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From careers as an accountant and a tax lawyer, and now pursuing a doctorate in clinical psychology at the University of Auckland, Gisborne-born Gina Waters is returning home after 20 years. She is part of a ground-breaking Attention Deficit Hyperactivity Disorder (ADHD) research team at Mātai Medical Research Institute. Gina talks to Avneesh Vincent about her role in the study, changing careers and the need for advanced medical technology.

Gina's journey back to Tairāwhiti has included travels in Europe and Western Australia while pursuing university studies. Now back home, she is working with Mātai researchers conducting pre-scanning assessments, which involve consent paperwork and performing a continuous performance task (CPT) with volunteers.

The research team carried out their last dry run on Wednesday with team members volunteering to scan their brain activity — to assess attention and decision-making (a Flankers test) —  under Mātai's state-of-the-art functional magnetic resonance imaging (fMRI) machine.

“This method of scanning images the blood flow in the brain, which makes it different from a standard MRI, and it's safe,” Gina said.

The scanning procedure takes an hour and 20 minutes to complete, including a break, and participants are required to be under the scanner most of the time.

“We recognise the time commitment the participants put into the test. That's why our Mātai staff here have taken the test themselves to make sure it's comfortable enough.”

A projection from an LCD (liquid crystal display) behind the participants screens instructions about what the researchers are doing, but most scans involve people getting a “relaxing treat” — images of landscapes coupled with soothing music in the scanner.

It is a collaborative study between researchers at Auckland Bioengineering Institute (ABI) and Mātai Medical Research Institute in Gisborne. ABI associate Professor Justin Fernandez is the project leader.

Three years ago he formed a hypothesis that increased blood flow to the frontal lobe and increased neurotransmitter activity caused by fidgeting might help people with ADHD to concentrate.

The research proposes to use fMRI scans to investigate whether fidgeting, often seen in people with ADHD, might improve activation in the decision-making region of the brain.

Gina said from a psychological perspective, her role was to administer a continuous performance task (CPT) — a 15-minute assessment — to determine if there was consistency between the fMRI imaging and the CPT testing.

“When it's consistent, I should be able to just pull out an image from the scanner and confirm whether it's ADHD or not and give them a score.”

Gina's interest in the heath sector was her third career change.

“I used to be an accountant as I loved crunching numbers and was passionate about it. I was a tax lawyer next and then I got to a point where I wanted to work with people rather than sitting in front of spreadsheets.”

She took a U-turn and studied for a social work in psychology degree, finishing her master's degree in Australia.

Following her studies, she worked as a mental health social worker with the Martu and Nyiyaparli people in the Western Australian desert and the Jawoyn people of Katherine in the Northern Territory.

“I went there as an addiction and suicide prevention specialist, attending to people who were unwell and needing psychiatric help,” she said.

Occasionally, Gina had to drive to remote communities as far as 1200km away and during this time she developed an interest in clinical mental health.

To further her interest in the health sector she decided to take up her doctorate, this time in Aotearoa.

“I wanted to come back home, as I have my whānau here in New Zealand. My oldest son is studying at the University of Auckland . . . so I chose the same university as him.”

While completing her preparatory year for the clinical doctorate last year, she attended an anatomy lecture which gave her insight into how the brain operates and impacted human behaviour, and saw her first fMRI scan of the human brain.

“From that moment I was fascinated by the anatomical relationship between the brain and behaviour. I found it exciting to see such an image and that there were people dedicating their careers to such study, which is quite cool.”

After attending a series of lectures on anatomy, she was convinced to pursue her newly-found interest.

She approached Mātai research director Dr Samantha Holdsworth, who put her in touch with Dr Fernandez and the ADHD project in Gisborne.

One of the core aspects of the research is its multidisciplinary approach, with the ABI research team bringing biomedical engineering experience, backed by Gina's psychological perspective and the medical centre's technical expertise.

“The role of psychology is to address the learning difficulties of those who are on the ADHD spectrum and displaying significant symptoms,” she said.

The research study will start its trials on adults and then follow up with children.

“If research such as this at Mātai and Justin's group can happen in remote rural communities like the East Coast, then advanced health technology becomes normalised and more accessible.”

She has taken up the challenge to normalise the use of technology to reduce health inequalities in the community.

“What excites me about the research is the preventative potential of this technology and how much good can be done if health issues are caught early.”

Gina plans to have her placement in Gisborne for the last year of her clinical doctorate.

“I have my whānau here in Gisborne — two nieces and a nephew, great-nephews and a great-niece, my aunties and uncle and my cousins. My whānau have maintained ahi kaa (kept the fire going) for me all these years, so it feels great to come home.”

COMPENSATORY STRATEGY: Gina Waters says fidgeting is a good strategy to develop if you have ADHD. 'It's my understanding that the earlier you develop it, the better.' Picture by Liam Clayton