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.
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
Clin Neurophysiol. 2018 Apr 22;:
Backhouse FA, Noda Y, Knyahnytska Y, Farzan F, Downar J, Rajji TK, Mulsant BH, Daskalakis ZJ, Blumberger DM
Lancet. 2018 Apr 28;391(10131):1683-1692
Blumberger DM, Vila-Rodriguez F, Thorpe KE, Feffer K, Noda Y, Giacobbe P, Knyahnytska Y, Kennedy SH, Lam RW, Daskalakis ZJ, Downar J
J Clin Psychiatry. 2018 Apr 17;79(3):
Weissman CR, Blumberger DM, Brown PE, Isserles M, Rajji TK, Downar J, Mulsant BH, Fitzgerald PB, Daskalakis ZJ
Depress Anxiety. 2018 Apr 10;:
Noda Y, Zomorrodi R, Vila-Rodriguez F, Downar J, Farzan F, Cash RFH, Rajji TK, Daskalakis ZJ, Blumberger DM
Biol Psychiatry Cogn Neurosci Neuroimaging. 2018 Apr;3(4):337-347
Fettes PW, Moayedi M, Dunlop K, Mansouri F, Vila-Rodriguez F, Giacobbe P, Davis KD, Lam RW, Kennedy SH, Daskalakis ZJ, Blumberger DM, Downar J
Biol Psychiatry Cogn Neurosci Neuroimaging. 2018 Apr;3(4):308-310
Fettes PW, Downar J
Clin EEG Neurosci. 2018 Mar 01;:1550059418760077
Ramlakhan JU, Zomorrodi R, Downar J, Blumberger DM, Daskalakis ZJ, George TP, Kiang M, Barr MS

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