Application of Drug Efficiency Index Metric for Analysis of Post-Traumatic Stress Disorder and Treatment Resistant Depression Gene Expression Profiles

Post-traumatic stress disorder (PTSD) is a severe mental illness with grave social, political, economic, and humanitarian implications. To apply the principles of personalized omics-based medicine to this psychiatric problem, we implemented our previously introduced drug efficiency index (DEI) to the PTSD gene expression datasets. Generally, omics-based personalized medicine evaluates individual drug action using two classes of data: (1) gene expression, mutation, and Big Data profiles, and (2) molecular pathway graphs that reflect the protein–protein interaction. In the particular case of the DEI metric, we evaluate the drug action according to the drug’s ability to restore healthy (control) activation levels of molecular pathways. We have curated five PTSD and one TRD (treatment-resistant depression) cohorts of next-generation sequencing (NGS) and microarray hybridization (MH) gene expression profiles, which, in total, comprise 791 samples, including 379 cases and 413 controls. To check the applicability of our DEI metrics, we have performed three differential studies with gene expression and pathway activation data: (1) case samples vs. control samples, (2) case samples after treatment or/and observation vs. before treatment, and (3) samples from patients positively responding to the treatment vs. those responding negatively or non-responding patients. We found that the DEI values that use the signaling pathway impact activation (SPIA) metric were better than those that used the Oncobox pathway activation level (Oncobox PAL) approach. However, SPIA, Oncobox PAL, and DEI evaluations were reliable only if there were differential genes between case and control, or treated and untreated, samples.