Category Archives: Researchers at Baycrest

Let Me Introduce Dr. Norman Farb

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On September 1, 2010 Dr. Norman Farb joined the staff at Baycrest as the Women of Baycrest postdoctoral fellow working with Dr. Tiffany Chow in the Frontotemporal Dementia Workgroup.  Norman is dedicated to advancing both public understanding of the disorder and developing new techniques for the assessment and care of patients with dementia.  The other area of Norman’s work is related to caregivers, who are also critically affected by Frontotemporal Dementia and related disorders.

The other evening, Dr. Farb was the guest speaker at the Women of Baycrest annual Membership Appreciation Reception and Dedication.  He spoke about the work he is doing to develop a new model of care to improve quality of life in aging.  Here’s some of what we learned from Dr. Norman Farb.

The Canadian Study of Health and Aging estimates that in 2011 there will be 145,000 new cases of dementia in Canada, of which approximately 93,000 will be women.  This is not simply a problem for the elderly, but one with broader social implications, as we will all be affected by the need to provide additional care for our elderly,

Worldwide, the elderly support ratio – that is the ratio between working-age people under the age of 65 and those 65 and older stands a 9 working age people to 1 elder, but this ratio will fall to 4:1 in the next 40 years.  In Canada the ratio is 5:1 right now, and by 2050 it will be closer to 2:1.  What this means is that many of us will have a parent, or relative in need of care in the coming years, with a proportionally smaller workforce to provide this care.

While increased healthcare spending is one way to provide this extra support, realistically, the biggest adjustments will need to be made by family members.  The question is not IF you will become a caregiver in your lifetime, it’s a matter of WHEN.  Familial caregiving is important and it makes a difference: the absence of a caregiver or having a caregiver who feels overburdened are both major predictors of earlier institutionalization of those with dementia.

Women have particular challenges in caregiving; social factors make women more likely to take on the caregiving role and be more heavily involved in caregiving activities than men.  In Canada over 70% of informal caregivers are women, mostly wives, daughters and daughters-in-law.  What’s more, 30% of these female informal caregivers are employed, and may also be providing care to their own families at the same time; this places increased stresses on women that are greater than what is experienced by male caregivers.  A recent study found that female caregivers had lower scores on 7 out of the 8 scales on a Quality of Life Questionnaire compared to males and an overall decreased quality of life, as a result of more emotional and physical health problems.  One major question that we face as a society in coming years, above and beyond how to care for our aging population is: who cares for the caregivers?

Norman is currently researching a new type of training for caregivers known as mindfulness training.  Derived from eastern meditation practices, mindfulness training helps a person to develop the capacity to directly experience each moment with a sense of acceptance, opening themselves up to immediate experience rather than turning to a world of judgments, explanations and rumination.  In many studies in healthy participants, mindfulness training has been shown to reduce feelings of stress and to promote well-being, and it may also help to protect caregivers from becoming overburdened and sick themselves.

It seems from the research that what the mindfulness training is allowing people to do is to stop worrying about the bigger picture for a moment and to concentrate on what’s actually happening in the room they are in.  In the context of caring for an ill or demented family member, this can be a powerful ability.  Imagine yourself in the role of caregiver for an elder relative, how would you react?  For many of us, there are negative feelings, like we are being forced into a bad situation.  But why is this?  Could it be that we are all secretly hoping that life will continue happily ever after?  Isn’t that the way that fairy tales end?  Cinderella does not end up cleaning bed pans.

There is nothing wrong with having ideals and dreams of a pleasant future.  These ideals become a benchmark by which to motivate ourselves to do and be more.  However, dreams alone do not prepare us to deal with the reality of our aging population and probable roles.  To effectively manage the stresses of familial caregiving, a deeper understanding must be cultivated.  Dr. Norman Farb believes that learning to put our evaluations and ideals aside and accept our present state is a powerful tool for reducing the stresses of confronting a life more ordinary than fairy tale, of allowing us to appreciate the gift of each moment even if that moment is being spent looking after mom or dad.

Margi Oksner

Announcing the Women of Baycrest Academic Symposium

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I have been delinquent in my duties as a blogger.  Not so much a case of shirking my responsibilities, but more a case of not being able to reveal some of the amazing things we’re working on.  But now I have the go ahead and want to share some very exciting developments on the Women of Baycrest Academic Symposium that is being held on April 6, 2011 in Toronto.

This has been in the planning stages since early June, and now its official enough that I can divulge what we have been working on.

Just a little background info.

