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September is World Alzheimer’s Month and Saturday, September 21 was World Alzheimer’s Day. 

In recognition, the Journal of Alzheimer’s Disease has published an open access, special issue that will be available to everyone for the first two weeks of publication. 

Dr. Manuel Montero-Odasso, Scientist at Lawson Health Research Institute, has edited and led the special issue focusing on gait disorders and dementia. 

He is world renowned for his findings on the relationship between cognition and mobility in the elderly, and gait as a predictor of frailty and dementia. He leads the Mobility, Exercise and Cognition (MEC) Team in London, comprised of top researchers in the areas of mobility, exercise and brain health.

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Dr. Montero-Odasso is also a professor at Western University’s Schulich Medicine & Dentistry, geriatrician at St. Joseph’s Health Care London and London Health Sciences Centre, and Director of the Gait and Brain Lab, a part of Lawson’s Parkwood Institute Research group. 

“This Journal of Alzheimer’s Disease supplemental issue showcases studies presenting the epidemiology of gait disturbances and cognitive impairment, dissecting specific associations between cognitive domains and quantitative gait parameters, and addressing with advanced neuroimaging techniques the potential mechanisms underlying the gait-cognitive interaction seen before dementia,” explains Dr. Montero-Odasso. “Also, this issue highlights how to manage mobility impairment in the cognitive impaired by using assistive devices.”

Alzheimer’s disease is an irreversible, progressive brain disorder that slowly destroys memory and thinking skills. It is the most common cause of dementia among older adults. There are over half a million Canadians living with dementia - plus about 25,000 new cases diagnosed every year. By 2031, that number is expected to rise to 937,000, an increase of 66 per cent.

Read the Gait Disorders Special Issue with editorial from Drs. Montero-Odasso and George Perry entitled “Gait Disorders in Alzheimer’s Disease and Other Dementias: There is Something in the Way You Walk.” 
 

In a new study, researchers at Lawson Health Research Institute and Western University are demonstrating that gait, or motion testing, while simultaneously performing a cognitively demanding task can be an effective predictor of progression to dementia and eventually help with earlier diagnosis. To date, there is no definitive way for health care professionals to forecast the onset of dementia in a patient with memory complaints.

Dr. Manuel Montero-Odasso, a Lawson scientist, geriatrician at St. Joseph’s Health Care London, and associate professor in the Division of Geriatric Medicine at Western University’s Schulich School of Medicine & Dentistry, is leading the “Gait and Brain Study.” His team is assessing up to 150 seniors with mild cognitive impairment (MCI), a slight decline of memory and other mental functions which is considered a pre-dementia syndrome, in order to detect an early predictor of cognitive and mobility decline and progression to dementia.

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Dr. Montero-Odasso with study participant, Roy Bratty

“Finding methods to detect dementia early is vital to our ability to slow or halt the progression of the disease,” says Dr. Montero-Odasso. The study, funded by the Canadian Institutes of Health Research, followed participants for six years and included bi-annual visits. Researchers asked participants to walk while simultaneously performing a cognitively demanding task, such as counting backwards or naming animals. Those individuals with MCI that slow down more than 20 per cent while performing a cognitively demanding task are at a higher risk of progressing to dementia.

“While walking has long been considered an automatic motor task, emerging evidence suggests cognitive function plays a key role in the control of walking, avoidance of obstacles and maintenance of navigation,” says Dr. Montero-Odasso. “We believe that gait, as a complex brain-motor task, provides a golden window of opportunity to see brain function.”

The “gait cost,” or speed at which participants completed a single task (walking) versus a dual-task, was higher in those MCI individuals with worse episodic memory and who struggle with executive functions such as attention keeping and time management.

“Our results reveal a ‘motor signature’ of cognitive impairment that can be used to predict dementia,” adds Dr. Montero-Odasso. “It is conceivable that we will be able to diagnose Alzheimer’s disease and other dementias before people even have significant memory loss. Our hope is to combine these methods with promising new medications to slow or halt the progression of MCI to dementia.”

The study, “Association of Dual-Task Gait with Incident Dementia in Mild Cognitive Impairment”, was published in the journal, JAMA NEUROLOGY.

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Members of the study’s research team, from left to right: Korbin Blue, Research Assistant (Co-op Student); Yanina Sarquis-Adamson, Lab Research Assistant; Frederico Faria, Post-Doctoral Fellow; Dr. Montero Odasso, Director, Gait and Brain Lab; research participant; Alanna Black, Lab Research Coordinator; Stephanie Cullen, Research Assistant (Undergraduate Student); and, Navena Lingum, Research Assistant (Master Student). 

Dr. Donna Goldhawk, an imaging scientist at Lawson Health Research Institute (Lawson), is providing a unique and valuable learning experience to senior high school students. Since 2009, she has accepted students to train in her hospital-based research laboratory at St. Joseph’s Health Care London in partnership with secondary schools in the Thames Valley region.

