blue)." typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/researchers-map-brain-cell-changes-alzheimers-disease" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Researchers map brain cell changes in Alzheimer’s disease</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/first-large-genetic-study-bipolar-disorder-asian-populations-launches" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/first-large-genetic-study-bipolar-disorder-asian-populations-launches"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=fsfHMyPk 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=fsfHMyPk 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LEt4QTt5 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LEt4QTt5 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=Iudqt44B 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LzxxBlIA 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LzxxBlIA" width="220" height="186" alt="Ricardo Job-Reese, Ó³»­´«Ã½ Communications" typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/first-large-genetic-study-bipolar-disorder-asian-populations-launches" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">First large genetic study of bipolar disorder in Asian populations launches</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/brain-organoids-replicate-key-events-human-brain-development" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/brain-organoids-replicate-key-events-human-brain-development"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=lstySHBC 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=lstySHBC 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=4HlxIV8e 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=4HlxIV8e 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=T0IPiSz3 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=njI3T1Gw 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=njI3T1Gw" width="220" height="186" alt="Human brain organoids showing neurons and their dendrites (green), telencephalic (forebrain) cells (blue), and a kind of cell-cell contact called tight junctions (red)." title="Human brain organoids showing neurons and their dendrites (green), telencephalic (forebrain) cells (blue), and a kind of cell-cell contact called tight junctions (red)." typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/brain-organoids-replicate-key-events-human-brain-development" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Brain organoids replicate key events in human brain development</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/two-large-studies-reveal-genes-and-genome-regions-influence-schizophrenia-risk" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/two-large-studies-reveal-genes-and-genome-regions-influence-schizophrenia-risk"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=xZ24Xgbw 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=xZ24Xgbw 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=ktxABhYV 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=ktxABhYV 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=5mQP8D3T 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=KwBq3Kyz 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=KwBq3Kyz" width="220" height="186" alt="Zayna Sheikh, Ó³»­´«Ã½ Communications" typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/two-large-studies-reveal-genes-and-genome-regions-influence-schizophrenia-risk" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Two large studies reveal genes and genome regions that influence schizophrenia risk</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/researchers-find-first-strong-genetic-risk-factor-bipolar-disorder" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/researchers-find-first-strong-genetic-risk-factor-bipolar-disorder"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=nZYvK0EX 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=nZYvK0EX 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=81f3TsED 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=81f3TsED 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=enlVPy8e 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=pxwXJ6Rv 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=pxwXJ6Rv" width="220" height="186" alt="Susanna Hamilton, Ó³»­´«Ã½ Communications" typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/researchers-find-first-strong-genetic-risk-factor-bipolar-disorder" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Researchers find first strong genetic risk factor for bipolar disorder</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/path-promising-treatments-schizophrenia" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/path-promising-treatments-schizophrenia"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=dxUHBnI1 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=dxUHBnI1 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=iDYg5eit 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=iDYg5eit 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=JSZhwT-E 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=VYKQHFQJ 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=VYKQHFQJ" width="220" height="186" alt="Morgan Sheng, core institute member and co-director of the Stanley Center for Psychiatric Research, is studying the function of genes linked to schizophrenia." title="Morgan Sheng, core institute member and co-director of the Stanley Center for Psychiatric Research, is studying the function of genes linked to schizophrenia." typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/path-promising-treatments-schizophrenia" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">A path to promising treatments for schizophrenia</span> </a> </div> </article> </div> </div> </div> </div> </div> </div> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Psychiatric and neurological disorders are widespread, yet the pace of drug development for these conditions lags far behind that of heart disease, cancer, and other conditions. Brain disorders are difficult to study and many drug candidates have failed in clinical trials, causing pharmaceutical companies to reduce their investments or even exit the field entirely.&nbsp;</p> <p>But a new path for bringing treatments to patients is starting to emerge. In a recent review in <a href="https://www.science.org/doi/10.1126/scitranslmed.adg4775" target="_blank"><em>Science Translational Medicine</em></a>, <a href="/node/7576">Steven Hyman</a>, director of the <a href="/node/8513">Stanley Center for Psychiatric Research</a> at the Ó³»­´«Ã½ of MIT and Harvard, and colleagues in the National Academies of Science, Engineering, and Medicine (NASEM) <a href="https://www.nationalacademies.org/our-work/forum-on-neuroscience-and-nervous-system-disorders" target="_blank">Forum on Neuroscience and Nervous System Disorders</a> — which includes industry — sketched out a six-point framework for re-invigorating psychiatric and neurological drug development that addresses many of the unique challenges this field faces. They wrote that a deeper understanding of the molecular mechanisms driving these disorders will improve diagnosis, enhance patient stratification in clinical trials, and lead to better therapeutics.&nbsp;</p> <p>To achieve this, the authors called for more genetics and longitudinal data types from patients of diverse ancestries, more data- and tool-sharing across sectors, the development of quantitative biomarkers for measuring disease mechanisms, and more.</p> <p>We asked Hyman, who is also a core institute member at Ó³»­´«Ã½, to talk about the new framework and what he thinks are the biggest opportunities.&nbsp;</p> <p>The following conversation was edited for length and clarity.</p> <p><strong>Why did you and your colleagues with the NASEM Forum decide to write this report?</strong></p> <p>One of our long abiding concerns has been the pharmaceutical industry's progressive exit from R&amp;D on treatments for central nervous system disorders apart from Alzheimer's and for large companies a nearly complete exit from new research in psychiatry.&nbsp;</p> <p>We all recognize the vast, unmet medical need. We have no treatments for the disabling cognitive and deficit symptoms of schizophrenia, and no pharmacologic treatments for the core communication difficulties of autism. We do very poorly at treating the depressed phase of bipolar disorder. And we have no pharmacologic treatments for anorexia nervosa, which at approximately 20 percent has the highest long-term mortality rate in psychiatry.&nbsp;</p> <p>So the need and the markets are there. The question becomes, under what circumstances would industry rebuild the infrastructure they need to re-engage in neuroscience and psychiatric development?&nbsp;</p> <p><strong>What do you think it will take for industry to re-engage in this space?&nbsp;</strong></p> <p>The single biggest problem for psychiatric disorders is that we lack the ability to look underneath the surface phenomena such as symptoms and disease course to group or stratify patients according to disease mechanisms.&nbsp;</p> <p>To use the example of depression, there have been many large, costly clinical trials in which drugs fail to separate convincingly from placebo but ultimately prove effective for a subset of patients. The key problem is that there appear to be many different underlying mechanisms that lead to depression. The genetic risk factors are highly complex, and they intersect with environmental risk factors ranging from infections to stress that are also diverse in their nature and effects (and which deserve intensive study).&nbsp;</p> <p>Without robust biomarkers, we cannot account for this mechanistic diversity and appropriately match patients with candidate treatments in clinical trials. Lumping everyone under this umbrella diagnosis of depression ignores the heterogeneous nature of this disorder, dilutes any signal that we might see in a clinical trial, and prevents us from learning from failures.&nbsp;</p> <p>Biomarkers could take many forms. Based on recent success in Alzheimer’s disease and amyotrophic lateral sclerosis, companies are very interested in quantifiable fluid biomarkers, which for neuroscience has meant markers that can be measured initially in CSF [cerebrospinal fluid]. Studies of Alzheimer's disease are teaching us that it's possible to measure some clinically important CSF biomarkers in blood. Some may even be measurable using positron emission tomography, which has the added benefit of providing information about where in the brain a biomarker is present.&nbsp;</p> <p>For some neurologic and psychiatric disorders, perhaps including depression and obsessive-compulsive symptoms, system-level biomarkers — ones that provide functional information about whole circuits instead of individual cells or molecules — appear promising. Thus magnetic resonance imaging or EEG studies may supplement molecular studies in ways that could prove to be highly useful in, for example, stratifying individuals with schizophrenia. At the Stanley Center, we are already gaining powerful evidence for this using EEG.&nbsp;</p> <p><strong>Your review article discussed the need to study genetically diverse patient samples. Can you expand on that?</strong></p> <p>Without a strong commitment to broadening the populations and societal contexts included in research, the promise of precision medicine rings rather hollow. It is becoming quite clear that even when disease mechanisms are alike across populations, polygenic scores and other genetic tools for risk prediction and stratification perform poorly across ancestries. The same may prove true for particular biomarkers.&nbsp;</p> <p>We cannot know — and cannot claim to be making equitable contributions to global public health — without significantly expanding the diversity of the populations we study. The Stanley Center has made it a central goal to increase population diversity in neuropsychiatric genetics l while increasing our sample sizes overall.&nbsp;</p> <p>There is both scientific benefit and a health equity imperative in looking across all of humanity. I see this as a moral necessity.</p> <p><strong>How important will new animal models be?</strong></p> <p>Industry is quite skeptical, and based on long experience rightly so, when it comes to the use of model systems for studying human psychiatric disorders. However, if we are to gain the most benefit from studies of genetics and neurobiology, diverse model systems — including animal models — are critical for investigating candidate disease mechanisms.&nbsp;</p> <p>Human stem cell-derived models and human brain organoids can help address questions arising from human genetics, especially ones related to human polygenic backgrounds. However, organoids are not brains. Animal models, carefully interpreted, are absolutely critical if we are to investigate relevant neurobiology and candidate disease mechanisms in living brains&nbsp;</p> <p><strong>Where do industry and research institutes like the Stanley Center fit into your framework?</strong></p> <p>Our foremost goal at the Stanley Center is to work both "bottom-up" from genetics up and "top down" from phenotypes and systems-level neuroscience to understand disease mechanisms. It's from an understanding of mechanisms that you have the best chance of identifying meaningful biomarkers and therapeutic targets.&nbsp;</p> <p>Academic centers, and certainly the Stanley Center, ultimately want to share the biomarkers that we discover with industry to ensure that these tools are robust and reliable enough for use in clinical trials. And of course industry has a huge role in optimizing compounds and, above all, in designing and running clinical trials that exceed the financial capacities and core capabilities of academic organizations.</p> <p><strong>Do you think the roadmap you've laid out is something the players in the field will find realistic?</strong></p> <p>There's a long way to travel, but it's not a Pollyanna-ish report. Following this path and breathing new life into treatment development is going to be a multi-sector effort. To meet the vast unmet needs of people with brain disorders, we must commit ourselves to moving forward. Thanks to the amazing discoveries that have come out of genetics over the last decade or so, basic research on psychiatric disorders has finally gained its first durable insights into disease mechanisms. There are now important translational opportunities, beginning with biomarkers. Let’s pursue these opportunities effectively and energetically.&nbsp;</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--table-outro paragraph--view-mode--default"> <div class="field field--name-field-paragraph field--type-entity-reference-revisions field--label-hidden field__items"> <div class="field__item"> <div class="paragraph paragraph--type--table-outro-row paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-heading field--type-text field--label-hidden field__item"><p>Paper cited</p> </div> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Koranic D, et al. <a href="https://www.science.org/doi/10.1126/scitranslmed.adg4775" target="_blank">Shifting the trajectory of therapeutic development for neurological and psychiatric disorders</a>. <em>Science Translational Medicine</em>. Online November 1, 2023. DOI: 10.1126/scitranslmed.adg4775.