In the spring, our fearless leader, Lynn Posluns pointed out that what we know is what we don’t know.  And it was time to find out where we stood in terms of women’s brain health – globally.  She quite rightly determined that what we really needed to do was define the field of women’s brain health by establishing the base line for where research and science currently stand and then share that information with both the scientific and general communities.   The question became how?  The original plan was to find a scientist to research and write a review of existing literature that Women of Baycrest could then publish in both medical journals (in its scientific format) and also translate into “lay speak” for general consumption. Yes, an ambition undertaking.

As we discussed the project with the expert researchers at Baycrest, it became clear that the best way to accomplish our goals for defining the field of study for women’s brain health, would be to bring the leading thinkers in the area together and have them discuss it in a conference setting and use the outcomes of their discussions as the basis for our magazine and medical journal articles.

Hence, the Women of Baycrest Academic Symposium was born – as an idea.  The really impressive part is how seemingly easy it was to reach out to the scientist to make this a reality.

Our Academic Symposium is now booked for April 6, 2011 – place still to be determined.  It will be open to 250-300 researchers, scientists, allied health care professionals and students who are interested in current thinking and research about women’s brain health.

Here are some of the Symposium details:

 

The day will be made up of morning and afternoon panel discussions to be followed by individual presentations by the participating speakers. The morning session will feature a panel discussion on “The biological bases for sex differences in brain health and aging,” and the afternoon session will focus on “Sex differences in clinical syndromes.” The day will be moderated by Dr. Randy McIntosh, Vice President Research, Baycrest Centre, and Director of the Rotman Research Institute.

Speakers include

  • Dr. Walter Rocca, Professor of Epidemiology and Neurology, Mayo Clinic, Rochester, Minnesota;
  • Dr. Robert Handa, Professor, Department of Basic Medical Sciences, University of Arizona;
  • Dr. Tomas Paus, Anne and Max Tanenbaum, Professor and Chair of Population Neuroscience, Rotman Research Institute, Baycrest;
  • Dr. Gillian Einstein, Director of the Collaborative Graduate Program in Women’s Health, University of Toronto;
  • Dr. Pauline M. Maki, Associate Professor in the Departments of Psychiatry and Psychology at the University of Illinois at Chicago;
  • Dr. Tiffany Chow, Assistant Professor at the University of Toronto and Clinician-Scientist at Baycrest’s Sam and Ida Ross Memory Clinic.

Are you impressed with the lineup?  I am!  Sadly, when I read each of the scientist’s individual presentation headings, I didn’t exactly understand what they are going to talk about – but that’s why we are going to translate these documents for the general public.  I’m very excited about the prospects of what we are going to achieve.  Think about it – we are actually going to define the area of women’s brain health so that when we have raised the dollars required to hire our Baycrest Chair in Women’s Brain Health and Aging, we will have created a template of science from which to move forward.  Now we just have to raise the rest of the money….and that is for another blog.

Margi Oksner

Girl Mice Do Not Wear Twin Sets!

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I don’t usually post reprints – but when I saw this article,  I found it fascinating and hope you will too.

Margi Oksner

Of Mice and Women: Testing Lab Animals to Understand Our Health

By Sari Harrar

About 20 years ago, scientists realized that testing drugs and medical procedures primarily on men told them little about how a woman might react. But animal researchers have just recently begun to conclude that using only males means they’re getting only half an answer.

“Seventy-nine percent of pain studies are on male lab animals only, even though far more women have problems with pain,” says Jeffrey Mogil, PhD, professor of pain studies at McGill University and a premier sex-difference researcher in the field of pain genetics. “We’re missing valuable information because so many researchers don’t look at both sexes when studying lab animals.”

“Sex matters in ways we haven’t really thought about before,” says Virginia M. Miller, PhD, a professor of physiology at the Mayo Clinic in Rochester, Minnesota. One of Miller’s lab studies (with female pigs) unearthed a possible reason why premenopausal women get little or no heart protection from low-dose aspirin: The linings of female arteries produce a mix of chemicals that don’t respond to aspirin the way males’ do. This helps explain why the conventional wisdom about aspirin—that it protects everyone’s heart from dangerous blood clots—was off the mark.

“The beauty of studying both sexes in animals is that what you see is what you get,” says Sherry Marts, PhD, executive director of the Organization for the Study of Sex Differences. “Girl mice don’t wear twinsets or have lower-paying jobs than boy mice. Different reactions are going to be due to genes, hormones, or physiology, not gender issues like income, education, or healthcare.”

Researchers have been reluctant to use female mice because—wouldn’t you know it—they’re more complex. “All those pesky hormones,” Marts says. “A mouse’s menstrual cycle is just four to six days long,” enough to influence results. “You have to test each mouse to see where she is.” The process is a little like performing a tiny Pap smear.

