February 2022

This month's brainbuzz™ includes exciting updates about CAMH's rankings amongst Canada's top 40 research hospitals, a new research grant awarded by Bell Let’s Talk and Brain Canada, and a look into the challenges of conducting cannabis research. Please reach out if you have any questions or feedback.

Aristotle Voineskos
VP Research, CAMH
 

CAMH ranked Canada’s top mental health research hospital with record research funding in 2021

On January 18, 2022, Research Infosource released its 2021 rankings for Canada’s Top 40 Research Hospitals.

CAMH has once again topped the list as the country’s leading mental health research hospital. During the 2019-20 fiscal year, CAMH reached $75.6 million in research spending followed by a new record high of $79.7 million in 2020-21, reflecting the continued importance of mental health and addictions research to CAMH’s overall mandate.

CAMH advanced its ranking within its sub-category of medium-sized hospitals to 3^rd overall in ‘researcher intensity,’ the amount of research spending per researcher. CAMH also maintained its 2^nd place position for ‘hospital intensity,’ which analyzes research spending as a percentage of total hospital spending.

"This past year CAMH set a record in research funding, despite the pressures CAMH and so many other hospitals have faced throughout the pandemic. Our continued focus on growing research is an acknowledgment of the importance of research in addressing the mental health of Canadians now and into the future," says Dr. Aristotle Voineskos, Vice President of Research at CAMH.

Over the last decade, CAMH has continued to expand its role in carrying out unique, important, and timely research in the field of mental health and addictions. In Research Infosource’s 2021 rankings, CAMH came in 14th overall among the country’s top 40 leading research hospitals, funding a variety of research with a focus in areas such as cannabis, depression, digital research, schizophrenia, and COVID-19.

Some of last year’s stand-out research stories included:

• ongoing research to help understand why young people vape, and to what resources they need to quit;
• Growing CAMH’s BrainHealth Databank to drive data-driven discoveries and innovations that will improve patient care;
• COVID-19-related research, including a better understanding of the pandemic’s effect on substance users and homeless 2SLGBTQ youth, as well as a potential link between long COVID and depression; and
• the additions of the Centre for Complex Interventions and the Centre for Youth Bipolar Disorder to CAMH’s Centres of Innovation.

Check out the complete list of Canada’s Top 40 Research Hospitals in 2021.

Read how CAMH did in last year’s rankings.
 

CAMH-led team of Toronto scientists receive new funding to help treat depression

Grant through Bell Let’s Talk and Brain Canada announced in advance of Bell Let’s Talk Day

Led by Dr. Tarek Rajji, Chief, Adult Neurodevelopment and Geriatric Psychiatry at the Centre for Addiction and Mental Health (CAMH) and Toronto Dementia Research Alliance (TDRA) Executive Director, a team of Toronto scientists has been awarded a grant by Bell Let’s Talk and Brain Canada to find a long-lasting treatment for depression, a risk factor for dementia.

The approach, currently under development by scientists at CAMH, Sinai Health, and Temerty Faculty of Medicine at the University of Toronto, involves tweaking an existing form of brain stimulation therapy to make it more potent for the treatment of depression. 

“It is a very exciting collaboration that combines bench and bedside research in the same project to learn, in an animal model of depression how best to optimize the efficacy of theta-burst stimulation in generating brain plasticity and then apply these learnings in adults with depression using clinical brain stimulation. And, throughout the project, people with lived experience and trainees are directly involved to integrate knowledge translation about bench-to-bedside research throughout all phases of the study,” said Dr. Rajji.

One component on the basic science end of the project is being led by Lunenfeld-Tanenbaum Research Institute (LTRI) Sinai Health and Tanz Centre for Research in Neurodegenerative Diseases researcher Dr. Graham Collingridge, alongside LTRI staff scientist Dr. John Georgiou. Drs. Collingridge and Georgiou are using brain stimulation in a research lab with mice to determine whether changing the rhythm, or spacing, of the pulses to the brain could ultimately deliver long-lasting brain plasticity.

A second component on the bench side also is being led by Temerty Faculty of Medicine researcher, Dr. Evelyn Lambe, preclinical expert in prefrontal cortex, a brain region required for emotional regulation and higher cognition, and will focus on optimizing the above brain stimulation in an animal model for depression. "The goal is to optimize the stimulation of brain cells to create new and lasting connections," according to Evelyn Lambe, one of 4 co-PIs who are leading this project. Dr. Lambe’s team investigates the impact of social isolation on the brain has become increasingly relevant to mental health during the COVID19 pandemic. 

The third component of the project will focus on adults with clinical depression. The theta-burst stimulation as optimized in rodents in the first two components will then be adapted to humans using Transcranial Magnetic Stimulation (TMS) and electroencephalograhy (EEG) in Dr. Rajji’s lab. It will then be tested again traditional theta-burst stimulation to examine whether it will lead to better brain plasticity in the frontal lobes of adults with acute depression. 

Throughout the above phases, Dr. Sanjeev Sockalingam, a Clinician-Scientist and Vice President of Education at CAMH, leads the knowledge translation component of the project, which includes mental health clinicians, people with lived/living experience and families working with researchers from the start of the grants. “This integrated approach involving clinicians and service users will help us co-create knowledge that gets to people who can use it faster and more effectively”, said Sockalingam.

