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Canadian researchers are the first to study how patterns in the way older adults walk could more accurately diagnose different types of dementia and identify Alzheimer’s disease. 

A new study by a Canadian research team, led by London researchers from Lawson Health Research Institute and Western University, evaluated the walking patterns and brain function of 500 participants currently enrolled in clinical trials. Their findings are published in Alzheimer's & Dementia: The Journal of the Alzheimer's Association.  

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Dr. Montero-Odasso is world renowned for his research on the relationship between mobility and cognitive decline in aging. Leading the Mobility, Exercise and Cognition (MEC) team in London, he is pioneering novel diagnostic approaches and treatments to prevent and combat early dementia. Dr. Montero-Odasso is also co-lead of the Mobility, Exercise and Cognition Team at CCNA, a team composed of 22 researchers and 6 trainees. 

This study compared gait impairments across the cognitive spectrum, including people with Subjective Cognitive Impairment, Parkinson’s Disease, Mild Cognitive Impairment, Alzheimer’s disease, Lewy body dementia and Frontotemporal dementia, as well as cognitively healthy controls. The study used data from the COMPASS-ND Cohort and the Gait and Brain Study Cohort. 

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Four independent gait patterns were identified: rhythm, pace, variability and postural control. Only high gait variability was associated with lower cognitive performance and it identified Alzheimer’s disease with 70 per cent accuracy. Gait variability means the stride-to-stride fluctuations in distance and timing that happen when we walk.  

“This is the first strong evidence showing that gait variability is an important marker for processes happening in areas of the brain that are linked to both cognitive impairment and motor control,” notes Dr. Frederico Perruccini-Faria, Research Assistant at Lawson and Postdoctoral Associate at Western’s Schulich School of Medicine & Dentistry, who is first author on the paper.

“We’ve shown that high gait variability as a marker of this cognitive-cortical dysfunction can reliably identify Alzheimer’s disease compared to other neurodegenerative disorders.”  

When cognitive-cortical dysfunction is happening, the person’s ability to perform multiple tasks at the same time is impacted, such as talking while walking or chopping vegetables while chatting with family.  

“Having gait variability as a motor marker for cognitive decline and different types of conditions could allow for gait assessment to be used as a clinical test, for example having patients use wearable technology,” says Dr. Richard Camicioli, Professor at the University of Alberta and co-senior author on the paper.  

The London team collaborated with researchers at the University of Toronto, University of Calgary and University of Alberta. They are part of the Canadian Consortium on Neurodegeneration of Aging (CCNA), a collaborative research program tackling the challenge of dementia and other neurodegenerative illnesses.

Dr. Montero-Odasso adds that this gait variability could be perceived as similar to an arrhythmia. Health care providers could potentially measure it in clinical settings, like how heart rhythm is assessed with electrocardiograms.  

This study was primarily funded by CCNA, supported by a grant from the Canadian Institutes of Health Research.  

In a new study from Lawson Health Research Institute (Lawson), scientists have discovered that a specific protein has the potential to be used to treat some patients with primary open-angle glaucoma.

Primary open-angle glaucoma is the most common type of glaucoma, which is a group of diseases that affect nearly 70 million people worldwide. Glaucoma is characterized by progressive damage to the optic nerve which ultimately leads to blindness. In this new study, led by Dr. Sunil Parapuram, researchers examined the role of a protein called “phosphatase and tensin homolog” (PTEN) in the trabecular meshwork. The trabecular meshwork is a porous tissue in the eye through which the clear fluid that fills the eye drains out.

In some primary open-angle glaucoma patients, the structure of the trabecular meshwork is damaged by fibrosis. Fibrosis is a thickening or scarring of tissue which is caused by an excess amount of matrix molecules such as collagen. Fibrosis of the trabecular meshwork prevents the fluid in the eye from draining out normally, which leads to increased pressure in the eye and damage to the optic nerve.

Dr. Parapuram’s team found that the inactivation of the protein PTEN can cause too many matrix molecules to be deposited in the trabecular meshwork, leading to fibrosis. On the other hand, when PTEN activity was increased, it reduced the amount of matrix molecules being deposited in the trabecular meshwork. These results indicate that drugs that can activate PTEN have high potential to be used as a treatment for open-angle glaucoma.

“There’s an immediate need for a new generation of therapeutic drugs for more effective treatment of glaucoma,” says Dr. Parapuram, a Lawson scientist at St. Joseph’s Health Care London and an assistant professor in the Departments of Ophthalmology and Pathology at the Schulich School of Medicine & Dentistry, Western University. “While further research is needed, drugs that activate PTEN could be the answer.”

Dr. Parapuram’s team will continue to study the function of PTEN in the trabecular meshwork in more detail and test the role of drugs that activate the protein as a potential treatment for primary open angle glaucoma.

