The last two decades have seen significant advances in our basic understanding of the neural mechanisms behind psychiatric illnesses, thanks to a proliferation of neuroimaging and neurostimulation studies. The Downar laboratory focuses on translational research, drawing upon these advances to help develop a new generation of tools for the diagnosis, prognosis and treatment of psychiatric disease.

The major therapeutic approach of the lab employs image-guided brain stimulation via repetitive transcranial magnetic stimulation (rTMS). Current research focuses on improving the speed, cost, efficacy and range of applications for rTMS in treating psychiatric illnesses. Projects currently underway include evaluating new stimulation targets beyond the standard target in dorsolateral prefrontal cortex, more rapid stimulation protocols such as theta-burst stimulation, accelerated treatment courses using multiple sessions per day, and applications of rTMS to disorders other than major depression, such as bulimia nervosa, post-traumatic stress disorder, and obsessive-compulsive disorder.

A second major focus of the lab is to develop clinically useful tools for predicting treatment outcome and for selecting the optimal treatment parameters in any given patient. These include the development of reliable automated classifiers for predicting treatment outcome in individuals based on resting-state functional MRI, the development of multimodal biomarker suites for predicting outcomes using a combination of EEG, MRI and behavioural measures.

The ultimate goal of this research is to develop rTMS and other neurostimulation treatments into cost-effective, widely accessible treatment options for patients with psychiatric illness, alongside medications and psychotherapy.
Am J Psychiatry. 2019 Feb 15;:appiajp201818091096
Kaster TS, Downar J, Vila-Rodriguez F, Thorpe KE, Feffer K, Noda Y, Giacobbe P, Knyahnytska Y, Kennedy SH, Lam RW, Daskalakis ZJ, Blumberger DM
Lancet. 2019 Feb 02;393(10170):403-404
Blumberger DM, Vila-Rodriguez F, Thorpe KE, Daskalakis ZJ, Downar J
Prog Neuropsychopharmacol Biol Psychiatry. 2019 Jan 24;:
Ge R, Downar J, Blumberger DM, Daskalakis ZJ, Lam RW, Vila-Rodriguez F
Brain Stimul. 2019 Jan 12;:
Trevizol AP, Vigod SN, Daskalakis ZJ, Vila-Rodriguez F, Downar J, Blumberger DM
Front Neurosci. 2018;12:877
Mansouri F, Fettes P, Schulze L, Giacobbe P, Zariffa J, Downar J
Transl Psychiatry. 2018 Nov 23;8(1):253
Sun Y, Blumberger DM, Mulsant BH, Rajji TK, Fitzgerald PB, Barr MS, Downar J, Wong W, Farzan F, Daskalakis ZJ
Front Pharmacol. 2018;9:1188
Shalbaf R, Brenner C, Pang C, Blumberger DM, Downar J, Daskalakis ZJ, Tham J, Lam RW, Farzan F, Vila-Rodriguez F
Neuromodulation. 2018 Nov 08;:
Kreuzer PM, Downar J, de Ridder D, Schwarzbach J, Schecklmann M, Langguth B
EBioMedicine. 2018 Oct 01;:
Neufeld NH, Mulsant BH, Dickie EW, Meyers BS, Alexopoulos GS, Rothschild AJ, Whyte EM, Hoptman MJ, Nazeri A, Downar J, Flint AJ, Voineskos AN

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Assistant Professor, Department of Psychiatry, University of Toronto
Co-Director, MRI-Guided rTMS Clinic, University Health Network