Completed Early Career Practitioner Fellowship: Jerome Maller



Completed Early Career Research Fellowship: Jerome Maller

Host Organisation: Monash Alfred Psychiatry Research Centre, Monash University

TAC Funding: $313,721

Mentor: Professor Paul Fitzgerald

Fellowship Project:

Diffusion tensor imaging as a marker of depression in diffuse axonal injury: Could this be predictive of outcome after traumatic brain injury?

Aims:

The aim of this study was to use an advanced form of magnetic resonance imaging (MRI) brain scanning, called DTI (diffusion tensor imaging), as a tool to study functional and structural connectivity in post-traumatic brain injury (TBI) depression. This could directly lead to the use of DTI as a method of predicting the likelihood of future development of post-TBI depression, leading to targeted early intervention. Improved understanding of the underlying causes of post-TBI depression should also enhance the development of new treatments. Prediction of outcome and requirement for early intervention will be greatly enhanced through this study.

Methods:

Forty people who had sustained a mild to moderate TBI were recruited from The Alfred hospital Emergency & Trauma Department, in addition to 25 people with depression but no TBI history, as well as 25 people with no depression or TBI. Each person was assessed for depression symptoms and underwent the MRI brain scan. Data was analysed by Dr Maller using specialised software which compared each person’s brain scan voxel-by-voxel (that is, a few millimetres at a time).

Results:

Results indicate that people who developed depression after a TBI had reduced integrity of the connection fibres (white matter) in their brains, more so than those who had depression with no history of TBI, or those with TBI who did not develop depression. These regions, particularly those near the front of their brain, are known to be related to personality and emotion. The reduced connection integrity also helps to explain the slowing down of reaction time in these patients.

Conclusions:

This study has shown that depression in people who have no history of brain injury has a different underlying brain activity than depression in people who developed depression after sustaining a brain injury. With these differences now identified via this TAC study, treatment approaches can begin to be customised to specifically target the regions identified as directly relevant to one of these forms of depression or the other.

Career Development

Jerome participated in the following activities funded during the course of his TAC Fellowship:

Short Courses:

• Media Training for scientists

International Exchange:

Jerome was selected to be part of a TAC delegation who visited Canada as part of a international research exchange with the Ontario Neurotrauma Foundation. The delegation travelled to Toronto, Hamilton and Ottawa in Canada during May 2009.

Mentorship:

• Co-supervised five students at undergraduate and postgraduate levels from Science, Engineering, Biomedical Engineering and Electrical Engineering Departments.

• On the 14th of November 2008, the Fellow shadowed Rachael Heveren, a Year 11 student from St Mary’s College in Seymour, Victoria. Rachel was among only two students to be the first Research Australia 2007 Youth Ambassadors for Health Research, following a state-wide competition.

• The Fellow also delivered MRI- and neuropsychiatry-related lectures in 2010.

Post Fellowship Career Development

Since his TAC Fellowship, Dr Maller has been awarded a 4-year NHMRC Industry Career Fellowship Award to investigate CT, MRI and electrovestibulography in identical groups as those recruited in the current TAC Fellowship. A major advantage of this additional award is that it will allow Dr Maller to complete his subject recruitments, run final analyses, and publish the results in peer-reviewed journals. Dr Maller’s long-term career goals encompass being a full-time neuroscientist studying neurotrauma and neuropsychiatric disorders with applied electrophysiological, brain stimulation, and structural and functional neuroimaging techniques.

Feedback on the Fellowship from Jerome Maller:

“I have already shown that the work I produce is world-class and has the potential to significantly advance our understanding of brain structure and function and relationship with behaviour. Completion of the TAC Fellowship has broadly enriched my capacity to progress along this current career path and fulfil future career intentions.”

“I am particularly grateful to the TAC for offering me so many wonderful opportunities. It was an honour to present to TAC and TAC staff at meeting/symposia. I am especially grateful to the TAC for including me as one of five invited TAC delegates who visited Ontario, Canada traumatic head injury rehabilitation facilities for five days in May 2009. It was a wonderful experience and gave me the opportunity to interact with Canadian-based TBI researchers, whom I have subsequently formed an affiliation with.”

