Category: neuroscience

Dr. Dar Dowlatshahi is a stroke neurologist and scientist at The Ottawa Hospital and the scientific director of the Ottawa Stroke Program.

If Dr. Dar Dowlatshahi looks familiar, maybe it’s because you’ve received care from the accomplished stroke neurologist here at The Ottawa Hospital, or maybe you’ve seen him playing a tourist in his own city, or maybe you watched Med Students back in the day — the documentary on medical students at McMaster University that featured Dr. Dar, as he’s known to patients, as one of its subjects. If he’s not familiar to you yet, get ready to meet one of the research powerhouses shaking things up at The Ottawa Hospital.

Dr. Dar grew up in Iran, lived briefly in France, and then moved to Canada in 1979 with his family. He moved around quite a bit during his youth, eventually settling in southern Ontario, which is where he earned three degrees — a Bachelor of Science, a PhD in Neuroscience, and an MD, all at McMaster in Hamilton — before completing a stroke fellowship in Calgary.

Today, Dr. Dar is a stroke neurologist and scientist at The Ottawa Hospital and the scientific director of the Ottawa Stroke Program.

Read on to learn which exciting developments in stroke neurology would have seemed like “science fiction” just two decades ago — and how Dr. Dar stays busy when he’s not working.

Q: How did you decide to pursue neurology?

A: When I started university at McMaster, I was studying the sciences, but I didn’t know exactly what I was doing and where I was going. Early in my undergrad, I took a psychology course and fell in love with the brain portion of the work. I went on to do a PhD in neuroscience, followed by med school. But even then, I had no intention of being a psychiatrist or neurologist.

I tried everything from general surgery to cardiology, but the surgeons kept telling me I should be a neurologist. It was always the one thing that was very easy for me; where I could walk into the situation and feel like I already understood it.

Q: What do you love about stroke neurology in particular?

A: What I like about neurology is the action. Often, people don’t see neurology as an action field, they see it as an intellectual field. But when you watch all those action movies, with these guys making decisions and saving lives, that really does happen in the world of stroke.

Dr. Dar Dowlatshahi is a neurologist and researcher at The Ottawa Hospital.

“With stroke, with the snap of the fingers, the brain can be gone. And you’re the person who can, during that snap of the fingers, save that brain.”

— Dr. Dar Dowlatshahi

You have to make these decisions, which can have massive implications, all within seconds. With stroke, with the snap of the fingers, the brain can be gone. And you’re the person who can, during that snap of the fingers, save that brain.

When someone has a stroke, it can change their life — and the lives of everyone around them. But there’s a system in place to bring them to the Civic Campus, the only hospital in the region that can reverse this, where a group of highly trained specialists arrive to make the decision to give you a drug or treatment that can stop the changes that are happening.

I don’t know how many of these patients realize how different the outcome could have been. But being right here in Ottawa means they’re back home the next weekend with a bit of a story to tell, but otherwise carry on as though nothing ever happened. You get to be a part of that.

Q: How has the field of stroke research and care changed since you started out?

A: It’s changed completely. When I was in my first year of med school, we did clinical work where I was in the room when a stroke happened. There was nothing that could be done at the time, but today, with that same patient, we’d have been able to reverse the stroke.

“The action that’s taken today when a person has a stroke would have been science fiction in my first year of medical school.”

— Dr. Dar Dowlatshahi

I saw the first round of breakthroughs in the first five to 10 years of my career. These were advancements in our knowledge of how to use clot-busting medications.

Then, I was part of the team here at The Ottawa Hospital who brought the next set of breakthroughs, which was thrombectomies to remove clots from the brain. It’s now standard care.

Dr. Robert Fahed navigates a catheter through a model of the circulatory system to replicate how a thrombectomy is performed.

A third round of breakthroughs came with imaging software that gave us the technology to better understand what was happening to people in the first few hours after a stroke.

The action that’s taken today when a person has a stroke would have been science fiction in my first year of medical school.

Q: As a scientist at The Ottawa Hospital, you’re working on an important trial for the treatment of a very dangerous type of stroke. Can you tell us more about that?