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Dr. Michael Motolko (left), Chair/Chief, Department of Ophthalmology, and Dr. Sunil Parapuram (right).

“This study highlights the expansion of our department’s research activities into basic science application and its findings are relevant to many other fibrotic diseases,” says Dr. Michael Motolko, Chair/Chief, Department of Ophthalmology, Schulich School of Medicine & Dentistry,Western University, London Health Sciences Centre and St. Joseph’s Health Care London.

The study, “TGF-β induces phosphorylation of phosphatase and tensin homolog: implications for fibrosis of the trabecular meshwork tissue in glaucoma,” is published in Nature’s Scientific Reports.

Dr. Arlene MacDougall has been appointed as Director of Research and Innovation for mental health care at St. Joseph’s Health Care London and Lawson Health Research Institute.

She will oversee and facilitate all mental health care research at both Parkwood Institute and Southwest Centre for Forensic Mental Health Care, working to develop strong local and global partnerships, engage patients and their caregivers in research activities, and foster trans-disciplinary approaches to research.

Her goal is to build on existing research strengths in mood disorders, suicide and smart technology. She also will look to develop research links between Mental Health and Parkwood Institute’s other major research programs, Cognitive Vitality and Brain Health, and Mobility and Activity.

Dr. MacDougall joined Lawson and the Department of Psychiatry at the Schulich School of Medicine & Dentistry, Western University in 2013 working with the Prevention and Early Intervention Program for Psychoses at London Health Sciences Centre. Last year she was cross appointed to the Department of Epidemiology and Biostatistics at Schulich.

“I come to this new role with a great deal of optimism, energy and enthusiasm. Parkwood Institute Research has a number of established strengths in the mental health care field as well as potential for new streams of research and innovation,” says Dr. MacDougall. “I look forward to working with researchers, staff, and patients and their supporters, as well as academic and community partners, to make Parkwood Institute a leading centre in Canada for mental health research.”

Parkwood Institute Research is a Lawson program that represents inter-disciplinary clinical research and focuses on the advancement of innovations and discoveries that directly improve patient care. 

Dr. MacDougall will continue her own program of research, which includes recovery-oriented interventions for people with serious mental illness locally and in Africa. She is leading local studies on the use of mindfulness meditation and participatory video interventions to promote recovery among youth with early psychosis. She is also leading a project based in Kenya using social businesses and a low cost psychosocial rehabilitation toolkit to create meaningful employment, promote social inclusion and support the overall functioning and recovery of people with serious mental illness in low income settings.

Most recently she has been involved in developing and leading initiatives that use social innovation approaches to tackle complex mental health system challenges both locally and globally.

At Western, she is the Director of Global MINDS (Mental Health Incubator for Disruptive Solutions) @ Western, an educational and research initiative that supports students, faculty and community stakeholders to create solutions that will reduce the global burden of mental disorders. Global MINDS is focused on innovating for low and middle income countries and for marginalized communities in Canada. Another initiative, MINDS of London-Middlesex, is working with multiple local stakeholders to collaboratively establish a social innovation lab and use collective impact approaches that will lead to solutions that address complex challenges in the local mental health system.

Dr. MacDougall began her new role on February 1, 2017 and joins Drs. Michael Borrie and Tim Doherty as Joint/Acting Beryl and Richard Ivey Research Chair in Aging, Mental Health, Rehabilitation and Recovery. She also joins Lawson’s Research Executive Committee as Assistant Director (interim) for Parkwood Institute Research, Mental Health.

Dr. Cheryl Forchuk is the recipient of the 2020 Innovation Award for her work to prevent discharges from hospital to homelessness. Throughout her career, Dr. Forchuk has been investigating potential best practice approaches to prevent homelessness in our community for a wide range of people, including those with severe mental illness, veterans, families, and youth. 

Her recent project, ‘Preventing Hospital Discharge into Homelessness: No Fixed Address Version 2 (NFAv2)’ streamlines housing and income services by bringing them into the hospital, and integrating them into a coordinated system of care.  

Research shows that when someone is housed, their use of medical and social services decreases. Safe and adequate housing is required for individuals to recover from illness. 

 Version one of this program was a great success, providing direct access to a housing advocate and Ontario Works from inpatient hospital psychiatric units in London. The No Fixed Address v2 program provides individual inpatients, at risk of becoming homeless, with housing and financial assistance while in hospital. A collaborative approach which includes the local Canadian Mental Health Association, the Salvation Army Rent Stability Bank, Ontario Works, and the City of London brings community supports to the hospital. This enables patients to recover from their illness and reduces the number who may return to the hospital. Dr. Forchuk’s use of in-depth, individual, quantitative interviews, and qualitative focus groups, allows stakeholders to voice their experiences with the program as well as capture traditional outcomes. 

