Prechter Bipolar Research Program Faculty Meeting 2019 Prechter - - PowerPoint PPT Presentation

Prechter Bipolar Research Program

Faculty Meeting 2019

Prechter Faculty Meeting: Agenda

• Introductions
• Overview of Prechter Program
• Overview and vision of Precision Health
• Three base questions – engagement /personal

reviews / priorities

• New ideas discussions
• Governance
• Advisory board
• ‘superuser’ / super participant projects

Prechter Program: History

• Story of Heinz Prechter
• Creative entrepreneur
• Suicide 2001
• Family Established Fund
• Moved to UM in 2005
• 2017: commitment of 5M in endowed funds
• Matching funds
• Continued engagement in fund raising

Mission and Vision Statements

• Our Mission:
• The mission of the Heinz C. Prechter Bipolar

Research Program is to discover the mechanisms that contribute to bipolar disorder, predict and improve outcomes, and develop effective, innovative treatments.

• Our Vision:
• We are building a future where personalized and

evidence‐based treatments for bipolar disorder will enable every individual with the illness to lead a healthy and productive life.

UM: Prechter Project origins

• Began project in 2005 (IRB) approval date.
• HUM0000606
• Logic: large scale genetic projects were emerging.

The Odds Ratios for each locus: modest (1.15)

• No projects focused on level of detail at phenotype level
• The Prechter program would be complementary to large

programs

Academic Landscape Bipolar Disorder Genetics ‐ 2005

• No genes associated with Bipolar Disorder
• Appreciation that many genes were involved
• Large collaboratives GWAS
• Wide studies: many participants, limited data
• Few longitudinal studies in Bipolar disorder
• Compare: Framingham Heart Study (began 1948)
• Deep studies: fewer participants, extensive data

Prechter Bipolar Research Program Precision Health

Heinz C Prechter 1942 – 2001

Clinic University Community

Eligibility Screening Ineligible Eligible Initial Visit

DIGS Interview

Neuropsychological Testing

Blood for Genetics & Biomarkers Questionnaires

Follow-up

Year 1: Neuropsychological Testing Year 3: Phone check in Year 2: LIFE Interview Questionnaires every 2 months Clinic University Community

Eligibility Screening Ineligible Eligible Initial Visit

DIGS Interview

Neuropsychological Testing

Blood for Genetics & Biomarkers Questionnaires

Follow-up

Year 1: Neuropsychological Testing Year 3: Phone check in Year 2: LIFE Interview Questionnaires every 2 months

• Mechanisms

– Predictive Modeling

• Longitudinal

– Active engagement

• > 1300 Participants

– 75% retention Entering Year 14

Longitudinal Study of Bipolar Disorder

Identify mechanisms & predictive outcomes patterns in bipolar disorder January 2019 Total Enrolled:1304 Current Participants: 926 (71%) Central Biorepository: 613 Prechter Bipolar Genetics Repository: 2,088 Data Sharing Agreements: 18 Peer Reviewed publications: 92

200 400 600 800 1000 1200 1400

Longitudinal Enrollment Status October 2018

Ontology: Disciplines & Pluralistic Relationship to Phenotype Class

Phenotype Classes (7) Disciplines (10)

– Disease – Neurocognitive – Temperament / Personality – Motivated Behavior – Life Story – Sleep / Circadian – Outcomes

Human Volunteer Participants

Prechter Phenotype classes

• Disease:
• DIGS & LIFE
• Temperament / Personality
• NEO PI‐R
• BIS‐11 (Barret Impulsivity)
• Buss‐Durkee Hostility
• Brown Goodwin Aggression
• Motivated Behavior
• Fagerstrom
• Audit‐R
• Alcohol and

substance use

• Sleep & Circadian
• PSQI (Pitt Sleep..)
• MCTQ (Munich ..)
• SPAQ (seasonal

pattern assessment

Prechter Phenotype classes

• Life Story/Experiences
• LEOS (Life Events occur..
• LEC (Life Events Checklist..
• FACES II (Family Adapt..
• CTQ (Childhood Trauma..
• LFQ (Life Functioning
• ECR (Experiences Close ..
• Working Alliance Inventory
• Clinical outcomes
• PHQ9, ASRM, GAD7, SF12
• YMRS, HAMD
• C‐SSRS
• Neurocognitive Function
• WAIS
• CVLT
• Rey‐Osterrieth
• Facial Emotion Perception
• Emotion Processing Test
• Purdue Pegboard
• Parametric Go/No Go
• Stroop Color Word
• Trail Making
• Wisconsin Card Sort
• Synonym Knowledge
• Test of Memory Malingering

Dynamic Energy State Mania Depression Time

Bipolar Disorder: Course Pathology of Energy

1 year Mania Depression anticipate change?

Data types

• Course and outcomes
• Illness patterns
• Psychology
• Neuropsychology
• Acoustic patterns
• Life Story
• Behaviors
• Circadian
• Biological Mechanisms
• Cell Developmental Biology
• Genetics
• Pharmacology
• Animal models
• Cellular models
• Missing Imaging
• S. Taylor

> 90 peer reviewed publications with scientists from 7 U‐M Schools

UM experts: local network

Bipolar DATA Management Systems University of Michigan ** ** ** ** ** Potential Data sources NDAR

Next UP….

• “Superuser” project: increasing depth

and detail at the individual level.

• Microbiome, metabolome, physiology
• Imaging & electrophysiology
• Health service utilizations patterns
• Cellular & developmental modelling
• Computational modeling
• Goal is a Bipolar P01 in 3 years.

Partnerships: Internal Pharmacology / Cardiology / Computer Science & Engineering Cell Developmental Biology / Life Sciences Institute / Mathematics External: Weizmann Inst., U Oslo, Lebanon, U Penn, UIC, U Wisconsin

Network Acknowledgments

• Prechter Bipolar Research Fund
• Richard Tam Foundation
• Department of Psychiatry
• U‐M Depression Center
• NIMH
• MICHR / MTRAC
• Woodworth Family
• Supporters of the Prechter Program
• Individual research participants and

families

• Staff and Faculty members at the

UM