Submitted by acs95 on Wed, 05/03/2025 - 15:45
Name: Hailun Cui
Research group: The Voon Lab
Supervisor: Valerie Voon
Advisor: Rafael Romero Garcia
Title of your PhD/MPhil: Optimizing the neuromodulation of pathological neural circuits: multiparametric approaches and biomarker prediction.
Can you give us a short background into what your PhD/MPhil was about?
Over recent decades, significant advancements have been made in the formulation of neurocircuitry models of the brain. These developments have paved the way for hypothesis-driven interventional approaches directly targeting specific brain circuits, offering new possibilities for effective interventions and therapeutic strategies. The modification of brain functioning derived from these devices or surgically based neuromodulations, in turn, has refined and deepened our understanding of the neural and cognitive mechanisms central to the pathophysiology of psychiatric illnesses.
My work during PhD is focusing on exploring the therapeutic outcomes and underlying mechanisms of two clinically well-established approaches of neuromodulation, namely, the invasive anterior capsulotomy procedure and the non-invasive transcranial magnetic stimulation (TMS) for the management of two common psychiatric disorders that can be clinically refractory: obsessive-compulsive disorder (OCD) and major depression.
How would you sum up your main findings?
What I found in the OCD project added to the understanding of the therapeutic mechanisms of anterior capsulotomy in treatment-resistant OCD, showing alleviation of dysfunction possibly through a functional remodification of neural circuits involving the nucleus accumbens and rostral cingulate, both implicated in negative emotional processing. This is critical, as it provides valuable insights for the mechanistic understanding of the disease and clinical care, effectively addressing the previously unanswered question of the predominant cortical region's connection to specific behavioural effects and treatment outcomes, which tractography studies were unable to clarify.
In the depression project, I examined the translational potential of incorporating additional targets or nexuses implicated in various neurocircuits based on the latest insights into the multi-network pathophysiology of depression. This involved employing an innovative dual-site TMS treatment protocol for depression patients, targeting two cortical areas: the orbitofrontal cortex and the dorsolateral prefrontal cortex, which demonstrated a faster onset in clinical response. Both studies have shown how an improved understanding of the mechanism of action underlying treatment effectiveness can be achieved through the progressive accumulation of clinical data and how the latest developments can reversely benefit the ongoing and future therapeutic options with enhanced treatment outcomes.
What made you want to do a PhD?
We could all agree that it is a rare and unique experience in one's life to have a few years' of time fully dedicated to understanding a particular question. Rather than scratching the surfaces, PhD allows a chance to go deeper and truly contribute to the understanding of a cause or outcome of a certain phenomenon. As a medical student, I was introduced to neuromodulatory strategies for psychiatric conditions previously considered highly debilitating and resistant to common treatments. I found this field of research extremely fascinating and full of potential. I believe by doing a PhD, I could gain a deeper understanding of the underlying mechanisms or even the unresolved limitations of these neuromodulatory techniques and could help better serve the patient population, hopefully with fewer side effects and more precision.
What was your best day during your PhD?
They are more like moments rather than days. Sometimes I spent days or weeks struggling on the explanation of a result or a phenomenon I found that was unexpected or appeared unreasonable at first sight. Just before I gave up a novel idea kicked in as I was going through the literature, and suddenly everything seemed to fall into place. To me, one thing that is truly fascinating about research is that the journey is nothing if not full of surprises or turnarounds.
What was your worst day during your PhD?
Everyone goes through highs and lows during the PhD study but what hits hardest for me is when my research gets rejected by peer-reviewed journals. While it becomes easier with time to recognize that rejection is an essential part of the research process, it's still not something people seek out for the optimal experience.
Do you have any words of advice for future PhD/MPhil students in Psychiatry?
Keeping an optimistic outlook is essential during the PhD process since setbacks are inevitable. If your research plan does not go as expected, always keep in mind that misfortune may be a blessing in disguise. Talk to your supervisor or colleagues; what they say may help clear up your thoughts.
What do you hope to do next?
I got accepted into a clinical residency program specializing in functional neurosurgery in Shanghai, where I may have the chance to apply what I learned during my PhD in real clinical settings. This journey will undoubtedly be challenging, yet I'm eager and thrilled at the prospect of acquiring new knowledge and skills.