Bipolar Diagnosis using BINOCULAR Rivalry

Online large scale data collection of binocular rivalry rates

Bipolar disorder (BD; manic depression) is a devastating and costly mental illness characterised by periods of mania and depression. Although BD can be hereditary, there are no genetic or biological tests to identify individuals with, or at risk of developing, the disorder. Misdiagnosis in these contexts is common, leading to inappropriate treatment choices and contributing to the enormous burden of illness of these psychiatric disorders. A test that improves diagnosis of BD, and that identifies genetic predisposition to the disorder, could improve outcomes in clinical psychiatry and also aid in gene-finding studies of BD.

Binocular rivalry involves presenting a different image to each eye, inducing perceptual fluctuations between each image. The rate of this fluctuation has been shown by Miller and colleagues to be slow in BD compared with controls, a finding previously independently replicated in small studies and most recently in a large study.

There is a need for large-scale Binocular rivalry rate (BRR) studies of BD, schizophrenia and major depression. These studies require sample sizes in the thousands to tens of thousands. A major barrier to meeting data collection targets in this research is the cost and burden of hands-on resources to test patients and controls on the BRR test. Such barriers will continue unless a more efficient means of administering the test is developed. There is thus a need to develop and validate an online version of the BRR test which can be completed by test subjects in their own homes. This project addresses the complexity of developing an online version of data collection that meet the criteria to produce consistently accurate results.

There are a number of stages to set up the data collection and the instructions need to be easy to follow and repeated by all participants. Some of the instructions include:

• Placing stickers on the keyboard to identify the correct keys
• Calibrating the images size using a know object size
• Measuring the distance to the screen
• Checking visual acuity

• Practicing the test to become competent with the input
• Understanding the number of required test blocks
• Waiting for the countdown
• Undertaking the test

An online BRR test has a number of advantages as mentioned above and enables a larger collection of data than would be possible by other collection methods. However, there are a number of barriers to the successful deployment of an online BRR test that need to be researched to ensure reliable results. Careful system design and development with extensive technical and user testing is required to ensure that data collected is accurate and in a form able to be analysed. From an Information Systems research perspective, the development and evaluation of the BRR test will use design science methodology to ensure viability for large scale online clinical data collection.

Collaborators

Project Leader:

• Dr Steven Miller, Monash University

Project Research officer:

• Mr Phillip Law, Monash University

Web platform developers:

• Dr Kirstin Ellis, Monash University
• Mr William Lay, Monash University

Collaborators:

• Prof Nick Martin, QIMR Berghofer Medical Research Institute
• A/Prof Margie Wright, QIMR Berghofer Medical Research Institute
• Dr Trung Ngo, Monash University and QIMR Berghofer Medical Research Institute
• Emeritus Prof Jack Pettigrew, University of Queensland
• Dr Guang Bin Liu, University of Southern Queensland
• Prof Michael Berk, Deakin University
• Prof Philip Mitchell, University of New South Wales
• Prof, Dr Thomas Schulze, Ludwig-Maximilians-University
• Prof Nick Craddock, Cardiff University
• Dr Xavier Caseras, Cardiff University
• Prof Paul Fitzgerald, Monash University
• Prof Gin Malhi, University of Sydney
• A/Prof James Scott, University of Queensland
• Dr Caroline Gurvich, Monash University
• Prof Julie Stout, Monash University

Funding

Monash Institute of Medical Engineering (Australia)

Defence Health Foundation (Australia)

Brain and Behavior Foundation (USA)

National Health and Medical Research Council (Australia)