The Brain Sciences program
Disorders of the brain and mind will be the largest public health issue in North America by the year 2020. The Brain Sciences Program at the Sunnybrook Health Sciences Centre leads in restoring mental health by understanding how the brain and mind work together and treating affected individuals. The program uses an inter-professional approach to create and implement best practices which enhance the quality of life of patients, their families and caregivers. Specialty clinics research and provide comprehensive care from prevention and acute intervention to long-term management for conditions such as:
- Dementia (i.e. Alzheimer’s disease)
- Traumatic brain injuries
- Multiple sclerosis
- Motor neuron diseases
- Brain tumours
- Mood and anxiety disorders (i.e. depression, bipolar disorder)
- Sleep disorders
Brain Imaging Research Centre
With a central future location in the M-wing expansion and nodes throughout the rest of Sunnybrook hospital, The Brain Imaging Research Centre will be home to scientists using imaging technology to determine physical changes in the brain throughout the course of a disease and during recovery. Scientists will design sophisticated image analysis techniques to better understand diseases and to allow image-guided interventions. Correlation of physical changes in the brain with patient mood, behaviour and cognition will further the understanding of disease mechanisms and lead to better outcomes for patients. To understand the effect of different interventions, scientists will also monitor physical changes in the brain before, during and after treatment. Knowledge gained from these investigations will allow physicians to choose the right treatment for the right patient at the right time. Overall, this expansion will create the technological foundation for an integrated approach to Brain Science and thus lead to improved patient care for stroke, Alzheimer’s and Parkinson’s disease, multiple sclerosis, bipolar disorder and depression.
Transcranial Doppler (TCD)
The Transcranial Doppler (TCD), also commonly referred to as Transcranial Ultrasound, is a diagnostic tool used to assess and prevent ischemic strokes. It is a non-invasive, safe and reliable technique to monitor cerebral vasculature by measuring changes in blood flow velocity within the brain.
In the acute phase of a stroke, TCD can be used to monitor blockage of a brain artery and its response to treatment with agents that break down blood clots. In fact, ultrasound monitoring in conjunction with infusion of clot busting agents may even increase the chances of opening a clot. TCD monitoring after treatment can signal when the clot breaks up and the artery re-opens, a good prognostic sign if it occurs within six hours of the stroke onset. Hence, TCD is an invaluable tool in the Emergency Department in the assessment and treatment of strokes.
TCD can also be used to prevent strokes in high-risk patients, such as individuals suffering from atrial fibrillation, a common form of abnormal heart rhythm, and heart attack patients. Patient monitoring by TCD can detect clot fragments from the heart or arteries, termed emboli, as they pass through the bloodstream in the neck, ready to lodge in the brain and cause a stroke. Emboli detection can lead to more intensive stroke prevention measures, such as use of blood thinners or a combination of anti-platelet agents. Even if the affected individual has not experienced any symptoms, emboli detection indicates urgency for an operation to remove high-grade artery blockage or to replace a constricted heart valve.
After a stroke, monitoring blood flow of the middle cerebral artery by TCD can indicate response to rehabilitation treatments. Specifically, TCD can detect increases in blood flow during motor, sensory and cognitive tasks which recruit particular brain regions to become active. Failure to increase blood flow may indicate ongoing arterial blockage or damage to the specific brain regions. In this context, TCD can be used in parallel with Transmagnetic Stimulation and functional Magnetic Resonance Imaging to delineate brain activity patterns in greater anatomical detail.