“This innovative program has been so successful in London’s hospitals that the City of London has integrated the NFAv2 service within its municipal housing support programs,” explains Dr. Arlene MacDougall, Lawson Scientist and Dr. Forchuk’s nominator. “It also has the potential to be integrated across the province as the best practice in reducing homelessness in communities. Her efforts have been recognized by multiple funding agencies, and it will soon be the model for the rest of the nation to follow. Dr. Forchuk’s commitment to improve the lives and of those in our community makes her truly deserving of this award.” 

“The No Fixed Address research project is the first evaluation anywhere of a strategy that aims to reduce the number of hospital patients being discharged into homelessness,” says Dr. Forchuk. “I’m really proud of our collective efforts. We have been able to help a lot of people, and have also learned a lot throughout the course of this study.” 

Dr. Janice DeMoor is the 2020 recipient of the Staff Award of Excellence. Dr. DeMoor began working with Lawson in 2007 as a Scientific Writer on Dr. Frank Prato’s research team, helping to develop grant applications. Although funding for this role eventually ran out, it was obvious that Dr. DeMoor was extremely valuable to researchers and to the institute as a whole. She joined Lawson’s Administration team in 2013 and has established an outstanding Grant Development team, supporting all of Lawson’s researchers. 

Dr. DeMoor now serves as the Manager of Lawson’s Grant Development team where she is responsible for the review and institutional approval of grant submissions. With the goal of increasing grant success, her team works with Lawson researchers to identify grant and award opportunities, develops grant-writing tools and resources, and assists in the preparation of external grant applications. Throughout her time in this role, Dr. DeMoor has been devoted to supporting Lawson scientists, trainees, and residents in advancing their research career, and ensures that her team operates with the same level of drive and efficiency as herself. 

“Dr. DeMoor is a leader who makes a difference. She has molded her team to become more and more efficient in dealing with an ever-increasing load of grant applications,” says Dr. Prato, Lawson Scientist and Dr. DeMoor’s nominator. 

Dr. DeMoor serves as an excellent role model and mentor, openly sharing her knowledge and experience with peers from across the industry. She is a generous manager and has greatly enriched collaborative efforts across the organization, including the establishment of a patient engagement initiative at Lawson. 

“I am honoured to have received this award. Working with Lawson’s researchers and seeing how we can add value is extremely rewarding.  The hard work of my entire team has led to our success, and their dedication is integral to us meeting our goals,” says Dr. DeMoor. 

Dr. DeMoor is highly respected within the research community due to her knowledge of funding opportunities and grantsmanship, her dedication to her work, and commitment to her team. She is an exemplary and supportive manager, fostering her team in developing their skills, finding their passion in the field, and supporting them in related projects. She is a great leader, exemplified by her team’s attitude and work ethic. 

“I thank Janice for all the support she has given Lawson’s Imaging Research Program, and the amazing contribution she has made for all Lawson Scientists,” adds Dr. Prato. 

Lawson associate scientist Dr. Lena Palaniyappan has won the Canadian College of Neuropsychopharmacology (CCNP)’s 2017 Young Investigator Award for outstanding contributions to the field of neuropsychopharmacology.

The Young Investigator Award is given for basic research or clinical research in alternating years. This year’s award was presented for clinical research. Scientists who have completed their post-doctoral or residency training 10 years ago or less are considered for the award.

Dr. Palaniyappan uses neuroimaging tools to study the processes that operate in the brain when patients experience symptoms of mental illness, including psychosis – repeated voices or visions (hallucinations) and disturbing thoughts (delusions). For many patients, it is not possible to prevent psychosis or reverse the condition fully. Through their research, Dr. Palaniyappan and his team are working to fully characterize the illness and create new treatments.

Recently he led a study that showed it is possible to use information from the brain’s connectivity maps to alter the chemistry of selected brain regions. The hope is that this approach can be used to target precise areas of dysfunction rather than altering the properties of the entire brain to treat psychiatric symptoms.

“Receiving this award highlights the importance of brain imaging in discovering new therapies for brain-based disorders,” says Dr. Palaniyappan. “I feel very inspired looking at the achievements of past recipients as many of them have gone on to change how we think about the brain and mind.”

Dr. Palaniyappan is the medical director of the Prevention and Early Intervention Program for Psychoses (PEPP), a community-focused mental health program located at London Health Sciences Centre (LHSC). He is also an associate professor at Western University’s Schulich School of Medicine & Dentistry.

“With the increasing sophistication of tools to understand the mysteries of the human brain and the world-renowned expertise available in London, there has never been a better time to study psychiatric disorders,” adds Dr. Palaniyappan. “I hope we will soon be able to use brain scans to provide patient-specific information on prognosis and monitor the effects of treatments.”