When researchers have made the effort to include both female and male animals, they’ve turned up startling differences. Among the tidbits so far:

Pain Relief
Male and female mouse brains have different pain-processing circuitry, which may help explain why women are so much more prone to chronic pain than men. They’re nine times more likely to have fibromyalgia, eight times more likely to have jaw pain, three times more likely to get migraines, and twice as likely to have irritable bowel syndrome. “Someday we could have pain treatments that target these sex-specific mechanisms—pills that work well for one gender but don’t work at all for the other,” says Mogil, who authored this research.

Sunburn
Female mice are more susceptible to burns; males get skin tumors earlier. This could lead to sunblock tailored to women’s and men’s needs, say scientists at Ohio State University. Their findings suggest women may need more anti-inflammatories to soothe sun damage after a day on the beach, while men may need more antioxidants to protect against cancer.

Stroke
The brains of female rats have a stronger inflammatory response, according to a study in Stroke. This may be one reason that women’s strokes are more debilitating—and more deadly—than men’s. Studies on animals suggest that compounds that block brain-damaging proteins during a stroke protect males but harm females.

Mogil believes that researchers who start working with female rodents will be pleasantly surprised. “Males can be more aggressive,” he says. “They’ll bite more readily than females.”

From:

O, The Oprah Magazine  |  September 19, 2008

Brain in a Box

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Last summer I was recruited to be a research subject.  I felt doubly honoured.  Not only was someone interested in my brain (I’m so easily flattered), but this study was being conducted by Dr. Paul Verhoeff.  Not a household name but let me tell you what he’s doing. Dr. Verhoeff is making strides at Baycrest in showing the potential for PET scans to advance an earlier diagnosis of Alzheimer’s as well as assessing the effectiveness of new Alzheimer’s treatments. He published the first PET study of brain deposits called beta-amyloids associated with Alzheimer’s in living patients in 2004, and the first published study in the world that compared two beta-amyloid PET tracers.

Before Dr. Verhoeff could actually look at my brain, I had to undergo a series of tests.  The first was some cognitive testing conducted by a research assistant at the Brain Health Centre – very interesting stuff, word associations, memory testing – that sort of thing.  My naturally inquisitive self asked a lot of questions, questions about the process, what the study hoped to achieve, how she came to be at Baycrest, what else she was studying. It was fascinating.  Step two was the physical neurological test.  This was my first chance to meet Dr. Verhoeff.  I was wowed.  Here was this world-class scientist taking his time to study me and he was so kind, so gracious, almost apologetic in manner as he asked me to balance on one foot or tested my reflexes.  Again, a chance to talk to him and ask questions about his work.

And as your typical type A overachiever, I was thrilled to learn that I passed these examinations and could now continue on to the real meat of the study, two PET Scans and an MRI.  I had stars in my eyes – this was my big chance to contribute to science and confirm that, in fact, I do have a brain.

Off I went for my first PET scan.  PET (positron emission tomography) scan is a form of nuclear medicine imaging which uses radioactive materials to produce 3-dimensional, color images of the functional processes within the human – in this case – my brain. The nuclear medicine part, in the form of a radionuclide, was injected into my body as a tracer. I didn’t know that in advance!

In order for the computer to properly compile the 3-D images you have to keep your head perfectly still – not something most of us can do for a prolonged period of time.  To solve this problem – the technician placed a moist cloth over my face and head and secured it to the sides of the table to totally immobilize my head.  This Papier Mache-like membrane then hardened into a mask that made it impossible to move my head.  I didn’t know that in advance either!

So there I was, wondering if I looked anything like Leonardo DiCaprio in Iron Mask, waiting for the technician to light up my brain by injecting me with radioactive molecules and then the slab I was lying on moved into the machine.  Now I’ve had MRIs before – once on my abdomen and once on my knee – in both cases, my head wasn’t part of the process.  This was definitely a different experience.  From the outside the PET looks pretty big, but once they moved me in – right down to the collar bones – believe me, it was a very tight fit. Hence, brain in a box.

My first thought was – I’m not going to be able to do this for the next forty-five minutes.  My second – how do I get out of here with my dignity?  My third – there is no way …it’s too late.

