Sri Mahavir Agarwal

Dr. Mahavir Agarwal completed his medical degree (MBBS) at JIPMER, Pondicherry, a premier medical school in India. He completed his residency in psychiatry at the National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, the largest mental health hospital and research institute in India. He obtained a PhD from the same institute where his work focused on multi-modality imaging based investigation of correlates of neural plasticity and cognition in schizophrenia. He moved to Toronto in 2017 where he completed a two-year fellowship at CAMH with Dr. Margaret Hahn and Dr. Gary Remington focusing on the relationship between metabolic health and cognition in schizophrenia, and the effect of antipsychotics on these domains. His expertise includes multi-modality neuroimaging, cognitive assessments, and in vivo measures of glucose metabolism (including the gold standard pancreatic euglycemic clamp).

Dr. Agarwal has over five years’ experience working with and helping individuals with mental illness achieve better physical and mental health. He has over 50 peer-reviewed publications. He is the recipient of the Discovery Fund Postdoctoral Fellowship in 2018, and the Hughes Postdoctoral Fellowship by the Banting & Best Diabetes Centre (BBDC), U of T and the Bebensee Schizophrenia Research Fellowship by the Ian Douglas Bebensee Foundation in 2017. His work has been funded by organizations including the PSI Foundation, Ontario and the Science & Engineering Research Board (SERB), Government of India. His current research is focused on investigating the neural correlates on antipsychotic induced insulin resistance in the brain and on clinical trials examining novel treatments that target cognitive and metabolic dysfunction in severe mental illness.

To complement his research interest, he works at the Mental Health and Metabolic Clinic and the Clozapine Clinics at CAMH, which focus on applying pharmacological interventions to improve psychopathology, cognition, and metabolic outcomes in individuals with serious mental illness.

Research Synopsis

Dr. Agarwal’s research interest lies in understanding the mechanistic underpinnings of the interactions between schizophrenia pathophysiology, antipsychotics, cognition and metabolic abnormalities with specific focus on the insulin signaling in the brain as an explanatory model. . This is clinically relevant as metabolic risk leads to a 20% reduction in life expectancy for patients with severe mental illness. He is also working on translating this knowledge to developing novel treatment strategies that can help decrease the cognitive and metabolic dysfunction in severe mental illness.

Recent Publications

1. Agarwal SM, Kowalchuk C, Castellani L, Costa-Dookhan K, Caravaggio F, Chnitoh A, Graff-Guerrero A, Hahn M. Brain insulin action: implications for the treatment of schizophrenia. Neuropharmacology. 2019 (accepted for publication).
2. Agarwal SM, Caravaggio F, Castellani L, Kowalchuk C, Costa-Dookhan K, Graff-Guerrero A, Hahn M. Brain insulin action in the disease and treatment of schizophrenia: something borrowed and something new. Neuropharmacology. 2019 (in press).
3. Agarwal SM, Hahn M, Ahsan Z, Lockwood J, Takeuchi H, Taylor V, Duncan M, Cohn T, Remington G, Faulkner G. Pharmacological interventions for reduction of weight gain in people with schizophrenia. Protocol. Cochrane Database Syst Rev. 2019 (in press).
4. Hahn M*, Agarwal SM*, Ahsan Z, Lockwood J, Takeuchi H, Taylor V, Duncan M, Cohn T, Remington G, Faulkner G. Pharmacological interventions for prevention of weight gain in people with schizophrenia. Protocol. Cochrane Database Syst Rev. 2019 (in press).
5. MacKenzie NE*, Kowalchuk C*, Agarwal SM*^$, Costa-Dookhan K, Caravaggio F, Gerretsen P, Remington G, Taylor V, Müeller DJ, Graff-Guerrero A, Hahn M^$. Antipsychotics, Metabolic Adverse Effects, and Cognitive Function in Schizophrenia. Front Psychiatry. (accepted for publication *shared first authors, ^$shared corresponding authors)
6. Bose A, Nawani H, Agarwal SM, Shivakumar V, Kalmady SV, Shenoy S, Sreeraj VS, Narayanaswamy JC, Kumar D, Venkatasubramanian G.  Effect of fronto-temporal transcranial direct current stimulation on corollary discharge in schizophrenia: a randomized, double-blind, sham-controlled mediation analysis study. Schizophr Res. 2018 Jul 31. pii: S0920-9964(18)30486-9

7. Caravaggio F, Iwata Y, Plitman E, Chavez S, Borlido C, Chung JK, Kim J, Agarwal SM, Gerretsen P, Remington G, Hahn M, Graff-Guerrero A. Reduced insulin sensitivity may be related to less striatal glutamate: An 1H-MRS study in healthy non-obese humans. Eur Neuropsychopharmacol. 2018 Feb;28(2):285-296.
8. Kowalchuk C, Teo C, Wilson V, Chintoh A, Lam L, Agarwal SM, Giacca A, Remington GJ, Hahn MK. In male rats, the ability of central insulin to suppress glucose production is impaired by olanzapine, whereas glucose uptake is left intact. J Psychiatry Neurosci. 2017 Nov; 42(6): 424–431.

