IMH Marshall Fellows Program

THOMAS CHAO, PhD

Project Description:

“People with concurrent disorders (PCD) have worse mental health and treatment outcomes than any other mental health group. Research on PCD and their treatment outcomes is severely lacking, as they are often excluded from studies due to the severe and complex nature of their disorders. With 1,500 planned participants, ROAR-CANADA is assembling the largest sample of people with concurrent disorders worldwide. For the past year, we have been successfully running ROAR CANADA at 4 sites in BC and Ontario. This 5-year Health Canada-funded project collects a wealth of unprecedented information pertaining to patient profiles, as well as unique information, such as self-report data on victimization and violence and administrative data, before and after the concurrent disorder treatment.

My project aims to enrich the current assessment protocol with the inclusion of neurocognitive tests and measures of stress, including biomarkers of acute and general stress. Cognitive functioning and stress have been shown to impact treatment outcomes across substance-using and mental health populations, but they have not been studied in PCD as a single clinical group. The knowledge obtained through this study will contribute to a more comprehensive assessment of concurrent disorders, and the risk factors and prevention strategies for overdose and relapse.”

Supervisor: Dr. Christian Schütz

ALOK KULKARNI, MD

Project Description:

“Bipolar disorder (BD), is a severe mental illness characterized by dramatic shifts in mood, energy, and activity levels causing substantial impairment in interpersonal and social functioning. The disease course has recurrent periods of highs (mania) and lows (depression) in a person’s mood and activity levels. Globally, BD is the 4th leading cause of disability in the 15-24 year old age group. It is associated with substantial functional impairment, and carries with it a high risk of suicide. Treatment outcomes have remained poor in BD. Previous research entailing early interventions has shown sub-optimal results making the case for even earlier interventions.

Our current study will identify persons who are at high-risk to develop BD, and compare the effectiveness of a medication, minocycline, as compared to the placebo, in preventing the emergence of the aforementioned periods of highs and lows. Research has identified inflammation as the primary contributor for the progression of BD. As minocycline is an antibiotic commonly used to treat acne in adolescents given its anti-inflammatory properties, it has great potential to arrest the disease progression by its anti-inflammatory and anti-oxidant actions. We hypothesize that fewer high-risk subjects receiving minocycline will experience mood episode(s) as against those receiving the dummy pills during the 1-year study period. If our hypothesis turns out to be true, it will provide the impetus for a larger and more definitive clinical trial. If minocyclin’s effectiveness is confirmed in preventing BD in high-risk subjects, it will transform the clinical management of BD.”

Supervisor: Dr. Lakshmi Yatham

KIRSTEN MARCHAND, PhD

Project Description:

“Since 2016, approximately 5,000 adolescents and young adults between the ages of 15 and 29 have died from opioid-related overdoses in Canada. This has left families and communities to mourn the loss of their loved ones. These overdose deaths can be avoided by getting youth the help they need, as early as possible. However, most of the currently available help has focused on adults, under the assumption that what works for adults will also work for youth. Unfortunately, research in British Columbia has recently found that this is not the case. Instead, existing options for help do not meet youths’ opioid treatment needs and preferences.

The main goal of this study is to determine how to best help youth who use opioids. To meet this objective, we will engage youth, parents/caregivers, and service providers in a research study. This study will explore priorities for opioid use treatment delivery. It will also determine how to best define the benefits of opioid use treatment for youth. These findings will then be used to study how well youths’ priorities are being met by available treatments and services across British Columbia. The findings of this study will help service providers and policy makers to deliver opioid treatments in a way that will better meet youths’ unique needs. The findings will also help future researchers to make sure that they are studying what matters most to youth.”

Supervisor: Dr. Skye Barbic

JOHN-JOSE NUNEZ, MD

Project Description:

“This project will use computerized ‘machine-learning’ to predict if, and when, a patient’s depression will recur after being treated successfully. If we can use machine learning to accurately predict when a patient’s depression is just starting to return, we may be able to offer extra medications or therapy to stop it from worsening. Depression is the second-biggest cause of disability around the world, and most patients will have more than one episode, so a prediction that works well would be clinically useful.

So far, researchers have used smartphone data by itself to predict when a patient’s depression will recur. In this project, we want to improve these predictions by training our algorithms with additional clinical data, such as other illnesses they have and how quickly their depression has improved with treatment in the past. Using both smartphone and clinical data from a recent study we completed, we will train algorithms using machine learning to predict when patients’ depression will recur. This will determine if clinical data can improve the accuracy of prediction with smartphone data alone. Our study has more patients and more comprehensive clinical data than researchers have previously used, which may also increase our ability to predict recurrence. We hope that a more accurate prediction of depression recurrence will help doctors and mental health clinicians to keep patients depression free by earlier treatment before their depression returns.”

