Everyone is unique! So why do psychiatric treatments still rely on a one-size-fits-all model?
Our main motivation and the core of our research revolves around the topic of ‘personalized medicine’: Going beyond the traditional ‘diagnostic-thinking’ and focusing on individual differences that can help optimize and individualize treatment or prevention strategies. In order to achieve this goal, our research focuses on multiple specialties listed below.
Neuromodulation is a term often used to describe a family of new treatments in psychiatry, that aim to modulate brain activity directly and focally, either through electrical stimulation (e.g. tDCS, tACS), via transcranial magnetic stimulation (rTMS) or via endogenous techniques such as neurofeedback or psychotherapy. Opposed to pharmacological approaches that rely on systemic application of psychoactive drugs, neuromodulation relies on neuroplasticity, and thus offers a new window of opportunity to change and modulate brain activity. For more detailed reviews and scientific backgrounds also see Neurofeedback in ADHD and rTMS in depression
For interested clients seeking neuromodulation treatment also see the neuroCare Clinics website
One specific example where we pioneered a more individualized approach to rTMS in the treatment of depression is through Neuro-Cardiac-Guided TMS, or NCG-TMS.
The broad field of ‘neuroscience’ currently comprises close to 400.000 scientific studies as indexed in PubMed. Most of these studies are relatively ‘fundamental’ studies, that are important in knowledge discovery, however, often fail to answer the ‘so what?’ question. We therefore specialize in ‘Applied Neuroscience’ where it is our primary aim to advance neuroscience from the lab to the clinic, so it can more quickly and directly serve the people that need such advances in the clinic.
One of the important techniques we use in this domain is Electroencephalography or EEG, either Quantitative EEG (QEEG) or Event Related Potentials (ERP’s). For further background reading, read more about the history from EEG to QEEG, the EEG as a biomarker or endophenotype, and some EEG examples of subtypes such as a Low-Voltage EEG and Beta spindles.
An example of new personalized insights we gained, was our applied neuroscience research in ADHD, where we started with investigating excess theta EEG activity as a biomarker in ADHD. By linking this biomarker to sleep, and understanding the role of the circadian system better, we eventually proposed and tested a theory that shed further light on the role of sleep and the circadian system in the etiology of ADHD. Below see one of our primary findings that demonstrates the overlap between the prevalence of ADHD (in blue) and the intensity of sunlight (orange and yellow) by using the slider, clearly suggesting a preventive effect of sunlight in developing ADHD mediated by the circadian system, or biological clock (Arns et al., 2013; Biol. Psychiatry).
Visualisation of the association between ADHD prevalence (blue) and sunlight intensity (orange-red), mediated by the sunlights capability to synchronize the biological clock. Use the slider to see the clear overlap.
In addition to our Applied Neuroscience research, we are also involved in several clinical trials and multicentre studies. We only take part in clinical trials that are close to our mission and vision.
iSPOT study in ADHD and Depression
Since 2008 we have been involved with the international iSPOT consortium (international Study to Predict Optimized Treatment) in ADHD (iSPOT-A) and Depression (iSPOT-D), a study sponsored by Brainresource. This is the largest biomarker study worldwide, that involved 20 clinical sites across the globe and recruited 1008 patients with depression, 332 patients with ADHD and 500 controls. Data collected included EEG, ERP, neuropsychological, clinical, imaging and genetics data collected before and after treatment (antidepressants or psychostimulant medication). For published studies on this trial see our publications.
International Collaborative Neurofeedback Study (ICAN)
The International Collaborative ADHD Neurofeedback Study is a NIMH (National Institute of Mental Health) funded study investigating the efficacy of neurofeedback for children between ages 7 and 10. This is the first multicenter double-blind placebo controlled study on the efficacy of neurofeedback in ADHD in a sample of 140 children. The cross-site investigation team was selected not only for balance between neurofeedback and mainstream ADHD investigators, but also for expertise in treatment strategy, assessment, design, biostatistics, data management, and multisite RCT execution. Data for the primary paper was collected and analyzed and the primary paper is currently under review.
Research, publications and education
For an overview of scientific publications, book chapters and books published by Brainclinics staff you can consult the Publications section or the Media section to read about some of the media appearances of Brainclinics. Or, have a look at an interactive model of the brain
Furthermore, Brainclinics also supports in the neuroCare neuroCademy workshops and training courses