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A new study aims to assess the use of functional near-infrared spectroscopy (fNIRS), a type of imaging, to provide neurofeedback during stroke rehabilitation with a goal of eventually improving patient outcomes.

fNIRS is used to detect changes in brain oxygen levels using light. More recently it has also been used to develop brain-computer interfaces (BCIs), which allow patients with brain injuries to control devices like robotic arms with their thoughts.

Dr. Sue Peters, a Scientist at Lawson Health Research Institute and Director of the Neurorehabilitation Physiology Lab at St. Joseph Health Care London’s Parkwood Institute, was one of the recipients of the Spring 2022 Lawson Internal Research Fund (IRF) Awards. 

The funds will go towards a new study to assess whether fNIRS can be used to direct neurofeedback in stroke survivors – helping them with rehabilitation.

“Currently, there's no real measure of brain activity that is used in stroke rehabilitation to help make clinical decisions,” says Dr. Peters, who is also a Professor at Western University.

Over 400,000 Canadians live with the effects of a stroke, according to the Heart and Stroke Foundation, and there’s hope that fNIRS could make a big difference by eventually improving movement and independence.

“We're going to use the device in some common tasks that people might do with their arm and determine whether we can use this device reliably and accurately in a stroke-related context,” Dr. Peters explains. 

Participants in the study will imagine moving while remaining still. This activates very similar parts of the brain to when people actually move. If done correctly, patients will see a visual cue generated through measurement using fNIRS.

“We know from MRI studies that when I move my right hand, the left side of my brain is activated,” notes Dr. Peters. “We think we can use this concept in stroke rehab.”

Dr. Peters is recruiting 40 people from the community who are at least six months post stroke and 40 healthy adults of all ages. They will first participate in motor assessment with a physiotherapist and then wear an fNIRS cap while thinking about moving their wrist to measure brain activity.

Previously, there were a lack of methods to image the brain during real-life movement.

“The hope is to eventually conduct a clinical trial where we're testing motor interventions to see whether some things are more effective than others at activating the regions of the brain that were impacted by the stroke.”

Dr. Peters believes the study has the potential to have a big impact on the future of rehabilitation for stroke patients, leading to lasting changes in quality of life.

Multiple studies are reporting the pandemic’s impact on the mental health of Canadians, but what effect is it having on our nation’s Veterans and their spouses? 

“With concerns about COVID-19 infection and drastic changes to everyday life, the pandemic is taking a toll on the health of Canadians,” explains Dr. Don Richardson, Associate Scientist at Lawson Health Research Institute and Director of the MacDonald Franklin Operational Stress Injury (OSI) Research Centre, located at St. Joseph's Health Care London's Parkwood Institute. “And it may be particularly distressing for those vulnerable to mental illness.”

Population studies show that Veterans are at double the risk of mental illness when compared to the rest of the population. They experience higher rates of depression, anxiety and loneliness. Spouses of Canadian Veterans are also at higher risk of distress, as they may sometimes undertake significant caregiving responsibilities that that require significant emotional and time investments.  

“It’s currently unknown how the pandemic will impact Veterans and their spouses, but it could result in particularly serious outcomes,” says Dr. Anthony Nazarov, Associate Scientist at Lawson and the MacDonald Franklin OSI Research Centre. 

In a new project from Lawson and the Centre of Excellence on Post-Traumatic Stress Disorder (PTSD), researchers will seek answers to these questions by partnering with up to 1,000 Canadian Veterans and 250 spouses of Canadian Veterans. Through online surveys, the project will hear directly from Veterans and their spouses to assess the pandemic’s effects on their well-being over time. The team hopes results can be used by health care workers and policy-makers to support Veterans and their families during both the current pandemic and future public health emergencies. 

“We want to hear from all Canadian Veterans and their spouses, whether they’re doing well or not and whether they’re seeking care or not,” explains Dr. Nazarov. 

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From left: Drs. Don Richardson and Anthony Nazarov

Participants will complete online surveys, available in both English and French, once every three months for a total of 18 months. They will be asked questions about their psychological, social, family-related and physical well-being, and any relevant changes to their lifestyle and health care treatment. 

