What is your current research project?
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| 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.
