Scanner a step toward making it possible to see mental illness

Machine one of only three in Canada and first for mental-health research

The Royal Ottawa Mental Health Centre unveiled a new scanner Thursday that brings together two technologies to give researchers a new way to look inside the brain.

The images from the positron emission tomography/magnetic resonance imaging (PET/MRI) machine will help them learn how to pinpoint diagnoses, predict the right treatment and tailor individual therapies.

Dr. Zul Merali, the head of the Royal’s Institute of Mental Health Research, says it will make the invisible visible to help people who too often suffer in silence.

“I dream of a day when mental illness is treated like any other medical condition, like diabetes or heart disease, when access to treatment is as simple as walking through a single door,” Merali told doctors, donors and patients at the launch.

“I hope for a day when we can talk about cures for mental illness, not temporary fixes.”

Installed at a total cost of $13.5 million, the PET/MRI unit has been Merali’s goal for almost a decade. Many called it an impossible dream, he said.

Made possible through an unprecedented $25-million fundraising campaign — there were 17 contributions of more than $1 million — the machine is one of only three in Canada and the first dedicated to mental-health research.

Until now, diagnosing mental illnesses has been symptom-based, asking patients “how do you feel?” Merali said.

The device is a step toward having diagnoses of mental illness confirmed with blood tests and medical imaging, just like cancer, resulting in targeted treatment instead of trial-and-error.

The primary focus of research will be depression — the costliest illness worldwide.

Of patients now being diagnosed and treated with mental illness, a third won’t be helped by any therapy doctors can offer.

“It’s not a pretty picture,” Merali said. “We’d like to do a lot better. The one way to make a difference is to be able to see the organ you’re treating.”

The Royal will be working with the Canadian Armed Forces — which is making a funding announcement at the mental health centre Monday — on using the machine for research on posttraumatic stress disorder.

On the new scanner, the brains of people with the disorder “light up like a Christmas tree,” Merali said, noting that “you don’t need to be a neuroscientist to differentiate the brain of a (someone in a) control (group) and someone who has PTSD.”

Among the questions a worldrenowned local researcher hopes to answer is where suicidal thoughts lie in the brain.

Dr. Pierre Blier, a Canada Research Chair in psychopharmacology at the University of Ottawa who heads research into mood disorders at the Royal, is studying how the anaesthetic ketamine works on patients with depression that’s resistant to traditional drug treatment. He was the first in Canada to use it.

In the first part of his study, twothirds of 25 patients were better within 24 hours after a single low dose, and it lasted up to three weeks. Nearly all stopped having suicidal thoughts, buying their doctors time to try other strategies.

In the next phase, with 40 patients, Blier will scan patients before and after the treatment to see what parts of the brain are involved.

“We could have an impact on suicide rates,” he said. “There are 4,000 suicides a year in Canada. There are more people committing suicide than dying on our roads. Worldwide, 900,000 — it’s like making Ottawa disappear every year.”

Dr. Fakhereh Mirrashed, manager of the Royal’s brain imaging centre, said the PET/MRI machine will allow researchers to have perfectly matched images that show both what’s going wrong and where.

The scan shows both the electrical pulses and neurotransmitters that allow the different parts of the brain to communicate and maps it, for example, tracing blood flow to areas that are more or less active.

Done separately, the two pictures never line up.

“When these two match, I know exactly what is happening,” Mirrashed said. “I have an anatomical picture and a molecular level picture.”

The one way to make a difference is to be able to see the organ you’re treating.