A high-tech company that specializes in genetic testing wants to help figure out some of the causes of those two potentially debilitating conditions.
It will be one of the first studies to harness the power of crowdsourcing via the internet.
The research team aims to enroll 25,000 people between the ages of 18 and 50 who live in the United States.
The study will include 15,000 people diagnosed by a physician with major depressive disorder, and 10,000 people diagnosed with bipolar disorder.
All the study participants must have had medication prescribed for their condition.
Each enrollee must also have access to a desktop or laptop computer with internet access.
“The goal of our study,” Anna Faaborg, manager of research communities for 23andMe, told Healthline, “is to contribute to our understanding of these conditions and ultimately impact the lives of people living with depression and bipolar in a positive way.”
The advantages of crowdsourcing
This study is unique in its sheer size.
Hosting a study involving 25,000 online participants won’t be easy, but Faaborg said 23andMe can handle it.
“We’re unique in the position to do that with our use of a crowdsource platform where people can contribute from the comfort of their own home,” Faaborg said.
Each month the participants will be emailed study sessions consisting of online cognitive tests and various surveys. This data-gathering portion will take nine months.
In addition, 23andMe will send each subject a DNA saliva collection kit. Subjects will then return their samples for processing.
Faaborg said that once all the data is collected, their scientists will analyze it in collaboration with Lundbeck and other scientific advisors.
The analysis phase should take at least another six months.
How data will be analyzed
Those registered in the study “are consenting to share their individual level data,” said Faaborg. “So there’s the opportunity for Lundbeck to continue their research. There’s so much data, and we want as much good to come out of it as we can.”
Faaborg said, “Of course, they’re [Lundbeck] in the position to develop the therapeutics that will impact people well beyond the study. They will continue to analyze the data with a focus on depression and bipolar.”
Among other things, researchers will try to determine gene influence on brain function.
“We’re looking for patterns,” said Faaborg. “We’ll have 25,000 people taking these cognitive tasks and in those tasks we’re measuring very specific brain processes. [For example] reaction time, processing speed, their risk taking behaviors.”
“In the end,” she continued, “we’re going to see people who perform differently on those tasks. Some are very risk averse. Others take a little more risk on these tasks. Some have a quick reaction time. Others don’t.”
Faaborg suggested some questions that researchers might ask.
For example, “Of people who perform differently on this task, what’s the history of their condition? Are they currently in a depressive episode, or in a manic episode? What medications are they on?”
“Then,” she continued, “we’ll start grouping people into these smaller cohorts and we start thinking, ‘What's the difference in the genetics of these people?’”
This questioning, analyzing, grouping of data will continue in the hope that it will eventually provide answers to the researchers’ questions.
“We can start doing these combinations of looking at people in different ways and looking back to genetics. And that’s what we’re really excited about,” said Faaborg.
The end game
Healthline discussed possible outcomes of the 23andMe study with James Giordano, PhD, a professor of neurology and biochemistry, and chief of neuroethics at Georgetown University Medical Center.
Giordano expressed some concern not about the study itself but about how, without clinicians to guide them, individuals might misinterpret the results.
He noted the difficulty of psychiatric genetics because genes, “tend to code for the disposition to the disorder, but not the disorder itself,” he explained.
“What genes really do,” said Giordano, “is they set up the blueprint, and like any other blueprint, the blueprint is just a potential plan.”
What this means is that there is no certainty that someone has a particular disorder simply because they exhibit a certain gene or group of genes. It only means that there exists the potential for them to develop the disorder.
“So showing a particular gene, or the presence of a particular gene, as they look to do in 23andMe, is important,” said Giordano, “because what it may do is allow some insight into what genes are present, and perhaps active, in that individual.”
“But then,” continued Giordano, “you have to put it into the bigger picture.”
Slippery when wet
Giordano gave Healthline an analogy to suggest a beneficial way that individuals can view their genetic test results.
“It’s sort of like the sign on the side of the road that says ‘Slippery When Wet.’ You know there’s a curve, and you know that if it’s wet, and your car doesn’t do well on a wet road, you might want to slow down and be careful.”
He suggested that this approach could help people who have certain genes and who exhibit certain patterns of behavior become more aware of risk factors when faced with various situations.
These people might want to consider modifying their lifestyles, Giordano said.
“They might want to decrease their stressors, they may want to be a little more attentive to certain early symptoms and signs, and they may want to seek clinical intervention early on,” he said.
“So again, think of the wet road,” continued Giordano. “If I start to slip, I’m going to start to slow down or I’m going to begin to steer into the turn.”
Giordano mentioned that the larger goal of genetic research is to use big data to be able to predict the actual probability of somebody developing a particular disorder.
This level of predictability does not yet exist.
“I give 23andMe a lot of credit here,” said Giordano. “They are not making any predictive inferences at all. They are only describing.”
The 23andMe study may eventually help individuals at risk of developing a mental disorder navigate life’s wet roads.
23andMe is actively seeking people who meet the criteria and who wish to participate in the study.
Those interested in joining the study can visit the 23andMe website for more information and apply for enrollment in the study.