Supervisor: Dr. Raymond Lam

MEGAN ROWLAND, PhD

Project Description:

“Autism spectrum disorder (ASD) is one of the most prevalent forms of developmental brain disorders, affecting 1 in 66 children in Canada. ASD is characterized by impairments in social communication, restricted interests, and repetitive behaviours which can be a significant burden on families, social services and the healthcare system. It is well established that ASD is heritable, however, there are hundreds of genes that have been implicated. One group of genes that are of particular interest are part of the Brg1 Associated Factor (BAF) complex. Mutations in the BAF complex have recently been linked to ASDs but it is still unknown how mutations in BAF genes actually lead to ASDs. A novel, neuron specific version of the BAF complex has emerged as a promising candidate.

My project will investigate the loss of the neuronal BAF complex specifically in parvalbumin (PV) inhibitory neurons in mice.  I hypothesize that loss of the neuronal BAF complex in PV neurons will alter gene expression that is necessary for proper function resulting in ASD-like behaviours. To understand the underlying cause of any behavioural changes, we will employ next generation sequencing to investigate alterations in gene expression and DNA structure in neurons that have lost the neuronal BAF complex. The proposed research represents a unique interface between neuroscience and computational biology for understanding gene expression in ASDs. By providing insight into the etiology of ASD, this work will provide the foundation for future rescue experiments to identify novel therapeutic targets for ASD.”

Supervisor: Dr. Annie Ciernia

WALTER SENA, MD

Project Description:

“Cognitive assessment has been a staple of medical treatment for over 50 years, used for diagnosis and treatment planning of patients with neurocognitive disorders. Functional magnetic resonance imaging (fMRI), although it measures brain activity of cognitive processes, has not yet been used clinically in cognitive assessments.

My project aims to help incorporate fMRI knowledge into clinical practice by proposing an fMRI-specific cognitive assessment procedure, including a novel normed fMRI-specific testing battery. If successful, this research will develop the first fMRI-based neurocognitive assessment battery that can be used for the diagnosis and treatment planning of patients with neurocognitive disorders.”

Supervisor: Dr. Todd Woodward

DR. KOMAL BHARTI
FELLOW

Dr. Bharti’s study will build upon on a recent CIHR-funded project in the NINET lab, which aims to investigate an association between the neural correlates of functional disturbances in the dorsolateral prefrontal cortex (DLPFC ) and subgenual anterior cingulate cortex (sgACC ) of major depressive disorder (MDD) and the heart rate variability (HRV) via a combined “TMS-fMRI-HRV” study. She will investigate the dynamic interaction and relationship between the functional connectivity (FC) in the brain and high frequency heart rate variability (HF HRV) in MDD patients, and develop a neuroimaging pipeline to examine the dynamic temporal interaction between FC during rTMS and HRV, providing an overview of dynamic functional interaction and interplay between HF HRV and functional association between the DLPFC and the sgACC with an approximate estimation of patients who respond in treatment-resistant depression and show symptom improvement.

Supervisor: Dr. Fidel Vila-Rodriguez

DR. K CHITHRA
FELLOW

As cannabidiol (CBD) has been shown to be a safe medication with few adverse effects in bipolar depressed patients and likely has antidepressant effects, Dr. Chithra’s project will to test CBD as a treatment for the depressive phases of bipolar disorder (BD) in a randomized clinical trial. This pilot study will be used to assess the feasibility and safety of CBD and to gauge signal for efficacy of CBD. In this study, Dr. Chithra will divide the participants into two groups, one of which will receive daily capsules containing CBD, while the other will receive matching placebo capsules for 8 weeks. The aim will be to determine if improvement in depression is greater in the CBD group vs placebo group. As all participants will continue using their usual medication during the study, the findings will open up possibilities to investigate adjunctive CBD for the treatment of acute bipolar depression in large multicentre trials.

Supervisor: Dr. Lakshmi Yatham

DR. HEATHER PALIS
FELLOW

In her second year as an IMH Marshall Fellow, Dr. Palis will continue to pursue studies to advance the health and well-being of people who use substances and are involved in the criminal justice system. Her project is utilizing the BC Provincial Overdose Cohort (BC-ODC), a linked administrative health and corrections dataset, to ascertain the effects of the health services transfer on reincarceration and overdose among persons with psychiatric disorders and criminal justice system involvement (CJSI). Her study’s objectives include describing the epidemiology of polysubstance use and overdose among people with psychiatric disorders, identifying trends of: a) health services utilization; b) reincarceration; and c) non-fatal and fatal overdose before and after the transfer among persons with CJSI involvement with and without psychiatric disorders, and identifying health services utilization characteristics that have a protective effect on risk of reincarceration and fatal and non-fatal overdose among people with psychiatric disorders.

Supervisors: Dr. Amanda Slaunwhite & Dr. Tonia Nicholls

DR. NICOLE SANFORD
FELLOW

In her second year as an IMH Marshall Fellow, Dr. Sanford will continue to build upon prior research that has established that major psychiatric disorders, notably schizophrenia (SCZ), bipolar disorder (BD), and to a lesser degree major depressive disorder (MMD), are associated with accelerated brain aging, reflected in a higher Brain age gap estimation (BrainAGE) in patients as compared to healthy individuals. Her project is targeting the two most significant unanswered questions with regards to accelerated aging in major psychiatric disorders: namely, how early it can be detected and what are the key environmental drivers. Addressing these key issues is the crucial first step towards early detection of accelerated aging and effective intervention to minimize modifiable risk factors.