A: The breakthroughs I described before are all for ischemic stroke. Unfortunately, for the other major type of stroke, intracerebral hemorrhage, we’ve not had the same level of discovery and advancement in the last 20 years.

This trial, called FASTEST, is for intracerebral hemorrhage, or ICH. About 40% of people who experience an ICH will die within the first month, and of those who survive, about 80% are disabled. It’s by far the worst stroke.

The Ottawa Hospital is the national lead on this trial, which is looking at a medication that’s a clotting factor, or protein, that’s already in your blood stream, and the drug is a concentrated form of it.

When any blood vessel tears, your own clotting factors try to fix the tear. Your vessel first releases something to sort of raise a flag to say, “the trouble is here.” The factors circulating the body looking for trouble see the flags and congregate at the site and form a clot, which is essentially a plug.

In this trial, we’re trying to get these clotting factors to go into superhuman mode. It gets injected into the blood stream, it courses through your veins, it gets to the target, and then immediately starts to form a clot to stop the bleeding.

Q: What is some of the other exciting research happening here at The Ottawa Hospital?

A: In stroke alone, we’re doing work on new catheters to pull clots out of the brain, we’re working on imaging to advance our ability to find treatable patients, and we’re bringing in new scientists to develop new clot-busting medications. We’re also looking at the connection between cancer and stroke and ways to prevent stroke. When it comes to stroke research, you name it, we’ve been in that space.

Q: As a neurologist, why do you work at The Ottawa Hospital?

“We’re a medium-sized city, but we’re on par with these famous international institutions.”

— Dr. Dar Dowlatshahi

A: When I started out in 2010, The Ottawa Hospital was doing stroke research, but it had room to grow. I had advanced training and the hospital had an interest in developing programs my areas of interest — cerebral hemorrhage and acute stroke therapies. Today, there’s a strong network of academic stroke physicians across Canada, and many of us have decided to call Ottawa home. We’re rich in stroke research culture. We’re a medium-sized city, but we’re on par with these famous international institutions.

We have this modesty we don’t need to have here. This is the capital; we should be the best. I wanted to be right where the heart — or should I say brain — of the country is.

Q: What would we find you up to when you’re not at work?

A: I’ve been playing in bands since I was 16. Music was my plan A, while medicine and academia were plan B. I went into medicine, but during the pandemic, a lot of people were holed up and went back to their old hobbies and things they wished they were still doing. Some colleagues and I started a band called Phenotype ─ I drum ─ and it’s just a lot of fun. It’s the opposite of what I do during the day, no one’s life is on the line.

I also enjoy going out and about the Ottawa area with my two boys and my wife. There’s a lot of really cool stuff when you live in a capital town. Rideau River Cruises, touring the Parliament Buildings, Beaver Tails in the market — all that stuff that you would only expect tourists to do, you’ll see me there.

Striking a chord with stroke research

Meet Dr. Ronda Lun — recipient of a rare honourable mention for the 2022 Worton Researcher in Training Award

Why do some people recover from their strokes while others don’t? Dr. Ronda Lun is answering questions like this one through her boundary-pushing stroke research. Author of over 34 papers, a recipient of the highest honour for emerging researchers from the American Academy of Neurology, and now, an honourable mention for the 2022 Worton Researcher in Training Award from The Ottawa Hospital, Dr. Lun combines clinical practice with practice-changing research every day.

Keep reading to learn about what motivated Dr. Lun to become a neurologist — and what drives her research.

Why do some people recover from their strokes while others don’t? Dr. Ronda Lun is answering questions like this one through her boundary-pushing stroke research. Author of over 34 papers, a recipient of the highest honour for emerging researchers from the American Academy of Neurology, and now, an honourable mention for the 2022 Worton Researcher in Training Award from The Ottawa Hospital, Dr. Lun combines clinical practice with practice-changing research every day.

Keep reading to learn about what motivated Dr. Lun to become a neurologist — and what drives her research.

Q: Can you tell us a bit about your childhood?