And then Dr. Verhoeff came into the room, he patted my hand, talked to me about the procedure and what I could expect and thanked me again for participating. He was so kind and understanding.  He was so gracious.  How could I let him down?  So I rethought my situation.  I could do this.  I was contributing to science.  I just had to make myself go to a ‘happy place.”  And then I did something totally inexcusable – totally embarrassing, something I’m sure no other test subject had ever done (no, not that!)  – I fell asleep.  Under the most stressful conditions, with all the noise of the PET scanner, I drifted off to never-never land.  I missed the whole thing.  When they slid me out of the PET, there was Dr. Verhoeff, sheepishly grinning and I was convinced he was trying to keep from howling with laughter – and it wasn’t my hat-head that was amusing him – it was the idiot who slept through the test.  What must he have thought of me?  But he was gracious and never mentioned it!

I did go back for PET II – the sequel. When that was over, they even offered to let me keep my mask (I passed on that). I did have the MRI and yes, they did confirm that there was a brain and it might actually be functional.  In the end, putting my brain in a box was a good thing. My brain was going to be compared to that of a woman of the same age and educational background as me but who suffers from severe dementia and the differences were of great interest to the scientists.

I now feel that I have a special bond with the science we are all working so hard to fund.  And best of all, whenever I see Dr. Verhoeff or one of his researchers in the halls at work, I get to chat and catch up with what they’re working on and how the research is progressing.

Flash forward to a few weeks ago.  I run into Dr. Verhoeff in the elevator and he mentions another study that is being conducted.  I tell him to get a researcher to call me – coach, I’m ready – send me. Another brain in the box-kind of test – I’m there!

All I needed to do is answer a few questions.  Yes, I met the age and gender criteria.  Yes, I met the education criteria.  Yes, I take a daily medication for an inner-ear disorder. No, I’m no longer eligible.  Is it possible – I’m being rejected?  I fail.  I’m crushed.  And this is where it got ugly – I started to beg the poor researcher on the other end of the phone.  I even tried the “but I know Dr. Verhoeff” card.  But it was over.  Basically, I was kicked off the island.

Well here’s one more thing I’ve learned from Dr. Verhoeff – I’m a research subject junkie.  I’ll do more volunteering and if you’re at all interested in some of these amazing experiences; you should consider giving your brain to science while you can be a part of the process.

 Margi Oksner

Blueberries – the wunderkind of the fruit family or maybe you shouldn’t put all your berries in one basket?

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For a girl who loves her food, what could be more perfect than working on a cook book?  I’ve died and gone to heaven – I have visions of being the tester for every recipe – free food and it’s not like I wanted to eat everything on my plate – but I had to.  It’s my job!

I’m working with an amazing team on this book.  In addition to WB chair Lynn Posluns, we have Dr. Carol Greenwood, a senior scientist at Baycrest’s Kunin-Lunenfeld Applied Research Unit and professor of nutritional sciences at the University of Toronto advising; Elise Mecklinger, author of six cookbooks; Joanna Gryfe who has just completed an internship in New York with Rachel Ray; and Bonnie Shore who is the most amazing marketing genius.

What could be more fun than having to talk about food for 2 hours every week – what we eat, when we eat, how we eat, what we should be eating, and when we’re really being honest with ourselves, what we really eat!  Have I mentioned that I love my job?

So last week we started getting down to the brass tacks of what format the book should take.  No one needs another Breakfast/Lunch/Dinner book with a forward from some academic telling you you’ve got to change your lifestyle or your diet.  We want a book that is reader and user friendly – that addresses real life and where readers can say – “Okay, I have that in my cupboard – maybe I’ll keep some in my desk or in my glove compartment for a quick fix to ward off the 3:00 pm hungries and boost my brain a bit  - I can do that, I can take tiny steps that are going to be good for me.”

We started with breakfast – and yes, it is the most important meal of the day!

So from my usual, not a breakfast kind of girl, perspective, I put forward this scenario – which by the way, I think is not out of the norm for many people.

“I’ve got an 8:00 am tee time at the golf course.  I think I’ve scored if I have enough time to grab a cup of coffee at Starbucks and gulp it down as I’m flying along the highway.  By the time I get to the turnaround after the ninth hole, I’m ready to gnaw off my arm – so what should I be grabbing in the snack bar?”

First there was horror on Elise’s face – she was downright spluttering with indignation! “The answer is simple,” said the shocked Elise.  “You get up half an hour earlier and have a decent breakfast with a complex carbohydrate – cooked oatmeal or quinoa, fruit and at least 8 oz of water to get you hydrated before you go play golf.”

Yeah right – it’s not happening – I’m not getting up earlier – I’m not cooking, stirring, poaching – I can barely find my car keys let alone the kitchen – so let’s get real!

I thought about ending my blog here – but I could hear your groans through the screen – because I know that although many people are disciplined and smart – like Elise – many of us aren’t there yet (and may never be).