</p> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> <div class="content-section container"> <div class="content-section__main"> <div class="block-node-broad-tags block block-layout-builder block-field-blocknodelong-storyfield-broad-tags"> <div class="block-node-broad-tags__row"> <div class="block-node-broad-tags__title">Tags:</div> <div class="field field--name-field-broad-tags field--type-entity-reference field--label-hidden field__items"> <div class="field__item"><a href="/broad-tags/stanley-center-psychiatric-research" hreflang="en">Stanley Center for Psychiatric Research</a></div> <div class="field__item"><a href="/broad-tags/psychiatric-disease-0" hreflang="en">Psychiatric disease</a></div> <div class="field__item"><a href="/broad-tags/psychiatric-disease" hreflang="en">Brain Health</a></div> <div class="field__item"><a href="/broad-tags/steven-hyman" hreflang="en">Steven Hyman</a></div> </div> </div> </div> </div> </div> Wed, 06 Apr 2022 15:00:20 +0000 tulrich@broadinstitute.org 1130626 at A path to promising treatments for schizophrenia /news/path-promising-treatments-schizophrenia <span class="field field--name-title field--type-string field--label-hidden"><h1>Q&amp;A: How to jump-start new psychiatric and neurological drug development</h1> </span> <span class="field field--name-uid field--type-entity-reference field--label-hidden"> <span>By Tom Ulrich</span> </span> <span class="field field--name-created field--type-created field--label-hidden"><time datetime="2023-12-18T10:02:23-05:00" class="datetime">December 18, 2023</time> </span> <div class="hero-section container"> <div class="hero-section__row row"> <div class="hero-section__content hero-section__content_left col-6"> <div class="hero-section__breadcrumbs"> <div class="block block-system block-system-breadcrumb-block"> <nav class="breadcrumb" role="navigation" aria-labelledby="system-breadcrumb"> <h2 id="system-breadcrumb" class="visually-hidden">Breadcrumb</h2> <ol> <li> <a href="/">Home</a> </li> <li> <a href="/news">News</a> </li> </ol> </nav> </div> </div> <div class="hero-section__title"> <div class="block block-layout-builder block-field-blocknodelong-storytitle"> <span class="field field--name-title field--type-string field--label-hidden"><h1>Q&amp;A: How to jump-start new psychiatric and neurological drug development</h1> </span> </div> </div> <div class="hero-section__description"> <div class="block block-layout-builder block-field-blocknodelong-storybody"> <div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><p>Stanley Center director Steve Hyman talks about a new report he co-authored that explores the obstacles in developing new treatments and how to overcome them</p> </div> </div> </div> <div class="hero-section__author"> <div class="block block-layout-builder block-extra-field-blocknodelong-storyextra-field-author-custom"> By Tom Ulrich </div> </div> <div class="hero-section__date"> <div class="block block-layout-builder block-field-blocknodelong-storycreated"> <span class="field field--name-created field--type-created field--label-hidden"><time datetime="2023-12-18T10:02:23-05:00" title="Monday, December 18, 2023 - 10:02" class="datetime">December 18, 2023</time> </span> </div> </div> </div> <div class="hero-section__right col-6"> <div class="hero-section__image"> <div class="block block-layout-builder block-field-blocknodelong-storyfield-image"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"> <article class="media media--type-image media--view-mode-multiple-content-types-header"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <picture> <source srcset="/files/styles/multiple_ct_header_desktop_xl/public/SEH%20SC%20II.jpg?itok=AnKU0Ryn 1x" media="all and (min-width: 1921px)" type="image/jpeg" width="754" height="503"> <source srcset="/files/styles/multiple_ct_header_desktop_xl/public/SEH%20SC%20II.jpg?itok=AnKU0Ryn 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/jpeg" width="754" height="503"> <source srcset="/files/styles/multiple_ct_header_desktop/public/SEH%20SC%20II.jpg?itok=Lo__sQt6 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/jpeg" width="736" height="520"> <source srcset="/files/styles/multiple_ct_header_laptop/public/SEH%20SC%20II.jpg?itok=L1JFI3U9 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/jpeg" width="641" height="451"> <source srcset="/files/styles/multiple_ct_header_tablet/public/SEH%20SC%20II.jpg?itok=gKnc95f8 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/jpeg" width="706" height="417"> <source srcset="/files/styles/multiple_ct_header_phone/public/SEH%20SC%20II.jpg?itok=10dB5jF6 1x" media="all and (max-width: 539px)" type="image/jpeg" width="499" height="294"> <img loading="eager" src="/files/styles/multiple_ct_header_phone/public/SEH%20SC%20II.jpg?itok=10dB5jF6" width="499" height="294" alt="Steven Hyman" title="Steven Hyman" typeof="foaf:Image"> </picture> </div> <div class="media-caption"> <div class="media-caption__description"> Steven Hyman </div> </div> </article> </div> </div> </div> </div> </div> </div> <div class="content-section container"> <div class="content-section__main"> <div class="block block-better-social-sharing-buttons block-social-sharing-buttons-block"> <div style="display: none"><link rel="preload" href="/modules/contrib/better_social_sharing_buttons/assets/dist/sprites/social-icons--no-color.svg" as="image" type="image/svg+xml" crossorigin="anonymous"></div> <div class="social-sharing-buttons"> <a href="https://www.facebook.com/sharer/sharer.php?u=/taxonomy/term/1791/feed&amp;title=" target="_blank" title="Share to Facebook" aria-label="Share to Facebook" class="social-sharing-buttons__button 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<div class="block block-layout-builder block-field-blocknodelong-storyfield-content-paragraphs"> <div class="field field--name-field-content-paragraphs field--type-entity-reference-revisions field--label-hidden field__items"> <div class="field__item"> <div class="paragraph paragraph--type--text-with-sidebar text-with-sidebar"> <div class="field field--name-field-sidebar field--type-entity-reference-revisions field--label-hidden field__items"> <div class="field__item"> <div class="paragraph paragraph--type--sidebar-menu sidebar-menu"> <div class="sidebar-menu__col"> <div class="clearfix text-formatted field field--name-field-heading field--type-text field--label-hidden field__item"><p>Related people</p> </div> <div class="field field--name-field-links field--type-link field--label-hidden field__items"> <div class="field__item"><a href="/bios/steven-e-hyman">Steven Hyman</a></div> </div> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--sidebar-menu sidebar-menu"> <div class="sidebar-menu__col"> <div class="clearfix text-formatted field field--name-field-heading field--type-text field--label-hidden field__item"><p>Related programs</p> </div> <div class="field field--name-field-links field--type-link field--label-hidden field__items"> <div class="field__item"><a href="/stanley-center-for-psychiatric-research">Stanley Center for Psychiatric Research</a></div> </div> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--sidebar-articles sidebar-articles"> <div class="sidebar-articles__col"> <div class="clearfix text-formatted field field--name-field-heading field--type-text field--label-hidden field__item"><p>Related News</p> </div> <div class="field field--name-field-content-reference field--type-entity-reference field--label-hidden field__items"> <div class="field__item"><article about="/news/scientists-map-locations-hundreds-thousands-cell-types-across-mammalian-brain" class="node"> <div 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media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/researchers-map-brain-cell-changes-alzheimers-disease"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=YbcVyrou 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=YbcVyrou 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=_khBWxft 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=_khBWxft 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=0DsI2w5k 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=rIgOybCw 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=rIgOybCw" width="220" height="186" alt="Fluorescence microscopy image of brain tissue from a mouse model of Alzheimer’s, showing tau tangles (red), amyloid plaques (white), RNA (green), and cell nuclei (blue)." title="Fluorescence microscopy image of brain tissue from a mouse model of Alzheimer’s, showing tau tangles (red), amyloid plaques (white), RNA (green), and cell nuclei (blue)." typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/researchers-map-brain-cell-changes-alzheimers-disease" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Researchers map brain cell changes in Alzheimer’s disease</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/first-large-genetic-study-bipolar-disorder-asian-populations-launches" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/first-large-genetic-study-bipolar-disorder-asian-populations-launches"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=fsfHMyPk 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=fsfHMyPk 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LEt4QTt5 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LEt4QTt5 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=Iudqt44B 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LzxxBlIA 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LzxxBlIA" width="220" height="186" alt="Ricardo Job-Reese, Ó³»­´«Ã½ Communications" typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/first-large-genetic-study-bipolar-disorder-asian-populations-launches" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">First large genetic study of bipolar disorder in Asian populations launches</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/brain-organoids-replicate-key-events-human-brain-development" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/brain-organoids-replicate-key-events-human-brain-development"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=lstySHBC 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=lstySHBC 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=4HlxIV8e 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=4HlxIV8e 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=T0IPiSz3 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=njI3T1Gw 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=njI3T1Gw" width="220" height="186" alt="Human brain organoids showing neurons and their dendrites (green), telencephalic (forebrain) cells (blue), and a kind of cell-cell contact called tight junctions (red)." title="Human brain organoids showing neurons and their dendrites (green), telencephalic (forebrain) cells (blue), and a kind of cell-cell contact called tight junctions (red)." typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/brain-organoids-replicate-key-events-human-brain-development" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Brain organoids replicate key events in human brain development</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/two-large-studies-reveal-genes-and-genome-regions-influence-schizophrenia-risk" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/two-large-studies-reveal-genes-and-genome-regions-influence-schizophrenia-risk"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=xZ24Xgbw 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=xZ24Xgbw 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=ktxABhYV 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=ktxABhYV 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=5mQP8D3T 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=KwBq3Kyz 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=KwBq3Kyz" width="220" height="186" alt="Zayna Sheikh, Ó³»­´«Ã½ Communications" typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/two-large-studies-reveal-genes-and-genome-regions-influence-schizophrenia-risk" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Two large studies reveal genes and genome regions that influence schizophrenia risk</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/researchers-find-first-strong-genetic-risk-factor-bipolar-disorder" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/researchers-find-first-strong-genetic-risk-factor-bipolar-disorder"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=nZYvK0EX 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=nZYvK0EX 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=81f3TsED 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=81f3TsED 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=enlVPy8e 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=pxwXJ6Rv 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=pxwXJ6Rv" width="220" height="186" alt="Susanna Hamilton, Ó³»­´«Ã½ Communications" typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/researchers-find-first-strong-genetic-risk-factor-bipolar-disorder" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Researchers find first strong genetic risk factor for bipolar disorder</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/path-promising-treatments-schizophrenia" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/path-promising-treatments-schizophrenia"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=dxUHBnI1 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=dxUHBnI1 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=iDYg5eit 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=iDYg5eit 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=JSZhwT-E 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=VYKQHFQJ 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=VYKQHFQJ" width="220" height="186" alt="Morgan Sheng, core institute member and co-director of the Stanley Center for Psychiatric Research, is studying the function of genes linked to schizophrenia." title="Morgan Sheng, core institute member and co-director of the Stanley Center for Psychiatric Research, is studying the function of genes linked to schizophrenia." typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/path-promising-treatments-schizophrenia" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">A path to promising treatments for schizophrenia</span> </a> </div> </article> </div> </div> </div> </div> </div> </div> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Psychiatric and neurological disorders are widespread, yet the pace of drug development for these conditions lags far behind that of heart disease, cancer, and other conditions. Brain disorders are difficult to study and many drug candidates have failed in clinical trials, causing pharmaceutical companies to reduce their investments or even exit the field entirely.&nbsp;</p> <p>But a new path for bringing treatments to patients is starting to emerge. In a recent review in <a href="https://www.science.org/doi/10.1126/scitranslmed.adg4775" target="_blank"><em>Science Translational Medicine</em></a>, <a href="/node/7576">Steven Hyman</a>, director of the <a href="/node/8513">Stanley Center for Psychiatric Research</a> at the Ó³»­´«Ã½ of MIT and Harvard, and colleagues in the National Academies of Science, Engineering, and Medicine (NASEM) <a href="https://www.nationalacademies.org/our-work/forum-on-neuroscience-and-nervous-system-disorders" target="_blank">Forum on Neuroscience and Nervous System Disorders</a> — which includes industry — sketched out a six-point framework for re-invigorating psychiatric and neurological drug development that addresses many of the unique challenges this field faces. They wrote that a deeper understanding of the molecular mechanisms driving these disorders will improve diagnosis, enhance patient stratification in clinical trials, and lead to better therapeutics.