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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.