A: I was born in China, and my parents and I immigrated to Canada when I was eight. I lived in Calgary until I moved to Ottawa to do my medical residency at The Ottawa Hospital.

My dad was a neurosurgeon when we were in China, so I was always fascinated by neuroscience and the brain, and I always looked up to my dad.

Then when I was around 10, I started playing piano and really fell in love with classical music.

Dr. Lun playing the piano.

Q: Can you tell us a bit about your childhood?

A: I was born in China, and my parents and I immigrated to Canada when I was eight. I lived in Calgary until I moved to Ottawa to do my medical residency at The Ottawa Hospital.

My dad was a neurosurgeon when we were in China, so I was always fascinated by neuroscience and the brain, and I always looked up to my dad.

Dr. Lun playing the piano.

Then when I was around 10, I started playing piano and really fell in love with classical music.

Q: How did you decide to study neuroscience?

A: Neuroscience and piano were my two big interests growing up, and I had a very hard time deciding what I wanted to pursue at the end of high school.

To be honest, I didn’t see my dad very much when I was younger, because he was so busy with work. But when he would come home, he would tell us stories about patients he helped, and how grateful families were that he was able to help them in some way. I really admired how generous and kind he was — and how caring he was for his patients. That was something I wanted to emulate.

I wound up doing my undergrad with a major in neuroscience and a minor in piano. But I actually didn’t finish my undergrad degree, because I ended up going to medical school before the end.

Q: Why did you choose to do your residency at The Ottawa Hospital?

A: As a final year medical student, we do electives at various universities, and I came to Ottawa for one. I remember being blown away by how nice and how willing to teach everyone was. My first day on stroke service with Dr. Michel Shamy, one of the stroke neurologists here at The Ottawa Hospital, he took me to a patient’s bedside and he walked me through how to do an acute stroke assessment, step by step. I felt so important, and I felt like people valued my education and wanted me to succeed, which I think really kind of set The Ottawa Hospital apart from other institutions I had rotated through. It’s such a supportive environment; I knew I wanted to come here for more training.

It’s such a supportive environment; I knew I wanted to come here for more training.

Dr. Ronda Lun

A: As a final year medical student, we do electives at various universities, and I came to Ottawa for one. I remember being blown away by how nice and how willing to teach everyone was. My first day on stroke service with Dr. Michel Shamy, one of the stroke neurologists here at The Ottawa Hospital, he took me to a patient’s bedside and he walked me through how to do an acute stroke assessment, step by step. I felt so important, and I felt like people valued my education and wanted me to succeed, which I think really kind of set The Ottawa Hospital apart from other institutions I had rotated through. It’s such a supportive environment; I knew I wanted to come here for more training.

It’s such a supportive environment; I knew I wanted to come here for more training.

Dr. Ronda Lun

I didn’t really realize my full academic potential until I started my residency at The Ottawa Hospital, and I feel like coming to Ottawa was the best decision I ever made.

Q: How did you get into more research?

A: When I started my residency, I had no experience at all in clinical research. I had just done a little bit of lab research as an undergrad. As a resident, I was open to exploring all opportunities, so I started talking with some of the staff here at The Ottawa Hospital, and I ended up finding an area of research that I’m really quite passionate about — intracerebral hemorrhage. That was when I realized, despite all the clinical things we do on a day-to-day basis, there is still so much we don’t know about this disease, and still so much we could learn. At first, I was just focused on how to do that research. But then I found the more research I did, the more I realized I didn’t have the necessary statistical skills or epidemiology tools I needed to push stroke research even further. That’s what got me really interested in epidemiology and made me want to pursue a master’s degree during my training.

Q: How does your stroke research intersect with cancer research?

A: The medical community has known cancer can cause a hypercoagulable state for a long time — cancer increases your chance of forming blood clots. But the majority of research done around cancer and blood clots has actually been on venous clots, and stroke is an arterial type of clot, so it’s different. We don’t know very much about who gets a stroke after a cancer diagnosis — or which types of cancer are the most at risk. I thought it was the perfect topic to dive into with my master’s thesis.

