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.
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
Cortex. 2018 Jul 30;108:160-172
Hawco C, Voineskos AN, Steeves JKE, Dickie EW, Viviano JD, Downar J, Blumberger DM, Daskalakis ZJ
Biol Psychiatry. 2018 Aug 17;:
Hanlon CA, Philip NS, Price RB, Bickel WK, Downar J
Neuropsychopharmacology. 2018 Jun 18;:
Kaster TS, Daskalakis ZJ, Noda Y, Knyahnytska Y, Downar J, Rajji TK, Levkovitz Y, Zangen A, Butters MA, Mulsant BH, Blumberger DM
J Neural Eng. 2018 Jun 11;:
Mansouri F, Mir-Moghtadaei A, Niranjan V, Wu JS, Akhmedjanov D, Nuh M, Cairo T, Giacobbe P, Zariffa J, Downar J



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