“Veterans who regularly access health care services could encounter significant changes, including a move to virtual care appointments. This could lead to increased caregiving responsibilities for spouses,” says Dr. Nazarov. “Given the uncertainty surrounding the pandemic, these changes may persist well into the future, mandating a thorough assessment of patient satisfaction and treatment outcomes.”

The team hopes results can be used to support the wellness of Veterans and their families during public health emergencies. This includes providing health care professionals and policy-makers with information to guide emergency preparedness policies and health care delivery models. They hope results can also be used to recognize early signs of distress in order to target with early interventions.

“We are seeking to understand the impact of COVID-19 on Veterans and their families to identify if this global pandemic is leading to psychological distress or triggering historical traumas,” says Dr. Patrick Smith, CEO of the Centre of Excellence on PTSD. “The Centre’s primary goal is to increase Canadian expertise related to military and Veteran mental health, suicide prevention and substance use disorders. This study can help us understand if the pandemic is having debilitating and life-altering effects, and help us address a potential mental health crisis.”  

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Dr. Patrick Smith

Dr. Gregor Reid, a scientist at Lawson Health Research Institute, and his Western University PhD student, Camilla Urbaniak, have previously shown that live bacteria are present in the breast tissues of healthy women. This proves the existence of a breast tissue microbiome. In past studies, Reid and Urbaniak have also proven that human milk contains beneficial bacteria. “Since breastfeeding decreases a woman’s risk for breast cancer, we wondered if beneficial bacteria, like those found in human milk, may be playing a role in lowering the risk of cancer and whether other types of bacteria could be influencing cancer formation,” said Dr. Reid.

To explore these questions, Urbaniak obtained breast tissue samples from 58 women who had either benign or cancerous tumours. In addition, she obtained 23 samples from healthy women undergoing breast reductions or enhancements. Through an analysis of these tissues, Urbaniak found that the bacteria present in the breasts of healthy women differ from those found in the breasts of women with breast cancer. 

Women with breast cancer had elevated levels of both Escherichia coli (E. coli) and Staphylococcus epidermidis. A NASA study has confirmed the London research findings and further identified bacteria associated with breast cancer. Urbaniak and Reid went even further by showing that these bacteria can cause significant damage, known as double-stranded breaks, to DNA. When this occurs, the body tries to repair the damage. However, these repairs often result in errors which can lead to the development of cancer.

Tissues taken from the breasts of healthy women showed high levels of Lactobacillus and Streptococcus, known to promote health and display characteristics that can prevent cancer. For example, Streptococcus produces antioxidants that can help prevent DNA damage.

“This study provides clear evidence that the breast tissue microbiome differs between healthy women and those with breast cancer,” said Dr. Reid. “Our colleagues in Spain have recently shown that probiotics with lactobacilli can be ingested by women and reach the mammary gland. This raises the questions of whether women, especially those at risk for breast cancer, should take probiotics to increase the proportion of beneficial bacteria in the breast.”

In addition to prevention, this finding could have potential for helping with the management of patient disease. “It may be possible to increase the abundance of beneficial bacteria at the expense of harmful ones through the use of probiotics,” said Dr. Reid. “Antibiotics targeting harmful bacteria may also be another option for improving breast cancer management. Additional research is warranted to further explore the role of the breast tissue microbiome in the development and prevention of breast cancer.” 

“In the near future, I hope we can discover which bacteria or combination of bacteria promote cancer development and which ones could help protect against it, and the mechanisms by which they do so,” said Urbaniak. “The next logical step would then be to unravel how we can use this knowledge to protect women from getting breast cancer or how we can manipulate the microbiome to help treat cancer once a woman gets it.”

The study, “The microbiota of breast tissue and its association with breast cancer”, was featured in Applied and Environmental Microbiology, a journal of the American Society for Microbiology. Dr. Gregor Reid is the Director, Canadian Centre for Human Microbiome and Probiotic Research at Lawson Health Research Institute and a Professor of Surgery, and Microbiology and Immunology at Western University. Urbaniak, who recently completed her PhD at Western University, will soon be a postdoctoral fellow at the NASA Jet Propulsion Laboratory (JPL) in Pasadena, California where she will perform microbiome analyses on samples collected from astronauts as well as those collected from the surfaces of the International Space Station.