&nbsp;</p> <p>To achieve this, the authors called for more genetics and longitudinal data types from patients of diverse ancestries, more data- and tool-sharing across sectors, the development of quantitative biomarkers for measuring disease mechanisms, and more.</p> <p>We asked Hyman, who is also a core institute member at Ó³»­´«Ã½, to talk about the new framework and what he thinks are the biggest opportunities.&nbsp;</p> <p>The following conversation was edited for length and clarity.</p> <p><strong>Why did you and your colleagues with the NASEM Forum decide to write this report?</strong></p> <p>One of our long abiding concerns has been the pharmaceutical industry's progressive exit from R&amp;D on treatments for central nervous system disorders apart from Alzheimer's and for large companies a nearly complete exit from new research in psychiatry.&nbsp;</p> <p>We all recognize the vast, unmet medical need. We have no treatments for the disabling cognitive and deficit symptoms of schizophrenia, and no pharmacologic treatments for the core communication difficulties of autism. We do very poorly at treating the depressed phase of bipolar disorder. And we have no pharmacologic treatments for anorexia nervosa, which at approximately 20 percent has the highest long-term mortality rate in psychiatry.&nbsp;</p> <p>So the need and the markets are there. The question becomes, under what circumstances would industry rebuild the infrastructure they need to re-engage in neuroscience and psychiatric development?&nbsp;</p> <p><strong>What do you think it will take for industry to re-engage in this space?&nbsp;</strong></p> <p>The single biggest problem for psychiatric disorders is that we lack the ability to look underneath the surface phenomena such as symptoms and disease course to group or stratify patients according to disease mechanisms.&nbsp;</p> <p>To use the example of depression, there have been many large, costly clinical trials in which drugs fail to separate convincingly from placebo but ultimately prove effective for a subset of patients. The key problem is that there appear to be many different underlying mechanisms that lead to depression. The genetic risk factors are highly complex, and they intersect with environmental risk factors ranging from infections to stress that are also diverse in their nature and effects (and which deserve intensive study).&nbsp;</p> <p>Without robust biomarkers, we cannot account for this mechanistic diversity and appropriately match patients with candidate treatments in clinical trials. Lumping everyone under this umbrella diagnosis of depression ignores the heterogeneous nature of this disorder, dilutes any signal that we might see in a clinical trial, and prevents us from learning from failures.&nbsp;</p> <p>Biomarkers could take many forms. Based on recent success in Alzheimer’s disease and amyotrophic lateral sclerosis, companies are very interested in quantifiable fluid biomarkers, which for neuroscience has meant markers that can be measured initially in CSF [cerebrospinal fluid]. Studies of Alzheimer's disease are teaching us that it's possible to measure some clinically important CSF biomarkers in blood. Some may even be measurable using positron emission tomography, which has the added benefit of providing information about where in the brain a biomarker is present.&nbsp;</p> <p>For some neurologic and psychiatric disorders, perhaps including depression and obsessive-compulsive symptoms, system-level biomarkers — ones that provide functional information about whole circuits instead of individual cells or molecules — appear promising. Thus magnetic resonance imaging or EEG studies may supplement molecular studies in ways that could prove to be highly useful in, for example, stratifying individuals with schizophrenia. At the Stanley Center, we are already gaining powerful evidence for this using EEG.&nbsp;</p> <p><strong>Your review article discussed the need to study genetically diverse patient samples. Can you expand on that?</strong></p> <p>Without a strong commitment to broadening the populations and societal contexts included in research, the promise of precision medicine rings rather hollow. It is becoming quite clear that even when disease mechanisms are alike across populations, polygenic scores and other genetic tools for risk prediction and stratification perform poorly across ancestries. The same may prove true for particular biomarkers.&nbsp;</p> <p>We cannot know — and cannot claim to be making equitable contributions to global public health — without significantly expanding the diversity of the populations we study. The Stanley Center has made it a central goal to increase population diversity in neuropsychiatric genetics l while increasing our sample sizes overall.&nbsp;</p> <p>There is both scientific benefit and a health equity imperative in looking across all of humanity. I see this as a moral necessity.</p> <p><strong>How important will new animal models be?</strong></p> <p>Industry is quite skeptical, and based on long experience rightly so, when it comes to the use of model systems for studying human psychiatric disorders. However, if we are to gain the most benefit from studies of genetics and neurobiology, diverse model systems — including animal models — are critical for investigating candidate disease mechanisms.&nbsp;</p> <p>Human stem cell-derived models and human brain organoids can help address questions arising from human genetics, especially ones related to human polygenic backgrounds. However, organoids are not brains. Animal models, carefully interpreted, are absolutely critical if we are to investigate relevant neurobiology and candidate disease mechanisms in living brains&nbsp;</p> <p><strong>Where do industry and research institutes like the Stanley Center fit into your framework?</strong></p> <p>Our foremost goal at the Stanley Center is to work both "bottom-up" from genetics up and "top down" from phenotypes and systems-level neuroscience to understand disease mechanisms. It's from an understanding of mechanisms that you have the best chance of identifying meaningful biomarkers and therapeutic targets.&nbsp;</p> <p>Academic centers, and certainly the Stanley Center, ultimately want to share the biomarkers that we discover with industry to ensure that these tools are robust and reliable enough for use in clinical trials. And of course industry has a huge role in optimizing compounds and, above all, in designing and running clinical trials that exceed the financial capacities and core capabilities of academic organizations.</p> <p><strong>Do you think the roadmap you've laid out is something the players in the field will find realistic?</strong></p> <p>There's a long way to travel, but it's not a Pollyanna-ish report. Following this path and breathing new life into treatment development is going to be a multi-sector effort. To meet the vast unmet needs of people with brain disorders, we must commit ourselves to moving forward. Thanks to the amazing discoveries that have come out of genetics over the last decade or so, basic research on psychiatric disorders has finally gained its first durable insights into disease mechanisms. There are now important translational opportunities, beginning with biomarkers. Let’s pursue these opportunities effectively and energetically.&nbsp;</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--table-outro paragraph--view-mode--default"> <div class="field field--name-field-paragraph field--type-entity-reference-revisions field--label-hidden field__items"> <div class="field__item"> <div class="paragraph paragraph--type--table-outro-row paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-heading field--type-text field--label-hidden field__item"><p>Paper cited</p> </div> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Koranic D, et al. <a href="https://www.science.org/doi/10.1126/scitranslmed.adg4775" target="_blank">Shifting the trajectory of therapeutic development for neurological and psychiatric disorders</a>. <em>Science Translational Medicine</em>. Online November 1, 2023. DOI: 10.1126/scitranslmed.adg4775.</p> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> <div class="content-section container"> <div class="content-section__main"> <div class="block-node-broad-tags block block-layout-builder block-field-blocknodelong-storyfield-broad-tags"> <div class="block-node-broad-tags__row"> <div class="block-node-broad-tags__title">Tags:</div> <div class="field field--name-field-broad-tags field--type-entity-reference field--label-hidden field__items"> <div class="field__item"><a href="/broad-tags/stanley-center-psychiatric-research" hreflang="en">Stanley Center for Psychiatric Research</a></div> <div class="field__item"><a href="/broad-tags/psychiatric-disease-0" hreflang="en">Psychiatric disease</a></div> <div class="field__item"><a href="/broad-tags/psychiatric-disease" hreflang="en">Brain Health</a></div> <div class="field__item"><a href="/broad-tags/steven-hyman" hreflang="en">Steven Hyman</a></div> </div> </div> </div> </div> </div> Wed, 06 Apr 2022 15:00:03 +0000 Corie Lok 1130676 at Three autism risk genes have similar effects on brain development, but by different routes /news/three-autism-risk-genes-have-similar-effects-brain-development-different-routes <span class="field field--name-title field--type-string field--label-hidden"><h1>Q&amp;A: How to jump-start new psychiatric and neurological drug development</h1> </span> <span class="field field--name-uid field--type-entity-reference field--label-hidden"> <span>By Tom Ulrich</span> </span> <span class="field field--name-created field--type-created field--label-hidden"><time datetime="2023-12-18T10:02:23-05:00" class="datetime">December 18, 2023</time> </span> <div class="hero-section container"> <div class="hero-section__row row"> <div class="hero-section__content hero-section__content_left col-6"> <div class="hero-section__breadcrumbs"> <div class="block block-system block-system-breadcrumb-block"> <nav class="breadcrumb" role="navigation" aria-labelledby="system-breadcrumb"> <h2 id="system-breadcrumb" class="visually-hidden">Breadcrumb</h2> <ol> <li> <a href="/">Home</a> </li> <li> <a href="/news">News</a> </li> </ol> </nav> </div> </div> <div class="hero-section__title"> <div class="block block-layout-builder block-field-blocknodelong-storytitle"> <span class="field field--name-title field--type-string field--label-hidden"><h1>Q&amp;A: How to jump-start new psychiatric and neurological drug development</h1> </span> </div> </div> <div class="hero-section__description"> <div class="block block-layout-builder block-field-blocknodelong-storybody"> <div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><p>Stanley Center director Steve Hyman talks about a new report he co-authored that explores the obstacles in developing new treatments and how to overcome them</p> </div> </div> </div> <div class="hero-section__author"> <div class="block block-layout-builder block-extra-field-blocknodelong-storyextra-field-author-custom"> By Tom Ulrich </div> </div> <div class="hero-section__date"> <div class="block block-layout-builder block-field-blocknodelong-storycreated"> <span class="field field--name-created field--type-created field--label-hidden"><time datetime="2023-12-18T10:02:23-05:00" title="Monday, December 18, 2023 - 10:02" class="datetime">December 18, 2023</time> </span> </div> </div> </div> <div class="hero-section__right col-6"> <div class="hero-section__image"> <div class="block block-layout-builder block-field-blocknodelong-storyfield-image"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"> <article class="media media--type-image media--view-mode-multiple-content-types-header"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <picture> <source 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</article> </div> <div class="field__item"><article about="/news/researchers-map-brain-cell-changes-alzheimers-disease" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/researchers-map-brain-cell-changes-alzheimers-disease"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=YbcVyrou 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=YbcVyrou 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=_khBWxft 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=_khBWxft 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=0DsI2w5k 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=rIgOybCw 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=rIgOybCw" width="220" height="186" alt="Fluorescence microscopy image of brain tissue from a mouse model of Alzheimer’s, showing tau tangles (red), amyloid plaques (white), RNA (green), and cell nuclei (blue)." title="Fluorescence microscopy image of brain tissue from a mouse model of Alzheimer’s, showing tau tangles (red), amyloid plaques (white), RNA (green), and cell nuclei (blue)." typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/researchers-map-brain-cell-changes-alzheimers-disease" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Researchers map brain cell changes in Alzheimer’s disease</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/first-large-genetic-study-bipolar-disorder-asian-populations-launches" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/first-large-genetic-study-bipolar-disorder-asian-populations-launches"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=fsfHMyPk 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=fsfHMyPk 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LEt4QTt5 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LEt4QTt5 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=Iudqt44B 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LzxxBlIA 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LzxxBlIA" width="220" height="186" alt="Ricardo Job-Reese, Ó³»­´«Ã½ Communications" typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/first-large-genetic-study-bipolar-disorder-asian-populations-launches" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">First large genetic study of bipolar disorder in Asian populations launches</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/brain-organoids-replicate-key-events-human-brain-development" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/brain-organoids-replicate-key-events-human-brain-development"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=lstySHBC 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=lstySHBC 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=4HlxIV8e 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=4HlxIV8e 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=T0IPiSz3 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=njI3T1Gw 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=njI3T1Gw" width="220" height="186" alt="Human brain organoids showing neurons and their dendrites (green), telencephalic (forebrain) cells (blue), and a kind of cell-cell contact called tight junctions (red)." title="Human brain organoids showing neurons and their dendrites (green), telencephalic (forebrain) cells (blue), and a kind of cell-cell contact called tight junctions (red)." typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/brain-organoids-replicate-key-events-human-brain-development" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Brain organoids replicate key events in human brain