Dr. Goldhawk recruits students in partnership with the Partners in Experiential Learning (PEL) program. This unique academic co-op education program in London, Ontario identifies high school students interested in health research and prepares them for placement in a health research environment. The students earn senior high school credits and receive training in basic laboratory research.

Originally conceived by Dr. Jim Koropatnick, a cancer scientist at Lawson, and Mr. Rodger Dusky, a retired secondary school teacher, PEL has been running successfully since 2004. It is a partnership between the Thames Valley District School Board, London District Catholic School Board, the Ontario Ministry of Education, Western University, London Health Sciences Centre and St. Joseph’s Health Care London. In Dr. Goldhawk’s experience, PEL attracts an excellent calibre of student who is eager to learn, aspiring to further education and capable of contributing to the science of molecular imaging.

Through the Ontario Research Fund (ORF), the Ministry of Research and Innovation also recognizes the value of attracting youth to the scientific enterprise and provides funding to support youth outreach. Dr. Goldhawk oversees one such initiative, approved under a grant entitled “Heart Failure: Prevention through Early Detection Using New Imaging Methods”. She works with PEL to attract summer students with an interest in molecular imaging.

This year, a total of three ORF summer studentships are available at the following collaborating research labs: Lawson Health Research Institute (London), University of Ottawa Heart Institute (Ottawa) and Sunnybrook Research Institute (Toronto). To learn more about these summer studentships, please email Dr. Goldhawk at @email by May 25, 2018.

Participating students can expect experiential learning tailored to their current understanding of science and aimed at expanding this knowledge for a fuller appreciation of biomedical research.

“ORF youth outreach recognizes the role of medical imaging in today’s workplace and promotes the study of cardiovascular disease in the next generation of researchers,” says Mr. Dusky. “This fills a clear gap in knowledge and career planning for high school youth.”

In Dr. Goldhawk’s laboratory, for example, cardiac research is focussed on the measurement of iron contrast using magnetic resonance imaging (MRI). “Many cells have naturally distinct iron metabolism. However, we are also using genes from magnetic bacteria to improve the magnetic sensitivity of mammalian cells. MRI can then be used to detect disease processes in living subjects.”

“We are particularly interested in reporter gene expression for MRI, a term coined to describe how changes in the pattern of gene activity, and its related protein activity, may be visualized.” Her research group uses laboratory models to track these biological molecules, particularly those involved in cardiac inflammation and cancer growth and metastasis.

Her current team of four graduate and four undergraduate students span various stages of their chosen programs. In this setting, high school students step into a work atmosphere where they interact with colleagues at multiple levels. In addition, since molecular imaging research is inherently interdisciplinary, students acquire training in both biology and physics.

Dr. Goldhawk finds that students exposed to high-quality science education more easily envision themselves in positions of responsibility within the health care sector. Youth learn that developing a scientific career is a process with many choices for fusing interests with a specific occupation.

“To retain the interest of talented young scientists, it is essential to provide them with interesting challenges that reward their curiosity and ambition to learn,” explains Dr. Goldhawk. “In hospital-based research institutes, youth are also exposed to the clinical side for which our research is targeted. This is a quality scientific experience for youth interested in expanding their outlook, performance, technical, problem-solving and record-keeping skills. I think it is essential to build these opportunities into our scientific programs.”

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Above: Suhail Shukri, 2018 PEL student at Oakridge Secondary School, and Sarah Donnelly, 2013 PEL student at Wilfred Laurier Secondary School and current MSc candidate at Western University’s Schulich School of Medicine & Dentistry, training with Dr. Jeremy Burton and Dr. Donna Goldhawk at Lawson Health Research Institute. 

Lawson Health Research Institute – the research institute of London Health Sciences Centre (LHSC) and St. Joseph’s Health Care London – is ranked seventh in the country in Re$earch Infosource’s 2023 list of Canada’s Top 40 Research Hospitals. 

This is the 13th year in a row that Lawson has ranked top ten in the country, and the seventh-place ranking is up two spots from 2022 – highlighting continued dedication to hospital-based research at LHSC and St. Joseph’s.

Lawson also ranked second for research intensity among the large tier institutions with more than $776,000 of research spending per researcher.

“These rankings help LHSC and St. Joseph’s assess how we compare to similar hospitals across the country,” says Dr. David Hill, Scientific Director at Lawson and Integrated Vice President, Research at LHSC and St. Joseph’s. “Our continuous placement in the top 10 of all research hospitals shows we are doing important and relevant medical research that is making a difference to patient care.”

Lawson has been at the forefront of research in a wide range of specializations, making advances in areas from cancer care and mental health supports to molecular imaging and theranostics in recent years.

“Conducting research in hospitals means it can go from bench to bedside much more quickly,” says Dr. Hill. “Things move much faster now than they ever did. Our top 10 ranking shows we are leading the way, and that funders are confident in London’s hospital-based researchers.”