 “We need better and more efficient treatments for depression especially treatments that reduce the cognitive deficits associated with depression and potentially reduce the risk of developing dementia in this high-risk population,” added Dr. Rajji. “Designing a translational project that will bridge within the span of 3 years new discoveries in the basic science labs to advancing clinical therapies for people with depression is a highly promising approach in the quest of these new treatments”.

Another CAMH project funded as part of this initiative is led by Dr. Daniel Blumberger, CAMH Clinician Scientist and Director of the Temerty Centre for Therapeutic Brain Intervention. He and his team will test the efficacy of a novel, 5-day treatment schedule for the approved intermittent theta-burst stimulation (iTBS) protocol as a potential new rapid acting treatment for treatment resistant depression (TRD).  The group of investigators have previously demonstrated that iTBS is as effective as standard transcranial magnetic stimulation for TRD, while taking a fraction of the time to administer.
 

Cannabis Research Blocked by Policy
Hinders Public Health

By Françoise Makanda at The Dalla Lana School of Public Health, U of T

Are edibles better than vaping cannabis? Is vaping cannabis better than smoking marijuana? Even the experts don't know—yet.

Since the legalization of cannabis in Canada, researchers are very focused on these questions, as explored in a new commentary published in The Lancet Regional Health – Americas entitled “Cannabis clinical research in purgatory: Canadian researchers caught between an inflexible regulatory environment and a conflicted industry.”

“You need full documentation on each cannabis product and that's incredibly expensive,” says co-author Michael Chaiton, Associate Professor at The Dalla Lana School of Public Health (DLSPH), and Independent Scientist at the Institute for Mental Health Policy Research (IMHPR) at CAMH.

Cannabis companies were initially enthusiastic about participating in this model until costs and capacity became an issue, says Chaiton. “[The attitude was] why do we want to do this? It is just going to tell us that some things are more harmful than others when we just want to not worry about that.”

Researchers like Chaiton want the ability to research cannabis products to compare their safety. But there is no independent system to study cannabis and enact quality control without support from the cannabis company themselves.

“There is sort of a push within Health Canada to try and get this sorted out, but it's not going fast enough. I'm worried that it's not going to end up in the way that it should.”

In a recent study comparing the health outcomes of vaping versus smoking, DLSPH Research Associate Anasua Kundu, U of T’s Assistant Professor of Psychiatry and IMHPR Independent Scientist Sergio Rueda, and Assistant Professor in the Department of Pharmacology and Toxicology and IMHPR Independent Scientist Patricia Di Ciano concluded that there was no substantial evidence that would pit one over the other. 

“The public health approach to cannabis, including Canada’s Lower-Risk Cannabis Use Guidelines, recommends vaping over smoking cannabis. Part of the reason for that is because we assume that smoking any organic product is going to have a negative impact,” says Chaiton.

“And that is probably true. But to be honest we don't know.” 

Vaping creates micro fine particles in the lungs that could be equally damaging to organic smoking.

Chaiton and DLSPH Professor and IMHPR Senior Scientist Robert Schwartz are kicking off a study to examine, through CT scans, lung damage from cannabis, vaping or organic smoking of cannabis. Chaiton believes it is one of the first studies to examine vaping cannabis versus tobacco. It might help resolve some of the enduring questions they can’t seem to answer.

"Cannabis was legalized on the pharmaceutical model. That really led to some understatement of the potential harms. And right now, certainly, compared to cigarette smoking, it seems to have limited damage compared to cigarette smoking, but partly I think, because that few people really ingest enough to have this sort of obvious effect,” he says. 

Further, cannabis ingestion comes in many forms. Chaiton has noticed an uptick in cannabis edibles use among older people. 

Still, Chaiton argues that the bottleneck is with Health Canada. "If you wanted to do a trial with alcohol, you can. You buy things from the LCBO and you can give them to people. Same with tobacco. You can just, again, buy things from a store since it is a product on the market. And again, ethically you give them to people who are already using them. And you can do comparative tests. You can't for cannabis.”

Products are evolving rapidly within the industry. Observational studies are needed. Canada is poised to be a leader in cannabis research as it is one of the few countries that have legalized its use, says Chaiton. 

He is asking for change. 

"We shouldn't have to rely on the cannabis companies to be able to do research. These are products on the market for consumers that are being used in normal way by people in their daily life.”
 

Buzz-worthy News

• Study was the first to use Ontario’s health administrative data to identify patients with eating disorders, and found that patients were about 90% female and, on average, about 30 years old. 

  https://twitter.com/EENet_news/status/1489250460259078160?cxt=HHwWoMCilefZ8KopAAAA

• Did you know that the way you eat, move and sleep can impact your mood? Check out this video created by the Cundill Centre for Child and Youth Depression that provides tips on healthy eating, movement and sleep habits.
  https://youtu.be/qMnQFTy3t30 
• Vaccine confidence low among 2SLGBTQ+ youth experiencing homelessness
  https://twitter.com/IAlexAbramovich/status/1488536964039065609?cxt=HHwWkoCyie6erKgpAAAA
• CAMH is excited to collaborate with the Centre for Aging + Brain Health Innovation, a Toronto-based innovation accelerator focused on advancing brain health solutions. 
  https://twitter.com/CABHI__/status/1486719444298567696