development</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/two-large-studies-reveal-genes-and-genome-regions-influence-schizophrenia-risk" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/two-large-studies-reveal-genes-and-genome-regions-influence-schizophrenia-risk"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=xZ24Xgbw 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=xZ24Xgbw 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=ktxABhYV 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=ktxABhYV 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=5mQP8D3T 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=KwBq3Kyz 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=KwBq3Kyz" width="220" height="186" alt="Zayna Sheikh, Ó³»­´«Ã½ Communications" typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/two-large-studies-reveal-genes-and-genome-regions-influence-schizophrenia-risk" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Two large studies reveal genes and genome regions that influence schizophrenia risk</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/researchers-find-first-strong-genetic-risk-factor-bipolar-disorder" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/researchers-find-first-strong-genetic-risk-factor-bipolar-disorder"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=nZYvK0EX 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=nZYvK0EX 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=81f3TsED 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=81f3TsED 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=enlVPy8e 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=pxwXJ6Rv 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=pxwXJ6Rv" width="220" height="186" alt="Susanna Hamilton, Ó³»­´«Ã½ Communications" typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/researchers-find-first-strong-genetic-risk-factor-bipolar-disorder" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Researchers find first strong genetic risk factor for bipolar disorder</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/path-promising-treatments-schizophrenia" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/path-promising-treatments-schizophrenia"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=dxUHBnI1 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=dxUHBnI1 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=iDYg5eit 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=iDYg5eit 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=JSZhwT-E 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=VYKQHFQJ 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=VYKQHFQJ" width="220" height="186" alt="Morgan Sheng, core institute member and co-director of the Stanley Center for Psychiatric Research, is studying the function of genes linked to schizophrenia." title="Morgan Sheng, core institute member and co-director of the Stanley Center for Psychiatric Research, is studying the function of genes linked to schizophrenia." typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/path-promising-treatments-schizophrenia" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">A path to promising treatments for schizophrenia</span> </a> </div> </article> </div> </div> </div> </div> </div> </div> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Psychiatric and neurological disorders are widespread, yet the pace of drug development for these conditions lags far behind that of heart disease, cancer, and other conditions. Brain disorders are difficult to study and many drug candidates have failed in clinical trials, causing pharmaceutical companies to reduce their investments or even exit the field entirely.&nbsp;</p> <p>But a new path for bringing treatments to patients is starting to emerge. In a recent review in <a href="https://www.science.org/doi/10.1126/scitranslmed.adg4775" target="_blank"><em>Science Translational Medicine</em></a>, <a href="/node/7576">Steven Hyman</a>, director of the <a href="/node/8513">Stanley Center for Psychiatric Research</a> at the Ó³»­´«Ã½ of MIT and Harvard, and colleagues in the National Academies of Science, Engineering, and Medicine (NASEM) <a href="https://www.nationalacademies.org/our-work/forum-on-neuroscience-and-nervous-system-disorders" target="_blank">Forum on Neuroscience and Nervous System Disorders</a> — which includes industry — sketched out a six-point framework for re-invigorating psychiatric and neurological drug development that addresses many of the unique challenges this field faces. They wrote that a deeper understanding of the molecular mechanisms driving these disorders will improve diagnosis, enhance patient stratification in clinical trials, and lead to better therapeutics.&nbsp;</p> <p>To achieve this, the authors called for more genetics and longitudinal data types from patients of diverse ancestries, more data- and tool-sharing across sectors, the development of quantitative biomarkers for measuring disease mechanisms, and more.</p> <p>We asked Hyman, who is also a core institute member at Ó³»­´«Ã½, to talk about the new framework and what he thinks are the biggest opportunities.&nbsp;</p> <p>The following conversation was edited for length and clarity.</p> <p><strong>Why did you and your colleagues with the NASEM Forum decide to write this report?</strong></p> <p>One of our long abiding concerns has been the pharmaceutical industry's progressive exit from R&amp;D on treatments for central nervous system disorders apart from Alzheimer's and for large companies a nearly complete exit from new research in psychiatry.&nbsp;</p> <p>We all recognize the vast, unmet medical need. We have no treatments for the disabling cognitive and deficit symptoms of schizophrenia, and no pharmacologic treatments for the core communication difficulties of autism. We do very poorly at treating the depressed phase of bipolar disorder. And we have no pharmacologic treatments for anorexia nervosa, which at approximately 20 percent has the highest long-term mortality rate in psychiatry.&nbsp;</p> <p>So the need and the markets are there. The question becomes, under what circumstances would industry rebuild the infrastructure they need to re-engage in neuroscience and psychiatric development?&nbsp;</p> <p><strong>What do you think it will take for industry to re-engage in this space?&nbsp;</strong></p> <p>The single biggest problem for psychiatric disorders is that we lack the ability to look underneath the surface phenomena such as symptoms and disease course to group or stratify patients according to disease mechanisms.&nbsp;</p> <p>To use the example of depression, there have been many large, costly clinical trials in which drugs fail to separate convincingly from placebo but ultimately prove effective for a subset of patients. The key problem is that there appear to be many different underlying mechanisms that lead to depression. The genetic risk factors are highly complex, and they intersect with environmental risk factors ranging from infections to stress that are also diverse in their nature and effects (and which deserve intensive study).&nbsp;</p> <p>Without robust biomarkers, we cannot account for this mechanistic diversity and appropriately match patients with candidate treatments in clinical trials. Lumping everyone under this umbrella diagnosis of depression ignores the heterogeneous nature of this disorder, dilutes any signal that we might see in a clinical trial, and prevents us from learning from failures.&nbsp;</p> <p>Biomarkers could take many forms. Based on recent success in Alzheimer’s disease and amyotrophic lateral sclerosis, companies are very interested in quantifiable fluid biomarkers, which for neuroscience has meant markers that can be measured initially in CSF [cerebrospinal fluid]. Studies of Alzheimer's disease are teaching us that it's possible to measure some clinically important CSF biomarkers in blood. Some may even be measurable using positron emission tomography, which has the added benefit of providing information about where in the brain a biomarker is present.&nbsp;</p> <p>For some neurologic and psychiatric disorders, perhaps including depression and obsessive-compulsive symptoms, system-level biomarkers — ones that provide functional information about whole circuits instead of individual cells or molecules — appear promising. Thus magnetic resonance imaging or EEG studies may supplement molecular studies in ways that could prove to be highly useful in, for example, stratifying individuals with schizophrenia. At the Stanley Center, we are already gaining powerful evidence for this using EEG.&nbsp;</p> <p><strong>Your review article discussed the need to study genetically diverse patient samples. Can you expand on that?</strong></p> <p>Without a strong commitment to broadening the populations and societal contexts included in research, the promise of precision medicine rings rather hollow. It is becoming quite clear that even when disease mechanisms are alike across populations, polygenic scores and other genetic tools for risk prediction and stratification perform poorly across ancestries. The same may prove true for particular biomarkers.&nbsp;</p> <p>We cannot know — and cannot claim to be making equitable contributions to global public health — without significantly expanding the diversity of the populations we study. The Stanley Center has made it a central goal to increase population diversity in neuropsychiatric genetics l while increasing our sample sizes overall.&nbsp;</p> <p>There is both scientific benefit and a health equity imperative in looking across all of humanity. I see this as a moral necessity.</p> <p><strong>How important will new animal models be?</strong></p> <p>Industry is quite skeptical, and based on long experience rightly so, when it comes to the use of model systems for studying human psychiatric disorders. However, if we are to gain the most benefit from studies of genetics and neurobiology, diverse model systems — including animal models — are critical for investigating candidate disease mechanisms.&nbsp;</p> <p>Human stem cell-derived models and human brain organoids can help address questions arising from human genetics, especially ones related to human polygenic backgrounds. However, organoids are not brains. Animal models, carefully interpreted, are absolutely critical if we are to investigate relevant neurobiology and candidate disease mechanisms in living brains&nbsp;</p> <p><strong>Where do industry and research institutes like the Stanley Center fit into your framework?</strong></p> <p>Our foremost goal at the Stanley Center is to work both "bottom-up" from genetics up and "top down" from phenotypes and systems-level neuroscience to understand disease mechanisms. It's from an understanding of mechanisms that you have the best chance of identifying meaningful biomarkers and therapeutic targets.&nbsp;</p> <p>Academic centers, and certainly the Stanley Center, ultimately want to share the biomarkers that we discover with industry to ensure that these tools are robust and reliable enough for use in clinical trials. And of course industry has a huge role in optimizing compounds and, above all, in designing and running clinical trials that exceed the financial capacities and core capabilities of academic organizations.</p> <p><strong>Do you think the roadmap you've laid out is something the players in the field will find realistic?</strong></p> <p>There's a long way to travel, but it's not a Pollyanna-ish report. Following this path and breathing new life into treatment development is going to be a multi-sector effort. To meet the vast unmet needs of people with brain disorders, we must commit ourselves to moving forward. Thanks to the amazing discoveries that have come out of genetics over the last decade or so, basic research on psychiatric disorders has finally gained its first durable insights into disease mechanisms. There are now important translational opportunities, beginning with biomarkers. Let’s pursue these opportunities effectively and energetically.&nbsp;</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--table-outro paragraph--view-mode--default"> <div class="field field--name-field-paragraph field--type-entity-reference-revisions field--label-hidden field__items"> <div class="field__item"> <div class="paragraph paragraph--type--table-outro-row paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-heading field--type-text field--label-hidden field__item"><p>Paper cited</p> </div> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Koranic D, et al. <a href="https://www.science.org/doi/10.1126/scitranslmed.adg4775" target="_blank">Shifting the trajectory of therapeutic development for neurological and psychiatric disorders</a>. <em>Science Translational Medicine</em>. Online November 1, 2023. DOI: 10.1126/scitranslmed.adg4775.</p> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> <div class="content-section container"> <div class="content-section__main"> <div class="block-node-broad-tags block block-layout-builder block-field-blocknodelong-storyfield-broad-tags"> <div class="block-node-broad-tags__row"> <div class="block-node-broad-tags__title">Tags:</div> <div class="field field--name-field-broad-tags field--type-entity-reference field--label-hidden field__items"> <div class="field__item"><a href="/broad-tags/stanley-center-psychiatric-research" hreflang="en">Stanley Center for Psychiatric Research</a></div> <div class="field__item"><a href="/broad-tags/psychiatric-disease-0" hreflang="en">Psychiatric disease</a></div> <div class="field__item"><a href="/broad-tags/psychiatric-disease" hreflang="en">Brain Health</a></div> <div class="field__item"><a href="/broad-tags/steven-hyman" hreflang="en">Steven Hyman</a></div> </div> </div> </div> </div> </div> Wed, 02 Feb 2022 16:32:08 +0000 tulrich@broadinstitute.org 1127196 at Some brain disorders exhibit similar circuit malfunctions /news/some-brain-disorders-exhibit-similar-circuit-malfunctions <span class="field field--name-title field--type-string field--label-hidden"><h1>Q&amp;A: How to jump-start new psychiatric and neurological drug development</h1> </span> <span class="field field--name-uid field--type-entity-reference field--label-hidden"> <span>By Tom Ulrich</span> </span> <span class="field field--name-created field--type-created field--label-hidden"><time datetime="2023-12-18T10:02:23-05:00" class="datetime">December 18, 2023</time> </span> <div class="hero-section container"> <div class="hero-section__row row"> <div class="hero-section__content hero-section__content_left col-6"> <div class="hero-section__breadcrumbs"> <div class="block block-system block-system-breadcrumb-block"> <nav class="breadcrumb" role="navigation" aria-labelledby="system-breadcrumb"> <h2 id="system-breadcrumb" class="visually-hidden">Breadcrumb</h2> <ol> <li> <a href="/">Home</a> </li> <li> <a href="/news">News</a> </li> </ol> </nav> </div> </div> <div class="hero-section__title"> <div class="block block-layout-builder block-field-blocknodelong-storytitle"> <span class="field field--name-title field--type-string field--label-hidden"><h1>Q&amp;A: How to jump-start new psychiatric and neurological drug development</h1> </span> </div> </div> <div class="hero-section__description"> <div class="block block-layout-builder block-field-blocknodelong-storybody"> <div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><p>Stanley Center director Steve Hyman talks about a new report he co-authored that explores the obstacles in developing new treatments and how to overcome them</p> </div> </div> </div> <div class="hero-section__author"> <div class="block block-layout-builder block-extra-field-blocknodelong-storyextra-field-author-custom"> By