Research Pillar: Clinical

More than 35,000 Canadians are living with spinal cord injury (SCI), and recent research indicates that this population is at an increased risk for chronic disease, particularly cardiovascular disease. In fact, individuals with complete tetraplegia (paralysis of all four limbs) are at a markedly greater risk of death resulting from cardiovascular disease in comparison to the able-bodied population, due to factors such as obesity, inactivity, increased risk for blood clots and lower levels of “good” cholesterol (HDL). Hybrid exercise training (involving the concurrent exercise of the arms and legs) is thought to have the potential to lead to marked improvements in the overall health status of persons with SCI. However, no investigations have been performed to evaluate and define the best hybrid exercise program for the treatment and rehabilitation of persons with SCI. Shirley Wong’s research is focused on developing and evaluating a novel intervention program involving hybrid exercise training for persons with SCI. The ultimate goal of Shirley’s research is to reduce the risk for chronic disease and improve the overall health status and quality of life for persons living with SCI.

Epilepsy is a brain disorder characterized by abrupt and recurrent seizures caused by sudden and brief changes in the brain conditions. Affecting approximately one per cent of people worldwide, epilepsy results in an increased chance of accidental injury and death, and a decreased quality of life. Drug therapy is not always effective in controlling the recurrence of seizures, especially with temporal lobe epilepsy (TLE). The toxicities of these drugs and frequent resistance of TLE to drugs greatly decrease quality of life for patients. Therefore, it is important to investigate new techniques for the prediction of impending seizures to facilitate prompt therapy. Dr. Reza Tafreshi’s PhD work in mechanical engineering involved using statistical pattern recognition to detect and diagnose engine faults. Now he is using this knowledge to predict epileptic seizures by employing computer algorithms and analyzing brain electrical activity through scalp EEG recordings. Predicting seizure onset by a few seconds would give patients a chance to remove themselves from dangerous circumstances and allow administration of a short-acting anticonvulsant drug in a dose that would prevent the seizure. This procedure could be employed in conjunction with an advisory system to warn patients of impending seizures, leading to increased safety and better quality of life.

A person’s field of vision, or visual field, includes an enormous amount of information. By means of attention and eye movements, people are able to select certain objects and location from any point in the visual field. Selection may be stimulus-driven (the properties of the object attract a person’s attention involuntarily, such as a flashing light) or goal-driven (the observer purposely turns their attention to an object). People with damage to the right parietal or parieto-temporal lobes of the brain—commonly brought on by stroke, vascular, demyelinating or infectious diseases—suffer from visual neglect, limiting their ability to select information from the visual field. They often fail to notice items in the visual field opposite to the damaged area of their brain. Interestingly, research has suggested that visual neglect in these people is a function of goal-driven selection, and that stimulus-driven selection function may remain intact. Wieske van Zoest’s research is investigating the role of stimulus-driven control in patients with visual neglect. While participants—patients and healthy controls alike—may not be aware of stimulus-driven influences in selection, direct measures (such as eye movement recording) allow for investigation of the contribution of stimulus-driven control. The proposed work may have significant practical relevance for patients, allowing them to process information if it is presented in such a way that it draws attention automatically in a stimulus-driven fashion.

Autism Spectrum Disorder (ASD) encompasses five neurological disorders that change how the brain processes information. Children and adults with ASD have varying levels of difficulty with social interaction and communication, may exhibit repetitive behaviours, and may have unusual attachments to objects or routines. One form of ASD – classic autism – is the most common neurological disorder affecting children, and usually appears in the first three years of a child’s life. Elina Birmingham is studying the deficiencies that limit the ability of people with ASD to interpret social cues and develop and maintain social interactions. She wants to determine whether these deficits reflect a perceptual inability to process people’s faces (the eyes and mouth, for instance), or a failure to understand and interpret the social cues that are part of social interactions. To do this, she is tracking eye movements to determine how people with ASD respond to social scenes of people interacting and non-social scenes with no interaction. The results should help confirm whether people with autism have the greatest difficulty interpreting social interactions, information that can be used to develop diagnostic and rehabilitation techniques.

Obsessive compulsive disorder (OCD) is characterized by persistent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). One of the most common manifestations of OCD is checking compulsions, where an individual is obsessed with the idea that they failed to do something, or failed to do it correctly (e.g., locked the door or turned off the stove). The OCD sufferer will feel compelled to repeatedly check that the task was completed in order to be satisfied that it was in fact completed, and/or completed properly. These obsessions and compulsive behaviours can be so pervasive and time-consuming that people with OCD have difficulty functioning at work, performing routine activities and relating to others. Many types of compulsive checking behaviours appear to be linked to prospective memory, defined as the ability to formulate intentions, plans and promises, to retain them, to recollect and carry them out appropriately. Carrie Cuttler’s preliminary research suggests that checking compulsions may develop to compensate for an impaired prospective memory—caused by either a real deficit, or by an individual’s own perception and beliefs about their “bad memory”. Now, she is conducting studies to compare prospective memory between non-checkers and checkers. By exploring the relationship between prospective memory and compulsions, Carrie hopes her research will point to ways to help OCD patients minimize their behaviours and anxieties, and improve their quality of life.