Publications

CHERBUIN N, WINDSOR T, ANSTEY KJ, REGLADE-MESLIN C, MALLER JJ, SACHDEV PS. Hippocampal volume is positively associated with behavioural inhibition (BIS) in a large community-based sample of mid-life adults: the PATH through life study. Social Cognitive and Affective Neuroscience. 2008;3:262-269.

LOOI JCL, LINDBERG O, LIBERG B, TATHAM V, KUMAR R, MALLER JJ, MILLARD E, SACHDEV P, HOGBERG G, PAGANI M, BOTES L, ENGMAN E-L, ZHANG Y, SVENSSON L, WAHLUND L-O. Volumetrics of the caudate nucleus: reliability and validity of a new manual tracing protocol. Psychiatry Research Neuroimaging. 2008;163(3):279-288.

CHERBUIN N, ANSTEY KJ, SACHDEV PS, MALLER JJ, MESLIN C, MACK H, WEN W, EASTEAL S. Total and regional grey matter volume is not related to APOE*E4 status in a community sample of middle-aged individuals. Journal of Gerontology. Medical Sciences. 2008;63:501-504.

FURTADO C, MALLER JJ, FITZGERALD PB. A MRI study of the Entorhinal Cortex in Treatment Resistant Depression. Psychiatry Research: Neuroimaging. 2008;163:133-142.

DASKALAKIS ZJ, FARZAN F, BARR MS, MALLER JJ, CHEN R, FITZGERALD PB. Long-Interval Cortical Inhibition from the Dorsolateral Prefrontal Cortex: a TMS-EEG Study. Neuropsychopharmacology. 2008;33:2860-2869.

FITZGERALD PB, DASKALAKIS ZJ, HOY K, FARZAN F, MALLER JJ. Cortical inhibition in motor and non-motor regions: a combined TMS-EEG study. Clinical EEG and Neuroscience. 2008;39:112-117.

FITZGERALD PB, MALLER JJ, HOY K, THOMSON R, DASKALAKIS ZJ. Exploring the Optimal site for the Localization of Dorsolateral Prefrontal Cortex in Brain Stimulation Experiments. Brain Stimulation. 2009;2(4):234-237.

SUN J, MALLER JJ, DASKALAKIS ZJ, FURTADO C, FITZGERALD PB. Morphology of the corpus callosum in treatment-resistant schizophrenia and major depression. Acta Psychiatrica Scandinavica. 2009;120(4):265-273.

FITZGERALD PB, DASKALAKIS ZJ, HOY K, FARZAN F, MALLER JJ. GABA and cortical inhibition in motor and non-motor regions using combined TMS-EEG: A time analysis. Clinical Neurophysiology. 2009;120(9):1706-1710.

BEAUCHAMP MH, ANDERSON VA, CATROPPA C, MALLER JJ, GODFREY C, MORSE S, ROSENFELD J, HARITOU F, KEAN M. Implications of reduced callosal area for social skills after severe traumatic brain injury in children. Journal of Neurotrauma. 2009;26(10):1645-54.

LOOI JCL, TATHAM V, KUMAR R, MALLER JJ, MILLARD E, WEN W, BRODATY H, SACHDEV P. Caudate nucleus volumes in stroke and vascular dementia. Psychiatry Research Neuroimaging. 2009;174(1):67-75.

SUN J, MALLER JJ, GUO L, FITZGERALD PB. Superior temporal gyrus volume change in schizophrenia: a review on Region of Interest volumetric studies. Brain Research Reviews. 2009;61(1):14-32.

LOOI JC, MALLER JJ, PAGANI M, HÖGBERG G, LINDBERG O, LIBERG B, BOTES L, ENGMAN EL, ZHANG Y, SVENSSON L, WAHLUND LO. Caudate volumes in public transportation workers exposed to trauma in the Stockholm train system. Psychiatry Res. 2009;171(2):138-143.

FITZGERALD PB, HOY K, MCQUEEN S, MALLER JJ, HERRING S, SEGRAVE R, BAILEY M, BEEN G, KULKARNI J, DASKALAKIS ZJ. A randomized trial of rTMS targeted with MRI based neuro-navigation in treatment-resistant depression. Neuropsychpharmacology. 2009;34(5):1255-62.