We found a couple interesting things from my research. We found that during the first year following a new cancer diagnosis, your risk for stroke is three times higher than someone in the general population.

As neurologists, this is quite exciting, because it represents a window of opportunity where we can try to prevent a stroke from happening after a cancer diagnosis. And when patients have a stroke that we can’t find a source for, we can start thinking about whether there’s an underlying cancer that’s undiagnosed.

That’s what I think is the most exciting part about some of these findings; we can really make a difference in these people’s lives.

Q: What motivates your work?

A: My clinical work is what drives me to better my research — the two go hand in hand. I would never have dreamed this is where I would be in five years when I first started my residency.

It’s super exciting to know the research I’m doing is making an impact, and I also get to see patients on a day-to-day basis who inspire me to find answers.

It’s extremely humbling to think about how much progress we have yet to make in the field of stroke treatment, especially in these understudied areas such as cancer-associated stroke.

Q: Where might we find you outside the lab?

A: It’s hard to keep up with music, especially when you’re doing a residency and research, but I do love attending concerts and musical festivals. I also love keeping active: running and hiking and going to the gym. It’s nice to have a balance of work during the week and fun on the weekends.

Dr. Lun hiking in the mountains.

It’s super exciting to know the research I’m doing is making an impact, and I also get to see patients on a day-to-day basis who inspire me to find answers.

It’s extremely humbling to think about how much progress we have yet to make in the field of stroke treatment, especially in these understudied areas such as cancer-associated stroke.

Q: Where might we find you outside the lab?

A: It’s hard to keep up with music, especially when you’re doing a residency and research, but I do love attending concerts and musical festivals. I also love keeping active: running and hiking and going to the gym. It’s nice to have a balance of work during the week and fun on the weekends.

Dr. Lun hiking in the mountains.

Honouring our top researchers of 2022

Soccer skills and stem cell science

Meet Dr. Bernard Thébaud, recipient of the 2022 Chrétien Researcher of the Year Award.

Lighting up cancer research with firefly proteins

Meet Dr. Taha Azad, recipient of the 2022 Worton Researcher in Training Award.

A self-proclaimed nerd with a knack for nephrology

Meet Dr. Kevin Burns — the 2022 winner of the Grimes Career Achievement Award.

Life-altering stroke treatment and care from a “gym rat”

Meet The Ottawa Hospital’s Dr. Robert Fahed, one of only four interventional neurologists in Canada

Not all heroes wear capes — Dr. Robert Fahed plucks blood clots from the brains of stroke patients, saving lives and mitigating injury. The revolutionary process, called thrombectomy, is just a part of what Dr. Fahed brings to the fight against strokes and their disabling effects as an Interventional Neuroradiologist and Stroke Neurologist at The Ottawa Hospital, and Assistant Professor at the University of Ottawa. After training in France, Dr. Fahed was recruited by The Ottawa Hospital, and he’s become known for his practice-changing research and care for stroke patients — and others.

Read on to learn about the eyebrow-raising moment Dr. Fahed learned about thrombectomies and why he chooses to call Ottawa home.

Q: How did you wind up at The Ottawa Hospital?

A: I was born and raised in the suburbs of Paris, France. Both my parents immigrated from Syria before I was born because they wanted a better life for their kids. I’ve always felt like everything I’ve achieved was thanks to them.

I did my neurology residency in Paris, and then I did my master’s degree in Montreal, because I wanted to do research. I have family in Montreal, and I’ve always loved Canada, ever since I was a kid. Why Ottawa? It’s for three reasons: two personal, one professional.

Number one is that The Ottawa Hospital is known for its great research infrastructure and how they support researchers. Number two is that Ottawa is a peaceful, quiet, family-friendly city, and I wanted exactly that environment to raise my kids. Number three is I find it very stimulating to be constantly working in and speaking English. It stimulates my brain because it’s not my natural language. My brain is always functioning at a higher pace because of it, and I like that.

Q: Why did you choose to go into neurology?

A: My father is a neurologist, so I grew up in the field and always liked it. Seeing my father as a hero, it was always pretty clear that I wanted to become a doctor.

