Translational Research
The NIHR BRC for Mental Health has been established to drive translational research (TR) in the field of mental health by finding new ways of preventing, diagnosing and treating mental health problems and ensuring that advances in biomedical research are used to benefit service users and carers.
Translational research is a new and innovative field of study aimed specifically at meeting clinical needs. It brings together scientists and clinicians from different disciplinary backgrounds – integrating different and complementary skills to accelerate the delivery of improved diagnostic tools, treatments and care.
The basic sciences that support the BRC for Mental Health include genetics, molecular biology, epidemiology and psychology as well as statistics, computing, physics and chemistry.
With integrated clinical involvement at every level, translational research becomes a two-way process. The knowledge generated through exploring fundamental scientific questions in a laboratory or elsewhere, is used to frame clinical studies in patients diagnosed with mental health conditions; and clinical needs and questions feed back into scientific research.
By structuring research in this way it is possible to implement research findings more rapidly.
Individualised health care
One of the ambitions of the BRC is to deliver individualised health care in psychiatry by furthering research into the causes and processes of mental illness and developing new treatments. The main way in which the BRC aims to achieve this is by discovering and validating novel biomarkers for disorders of mental health.
Case study: Alzheimer's disease blood biomarkers
One of the problems in Alzheimer's disease (AD) is that it is difficult to diagnose in the early stages. It can be difficult to tell the difference between normal forgetfulness, mood disorders and AD. There are also difficulties monitoring disease progression – patients have good days and bad days and other illnesses, and the tests used to measure cognition show considerable variability in individual patients. For all of these reasons biomarkers, or tests, for Alzheimer's are needed, and specifically biomarkers for very early diagnosis, for prediction, for deterioration and for monitoring progression.
Finding such biomarkers is a core activity of the BRC. A biomarker might be a blood test, a brain scan, an EEG or any other characteristic developing as a consequence of disease. Over the past few years we have found increasing evidence that proteins in the blood may be one such biomarker. We first found proteins that were different in moderate Alzheimer's disease compared to non-demented older people, then, that they are also elevated in mild dementia but correlate with clinical measures of severity, and finally that they correlate with functional neuroimaging. This all points towards a panel of proteins in blood being a possible biomarker.
The Medical Research Council (MRC) has awarded the Dementia theme of the BRC a major grant to develop improved laboratory analyses and test these in large numbers of people. We hope to be able to measure all of the proteins we are interested in, in a single test. We will then see if this test helps to diagnose and monitor progression in Alzheimer's and mild cognitive impairment. An early diagnosis of AD will in the future enable treatments that are currently in development to be used at an early stage of disease, where they are most likely to be of benefit.