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.
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
BJPsych Open. 2019 Jun 13;5(4):e52
Tracy DK, Shergill SS, David AS, Fonagy P, Zaman R, Downar J, Eliott E, Bhui K
PLoS One. 2019;14(9):e0222546
Mendlowitz AB, Shanbour A, Downar J, Vila-Rodriguez F, Daskalakis ZJ, Isaranuwatchai W, Blumberger DM
Clin Pharmacol Ther. 2019 Oct;106(4):709-711
Downar J
Neuropsychopharmacology. 2019 Sep 05;:
Daskalakis ZJ, Dimitrova J, McClintock SM, Sun Y, Voineskos D, Rajji TK, Goldbloom DS, Wong AHC, Knyahnytska Y, Mulsant BH, Downar J, Fitzgerald PB, Blumberger DM
J Affect Disord. 2019 Oct 01;257:765-773
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 Jun 20;:
Miron JP, Feffer K, Cash RFH, Derakhshan D, Kim JMS, Fettes P, Giacobbe P, Blumberger DM, Daskalakis ZJ, Downar J

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