One of my first electives was in stroke neurology, and I saw these patients coming back from the dead, basically, after a stroke. That was an epiphany for me; it was what I wanted to do.

Then, when I was a first-year resident in France, I had already decided I wanted to be a neurologist, but the vast majority of neurologists don’t do endovascular procedures. A woman in her 50s showed up with a massive stroke, her right side was paralyzed, and she couldn’t speak.

I thought to myself, “Poor woman, she’s going to be paralyzed for the rest of her life.” Then one of my team members said, “Robert, there is something we can try. It’s experimental; it’s called thrombectomy. Bring her to that room.” I pushed her to the suite, she went in, the doors closed, and I went around to my patients. Half an hour later, I received a call that the procedure was done, and I went to pick her up. I saw a woman coming out of the room, and she was moving her right arm. She wasn’t paralyzed anymore!

I immediately though, “I don’t know what happened in that room, but I want to be the one doing it. I want to be the one bringing those people back to life.”

“I don’t know what happened in that room, but I want to be the one doing it. I want to be the one bringing those people back to life.”

— Dr. Robert Fahed
Dr. Robert Fahed_neuroradiology_The Ottawa Hospital_profile

I thought to myself, “Poor woman, she’s going to be paralyzed for the rest of her life.” Then one of my team members said, “Robert, there is something we can try. It’s experimental; it’s called thrombectomy. Bring her to that room.” I pushed her to the suite, she went in, the doors closed, and I went around to my patients. Half an hour later, I received a call that the procedure was done, and I went to pick her up. I saw a woman coming out of the room, and she was moving her right arm. She wasn’t paralyzed anymore!

“I don’t know what happened in that room, but I want to be the one doing it. I want to be the one bringing those people back to life.”

— Dr. Robert Fahed
Dr. Robert Fahed_neuroradiology_The Ottawa Hospital_profile

I immediately though, “I don’t know what happened in that room, but I want to be the one doing it. I want to be the one bringing those people back to life.”

This woman wanted to give us a gift for what we did for her. Her job was running a beauty salon, so she gave me a coupon, and she said, “This is for your …” and she couldn’t remember the name, but she pointed at my eyebrows.

I thought that was hilarious. She gave me a hug, she left, and I never saw her again. It just resonates, and every time I do a thrombectomy, I think about that woman.

Q: How would you describe your role at The Ottawa Hospital?

A: I have dual training: I’m a neurologist who deals with strokes, and I am an interventional neuroradiologist, which means I do endovascular neurology, which consists of navigating little catheters into the brain from the groin or wrist, using just a little puncture that leaves no scar. After treatment, you can’t tell you had a procedure, because the process is what we call minimally invasive.

There are only four neurologists who do interventional neurology in the whole country, and I’m one of them. It’s usually done by radiologists or neurosurgeons, but it can be done if you’re a neurologist.

Here at The Ottawa Hospital, we cultivate this multidisciplinary approach, and I think that’s the best way to offer optimal care to our patients.

I’m also a researcher. I think research is important because today’s research is tomorrow’s care. What we are studying today will be the cutting-edge, groundbreaking, disruptive treatment we can offer to our patients.

Q: How is the field of neurology changing?

A: I’m proud to be able to be part of such disruptive innovations and treatments, and I have a lot of excitement, because the future is even brighter.

Not only are we going to be better at treating stroke, but we are also going to expand the number of people we treat. We’re treating more strokes because we can go get clots that are smaller, and we can treat patients who are a bit older, and we have catheters that can navigate basically anywhere.

We’ve even started to treat other things, like tinnitus, and we might in the future help treat Parkinson’s disease, because we’re not able to implant little electrodes in the brain from inside the vessels.

The pace of evolution and improvements is exponentially higher and better every year. My job already has nothing to do with what my job was 10 years ago when I started; it’s already so different. And 10 years from now, it will again be a completely different field.