Tom Ulrich </div> </div> <div class="hero-section__date"> <div class="block block-layout-builder block-field-blocknodelong-storycreated"> <span class="field field--name-created field--type-created field--label-hidden"><time datetime="2023-12-18T10:02:23-05:00" title="Monday, December 18, 2023 - 10:02" class="datetime">December 18, 2023</time> </span> </div> </div> </div> <div class="hero-section__right col-6"> <div class="hero-section__image"> <div class="block block-layout-builder block-field-blocknodelong-storyfield-image"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"> <article class="media media--type-image media--view-mode-multiple-content-types-header"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <picture> <source 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</article> </div> <div class="field__item"><article about="/news/researchers-map-brain-cell-changes-alzheimers-disease" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/researchers-map-brain-cell-changes-alzheimers-disease"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=YbcVyrou 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=YbcVyrou 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=_khBWxft 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=_khBWxft 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=0DsI2w5k 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=rIgOybCw 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=rIgOybCw" width="220" height="186" alt="Fluorescence microscopy image of brain tissue from a mouse model of Alzheimer’s, showing tau tangles (red), amyloid plaques (white), RNA (green), and cell nuclei (blue)." title="Fluorescence microscopy image of brain tissue from a mouse model of Alzheimer’s, showing tau tangles (red), amyloid plaques (white), RNA (green), and cell nuclei (blue)." typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/researchers-map-brain-cell-changes-alzheimers-disease" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Researchers map brain cell changes in Alzheimer’s disease</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/first-large-genetic-study-bipolar-disorder-asian-populations-launches" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/first-large-genetic-study-bipolar-disorder-asian-populations-launches"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=fsfHMyPk 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=fsfHMyPk 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LEt4QTt5 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LEt4QTt5 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=Iudqt44B 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LzxxBlIA 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LzxxBlIA" width="220" height="186" alt="Ricardo Job-Reese, Ó³»­´«Ã½ Communications" typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/first-large-genetic-study-bipolar-disorder-asian-populations-launches" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">First large genetic study of bipolar disorder in Asian populations launches</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/brain-organoids-replicate-key-events-human-brain-development" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/brain-organoids-replicate-key-events-human-brain-development"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=lstySHBC 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=lstySHBC 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=4HlxIV8e 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=4HlxIV8e 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=T0IPiSz3 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=njI3T1Gw 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=njI3T1Gw" width="220" height="186" alt="Human brain organoids showing neurons and their dendrites (green), telencephalic (forebrain) cells (blue), and a kind of cell-cell contact called tight junctions (red)." title="Human brain organoids showing neurons and their dendrites (green), telencephalic (forebrain) cells (blue), and a kind of cell-cell contact called tight junctions (red)." typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/brain-organoids-replicate-key-events-human-brain-development" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Brain organoids replicate key events in human brain development</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/two-large-studies-reveal-genes-and-genome-regions-influence-schizophrenia-risk" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/two-large-studies-reveal-genes-and-genome-regions-influence-schizophrenia-risk"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=xZ24Xgbw 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=xZ24Xgbw 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=ktxABhYV 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=ktxABhYV 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=5mQP8D3T 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=KwBq3Kyz 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=KwBq3Kyz" width="220" height="186" alt="Zayna Sheikh, Ó³»­´«Ã½ Communications" typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/two-large-studies-reveal-genes-and-genome-regions-influence-schizophrenia-risk" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Two large studies reveal genes and genome regions that influence schizophrenia risk</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/researchers-find-first-strong-genetic-risk-factor-bipolar-disorder" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/researchers-find-first-strong-genetic-risk-factor-bipolar-disorder"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=nZYvK0EX 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=nZYvK0EX 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=81f3TsED 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=81f3TsED 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=enlVPy8e 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=pxwXJ6Rv 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=pxwXJ6Rv" width="220" height="186" alt="Susanna Hamilton, Ó³»­´«Ã½ Communications" typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/researchers-find-first-strong-genetic-risk-factor-bipolar-disorder" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Researchers find first strong genetic risk factor for bipolar disorder</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/path-promising-treatments-schizophrenia" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/path-promising-treatments-schizophrenia"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=dxUHBnI1 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=dxUHBnI1 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=iDYg5eit 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=iDYg5eit 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=JSZhwT-E 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=VYKQHFQJ 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=VYKQHFQJ" width="220" height="186" alt="Morgan Sheng, core institute member and co-director of the Stanley Center for Psychiatric Research, is studying the function of genes linked to schizophrenia." title="Morgan Sheng, core institute member and co-director of the Stanley Center for Psychiatric Research, is studying the function of genes linked to schizophrenia." typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/path-promising-treatments-schizophrenia" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">A path to promising treatments for schizophrenia</span> </a> </div> </article> </div> </div> </div> </div> </div> </div> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Psychiatric and neurological disorders are widespread, yet the pace of drug development for these conditions lags far behind that of heart disease, cancer, and other conditions. Brain disorders are difficult to study and many drug candidates have failed in clinical trials, causing pharmaceutical companies to reduce their investments or even exit the field entirely.&nbsp;</p> <p>But a new path for bringing treatments to patients is starting to emerge. In a recent review in <a href="https://www.science.org/doi/10.1126/scitranslmed.adg4775" target="_blank"><em>Science Translational Medicine</em></a>, <a href="/node/7576">Steven Hyman</a>, director of the <a href="/node/8513">Stanley Center for Psychiatric Research</a> at the Ó³»­´«Ã½ of MIT and Harvard, and colleagues in the National Academies of Science, Engineering, and Medicine (NASEM) <a href="https://www.nationalacademies.org/our-work/forum-on-neuroscience-and-nervous-system-disorders" target="_blank">Forum on Neuroscience and Nervous System Disorders</a> — which includes industry — sketched out a six-point framework for re-invigorating psychiatric and neurological drug development that addresses many of the unique challenges this field faces. They wrote that a deeper understanding of the molecular mechanisms driving these disorders will improve diagnosis, enhance patient stratification in clinical trials, and lead to better therapeutics.&nbsp;</p> <p>To achieve this, the authors called for more genetics and longitudinal data types from patients of diverse ancestries, more data- and tool-sharing across sectors, the development of quantitative biomarkers for measuring disease mechanisms, and more.</p> <p>We asked Hyman, who is also a core institute member at Ó³»­´«Ã½, to talk about the new framework and what he thinks are the biggest opportunities.&nbsp;</p> <p>The following conversation was edited for length and clarity.</p> <p><strong>Why did you and your colleagues with the NASEM Forum decide to write this report?</strong></p> <p>One of our long abiding concerns has been the pharmaceutical industry's progressive exit from R&amp;D on treatments for central nervous system disorders apart from Alzheimer's and for large companies a nearly complete exit from new research in psychiatry.&nbsp;</p> <p>We all recognize the vast, unmet medical need. We have no treatments for the disabling cognitive and deficit symptoms of schizophrenia, and no pharmacologic treatments for the core communication difficulties of autism. We do very poorly at treating the depressed phase of bipolar disorder. And we have no pharmacologic treatments for anorexia nervosa, which at approximately 20 percent has the highest long-term mortality rate in psychiatry.&nbsp;</p> <p>So the need and the markets are there. The question becomes, under what circumstances would industry rebuild the infrastructure they need to re-engage in neuroscience and psychiatric development?&nbsp;</p> <p><strong>What do you think it will take for industry to re-engage in this space?&nbsp;</strong></p> <p>The single biggest problem for psychiatric disorders is that we lack the ability to look underneath the surface phenomena such as symptoms and disease course to group or stratify patients according to disease mechanisms.&nbsp;</p> <p>To use the example of depression, there have been many large, costly clinical trials in which drugs fail to separate convincingly from placebo but ultimately prove effective for a subset of patients. The key problem is that there appear to be many different underlying mechanisms that lead to depression. The genetic risk factors are highly complex, and they intersect with environmental risk factors ranging from infections to stress that are also diverse in their nature and effects (and which deserve intensive study).&nbsp;</p> <p>Without robust biomarkers, we cannot account for this mechanistic diversity and appropriately match patients with candidate treatments in clinical trials. Lumping everyone under this umbrella diagnosis of depression ignores the heterogeneous nature of this disorder, dilutes any signal that we might see in a clinical trial, and prevents us from learning from failures.&nbsp;</p> <p>Biomarkers could take many forms. Based on recent success in Alzheimer’s disease and amyotrophic lateral sclerosis, companies are very interested in quantifiable fluid biomarkers, which for neuroscience has meant markers that can be measured initially in CSF [cerebrospinal fluid]. Studies of Alzheimer's disease are teaching us that it's possible to measure some clinically important CSF biomarkers in blood. Some may even be measurable using positron emission tomography, which has the added benefit of providing information about where in the brain a biomarker is present.&nbsp;</p> <p>For some neurologic and psychiatric disorders, perhaps including depression and obsessive-compulsive symptoms, system-level biomarkers — ones that provide functional information about whole circuits instead of individual cells or molecules — appear promising. Thus magnetic resonance imaging or EEG studies may supplement molecular studies in ways that could prove to be highly useful in, for example, stratifying individuals with schizophrenia. At the Stanley Center, we are already gaining powerful evidence for this using EEG.&nbsp;</p> <p><strong>Your review article discussed the need to study genetically diverse patient samples. Can you expand on that?</strong></p> <p>Without a strong commitment to broadening the populations and societal contexts included in research, the promise of precision medicine rings rather hollow. It is becoming quite clear that even when disease mechanisms are alike across populations, polygenic scores and other genetic tools for risk prediction and stratification perform poorly across ancestries. The same may prove true for particular biomarkers.&nbsp;</p> <p>We cannot know — and cannot claim to be making equitable contributions to global public health — without significantly expanding the diversity of the populations we study. The Stanley Center has made it a central goal to increase population diversity in neuropsychiatric genetics l while increasing our sample sizes overall.&nbsp;</p> <p>There is both scientific benefit and a health equity imperative in looking across all of humanity. I see this as a moral necessity.</p> <p><strong>How important will new animal models be?</strong></p> <p>Industry is quite skeptical, and based on long experience rightly so, when it comes to the use of model systems for studying human psychiatric disorders. However, if we are to gain the most benefit from studies of genetics and neurobiology, diverse model systems — including animal models — are critical for investigating candidate disease mechanisms.&nbsp;</p> <p>Human stem cell-derived models and human brain organoids can help address questions arising from human genetics, especially ones related to human polygenic backgrounds. However, organoids are not brains. Animal models, carefully interpreted, are absolutely critical if we are to investigate relevant neurobiology and candidate disease mechanisms in living brains&nbsp;</p> <p><strong>Where do industry and research institutes like the Stanley Center fit into your framework?</strong></p> <p>Our foremost goal at the Stanley Center is to work both "bottom-up" from genetics up and "top down" from phenotypes and systems-level neuroscience to understand disease mechanisms. It's from an understanding of mechanisms that you have the best chance of identifying meaningful biomarkers and therapeutic targets.&nbsp;</p> <p>Academic centers, and certainly the Stanley Center, ultimately want to share the biomarkers that we discover with industry to ensure that these tools are robust and reliable enough for use in clinical trials. And of course industry has a huge role in optimizing compounds and, above all, in designing and running clinical trials that exceed the financial capacities and core capabilities of academic organizations.