Researcher Profile: Dr. John Fisk

What is your current research project?

Dr. John Fisk

I have a number of ongoing projects together with colleagues here at NSHA and at other centres across Canada. For a number of years, I have been looking at the impact of mental health conditions, including anxiety and depression, on cognitive functioning, quality of life, and chronic disease development and progression. Most of this work has examined these issues in persons with multiple sclerosis (MS) although we are examining other chronic health conditions as well. Some of these studies have included MRI measures of brain structure and function in attempts to better understand these issues. An example of an ongoing project with colleagues here is the Lupus Brain Map Study, being led by Dr. John Hanly. In this project we are using advanced neuroimaging studies being conducted at BIOTIC, to explore associations between blood-brain-barrier permeability abnormalities and the presence of cognitive deficits as well as changes in the functional connectivity of brain networks, in persons with systemic lupus erythematosus.

How did you become interested in your research topic? 

The research that I have done has always been informed by the people who I meet in my clinical practice, including both my patients and my colleagues. My patients are the ones who tell me the really important issues that need to be addressed and my colleagues often pose the clinical conundrums that need to be understood better. What has typically guided my research has been the fact that common themes arise across a variety of clinical health conditions, diagnoses, and areas of clinical practice and I enjoy the taking what I have learned in one setting and applying that knowledge in a new setting.

What has been unexpected about your findings so far? 

To me, one of the unexpected findings has been just how hard it is to demonstrate, through our research, some of the things that our patients tell us regularly when we talk to them. For example, patients with MS have often told me how their cognitive difficulties, anxiety, depression and fatigue (for example) can be as disabling as their neurologic symptoms. But it took a study of over 900 patients done across three provinces, with numerous clinical and symptom measures, in order for us to demonstrate this. We have also shown that mental health conditions can be associated with progression of neurologic disability in MS and can precede MS development in some. For most of the patient populations that I work with there are common inter-related issues and understanding their relative contributions to each individual is key.

What’s innovative about your research? 

One of the innovative aspects of the research that I have done has been the linkage of detailed clinical data with health administrative data at a Provincial level, and the collaboration with others across Canada using similar linked datasets. This approach has allowed my colleagues and me to examine associations between particular health conditions and the development and progression of MS, and is an approach that can be applied to other diseases as well. In doing this we have gained opportunities to identify key factors to improve disease management as well as suggestions of possible shared pathophysiological mechanisms that support other areas of future research.

One word that best describes how you work: Collaboratively

What technology can’t you live without? 

As a clinical neuropsychologist, my work is fundamentally based on the observation and description of human behaviour. There are many technologies that can facilitate this work, even to the point of using MRI to examine relations between brain structure/function and behaviour. However, since I started in this business quite a while ago, there are really no particular technologies that I truly can’t live without to do my work.  That being said, almost all of my research involves collaboration with colleagues who are spread out across Canada and occasionally other countries as well. Email and internet access means that I can work as closely with these colleagues as with my colleagues next door. Without this, all of our work would be greatly diminished.