1
A major blood vessel in the brain is blocked by a blood clot, causing an acute ischemic stroke.
2
A thin catheter inserted into the groin travels through an artery until it reached the clot. A stent passes through the catheter and engages with the clot.
3
The stent is then pulled back taking the clot with it. The goal is to remove the entire clot on the first try to restore blood flow as quickly as possible, limiting damage caused by the stroke. 
4
Blood flow is restored, and brain function can often improve immediately.
5
Read how new technology and techniques like the endovascular thrombectomy changes the outcome for stroke .
Learn More
Previous
Next

New technology and techniques like the endovascular thrombectomy changes the outcome for stroke .

Q: How is the field of neurology changing?

A: I’m proud to be able to be part of such disruptive innovations and treatments, and I have a lot of excitement, because the future is even brighter.

Not only are we going to be better at treating stroke, but we are also going to expand the number of people we treat. We’re treating more strokes because we can go get clots that are smaller, and we can treat patients who are a bit older, and we have catheters that can navigate basically anywhere.

We’ve even started to treat other things, like tinnitus, and we might in the future help treat Parkinson’s disease, because we’re not able to implant little electrodes in the brain from inside the vessels.

1
A major blood vessel in the brain is blocked by a blood clot, causing an acute ischemic stroke.
2
A thin catheter inserted into the groin travels through an artery until it reached the clot. A stent passes through the catheter and engages with the clot.
3
The stent is then pulled back taking the clot with it. The goal is to remove the entire clot on the first try to restore blood flow as quickly as possible, limiting damage caused by the stroke. 
4
Blood flow is restored, and brain function can often improve immediately.
5
Read how new technology and techniques like the endovascular thrombectomy changes the outcome for stroke .
Learn More
Previous
Next

New technology and techniques like the endovascular thrombectomy changes the outcome for stroke .

The pace of evolution and improvements is exponentially higher and better every year. My job already has nothing to do with what my job was 10 years ago when I started; it’s already so different. And 10 years from now, it will again be a completely different field.

Q: What will the Campaign to Create Tomorrow mean for your work in neurology?

A: It means more beds to treat more patients in a timely manner, so it means better care. But more importantly, it means more support to do research. I think many people dichotomize research and care, they separate those two entities, which is a big mistake that The Ottawa Hospital is not making. The Ottawa Hospital is supporting trials and studies embedded within clinical care, so we can care for patients while offering them cutting-edge treatments within the context of a research study.

Dr. Fahed welcomes a new piece of technology to TOH.

In terms of research, we’re going to find neuroprotective drugs that can be administered in the ambulance to protect the brain. We’re also working on stem cell therapy to enhance rehabilitation and brain recovery following on a stroke. And we’re going to have new tools and techniques that will allow us to reopen vessels faster and better, which will translate into better outcomes for patients.

I think our performance in neuroscience research is already pretty amazing worldwide, but we’re going to go up to that next level with a new neuroscience institute. I am very hopeful that with this new space and research infrastructure, we’ll be able to do miracles.

Dr. Fahed welcomes a new piece of technology to TOH.

In terms of research, we’re going to find neuroprotective drugs that can be administered in the ambulance to protect the brain. We’re also working on stem cell therapy to enhance rehabilitation and brain recovery following on a stroke. And we’re going to have new tools and techniques that will allow us to reopen vessels faster and better, which will translate into better outcomes for patients.

I think our performance in neuroscience research is already pretty amazing worldwide, but we’re going to go up to that next level with a new neuroscience institute. I am very hopeful that with this new space and research infrastructure, we’ll be able to do miracles.

Q: Where would we find you when you’re not working with patients or in the lab?

A: That one is easy: I’m a gym rat, I love working out! I’ve been doing it ever since I was a teenager. I have dumbbells, a bench, a rowing machine. I started working out at the gym on campus, but when COVID started, I stocked up on some equipment. My colleagues all made fun of me, saying it wouldn’t be that long. Two months later, everyone was knocking on my door asking if they could use my equipment for a workout.

There is a saying in Latin, “mens sana in corpore sano,” which basically means a healthy mind, a healthy body. I’m training my brain enough with my work, but the body is very important too. We only get one, and we need to look after it. Prevention is the best medicine.

