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.
Psychother Psychosom. 2019 Dec 03;:1-2
Brunoni AR, Arns M, Baeken C, Blumberger D, Brunelin J, Carpenter LL, Downar J, Keeser D, Langguth B, Rachid F, Sack AT, Vila-Rodriguez F, Padberg F
J Affect Disord. 2019 Nov 13;:
Alders GL, Davis AD, MacQueen G, Strother SC, Hassel S, Zamyadi M, Sharma GB, Arnott SR, Downar J, Harris JK, Lam RW, Milev R, Müller DJ, Ravindran A, Kennedy SH, Frey BN, Minuzzi L, Hall GB, CAN-BIND Investigator Team
Brain Stimul. 2019 Nov 09;:
Miron JP, Voetterl H, Mansouri F, Blumberger DM, Daskalakis ZJ, Downar J
J Affect Disord. 2019 Nov 06;:
Kaster TS, Fitzgerald PB, Downar J, Vila-Rodriguez F, Daskalakis ZJ, Blumberger DM
Biomed Eng Online. 2019 Nov 14;18(1):109
Kapadia N, Zivanovic V, Moineau B, Downar J, Zariffa J, Popovic MR
Brain Stimul. 2019 Oct 31;:
Dunlop K, Sheen J, Schulze L, Fettes P, Mansouri F, Feffer K, Blumberger DM, Daskalakis ZJ, Kennedy SH, Giacobbe P, Woodside B, Downar J
Brain Stimul. 2019 Oct 09;:
Iseger TA, Arns M, Downar J, Blumberger DM, Daskalakis ZJ, Vila-Rodriguez F
Neuropsychopharmacology. 2019 Oct 14;:
Nogovitsyn N, Muller M, Souza R, Hassel S, Arnott SR, Davis AD, Hall GB, Harris JK, Zamyadi M, Metzak PD, Ismail Z, Downar J, Parikh SV, Soares CN, Addington JM, Milev R, Harkness KL, Frey BN, Lam RW, Strother SC, Rotzinger S, Kennedy SH, MacQueen GM

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