</p> <p><strong>Do you think the roadmap you've laid out is something the players in the field will find realistic?</strong></p> <p>There's a long way to travel, but it's not a Pollyanna-ish report. Following this path and breathing new life into treatment development is going to be a multi-sector effort. To meet the vast unmet needs of people with brain disorders, we must commit ourselves to moving forward. Thanks to the amazing discoveries that have come out of genetics over the last decade or so, basic research on psychiatric disorders has finally gained its first durable insights into disease mechanisms. There are now important translational opportunities, beginning with biomarkers. Let’s pursue these opportunities effectively and energetically.&nbsp;</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--table-outro paragraph--view-mode--default"> <div class="field field--name-field-paragraph field--type-entity-reference-revisions field--label-hidden field__items"> <div class="field__item"> <div class="paragraph paragraph--type--table-outro-row paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-heading field--type-text field--label-hidden field__item"><p>Paper cited</p> </div> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Koranic D, et al. <a href="https://www.science.org/doi/10.1126/scitranslmed.adg4775" target="_blank">Shifting the trajectory of therapeutic development for neurological and psychiatric disorders</a>. <em>Science Translational Medicine</em>. Online November 1, 2023. DOI: 10.1126/scitranslmed.adg4775.</p> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> <div class="content-section container"> <div class="content-section__main"> <div class="block-node-broad-tags block block-layout-builder block-field-blocknodelong-storyfield-broad-tags"> <div class="block-node-broad-tags__row"> <div class="block-node-broad-tags__title">Tags:</div> <div class="field field--name-field-broad-tags field--type-entity-reference field--label-hidden field__items"> <div class="field__item"><a href="/broad-tags/stanley-center-psychiatric-research" hreflang="en">Stanley Center for Psychiatric Research</a></div> <div class="field__item"><a href="/broad-tags/psychiatric-disease-0" hreflang="en">Psychiatric disease</a></div> <div class="field__item"><a href="/broad-tags/psychiatric-disease" hreflang="en">Brain Health</a></div> <div class="field__item"><a href="/broad-tags/steven-hyman" hreflang="en">Steven Hyman</a></div> </div> </div> </div> </div> </div> Wed, 30 Jun 2021 15:21:19 +0000 Corie Lok 962806 at Autonomy, equity, and cultural considerations: Bioethicists discuss mental health genetics in Africa /autonomy-equity-and-cultural-considerations-bioethicists-discuss-mental-health-genetics-africa <span class="field field--name-title field--type-string field--label-hidden"><h1>Q&amp;A: How to jump-start new psychiatric and neurological drug development</h1> </span> <span class="field field--name-uid field--type-entity-reference field--label-hidden"> <span>By Tom Ulrich</span> </span> <span class="field field--name-created field--type-created field--label-hidden"><time datetime="2023-12-18T10:02:23-05:00" class="datetime">December 18, 2023</time> </span> <div class="hero-section container"> <div class="hero-section__row row"> <div class="hero-section__content hero-section__content_left col-6"> <div class="hero-section__breadcrumbs"> <div class="block block-system block-system-breadcrumb-block"> <nav class="breadcrumb" role="navigation" aria-labelledby="system-breadcrumb"> <h2 id="system-breadcrumb" class="visually-hidden">Breadcrumb</h2> <ol> <li> <a href="/">Home</a> </li> <li> <a href="/news">News</a> </li> </ol> </nav> </div> </div> <div class="hero-section__title"> <div class="block block-layout-builder block-field-blocknodelong-storytitle"> <span class="field field--name-title field--type-string field--label-hidden"><h1>Q&amp;A: How to jump-start new psychiatric and neurological drug development</h1> </span> </div> </div> <div class="hero-section__description"> <div class="block block-layout-builder block-field-blocknodelong-storybody"> <div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><p>Stanley Center director Steve Hyman talks about a new report he co-authored that explores the obstacles in developing new treatments and how to overcome them</p> </div> </div> </div> <div class="hero-section__author"> <div class="block block-layout-builder block-extra-field-blocknodelong-storyextra-field-author-custom"> By Tom Ulrich </div> </div> <div class="hero-section__date"> <div class="block block-layout-builder block-field-blocknodelong-storycreated"> <span class="field field--name-created field--type-created field--label-hidden"><time datetime="2023-12-18T10:02:23-05:00" title="Monday, December 18, 2023 - 10:02" class="datetime">December 18, 2023</time> </span> </div> </div> </div> <div class="hero-section__right col-6"> <div class="hero-section__image"> <div class="block block-layout-builder block-field-blocknodelong-storyfield-image"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"> <article class="media media--type-image media--view-mode-multiple-content-types-header"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <picture> <source 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media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/longstory/Editorial%20Illustration%20-%20Synapse%20%281%29.png?h=5e7a6b0b&amp;itok=f8ScPVg7" width="220" height="186" alt="Protein changes at brain cell synapses from patients with schizophrenia were strikingly similar to those from patients with bipolar disorder." title="Protein changes at brain cell synapses from patients with schizophrenia were strikingly similar to those from patients with bipolar disorder." typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/survey-brain-cell-junctions-shows-striking-similarities-between-schizophrenia-and-bipolar" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Survey of brain cell junctions shows striking similarities between schizophrenia and bipolar disorder</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/researchers-map-brain-cell-changes-alzheimers-disease" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/researchers-map-brain-cell-changes-alzheimers-disease"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=YbcVyrou 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=YbcVyrou 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=_khBWxft 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=_khBWxft 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=0DsI2w5k 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=rIgOybCw 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=rIgOybCw" width="220" height="186" alt="Fluorescence microscopy image of brain tissue from a mouse model of Alzheimer’s, showing tau tangles (red), amyloid plaques (white), RNA (green), and cell nuclei (blue)." title="Fluorescence microscopy image of brain tissue from a mouse model of Alzheimer’s, showing tau tangles (red), amyloid plaques (white), RNA (green), and cell nuclei (blue)." typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/researchers-map-brain-cell-changes-alzheimers-disease" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Researchers map brain cell changes in Alzheimer’s disease</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/first-large-genetic-study-bipolar-disorder-asian-populations-launches" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/first-large-genetic-study-bipolar-disorder-asian-populations-launches"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=fsfHMyPk 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=fsfHMyPk 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LEt4QTt5 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LEt4QTt5 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=Iudqt44B 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LzxxBlIA 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LzxxBlIA" width="220" height="186" alt="Ricardo Job-Reese, Ó³»­´«Ã½ Communications" typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/first-large-genetic-study-bipolar-disorder-asian-populations-launches" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">First large genetic study of bipolar disorder in Asian populations launches</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/brain-organoids-replicate-key-events-human-brain-development" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/brain-organoids-replicate-key-events-human-brain-development"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=lstySHBC 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=lstySHBC 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=4HlxIV8e 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=4HlxIV8e 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=T0IPiSz3 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=njI3T1Gw 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=njI3T1Gw" width="220" height="186" alt="Human brain organoids showing neurons and their dendrites (green), telencephalic (forebrain) cells (blue), and a kind of cell-cell contact called tight junctions (red)." title="Human brain organoids showing neurons and their dendrites (green), telencephalic (forebrain) cells (blue), and a kind of cell-cell contact called tight junctions (red)." typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/brain-organoids-replicate-key-events-human-brain-development" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Brain organoids replicate key events in human brain development</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/two-large-studies-reveal-genes-and-genome-regions-influence-schizophrenia-risk" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/two-large-studies-reveal-genes-and-genome-regions-influence-schizophrenia-risk"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=xZ24Xgbw 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=xZ24Xgbw 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=ktxABhYV 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=ktxABhYV 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=5mQP8D3T 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=KwBq3Kyz 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=KwBq3Kyz" width="220" height="186" alt="Zayna Sheikh, Ó³»­´«Ã½ Communications" typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/two-large-studies-reveal-genes-and-genome-regions-influence-schizophrenia-risk" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Two large studies reveal genes and genome regions that influence schizophrenia risk</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/researchers-find-first-strong-genetic-risk-factor-bipolar-disorder" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/researchers-find-first-strong-genetic-risk-factor-bipolar-disorder"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=nZYvK0EX 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=nZYvK0EX 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=81f3TsED 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=81f3TsED 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=enlVPy8e 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=pxwXJ6Rv 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=pxwXJ6Rv" width="220" height="186" alt="Susanna Hamilton, Ó³»­´«Ã½ Communications" typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/researchers-find-first-strong-genetic-risk-factor-bipolar-disorder" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Researchers find first strong genetic risk factor for bipolar disorder</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/path-promising-treatments-schizophrenia" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/path-promising-treatments-schizophrenia"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=dxUHBnI1 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=dxUHBnI1 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=iDYg5eit 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=iDYg5eit 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=JSZhwT-E 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=VYKQHFQJ 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=VYKQHFQJ" width="220" height="186" alt="Morgan Sheng, core institute member and co-director of the Stanley Center for Psychiatric Research, is studying the function of genes linked to schizophrenia." title="Morgan Sheng, core institute member and co-director of the Stanley Center for Psychiatric Research, is studying the function of genes linked to schizophrenia." typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/path-promising-treatments-schizophrenia" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">A path to promising treatments for schizophrenia</span> </a> </div> </article> </div> </div> </div> </div> </div> </div> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Psychiatric and neurological disorders are widespread, yet the pace of drug development for these conditions lags far behind that of heart disease, cancer, and other conditions. Brain disorders are difficult to study and many drug candidates have failed in clinical trials, causing pharmaceutical companies to reduce their investments or even exit the field entirely.&nbsp;</p> <p>But a new path for bringing treatments to patients is starting to emerge. In a recent review in <a href="https://www.science.org/doi/10.1126/scitranslmed.adg4775" target="_blank"><em>Science Translational Medicine</em></a>, <a href="/node/7576">Steven Hyman</a>, director of the <a href="/node/8513">Stanley Center for Psychiatric Research</a> at the Ó³»­´«Ã½ of MIT and Harvard, and colleagues in the National Academies of Science, Engineering, and Medicine (NASEM) <a href="https://www.nationalacademies.org/our-work/forum-on-neuroscience-and-nervous-system-disorders" target="_blank">Forum on Neuroscience and Nervous System Disorders</a> — which includes industry — sketched out a six-point framework for re-invigorating psychiatric and neurological drug development that addresses many of the unique challenges this field faces. They wrote that a deeper understanding of the molecular mechanisms driving these disorders will improve diagnosis, enhance patient stratification in clinical trials, and lead to better therapeutics.&nbsp;</p> <p>To achieve this, the authors called for more genetics and longitudinal data types from patients of diverse ancestries, more data- and tool-sharing across sectors, the development of quantitative biomarkers for measuring disease mechanisms, and more.</p> <p>We asked Hyman, who is also a core institute member at Ó³»­´«Ã½, to talk about the new framework and what he thinks are the biggest opportunities.&nbsp;</p> <p>The following conversation was edited for length and clarity.</p> <p><strong>Why did you and your colleagues with the NASEM Forum decide to write this report?</strong></p> <p>One of our long abiding concerns has been the pharmaceutical industry's progressive exit from R&amp;D on treatments for central nervous system disorders apart from Alzheimer's and for large companies a nearly complete exit from new research in psychiatry.&nbsp;</p> <p>We all recognize the vast, unmet medical need. We have no treatments for the disabling cognitive and deficit symptoms of schizophrenia, and no pharmacologic treatments for the core communication difficulties of autism. We do very poorly at treating the depressed phase of bipolar disorder. And we have no pharmacologic treatments for anorexia nervosa, which at approximately 20 percent has the highest long-term mortality rate in psychiatry.