RUSJAN PM, BARR, MS, FARZAN F, ARENOVICH T, MALLER JJ, FITZGERALD PB, DASKALAKIS ZJ. Optimal TMS Coil Placement for Targeting the DLPFC Using Novel MRI-Guided Neuronavigation. Human Brain Mapping. 2010;31(11):1643-1652.

MALLER JJ, THOMSON RH, LEWIS PM, ROSE SE, PANNEK K, FITZGERALD PB. Traumatic brain injury, major depression, and diffusion tensor imaging: Making connections. Brain Research Reviews. 2010;64(1):214-230.

MALLER JJ, DASKALAKIS ZJ, THOMSON RHS, DAIGLE M, BARR MS, FITZGERALD PB. Hippocampal volumetrics in treatment-resistant depression and schizophrenia: The Devil’s in de-tail. Hippocampus. 2010;doi:10.1002/hipo.20873.

MOUSAVI EA, MALLER JJ, FITZGERALD PB, LITHGOW BJ. Wavelet Common Spatial Patterns in Offline Brain Computer Interfaces. Biomedical Signal Processing and Control. 2011:6(2):121-128.

FITZGERALD PB, HOY KE, MALLER JJ, HERRING S, SEGRAVE R, MCQUEEN S, PEACHEY A, HOLLANDER Y, ANDERSON JF, DASKALAKIS ZJ. Transcranial Magnetic Stimulation for depression following Traumatic Brain Injury: A case study. Journal of ECT. 2011;27(1):38-40.

BEAUCHAMP MH, ANDERSON VA, CATROPPA C, MALLER JJ, GODFREY C, MORSE S, ROSENFELD J, HARITOU F, KEAN M. Structural brain changes persist 10 years after childhood traumatic brain injury. International Journal of Developmental Neuroscience. 2011;29(2):137-43.

MALLER JJ, REGLADE-MESLIN C, CHAN P, DASKALAKIS ZJ, THOMSON RHS, ANSTEY KJ, BUDGE M, SACHDEV P, FITZGERALD PB. Hippocampal sulcal cavities: prevalence, risk factors and relationship to memory impairment. Brain Research. 12;1368:222-30.

CYPRIEN F, COURTET P, MALAFOSSE A, MALLER JJ, MESLIN C, BONAFÉ, LE BARS E, MENJOT DE CHAMPFLEUR N, RITCHIE K, ARTERO S. Suicidal behavior is associated with reduced corpus callosum area. Biological Psychiatry. 2011; In press. DOI: 10.1016/j.biopsych. 2011.02.035.

THOMSON RH, MALLER JJ, DASKALAKIS ZJ, FITZGERALD PB. Blood oxygenation changes resulting from trains of low frequency Transcranial Magnetic Stimulation. Cortex. 2011(04):028.

THOMSON RH, MALLER JJ, DASKALAKIS ZJ, FITZGERALD PB. Blood oxygenation changes resulting from suprathreshold Transcranial Magnetic Stimulation. Brain Stimulation. 2011:4(3)165-8.

Presentations

BEAUCHAMP MH, MALLER J, CATROPPA C, GODFREY C, DITCHFIELD M, ANDERSON V. Hippocampal correlates of memory dysfunction 10 years after childhood TBI. 14th Human Brain Mapping Conference; 2008 June, Canberra, Australia.

MALLER JJ. The present, past and future of structural neuroimaging in psychiatry. 14th Human Brain Mapping Conference; June 2008, Canberra, Australia.

MALLER JJ, DASKALAKIS ZJ, FITZGERALD PB. Hippocampal volumetrics in treatment-resistant schizophrenia and depression: the importance of the tail. 32nd Australasian Society for Psychiatric Research; 2008 December, Newcastle, NSW, Australia.

NILSSON JM, MALLER JJ, DASKALAKIS ZJ, FITZGERALD PB. Are antidepressants neuroprotective? Amygdalar volume in treatment-resistant major depression. 1st Neuroscience Symposium, Institute of Neuroscience in Newcastle on Tyne; 2008 December, UK.