Supervisor: Dr. Sophia Frangou

DR. RUIYANG GE
FELLOW

Dr. Ge’s research centers around the study of neuroimaging in healthy population and patients with psychiatric disorders. As evidence supports the notion that there is an association between rTMS treatment induced changes in brain function and autonomic nervous system, understanding this association is important for translational purpose because an avenue for identifying a functionally meaningful stimulation target for rTMS treatment is to probe the brain-heart connection. Dr. Ge’s project aims first to interrogate the association between rTMS treatment induced changes in brain function and autonomic nervous system. The secondary aim is to test whether the fMRI data and heart rate varilability (HRV) metric serve as potential predictors for treatment response of the following 4-week rTMS treatment.

Supervisor: Dr. Fidel Vila-Rodriguez

(Dr. Ge was appointed as a Research Associate within Dr. Sophia Frangou’s research group in January 2021)

DR. HEATHER PALIS
FELLOW

Dr. Palis is currently engaged in studies to advance the health and well-being of people who use substances and are involved in the criminal justice system. Her project will utilize the BC Provincial Overdose Cohort (BC-ODC), a linked administrative health and corrections dataset, to ascertain the effects of the health services transfer on reincarceration and overdose among persons with psychiatric disorders and criminal justice system involvement (CJSI). Her study’s objectives include describing the epidemiology of polysubstance use and overdose among people with psychiatric disorders, identifying trends of: a) health services utilization; b) reincarceration; and c) non-fatal and fatal overdose before and after the transfer among persons with CJSI involvement with and without psychiatric disorders, and identifying health services utilization characteristics that have a protective effect on risk of reincarceration and fatal and non-fatal overdose among people with psychiatric disorders.

Supervisors: Dr. Amanda Slaunwhite & Dr. Tonia Nicholls

DR. NICOLE SANFORD
FELLOW

Dr. Sanford’s research seeks to build upon prior research that has established that major psychiatric disorders, notably schizophrenia (SCZ), bipolar disorder (BD), and to a lesser degree major depressive disorder (MMD), are associated with accelerated brain aging, reflected in a higher Brain age gap estimation (BrainAGE) in patients as compared to healthy individuals. Her project targets the two most significant unanswered questions with regards to accelerated aging in major psychiatric disorders: namely, how early it can be detected and what are the key environmental drivers. Addressing these key issues is the crucial first step towards early detection of accelerated aging and effective intervention to minimise modifiable risk factors.

Supervisor: Dr. Sophia Frangou

DR. MELISSA WOODWARD
FELLOW

Dr. Woodward is currently researching the innovative use of of ultra-high-resolution retinal imaging using optical coherence tomography (OCT), which allows the direct quantification of retinal nerve fibers and microvasculature using a non-invasive, quick eye examination, in the early detection of pathologies
prominent in marginally-housed psychiatric populations. The objective of her project is to carry out an investigation using OCT imaging of the retina in an impoverished population in Vancouver’s Downtown Eastside, in order to assess damage to the blood vessels of the retina and to see if this helps to explain the relationship between fentanyl use and clinical factors like impaired thinking abilities and psychiatric symptoms.

Supervisor: Dr. William Honer

SCHOLARSHIP AWARDEES AND RESEARCH TITLES

ASHLEY BATTAGLINI

Intra- and Interpersonal Emotion Regulation in Major Depressive Disorder

ARIANA CAHN

Quantification of cortical thickness changes in bipolar disorder patients following first episode mania: A prospective study

MALLORY FLYNN

Estimating the True Incidence of Accidental Illicit Drug Overdose

TONY FONG

High Throughput Platform to Assess and Manipulate Cortical Circuits in Mouse Models of Depression

ALLISON GIESBRECHT

Understanding the Healthcare Access Experiences of Mental Health and Substance Use High Users of Healthcare

TRISTAN HYNES

Toward a Precision Treatment for Addiction: Focus on Dopamine Circuits and Sex

BONNIE LEE

The Impact of Motherhood and APOE Genotype on the Aging Brain

DAPHNE LING

The Neural Basis of Low-Dose versus Normal-Dose Psychostimulants on Executive Functions in Youth with Attention-Deficit / Hyperactivity Disorder: A Randomised Controlled Trial

MELANIE LYSENKO-MARTIN

Neural and Behavioral Substrates of THC-Induced Impairments in Decision Making

ALEXANDER MORIN

Integrating transcription factor binding and perturbation data to understand gene regulation in the brain

RAE MORRIS

Mental Health Service Provision with Adults with Autism Spectrum Disorder: An Interpretive Description Study

SHAWNA NARAYAN

Exploring cultural responsiveness in e-mental health resources for depression and anxiety (CREDA)

MAYA NESBIT

Preclinical Study of d-govadine and its Effects on Corticostriatal Mechanisms of Amphetamine Addiction

BOAZ SAFFER

Identifying the Neurocognitive Mechanisms of Suicidal Behaviours in Emerging Adults

JEAN WESTENBERG

Rapid micro-induction of buprenorphine/naloxone for treatment of Opioid Use Disorder