The Use of Biomarkers in the Military: Theory to Practice

This day aims to bring together researches who have been supported by the Department of Defense, Veterans Administration, the National Institute of Health, and government funded agencies around the world to identify biomarkers for PTSD risk, diagnosis, symptom severity, and treatment response. A poster session will highlighting individual contributions in this field will be held on the evening of September 13th, 2012, at the New York Academy of Sciences. On September 14, 2012, we will feature a discussion by pre-eminent researchers in the field in the form of several roundtables. To participate as a panelist, please apply now..... to submit a poster, click here.

WHEN: Friday September 14th, 2012

WHERE: New York Academy of Science

  Google link: http://goo.gl/maps/3GjS7

  7 World Trade Center, 250 Greenwich St, 40th Fl, New York, NY 10007-2157

The Use of Biomarkers in the Military:  Theory to Practice

8:15 a.m.– 10:30 a.m.  Opening Session

Welcome and Opening Remarks:  Col. Carl Castro

 Criteria for rationally evaluating biomarkers of PTSD risk, diagnoses, recovery, and trauma exposure

Rachel Yehuda, Ph.D.

 International perspectives on identification of potentially relevant biomarkers for the military:  Decision making on target sample, design, biological variables, and level of investment.

 Alexander McFarlane AO, M.D  (GPCAPT Specialist Reserves, RAAF): Australia

Col. Eric Vermetten, M.D., Ph.D.: The Netherlands

Clemens Kirschbaum, Ph.D.: Germany

Charlie Marmar, M.D. : United States

 Discussant: Col. Carl Castro         

10:30 a.m.-11:00 a.m. Coffee

 11:00-12:00  Panel 1:  Defining optimal biomarker(s) for the military

Moderator:  Col. Carl Castro, M.D.

Panelists:   Alexander McFarlane, AO, M.D., Steven Hamilton, M.D., Ph.D.,  Linda M. Bierer, M.D. , Roger Pitman, M.D., Dewleen Baker, M.D.,

 This panel will focus on the kind of biomarkers that would be most useful in a military context.   The following are representative topic areas:

 1)       Do we need biomarkers to quantify either deployment stress exposures or mental symptoms?

2)       Should biomarkers be used to detect over- or under-reporting of symptoms? 

3)       At what point in discovery should a finding related to a biological difference between persons with and without PTSD be adapted into military or post-military practice? 

4)       What are the ethical considerations of using biomarkers?  Are these different if assessed at pre-deployment, after a critical incident, or post-deployment?  

5)       What are some of the special consideration of using genotype as a biomarker of risk/resilience?   For example, what are the implications of false positives (persons who have a biomarker but don’t develop disorder, and false negatives (persons who have disorder without the biomarker).

6)       Would a biomarkers developed in one country (sample) be relevant to carriers in a different military.  This issue is of interest given that different militaries report such different prevalence rates of PTSD.

7)       What can be learned from the differences/similarities in biomarker development across nations.

 12:00 p.m. -1:30 p.m.  Lunch and poster session

 1:30 p.m.-2:30 p.m.  Panel 2:  Strategies for identifying and confirming candidate biomarkers

Moderator:  Alexander McFarlane, AO, M.D. (GPCAPT RAAAF SR)

Panelists:  Charles Marmar, M.D., Col. Eric Vermetten, M.D., Ph.D., Janine Flory, Ph.D., Karestan  Koenen Ph.D.,  Joe Palma, M.D. ,

This panel will focus on how to identify and validate biomarkers.  The following are representative topic areas:

1)       What are the optimal designs for identifying biomarkers? Can biomarkers be identified in cross-sectional studies?

2)       How important is the longitudinal perspective for biomarker validation? 

3)       What groups need to be included in biomarker studies (how are “cases” and “controls” defined)

4)       What are the important “covariates” or confounds in studies, and how does this translate into application?

5)       How should the overlap with the biomarkers for somatic postdeployment syndromes and physical illness be addressed?

6)       What are the implications of comorbidity?  Should biomarkers for PTSD be distinct from disorders that frequently co-occur with PTSD (including depression and TBI)?

7)       Are their animal models for PTSD and would they be helpful in identifying biomarkers. 

8)       How important is it to distinguish diagnostic biomarkers from general amplifiers of distress?

9)       What is the role of a composite biomarker (i.e., comprised of multiple variables).  Would increasing the number of biomarkers enhance specificity for diagnosis or lead to a falsely high “signal.”

 2:30-3:30  Panel 3:  Most promising biomarkers of PTSD diagnosis

Moderator:  Rachel Yehuda, Ph.D.

Tom Neylan, M.D., Schahram Akbarian, M.D.,  Alex Neumeister, M.D., Ph.D., Clemens Kirschbaum, Ph.D. Israel Liberzon, M.D.,  Ph.D.,

This panel will focus on the actual biomarkers that should/should not be the focus of biomarker research.  The following are representative topic areas:  

1)      What are the promising candidate biomarkers of risk, exposure, diagnosis, chronicity, and recovery that have been identified thus far in association with trauma/PTSD? 

2)      How important is it for a diagnostic biomarker to be related to pathophysiology?

3)      Does overlap between biomarkers of exposure, risk, diagnosis (symptom severity) and recovery challenge how biomarkers can be used?

4)      Are markers that are highly responsive to the environment useful as biomarkers of diagnosis?  What about measures that reflect a more integrated activity over time?

5)      Can we distinguish between markers that determine how cells may function (genes, epigenetic marks, gene expression), regulators of biological activity (e.g., microRNA, activity of rate limiting enzymes, receptor sensitivity), and chemical fingerprints that reflect how cells have already functioned (proteomics, metabolic)?   Can we really distinguish such measures?

6)      How valuable are indicators of long term cellular processes such as teleomer length, or cellular metabolic activity, which are likely to be nonspecific? 

7)      What about hormones and neurotransmitter concentrations, which should theoretically, be nonspecific to a psychiatric disorder? 

Frequently Asked Questions

1) How do I register for the Biomakers Satellite Conference?

To register for the Biomakers conference, you use the same registration form as the main ISPNE conference. You may select to register for the Biomakers conference along with the ISPNE conference, or you may select the option for "Satellite Conference Only" under the conference registration types in order to register for the Biomakers conference only. We have arranged a special discount for ISPNE Conference attendees to get free registration for the Biomarkers conference, a $125 (100%) savings off the standard price for the Biomarkers conference.

2) How do I submit an abstract for the Biomakers Satellite Conference?

To submit and abstract for the Biomakers conference, you use the the same abstract submission process as the main ISPNE conference. When you are entering the details of your abstract, you will have the option to check two boxes to submit your abstract to either or both of the satellite conferences.