Dr. Nir Lipsman wins 10th annual Royal-Mach-Gaensslen Prize

Non-invasive brain surgery helps heal mental illness

As an aspiring young psychiatrist, Nir Lipsman learned about the possibilities of new treatments called “neuromodulation” for mental illnesses. He switched to neurosurgery and has never looked back.

Today, Dr. Lipsman is director of the Harquail Centre for Neuromodulation at Sunnybrook Health Sciences Centre in Toronto. Neuromodulation involves stimulating nerves using drugs, electrical signals or other forms of energy. For example, Lipsman has used deep brain stimulation to treat alcohol use disorder and post-traumatic stress disorder. MRI-guided focused ultrasound is being used to treat obsessive-compulsive disorder and depression. Lipsman’s centre is also a leader in repetitive transcranial magnetic stimulation.

This work has garnered Dr. Lipsman the 10th annual Royal-Mach-Gaensslen Prize, jointly sponsored by the University of Ottawa Institute of Mental Health Research at The Royal and the Mach-Gaensslen Foundation of Canada.

“Dr. Lipsman, a clinician-scientist, is the first winner in the 10 years of the Royal-Mach-Gaensslen Prize who is a neurosurgeon,” says Dr. Chris Carruthers, chair of the board of the Mach-Gaensslen Foundation of Canada. “His area of research is novel and represents the value that the prize can bring to new approaches to mental health and illness.”

Neuromodulation approaches are less invasive or entirely non-invasive, avoiding traditional surgery. Lipsman and his team are trying them in patients who still have significant mental illness despite previous treatments with other, more conventional therapies, such as drugs and psychotherapy.

At the prize ceremony December 2 in Ottawa, Dr. Lipsman told the story of a young adult patient with severe obsessive-compulsive disorder that had a devastating effect on her life. Non-invasive neurosurgery resulted in a dramatic improvement that has allowed her to reach some of her life goals. The patient is now part of a patient team helping the hospital design new research studies.

Lipsman says many serious mental illnesses have their origin in brain circuits that don’t function as they should. In a video about his work, Lipsman says, “To me, it’s a reflection of where we are as a field, of recognizing that these are hard-and-fast organic conditions that require surgical intervention, whether non-invasive or invasive or across that spectrum.”

Media host and fundraiser Sam Laprade, who served as emcee of the ceremony, asked Lipsman about making sure that all members of society have access to such cutting-edge treatments.

“These are conditions that touch people from all socio-economic backgrounds,” said Lipsman. Reaching people who could benefit from neuromodulation is one of Sunnybrook’s aims. “It’s not enough to just have the fancy tools.” He described Sunnybrook’s outreach program to clinicians, especially throughout Ontario, to let them know that treatments are available. He says the hospital also receives referrals from across the country.

But there can be long waitlists for neurosurgery. He says the wait for neurosurgery for epilepsy — an effective and well-known treatment — is currently 18 years. “There is an access problem, and we need to address that.”

He would like to see neuromodulation for mental illness move from research studies to first-line treatment. Currently, he says the risks associated with neuromodulation are low and approaching zero. And treatment times are shrinking from weeks to minutes. These developments would make neuromodulation safer and more accessible.

Learn about Dr. Nir Lipsman’s research in this short video. Video production: SandBay Entertainment.

If you missed the prize ceremony, you can view it here.

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