FITZGERALD PB, MALLER JJ, YUEN J, DASKALAKIS ZJ. Superior temporal gyrus subvolumes in healthy individuals and in treatment resistant schizophrenia with auditory hallucinations. 32nd Australasian Society for Psychiatric Research; 2008 December, Newcastle, Australia.

FITZGERALD PB, MALLER JJ, HOY K, FARZAN F, DASKALAKIS ZJ. Paired pulse transcranial magnetic stimulation to investigate cortical inhibition. 14th Human Brain Mapping Conference; 2008 June, Melbourne, Australia.

HOY KE, MALLER JJ, HERRING SE, MCQUEEN S, SEGRAVE R, FITZGERALD PB. Does Size Matter? The relationship between hippocampal volume and memory ability in patients with treatment resistant MDD. 14th Human Brain Mapping Conference; 2008 June, Melbourne, Australia.

MALLER JJ, DASKALAKIS ZJ, FITZGERALD PB. Hippocampal volumetrics in treatment-resistant schizophrenia and depression: the importance of the tail. 14th Human Brain Mapping Conference; 2008 June, Melbourne, Australia.

FITZGERALD PB, MALLER JJ, YUEN J, DASKALAKIS ZJ. Superior temporal gyrus subvolumes in healthy individuals and in treatment resistant schizophrenia with auditory hallucinations. 14th Human Brain Mapping Conference; 2008 June, Melbourne, Australia.

BEAUCHAMP MH, CATROPPA C, MALLER J, GODFREY C, ANDERSON V. Long-term implications of paediatric TBI for social skills and brain structure. 2nd Biennial Decog Conference - Clinical and Research Perspectives in Developmental Neuropsychology; 2008 March, Sydney, Australia.

HOY KE, MALLER JJ, HERRING SE, MCQUEEN S, SEGRAVE R, FITZGERALD PB. Does Size Matter? The relationship between hippocampal volume and memory ability in patients with treatment resistant MDD. 32nd Australasian Society for Psychiatric Research; 2008 December, Newcastle, Australia.

de SOUZA-DAW T, JUNOR P, STEWART R, LEWIS PM, MANASSEH R, MALLER J. Cross-sectional human tissue equivalent phantoms. EPSM-ABEC Conference; 2009 November, Melbourne, Australia.

MOUSAVI EA, LITHGOW B, MALLER J. Wavelet common spatial patterns in asynchronous brain-computer interfaces. International symposium on Bioelectrics and Bioinformatics; 2009 December, Melbourne, Australia.

de SOUZA-DAW T, ALDHAM B, LEE B, MANASSEH R, LEWIS PM, MALLER J, RAICEVIC A,

SUTALO I, THRELFALL G. Assessing ultrasound response of materials for contrast agents and soft tissue phantoms. CSIRO Advanced Materials Conference; 2009 February, Melbourne, Australia.

MALLER JJ. Diffusion Tensor Imaging Workshop. 20th Australasian Cognitive Neurosciences Conference; 2010 November 26-29, Melbourne, Australia.

THOMSON RH, ROGASCH NC, MALLER JJ, DASKALAKIS ZJ, FITZGERALD PB. Modulation of blood oxygenation by transcranial magnetic stimulation. 20th Australasian Cognitive Neurosciences Conference; 2010 November 26-29, Melbourne, Australia.

de SOUZA-DAW T, STEWART P, LEWIS PM, JUNOR P, MALLER J, MANASSEH R. Enhanced Transcranial Doppler Procedure for the Third World. Engineering and Physical Sciences in Medicine and Australian Biomedical Engineering Conference; 2010 December 5-9, Melbourne, Australia.

ADNAN A, MALLER J, MIKULIS D, MOSCOVITCH M, GREEN REA. A second wave of damage to the brain after moderate to severe traumatic brain injury: A diffusion tensor image study of the fornix from 5 to 25 months post-injury. International Brain Injury Association conference; 2010 March 10-14, Washington, USA.

GOH CP, BYE N, MORGANTI-KOSSMANN MC, PUTZ U, TAN SS. Ndfip1 protects neurons from death following brain injury. Australian Neuroscience Society 31st Annual Meeting; 2011 January 31- February 3, Auckland, New Zealand.

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