The top 40 list analyzes hospital-based research institutes from across the country on several metrics, including total research expenditure from the previous fiscal year. The ranking looks at funds from all sources, including both internal and external, to support research in hospitals.

For the 12th year in a row, Lawson Health Research Institute has ranked top ten in the country for the 2022 edition of Canada’s Top 40 Research Hospitals List by Re$earch Infosource.   

Lawson, the research institute of London Health Sciences Centre (LHSC) and St. Joseph’s Health Care London, has ranked in ninth place, and has also maintained the top ranking for research intensity among the large tier institutions with more than $700,000 of research spending per researcher.

“The most important metric is how we are growing year by year as an effective hospital research community,” says Dr. David Hill, Scientific Director at Lawson and Integrated Vice President, Research at LHSC and St. Joseph’s. “The rankings give us a measure of how we are comparing to peer hospitals across the country.”

Hospital-based research has been at the forefront since the COVID-19 pandemic began. The hard work and innovation to take research from bench to bedside during such a critical time has made a difference in patient outcomes around the world.

“Today’s research innovation is tomorrow’s health care. We need to maximize the former while shortening the gap between the two as much as possible. Being recognized in the top 10 reflects confidence research funders have in London’s hospital-based scientists.” says Dr. Hill. 

The top 40 list analyzes hospital-based research institutes from across the country on several metrics, including total research income from the previous fiscal year.  Lawson received $129,832 million in research income in 2022. The ranking looks at funds received from all sources, including both internal and external, to support research at LHSC and St. Joseph’s.
 

The American Shoulder and Elbow Surgeons association has awarded a team of London researchers the 2017 Charles S. Neer Award for Clinical Science, one of the most prestigious awards in the areas of shoulder and elbow surgical research in North America.

The award recognizes the scientists’ development of the PCR-RFLP (polymerase chain reaction restriction fragment length polymorphism) assay, a test that can accurately identify Propionibacterium acnes (P acnes) infection of the shoulder within 24 hours. Current methods take an average of six or more days, and are prone to sample contamination and false-positive results.

“We are incredibly honoured to receive this award,” says Dr. David O’Gorman, Lawson scientist, Co-Director of Molecular and Cellular Research at the Roth McFarlane Hand and Upper Limb Centre (HULC) at St. Joseph’s Health Care London, and senior author of the publication. “We believe it illustrates the high quality of research being done at Lawson and marks the beginning of another clinically relevant research program at HULC.”

P acnes is a type of bacteria typically found deep in the hair follicles and sebaceous pores of the skin. A P acnes infection of the shoulder is a common and serious complication that occurs after arthroplasty (surgery to replace a damaged joint, most commonly with artificial material). It can cause pain in the shoulder joint and often loosens the implant. In most cases, the patient requires additional surgery to remove the infection and replace the implant.

It can be difficult to diagnose a P acnes infection as it often presents without symptoms that would be characteristic of an infection, such as pain, skin reddening or wound drainage. The prevalence of P acnes in the deeper layers of the skin also increases the chance of sample contamination and false-positive results making it hard to isolate and identify in a pathology lab.

Currently P acnes infection is identified by administering a tissue swab for anaerobic culture, which takes an average of six or more days but could take up to three weeks. This technique also carries substantial risk of contamination from the adjacent skin and other sites where P acnes is present.

The PCR-RFLP assay can identify P acnes in tissue from a shoulder biopsy within a 24-hour period. The extremely sensitive technology also has the ability to detect fewer than ten P acnes cells in the sample, which may decrease the false-positive rate in cultures caused by swab contamination.

“The accuracy of this test and the shorter period of time needed for identification can help with treatment decision making, targeted antibiotic therapy, and monitoring to minimize implant failure and revision surgery,” explains Dr. O’Gorman, who is also an Assistant Professor in the Departments of Surgery and Biochemistry at Western University’s Schulich School of Medicine & Dentistry. “We hope that the test can be further developed into a ‘point of case’ assay that can detect P acnes in tissue samples in real time while the patient is undergoing shoulder surgery.”

Since the PCR and RFLP mapping used for the assay are techniques routinely performed in many clinical microbiology and pathology labs, the test would be a cost-efficient approach not restricted to highly specialized research labs.

Other scientists who were part of the study include Dr. George Athwal and Dr. Kenneth Faber, HULC orthopaedic surgeons, Lawson scientists and Schulich professors; Ana Pena Diaz, research technician for the HULC Molecular and Cellular Biology Research Lab; and Scott Holmes, a medical student and Schulich Research Opportunities Program participant who was primarily responsible for designing and optimizing the assay.

Both Dr. O’Gorman and Dr. Faber are also members of Western’s Bone and Joint Institute.

“A rapid method for detecting Propionibacterium acnes in surgical biopsy specimens from the shoulder” was published in the Journal of Shoulder and Elbow Surgery (JSES).