Agarwal SM, Shivakumar V, Kalmady SV, Danivas V, Amaresha AC, Bose A, Narayanaswamy JC, Amorim MA, Venkatasubramanian G. Neural correlates of a perspective-taking task using a realistic 3D environment based task: a pilot functional MRI study. Clin Psychopharmacol Neurosci. 2017 Aug 31;15(3):276-281

Appointments

Assistant Professor, Brain and Therapeutics, Department of Psychiatry, University of Toronto

Honours and Awards

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2018: Discovery Fund Postdoctoral Fellowship by the Centre for Addiction and Mental Health, Toronto, Canada

2017: Hughes Postdoctoral Fellowship Award by the Banting & Best Diabetes Centre (BBDC), University of Toronto, Canada

2017: CAMH Postdoctoral Fellowship by the Centre for Addiction and Mental Health, Toronto, Canada (declined)

2017: Bebensee Schizophrenia Research Fellowship by the Ian Douglas Bebensee Foundation, Toronto, Canada

2018: Fellowship Travel Award, Department of Psychiatry, University of Toronto, Canada

2017: International Congress on Schizophrenia Research (ICOSR) Young Investigator Award, 16^th International Congress on Schizophrenia Research, San Diego, USA

2016: Schizophrenia International Research Society (SIRS) Travel Award, 5^th Biennial Schizophrenia International Research Society Conference-2016, Florence, Italy

2015: Young Psychiatrist Award, WPA International Conference (WPAIC-2015), Taipei, Taiwan

2014: Young Researcher Award, International Conference on Schizophrenia (ICONS –VI), Chennai, India

2013: Early Career Psychiatrist Travel fellowship, 4th World Congress of Asian Psychiatry, Colombo, Sri Lanka

2013: National Institute of Mental Health and Neurosciences Silver Jubilee Award for the best resident in M.D. in Psychiatry

2012: International Travel Fellowship award, 67^th Annual meeting of the Society of Biological Psychiatry (SOBP), Philadelphia, USA

2012: D.S.Raju Memorial P.G. Award for the best postgraduate paper in the south zone for the year 2012

2010: Dr.K.S.Sridhar Memorial JIPMER Alumni Association Prize and Sri.M.C. RamaVarma Valia Raja Memorial Gold Medal for the Best all-rounder among outgoing MBBS Students, Batch of 2004, JIPMER, Puducherry, India

2009: Best Paper award among medical students by JIPMER Scientific Society, Puducherry, India

2007: Short Term Studentship (STS) award for outstanding research by a medical student, Indian Council of Medical Research (ICMR), New Delhi, India. Total Amount: 5,000 INR

2006: Short Term Studentship (STS) award for outstanding research by a medical student, Indian Council of Medical Research (ICMR), New Delhi, India. Total Amount: 5,000 INR

2004: Silver Medal, International Biology Olympiad (IBO), Brisbane, Australia

Grants

2018/11-2020/10    Principal Investigator. Neural effects of antipsychotics on insulin in relation to brain glutamate level and cognition. PSI Foundation, ON, Canada. Mental Health Research Grant 2018. Total funding- 196,000 (Canadian dollar). Co-investigators: Ariel Graff-Guerrero (co-PI), Margaret Hahn (co-PI), Satya Dash, David Streiner, Aristotle Voineskos, Valerie Taylor, Fernando Caravaggio.
Collaborators: Gary Remington G, Nancy Lobaugh N, Sofia Chavez, Napapon Sailasuta

2017/4 - 2019/5    Co-Investigator. Unraveling the role of central insulin action in relation to glucose abnormalities in first-time antipsychotic users. Canadian Institutes of Health Research (CIHR) Project Scheme. 
Principal Investigator: Hahn, Margaret. Total Funding - 426,000 (Canadian dollar). 
Co-investigators: Satya Dash (co-PI), Sri Mahavir Agrawal; Adria Giacca; Ariel Graff-Guerrero; Aristotle Voineskos; Daniel Mueller; Gary Remington; Valerie Taylor; Collaborator: Gary Lewis; 

2014/11-2016/11    Principal Investigator. Neural correlates and endophenotypic validity of neuroplasticity modulation in Schizophrenia. Science & Engineering Research Board (SERB), Government of India. Start Up Research Grant (Young Scientists). Total funding- INR 610,000 (~ CAD 12,500)
Co-investigators: Venkatasubramanian, Ganesan; Debnath, Monojit