Interview with Dr. Sam Doesburg

Department of Biomedical Physiology & Kinesiology

(Developmental Cognitive Neuroscience)

Callum Frost Professor in Translational Research in Autism

Joined SFU in September 2015

Our ability to unravel the biological mechanisms underpinning behaviour and the mind is expanding. Imaging techniques are critical to brain research, and advances in the development of these tools are fuelled by the rapidly moving fields of computing science and biology. Dr. Doesburg’s research program leverages brain imaging technology to probe the effectiveness of intervention strategies for autism and ultimately establish a clear, scientifically-founded basis for autism treatments.

What motivated you to pursue a career in science?
I was fascinated with the mind and psychology. During university I realized that, to understand the mind you need to understand the underlying biological processes of the brain.

Where is your research program based?
Simon Fraser University (SFU) has science research facilities on the Burnaby and Surrey campuses, as well as space at Surrey Memorial Hospital where SFU will lead the new ImageTech Lab to facilitate translational brain research. The lab will have a research-dedicated magnetoencephalography (MEG) scanner and magnetic resonance imaging (MRI) scanner, making it the only Canadian lab west of Toronto to have this combined research capacity. Having these instruments integrated at the hospital is a bonus in terms of accelerating translational research.

My research also involves infrastructure on SFU’s Burnaby campus, such as the hyperbaric oxygen chamber, which we will use in combination with the brain imaging technologies to test hyperbaric oxygen therapy as a treatment for autism.

How did the development of the ImageTech Lab and the Callum Frost Professorship for Translational Research in Autism come together?
There has been a big push for translational research in autism, which is the basis of my Chair.  This push and the combined MEG/MRI research facility at ImageTech Lab have real synergy because infrastructure for structural and functional brain imaging in a hospital setting are the ingredients for success in an imaging-driven translational approach to autism research.

My professorship came about because of the Frost family, whose son Callum was diagnosed with autism. He was treated with Applied Behavioural Analysis (ABA) therapy, but he also received alternative therapies. The family tried everything possible: ABA, dietary intervention, speech language pathology, hyperbaric oxygen, – everything – and the improvement in their son was remarkable. However, there's no way for them to say with certainty which treatment was effective, so they funded a professorship to figure this out. The questions they want answered are not for their own benefit—they have achieved positive results with their son—but instead are to see those results replicated for others. The Frost family made an entirely benevolent investment in science for the public; their motivation is philanthropic.

What opportunities does having your professorship sponsored by the Frost family bring?
There is a natural opportunity to do more outreach and engagement with the autism community because the professorship came about from parents who have been impacted by autism. This starting point removes some of the traditional barriers between science and the public, because the engagement is there from day one.

Why are you so passionate about translational autism research?
Many autism imaging studies have characterized the autistic brain, the development of the autistic brain and how those abnormalities relate to atypicalities and behaviour. These are important scientific questions but they don't offer very much translational impact; describing the brain differences doesn't provide a roadmap for families dealing with autism.

Autism is particularly interesting because there has been such a massive increase in prevalence without an accompanying increase in scientifically grounded effective intervention strategies. It is complicated by heterogeneity: it may be that some treatments are effective for some but not for others.

Treatments are expensive, yet most are not funded by the government. Parents can spend as much as $150,000 a year on some of them.  What we need is a large sample size scientific study of all of the treatments to see what is and is not effective, and what may be effective for a specific type of autistic kid.

If we can identify highly effective therapies, this would lead to better government funding for treatments and more information for the physicians.  And if some of these treatments are ineffective, then parents need to know.

How does MEG/MRI enable autism research?
We can actually map communication between different regions of the brain while the child is at rest, to look at spontaneous communication in the brain and how that develops in a person with autism. We can also map the communication – with millisecond precision – while the person is active, to show how the brain responds. These tests allow us to map how autistic and non-autistic brain communication differs. We can combine that imaging with novel treatment to determine whether the therapy has an effect.

We combine the MEG and MRI to do ‘magnetic source imaging’. MEG gives you a direct non-invasive measure of neural activity with an unprecedented combination of spatial resolution and timing accuracy. To maximize the spatial resolution you also need brain structure information from MRI. Essentially, we perform a basic neuropsychological assessment of the subject, do an MEG scan at rest and during activity and do the MRI to obtain brain structure data; together, this information gives you the most effective combination of functional imaging.

The ideal platform for this research is to have the MEG and MRI integrated in a lab, and having that lab in the hospital allows access to patients and clinical expertise. The hospital-based research lab is a good route to understanding how the developing technology can be translated to the clinical realm.

What therapies do you plan to assess?
I am interested in them all. Hyperbaric oxygen therapy is the obvious first one to test because SFU has a hyperbaric pressure chamber. With dietary interventions, there is anecdotal evidence of improvements in autistic people, and it also makes sense to look at behavioural interventions. I also foresee looking at the effects of pharmacology and neural stimulation.

How does hyperbaric oxygen therapy affect the brain and how might it affect autism?
By increasing the oxygen content in the brain you increase oxygen perfusion and you can use imaging to see this increase. Some preliminary studies and a lot of anecdotal evidence indicate that this intervention helps in autism, but the precise mechanism is not understood.

So hyperbaric oxygen therapy is used extensively despite the lack of scientific evidence?
There are numerous private clinics that offer this treatment. In BC, when you have a child diagnosed with autism, you get a relatively small amount of money from the government and the pediatrician typically recommends ABA therapy because it has received the most scientific evidence. However, people often don’t get what they consider to be a satisfactory outcome from ABA treatment. Because this is such an increasingly prevalent condition, things like dietary intervention or hyperbaric oxygen therapy are offered as private services, with claims that they can improve autism, yet there is insufficient scientific evidence of their effectiveness.

Why do you think there is such inconsistency among individual responses to autism treatments?
Several brain atypicalities (e.g., severe depression) show a bimodal response to a variety of treatments (either it works or it doesn’t), indicating that different types of brain network abnormalities may respond differently. It's quite possible that there isn't a silver bullet treatment for autism. There may be different types of abnormalities that would benefit most from different treatments.

In addition to figuring out what works best, the bigger question may be whether there are autism subgroups that respond better to certain therapies. If such subgroups can be identified using neural imaging to map the functional activity in the brain, then that will help determine who's in which group and develop a tailored approach to therapy.

What educational backgrounds and personal strengths do you look for in prospective students?
People come to brain imaging research from psychology, medicine and physiology, and on the technical side from fields like engineering and physics. I think that the drive to expand understanding, to take on something challenging, to change the way you look at things and think about the world is critical to getting the most out of graduate training.

What's the best part of the work you do?
The prospect of providing hard evidence of whether a particular autism treatment is effective, because it would impact the availability and the uptake of the treatment and influence people's lives in a positive way.

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Dr. Doesburg’s research program complements those of his SFU colleagues and harnesses the full potential of SFU’s infrastructure, expertise, strategic partnerships and commitment to translational research. His expertise combined with his unique professorship and access to state-of-the-art facilities provide an ideal platform to generate meaningful results that can be directly translated to families in dire need of effective treatments for autism.

Read more: Dr. Doesburg’s profile on the Biomedical Physiology & Kinesiology website and the New Science Faculty page

Interview by Jacqueline Watson with Theresa Kitos