There is a large amount of variation in the manifestation of brain disease. There is also a large amount of variation in the response to treatment. Often patients are prescribed drugs on a trial-and-error basis until the right drug is found. This situation, multiplied across many cases, can lead to over-servicing, inefficiency and high expenses in the healthcare industry—not to mention the stress this places on individuals, their families and friends. Integrated Neuroscience could be heading towards an answer in dealing with the large amount of variation in the symptoms, diagnosis and treatment of brain disorders. This answer is called ‘Personalized Medicine’. A Brain-related Personalized Medicine approach matches genetic markers (gene-related information) with neuromarkers (brain-related information).
The brain is arguably the most complex organ of the body. It is subject to biological and environmental influences as well as the personal life history and experiences of individuals. A Personalized Medicine approach hopes to match treatment programs with the biological and psychological profile of each individual. With recent advances in biomedical science, this treatment ethic may be more realistic than ever before. Neurogenomics has gone some way in elucidating a vast number of genes that play a role in various brain disorders. However, a genetic approach alone is insufficient to diagnose and treat the development of brain disease. The combination of both genetic-markers and neuro- markers is crucial in the ultimate success of any one particular treatment.
Neuromarkers include observations of brain structure (using MRI), imaging of brain function (EEG, ERP, MEG, fMRI and PET) and psychological tests measuring social, emotional and cognitive performance. Further research is needed towards the orientation of Brain-related Personalized Medicine. Research will need to establish the links between genetic-markers and neuromarkers (genomic-neuromarkers) for use in diagnostics, drug development, treatment prediction and treatment efficacy monitoring. From here, clinicians will be able to better match the appropriate treatment for each patient according to the developmental stage of their disorder. The outcomes may even extend further to a preventative medicine that contributes to disability management, harm minimization, psychosocial and quality of life recovery.
The Brain Resource International Database is one methodology used to acquire genomic-neuromarker profiles. The Database pools data about genetic make-up, brain structure and function, cognition and psychology as well as the life history of participants.
These ‘genomic-neuromarkers’ will be incorporated in the next version of the DSM (DSM V) expected to be released in 2011.