&nbsp;</p> <p>So the need and the markets are there. The question becomes, under what circumstances would industry rebuild the infrastructure they need to re-engage in neuroscience and psychiatric development?&nbsp;</p> <p><strong>What do you think it will take for industry to re-engage in this space?&nbsp;</strong></p> <p>The single biggest problem for psychiatric disorders is that we lack the ability to look underneath the surface phenomena such as symptoms and disease course to group or stratify patients according to disease mechanisms.&nbsp;</p> <p>To use the example of depression, there have been many large, costly clinical trials in which drugs fail to separate convincingly from placebo but ultimately prove effective for a subset of patients. The key problem is that there appear to be many different underlying mechanisms that lead to depression. The genetic risk factors are highly complex, and they intersect with environmental risk factors ranging from infections to stress that are also diverse in their nature and effects (and which deserve intensive study).&nbsp;</p> <p>Without robust biomarkers, we cannot account for this mechanistic diversity and appropriately match patients with candidate treatments in clinical trials. Lumping everyone under this umbrella diagnosis of depression ignores the heterogeneous nature of this disorder, dilutes any signal that we might see in a clinical trial, and prevents us from learning from failures.&nbsp;</p> <p>Biomarkers could take many forms. Based on recent success in Alzheimer’s disease and amyotrophic lateral sclerosis, companies are very interested in quantifiable fluid biomarkers, which for neuroscience has meant markers that can be measured initially in CSF [cerebrospinal fluid]. Studies of Alzheimer's disease are teaching us that it's possible to measure some clinically important CSF biomarkers in blood. Some may even be measurable using positron emission tomography, which has the added benefit of providing information about where in the brain a biomarker is present.&nbsp;</p> <p>For some neurologic and psychiatric disorders, perhaps including depression and obsessive-compulsive symptoms, system-level biomarkers — ones that provide functional information about whole circuits instead of individual cells or molecules — appear promising. Thus magnetic resonance imaging or EEG studies may supplement molecular studies in ways that could prove to be highly useful in, for example, stratifying individuals with schizophrenia. At the Stanley Center, we are already gaining powerful evidence for this using EEG.&nbsp;</p> <p><strong>Your review article discussed the need to study genetically diverse patient samples. Can you expand on that?</strong></p> <p>Without a strong commitment to broadening the populations and societal contexts included in research, the promise of precision medicine rings rather hollow. It is becoming quite clear that even when disease mechanisms are alike across populations, polygenic scores and other genetic tools for risk prediction and stratification perform poorly across ancestries. The same may prove true for particular biomarkers.&nbsp;</p> <p>We cannot know — and cannot claim to be making equitable contributions to global public health — without significantly expanding the diversity of the populations we study. The Stanley Center has made it a central goal to increase population diversity in neuropsychiatric genetics l while increasing our sample sizes overall.&nbsp;</p> <p>There is both scientific benefit and a health equity imperative in looking across all of humanity. I see this as a moral necessity.</p> <p><strong>How important will new animal models be?</strong></p> <p>Industry is quite skeptical, and based on long experience rightly so, when it comes to the use of model systems for studying human psychiatric disorders. However, if we are to gain the most benefit from studies of genetics and neurobiology, diverse model systems — including animal models — are critical for investigating candidate disease mechanisms.&nbsp;</p> <p>Human stem cell-derived models and human brain organoids can help address questions arising from human genetics, especially ones related to human polygenic backgrounds. However, organoids are not brains. Animal models, carefully interpreted, are absolutely critical if we are to investigate relevant neurobiology and candidate disease mechanisms in living brains&nbsp;</p> <p><strong>Where do industry and research institutes like the Stanley Center fit into your framework?</strong></p> <p>Our foremost goal at the Stanley Center is to work both "bottom-up" from genetics up and "top down" from phenotypes and systems-level neuroscience to understand disease mechanisms. It's from an understanding of mechanisms that you have the best chance of identifying meaningful biomarkers and therapeutic targets.&nbsp;</p> <p>Academic centers, and certainly the Stanley Center, ultimately want to share the biomarkers that we discover with industry to ensure that these tools are robust and reliable enough for use in clinical trials. And of course industry has a huge role in optimizing compounds and, above all, in designing and running clinical trials that exceed the financial capacities and core capabilities of academic organizations.</p> <p><strong>Do you think the roadmap you've laid out is something the players in the field will find realistic?</strong></p> <p>There's a long way to travel, but it's not a Pollyanna-ish report. Following this path and breathing new life into treatment development is going to be a multi-sector effort. To meet the vast unmet needs of people with brain disorders, we must commit ourselves to moving forward. Thanks to the amazing discoveries that have come out of genetics over the last decade or so, basic research on psychiatric disorders has finally gained its first durable insights into disease mechanisms. There are now important translational opportunities, beginning with biomarkers. Let’s pursue these opportunities effectively and energetically.&nbsp;</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--table-outro paragraph--view-mode--default"> <div class="field field--name-field-paragraph field--type-entity-reference-revisions field--label-hidden field__items"> <div class="field__item"> <div class="paragraph paragraph--type--table-outro-row paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-heading field--type-text field--label-hidden field__item"><p>Paper cited</p> </div> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Koranic D, et al. <a href="https://www.science.org/doi/10.1126/scitranslmed.adg4775" target="_blank">Shifting the trajectory of therapeutic development for neurological and psychiatric disorders</a>. <em>Science Translational Medicine</em>. Online November 1, 2023. DOI: 10.1126/scitranslmed.adg4775.</p> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> <div class="content-section container"> <div class="content-section__main"> <div class="block-node-broad-tags block block-layout-builder block-field-blocknodelong-storyfield-broad-tags"> <div class="block-node-broad-tags__row"> <div class="block-node-broad-tags__title">Tags:</div> <div class="field field--name-field-broad-tags field--type-entity-reference field--label-hidden field__items"> <div class="field__item"><a href="/broad-tags/stanley-center-psychiatric-research" hreflang="en">Stanley Center for Psychiatric Research</a></div> <div class="field__item"><a href="/broad-tags/psychiatric-disease-0" hreflang="en">Psychiatric disease</a></div> <div class="field__item"><a href="/broad-tags/psychiatric-disease" hreflang="en">Brain Health</a></div> <div class="field__item"><a href="/broad-tags/steven-hyman" hreflang="en">Steven Hyman</a></div> </div> </div> </div> </div> </div> Thu, 08 Oct 2020 04:00:00 +0000 tulrich@broadinstitute.org 661246 at Meet members of the next generation of psychiatric genetics researchers in Kenya and Uganda /meet-members-next-generation-psychiatric-genetics-researchers-kenya-and-uganda <span class="field field--name-title field--type-string field--label-hidden"><h1>Q&amp;A: How to jump-start new psychiatric and neurological drug development</h1> </span> <span class="field field--name-uid field--type-entity-reference field--label-hidden"> <span>By Tom Ulrich</span> </span> <span class="field field--name-created field--type-created field--label-hidden"><time datetime="2023-12-18T10:02:23-05:00" class="datetime">December 18, 2023</time> </span> <div class="hero-section container"> <div class="hero-section__row row"> <div class="hero-section__content hero-section__content_left col-6"> <div class="hero-section__breadcrumbs"> <div class="block block-system block-system-breadcrumb-block"> <nav class="breadcrumb" role="navigation" aria-labelledby="system-breadcrumb"> <h2 id="system-breadcrumb" class="visually-hidden">Breadcrumb</h2> <ol> <li> <a href="/">Home</a> </li> <li> <a href="/news">News</a> </li> </ol> </nav> </div> </div> <div class="hero-section__title"> <div class="block block-layout-builder block-field-blocknodelong-storytitle"> <span class="field field--name-title field--type-string field--label-hidden"><h1>Q&amp;A: How to jump-start new psychiatric and neurological drug development</h1> </span> </div> </div> <div class="hero-section__description"> <div class="block block-layout-builder block-field-blocknodelong-storybody"> <div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><p>Stanley Center director Steve Hyman talks about a new report he co-authored that explores the obstacles in developing new treatments and how to overcome them</p> </div> </div> </div> <div class="hero-section__author"> <div class="block block-layout-builder block-extra-field-blocknodelong-storyextra-field-author-custom"> By Tom Ulrich </div> </div> <div class="hero-section__date"> <div class="block block-layout-builder block-field-blocknodelong-storycreated"> <span class="field field--name-created field--type-created field--label-hidden"><time datetime="2023-12-18T10:02:23-05:00" title="Monday, December 18, 2023 - 10:02" class="datetime">December 18, 2023</time> </span> </div> </div> </div> <div class="hero-section__right col-6"> <div class="hero-section__image"> <div class="block block-layout-builder block-field-blocknodelong-storyfield-image"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"> <article class="media media--type-image media--view-mode-multiple-content-types-header"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <picture> <source srcset="/files/styles/multiple_ct_header_desktop_xl/public/SEH%20SC%20II.jpg?itok=AnKU0Ryn 1x" media="all and (min-width: 1921px)" type="image/jpeg" width="754" height="503"> <source srcset="/files/styles/multiple_ct_header_desktop_xl/public/SEH%20SC%20II.jpg?itok=AnKU0Ryn 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/jpeg" width="754" height="503"> <source srcset="/files/styles/multiple_ct_header_desktop/public/SEH%20SC%20II.jpg?itok=Lo__sQt6 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/jpeg" width="736" height="520"> <source srcset="/files/styles/multiple_ct_header_laptop/public/SEH%20SC%20II.jpg?itok=L1JFI3U9 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/jpeg" width="641" height="451"> <source srcset="/files/styles/multiple_ct_header_tablet/public/SEH%20SC%20II.jpg?itok=gKnc95f8 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/jpeg" width="706" height="417"> <source 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media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/longstory/Editorial%20Illustration%20-%20Synapse%20%281%29.png?h=5e7a6b0b&amp;itok=f8ScPVg7" width="220" height="186" alt="Protein changes at brain cell synapses from patients with schizophrenia were strikingly similar to those from patients with bipolar disorder." title="Protein changes at brain cell synapses from patients with schizophrenia were strikingly similar to those from patients with bipolar disorder." typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/survey-brain-cell-junctions-shows-striking-similarities-between-schizophrenia-and-bipolar" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Survey of brain cell junctions shows striking similarities between schizophrenia and bipolar disorder</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/researchers-map-brain-cell-changes-alzheimers-disease" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/researchers-map-brain-cell-changes-alzheimers-disease"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=YbcVyrou 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=YbcVyrou 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=_khBWxft 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=_khBWxft 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=0DsI2w5k 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=rIgOybCw 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/longstory/main_mAD-Figure-1_20221206-01.png?h=93c99ee8&amp;itok=rIgOybCw" width="220" height="186" alt="Fluorescence microscopy image of brain tissue from a mouse model of Alzheimer’s, showing tau tangles (red), amyloid plaques (white), RNA (green), and cell nuclei (blue)." title="Fluorescence microscopy image of brain tissue from a mouse model of Alzheimer’s, showing tau tangles (red), amyloid plaques (white), RNA (green), and cell nuclei (blue)." typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/researchers-map-brain-cell-changes-alzheimers-disease" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Researchers map brain cell changes in Alzheimer’s disease</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/first-large-genetic-study-bipolar-disorder-asian-populations-launches" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/first-large-genetic-study-bipolar-disorder-asian-populations-launches"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=fsfHMyPk 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=fsfHMyPk 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LEt4QTt5 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LEt4QTt5 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=Iudqt44B 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LzxxBlIA 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/1022%20Bipolar%20Disorder%20Study_Main_557x415_02%20%282%29.png?h=9423a5c0&amp;itok=LzxxBlIA" width="220" height="186" alt="Ricardo Job-Reese, Ó³»­´«Ã½ Communications" typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/first-large-genetic-study-bipolar-disorder-asian-populations-launches" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">First large genetic study of bipolar disorder in Asian populations launches</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/brain-organoids-replicate-key-events-human-brain-development" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/brain-organoids-replicate-key-events-human-brain-development"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=lstySHBC 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=lstySHBC 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=4HlxIV8e 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=4HlxIV8e 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=T0IPiSz3 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=njI3T1Gw 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/edited_CNTMix_PGP1_MAP2-488_Foxg1-647_ZO1-546_merge5_flat.png?itok=njI3T1Gw" width="220" height="186" alt="Human brain organoids showing neurons and their dendrites (green), telencephalic (forebrain) cells (blue), and a kind of cell-cell contact called tight junctions (red)." title="Human brain organoids showing neurons and their dendrites (green), telencephalic (forebrain) cells (blue), and a kind of cell-cell contact called tight junctions (red)." typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/brain-organoids-replicate-key-events-human-brain-development" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Brain organoids replicate key events in human brain development</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/two-large-studies-reveal-genes-and-genome-regions-influence-schizophrenia-risk" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/two-large-studies-reveal-genes-and-genome-regions-influence-schizophrenia-risk"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=xZ24Xgbw 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=xZ24Xgbw 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=ktxABhYV 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=ktxABhYV 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=5mQP8D3T 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=KwBq3Kyz 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Singh_Daly_Neale-Graphic.png?h=d3e04ee7&amp;itok=KwBq3Kyz" width="220" height="186" alt="Zayna Sheikh, Ó³»­´«Ã½ Communications" typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/two-large-studies-reveal-genes-and-genome-regions-influence-schizophrenia-risk" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Two large studies reveal genes and genome regions that influence schizophrenia risk</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/researchers-find-first-strong-genetic-risk-factor-bipolar-disorder" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/researchers-find-first-strong-genetic-risk-factor-bipolar-disorder"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=nZYvK0EX 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=nZYvK0EX 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=81f3TsED 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=81f3TsED 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=enlVPy8e 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=pxwXJ6Rv 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/Bipolar_story.png?h=d3e04ee7&amp;itok=pxwXJ6Rv" width="220" height="186" alt="Susanna Hamilton, Ó³»­´«Ã½ Communications" typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/researchers-find-first-strong-genetic-risk-factor-bipolar-disorder" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">Researchers find first strong genetic risk factor for bipolar disorder</span> </a> </div> </article> </div> <div class="field__item"><article about="/news/path-promising-treatments-schizophrenia" class="node"> <div class="field field--name-field-image field--type-entity-reference field--label-hidden field__item"><article class="media media--type-image media--view-mode-multiple-ct-sidebar-link-with-image"> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/news/path-promising-treatments-schizophrenia"><picture> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=dxUHBnI1 1x" media="all and (min-width: 1921px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop_xl/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=dxUHBnI1 1x" media="all and (min-width: 1601px) and (max-width: 1920px)" type="image/png" width="104" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=iDYg5eit 1x" media="all and (min-width: 1340px) and (max-width: 1600px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_desktop/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=iDYg5eit 1x" media="all and (min-width: 800px) and (max-width: 1339px)" type="image/png" width="87" height="104"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_tablet/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=JSZhwT-E 1x" media="all and (min-width: 540px) and (max-width: 799px)" type="image/png" width="285" height="186"> <source srcset="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=VYKQHFQJ 1x" media="all and (max-width: 539px)" type="image/png" width="220" height="186"> <img loading="eager" src="/files/styles/multiple_ct_sidebar_link_with_image_phone/public/news/images/2022/MS_internet_main.png?h=d3e04ee7&amp;itok=VYKQHFQJ" width="220" height="186" alt="Morgan Sheng, core institute member and co-director of the Stanley Center for Psychiatric Research, is studying the function of genes linked to schizophrenia." title="Morgan Sheng, core institute member and co-director of the Stanley Center for Psychiatric Research, is studying the function of genes linked to schizophrenia." typeof="foaf:Image"> </picture></a> </div> </article> </div> <div class="node__content"> <a href="/news/path-promising-treatments-schizophrenia" class="node__title"><span class="field field--name-title field--type-string field--label-hidden">A path to promising treatments for schizophrenia</span> </a> </div> </article> </div> </div> </div> </div> </div> </div> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Psychiatric and neurological disorders are widespread, yet the pace of drug development for these conditions lags far behind that of heart disease, cancer, and other conditions. Brain disorders are difficult to study and many drug candidates have failed in clinical trials, causing pharmaceutical companies to reduce their investments or even exit the field entirely.&nbsp;</p> <p>But a new path for bringing treatments to patients is starting to emerge. In a recent review in <a href="https://www.science.org/doi/10.1126/scitranslmed.adg4775" target="_blank"><em>Science Translational Medicine</em></a>, <a href="/node/7576">Steven Hyman</a>, director of the <a href="/node/8513">Stanley Center for Psychiatric Research</a> at the Ó³»­´«Ã½ of MIT and Harvard, and colleagues in the National Academies of Science, Engineering, and Medicine (NASEM) <a href="https://www.nationalacademies.org/our-work/forum-on-neuroscience-and-nervous-system-disorders" target="_blank">Forum on Neuroscience and Nervous System Disorders</a> — which includes industry — sketched out a six-point framework for re-invigorating psychiatric and neurological drug development that addresses many of the unique challenges this field faces. They wrote that a deeper understanding of the molecular mechanisms driving these disorders will improve diagnosis, enhance patient stratification in clinical trials, and lead to better therapeutics.&nbsp;</p> <p>To achieve this, the authors called for more genetics and longitudinal data types from patients of diverse ancestries, more data- and tool-sharing across sectors, the development of quantitative biomarkers for measuring disease mechanisms, and more.</p> <p>We asked Hyman, who is also a core institute member at Ó³»­´«Ã½, to talk about the new framework and what he thinks are the biggest opportunities.&nbsp;</p> <p>The following conversation was edited for length and clarity.</p> <p><strong>Why did you and your colleagues with the NASEM Forum decide to write this report?</strong></p> <p>One of our long abiding concerns has been the pharmaceutical industry's progressive exit from R&amp;D on treatments for central nervous system disorders apart from Alzheimer's and for large companies a nearly complete exit from new research in psychiatry.&nbsp;</p> <p>We all recognize the vast, unmet medical need. We have no treatments for the disabling cognitive and deficit symptoms of schizophrenia, and no pharmacologic treatments for the core communication difficulties of autism. We do very poorly at treating the depressed phase of bipolar disorder. And we have no pharmacologic treatments for anorexia nervosa, which at approximately 20 percent has the highest long-term mortality rate in psychiatry.&nbsp;</p> <p>So the need and the markets are there. The question becomes, under what circumstances would industry rebuild the infrastructure they need to re-engage in neuroscience and psychiatric development?&nbsp;</p> <p><strong>What do you think it will take for industry to re-engage in this space?&nbsp;</strong></p> <p>The single biggest problem for psychiatric disorders is that we lack the ability to look underneath the surface phenomena such as symptoms and disease course to group or stratify patients according to disease mechanisms.&nbsp;</p> <p>To use the example of depression, there have been many large, costly clinical trials in which drugs fail to separate convincingly from placebo but ultimately prove effective for a subset of patients. The key problem is that there appear to be many different underlying mechanisms that lead to depression. The genetic risk factors are highly complex, and they intersect with environmental risk factors ranging from infections to stress that are also diverse in their nature and effects (and which deserve intensive study).&nbsp;</p> <p>Without robust biomarkers, we cannot account for this mechanistic diversity and appropriately match patients with candidate treatments in clinical trials. Lumping everyone under this umbrella diagnosis of depression ignores the heterogeneous nature of this disorder, dilutes any signal that we might see in a clinical trial, and prevents us from learning from failures.&nbsp;</p> <p>Biomarkers could take many forms. Based on recent success in Alzheimer’s disease and amyotrophic lateral sclerosis, companies are very interested in quantifiable fluid biomarkers, which for neuroscience has meant markers that can be measured initially in CSF [cerebrospinal fluid]. Studies of Alzheimer's disease are teaching us that it's possible to measure some clinically important CSF biomarkers in blood. Some may even be measurable using positron emission tomography, which has the added benefit of providing information about where in the brain a biomarker is present.&nbsp;</p> <p>For some neurologic and psychiatric disorders, perhaps including depression and obsessive-compulsive symptoms, system-level biomarkers — ones that provide functional information about whole circuits instead of individual cells or molecules — appear promising. Thus magnetic resonance imaging or EEG studies may supplement molecular studies in ways that could prove to be highly useful in, for example, stratifying individuals with schizophrenia. At the Stanley Center, we are already gaining powerful evidence for this using EEG.&nbsp;</p> <p><strong>Your review article discussed the need to study genetically diverse patient samples. Can you expand on that?</strong></p> <p>Without a strong commitment to broadening the populations and societal contexts included in research, the promise of precision medicine rings rather hollow. It is becoming quite clear that even when disease mechanisms are alike across populations, polygenic scores and other genetic tools for risk prediction and stratification perform poorly across ancestries. The same may prove true for particular biomarkers.&nbsp;</p> <p>We cannot know — and cannot claim to be making equitable contributions to global public health — without significantly expanding the diversity of the populations we study. The Stanley Center has made it a central goal to increase population diversity in neuropsychiatric genetics l while increasing our sample sizes overall.&nbsp;</p> <p>There is both scientific benefit and a health equity imperative in looking across all of humanity. I see this as a moral necessity.</p> <p><strong>How important will new animal models be?</strong></p> <p>Industry is quite skeptical, and based on long experience rightly so, when it comes to the use of model systems for studying human psychiatric disorders. However, if we are to gain the most benefit from studies of genetics and neurobiology, diverse model systems — including animal models — are critical for investigating candidate disease mechanisms.&nbsp;</p> <p>Human stem cell-derived models and human brain organoids can help address questions arising from human genetics, especially ones related to human polygenic backgrounds. However, organoids are not brains. Animal models, carefully interpreted, are absolutely critical if we are to investigate relevant neurobiology and candidate disease mechanisms in living brains&nbsp;</p> <p><strong>Where do industry and research institutes like the Stanley Center fit into your framework?</strong></p> <p>Our foremost goal at the Stanley Center is to work both "bottom-up" from genetics up and "top down" from phenotypes and systems-level neuroscience to understand disease mechanisms. It's from an understanding of mechanisms that you have the best chance of identifying meaningful biomarkers and therapeutic targets.&nbsp;</p> <p>Academic centers, and certainly the Stanley Center, ultimately want to share the biomarkers that we discover with industry to ensure that these tools are robust and reliable enough for use in clinical trials. And of course industry has a huge role in optimizing compounds and, above all, in designing and running clinical trials that exceed the financial capacities and core capabilities of academic organizations.</p> <p><strong>Do you think the roadmap you've laid out is something the players in the field will find realistic?</strong></p> <p>There's a long way to travel, but it's not a Pollyanna-ish report. Following this path and breathing new life into treatment development is going to be a multi-sector effort. To meet the vast unmet needs of people with brain disorders, we must commit ourselves to moving forward. Thanks to the amazing discoveries that have come out of genetics over the last decade or so, basic research on psychiatric disorders has finally gained its first durable insights into disease mechanisms. There are now important translational opportunities, beginning with biomarkers. Let’s pursue these opportunities effectively and energetically.&nbsp;</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--table-outro paragraph--view-mode--default"> <div class="field field--name-field-paragraph field--type-entity-reference-revisions field--label-hidden field__items"> <div class="field__item"> <div class="paragraph paragraph--type--table-outro-row paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-heading field--type-text field--label-hidden field__item"><p>Paper cited</p> </div> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Koranic D, et al. <a href="https://www.science.org/doi/10.1126/scitranslmed.adg4775" target="_blank">Shifting the trajectory of therapeutic development for neurological and psychiatric disorders</a>. <em>Science Translational Medicine</em>. Online November 1, 2023. DOI: 10.1126/scitranslmed.adg4775.</p> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> <div class="content-section container"> <div class="content-section__main"> <div class="block-node-broad-tags block block-layout-builder block-field-blocknodelong-storyfield-broad-tags"> <div class="block-node-broad-tags__row"> <div class="block-node-broad-tags__title">Tags:</div> <div class="field field--name-field-broad-tags field--type-entity-reference field--label-hidden field__items"> <div class="field__item"><a href="/broad-tags/stanley-center-psychiatric-research" hreflang="en">Stanley Center for Psychiatric Research</a></div> <div class="field__item"><a href="/broad-tags/psychiatric-disease-0" hreflang="en">Psychiatric disease</a></div> <div class="field__item"><a href="/broad-tags/psychiatric-disease" hreflang="en">Brain Health</a></div> <div class="field__item"><a href="/broad-tags/steven-hyman" hreflang="en">Steven Hyman</a></div> </div> </div> </div> </div> </div> Thu, 08 Oct 2020 04:00:00 +0000 Corie Lok 660721 at