Here’s what Carol said on the subject.  You want two things:

  1. Carbohydrate to help improve mental alertness and memory (after all you need to remember where that last ball fell), and
  2.  something that will keep you feeling reasonably full/satiated until you finish your game so that you don’t lose concentration on your swing while dealing with hunger pangs .

So, I’m looking to combine carbohydrate for #1 with either fibre or protein to help you with the hunger piece (#2).  So, a couple of suggestions would be:

  • Trail mix with a good selection of healthy nuts such as walnuts and almonds along with some dried fruits such as raisins, mango/papaya/apricots (keep away from the dried banana chips they are actually high in fat) – if you make your own you could even add in some Cheerios – they are made from oats and help lower cholesterol along with Mini-Wheats or another unsweetened cereal.
  • High fibre muffin such as a bran muffin – if they offer a lower fat option, go for it.
  • Yoghurt and piece of fruit – the yoghurt will actually help with the hunger piece but chose a flavoured/sweetened one to get a bit more sugar/carbohydrate.
  • Good old fashioned gummy bears and jujubes for the sugar along with some nuts to help with hunger.  Go for it, you are out and exercising, no one is watching except your girlfriends!  Just don’t over do it.

So what’s all this got to do with blueberries?  The hype isn’t just hype – turns out they really are very good for you – full of all the ‘stuff’ we’ve been reading about – but don’t exclude other berries.  Strawberries and blackberries are equally good – they just may not have as much marketing money!

Here’s a link to an article about food and nutrition you might enjoy.  http://www.baycrest.org/Breakthroughs/12799.asp

 Margi Oksner

But doctor will I be able to play the piano?

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Remember that old chestnut about the guy who is recovering from hand surgery and asks his doctor if he’ll be able to play the piano. The doctor says yes.  The man replies, “great, ‘cause I couldn’t play before.”  Groan!!

I met an amazing Baycrest research scientist a few weeks ago, Dr. Takako Fujioka.  This lovely young woman was a child prodigy playing piano and cello from the age of 4 and had a future as a concert musician, but chose instead to focus on engineering when she reached university.  Somewhere along the line, she switched gears and did her PhD. in physiology and now researches how music and playing a musical instrument impacts the way we use our brains.

Here’s what I learned during my meeting with Dr. F.   I’m sure this summary doesn’t do her justice, but I want to whet your appetite with this intriguing research.  A little technical background – stuff I didn’t know.  Brain waves actually give off electrical sparks and signals.  At Baycrest we have one of only 5 MEG (magneto encephalography) machines in all of Canada.  Think of the MEG doing for the brain what an EEG does for the heart which is monitoring heart beats and rhythms – but with one giant difference.  The MEG requires no electrodes or gels to transmit the signals – it works like a radio picking up our brain waves.  Pretty cool.

So what Dr. F and her team did was to look at the visible differences between the brains of the musically trained and untrained.  Using children as the subjects for this study, they took one group who were learning to play an instrument and one that was not and studied their brain development at four different intervals over the course of a year.  The musical group showed accelerated brain development.

With this information under her belt, Dr. F. is now involved in a brain fitness program here at Baycrest.  Using older adults (60+), she has enrolled them in what she playfully refers to as her “Piano Boot Camp.”  Her study investigates what enhanced sensory motor integration looks like through MEG imagery and whether it corroborates her hypothesis that increased perception/action/auditory use of the brain actually translates to more effective use of our brain.  She explained this to me as follows: learning to play an instrument makes you think more vigorously.  You have to engage in the activity of practicing which requires you to pay attention and understand when you’ve made a mistake, go back and redo the activity until you get it right.  You’re learning to read music at the same time as making music – it is a more dynamic form of learning.  It is teaching your brain to plan according to the activity, gives you an enhanced ability to concentrate, a greater ability to switch from one task to another – all in all, a lot of different types of activities to boost your brain control.  And even more importantly – it’s never too late to engage in this kind of brain exercise.

At this juncture I of course had to ask about playing piano vs. my obsession with crossword puzzles and Sudoku.  Sadly – it wasn’t the answer I was looking for.  Apparently because these puzzles are singular activities and require no social interaction, the benefit is pretty limited.

But the good news is that we have Dr. F. and her team and they are constantly looking at ways to improve the human condition.  Maybe I’ll meet with her again soon and get filled in on her research with Stroke patients and recovery of motor skills through music therapy.

For more details about the research done with those two groups of children, go to  http://www.sciencedaily.com/releases/2006/09/060920093024.htm