I also spend a lot of time with my family. My parents and sister are now in Gatineau. Along with my wife and my daughter, and soon my second daughter, we enjoy everything Canada has to offer. Ottawa is a magical city: it’s full of parks, you can go on a boat on Dow’s Lake in the summertime, and in the wintertime, you can do ice skating, which is completely new to me. You can go skiing, you can go to zoos, you have so many things to do. I’ve been here for three years, and I have so many things to discover. I am enjoying everything this beautiful country has to offer.

Q: Can you tell us about the world-first treatment you just completed on a tinnitus patient?

A: We recently used this endovascular procedure on a patient with pulsatile tinnitus. It’s a rare type of tinnitus in which patients have any variety of underlying vessel disorders that cause a whooshing sound in the ears. We can almost always treat this type of tinnitus endovascularly, and traditionally, we’d place a stent and put the patient on blood thinners. But for patient Chris Scharff, we used the process typically used for brain arterial aneurysms on the venous aneurysm that was causing the pulsatile tinnitus. It solved the tinnitus without the need to put the patient on blood thinners. It was the first time this treatment had ever been done in the world.

We also recently opened the Ottawa Pulsatile Clinic. While other types of tinnitus are treated by an ear, nose, and throat doctor (ENT), pulsatile tinnitus requires a different approach.

This new treatment and the clinic really highlight how The Ottawa Hospital is at the forefront of innovation.

From co-op student to lab leader

Meet The Ottawa Hospital’s Dr. Julianna Tomlinson

Born, raised, educated, and trained in Ottawa, Dr. Julianna Tomlinson is using research to change the way we think about Parkinson’s disease. Her work focuses on Parkinson’s-linked genes and is revealing the complexity of the disease. As the Senior Laboratory Manager in Dr. Michael Schlossmacher’s lab at the Ottawa Hospital Research Institute (OHRI), Dr. Tomlinson is highly involved in community outreach, and her work is inspired and influenced by people living with Parkinson’s.

Read on to learn more about Dr. Tomlinson’s unique connection to The Ottawa Hospital and what’s new and exciting in Parkinson’s research.

Q: Can you tell us a bit about your connection to The Ottawa Hospital?

A: I grew up in the Civic Hospital area, and I’ve always had a connection to it. My mum worked there for many years, I remember going to her office and picking her up. I spent summers as a volunteer — a candy striper, as they used to call us. I spent a lot of time in the geriatric assessment unit, listening to patients and taking them down for lunch. I loved it all.

During my last year of high school at Glebe Collegiate, I had the opportunity to do a co-op placement, and I was placed in a research lab at the Loeb building. I was able to go into the lab and be exposed to doing academic, basic science-based research. I loved it immediately. I had no idea this really existed. It just opened up this whole new world for me. Now, I really appreciate that my supervisor at that time, Dr. Robert Haché, said yes to taking on a high school student. That first year I had mostly “make work” tasks I think; I don’t know how much I actually contributed to an actual project.

Dr. Tomlinson in the lab in 2003.
Dr. Tomlinson in the lab in 2003.

I did my masters and then PhD in the same lab, and when I graduated, I was looking for a post-doctoral position here in Ottawa. Following a lead from my husband, who is also in science, I started working in Dr. Schlossmacher’s lab. There, I brought my research training and background to the Parkinson’s field.

Q: What is the most interesting thing you have learned during your time studying Parkinson’s?

A: For my graduate studies, my project was really basic research only — it didn’t have a patient connection. When I joined Michael’s lab, I felt immediately that there was a patient connection and a strong link to the community surrounding them, and it opened my eyes. Yes, my PhD work was related to human diseases, but it was studying the nuts and bolts of what was happening at the molecular level. When I came to work on Parkinson’s, I was working on a specific human disease afflicting people. I was still asking those nuts and bolts questions, but now it always comes back to, “what does it look like in the patient?”

Q: What is The Ottawa Hospital doing in Parkinson’s research that is exciting or groundbreaking?

A: I think we are asking bold, new questions. We were one of the first labs to look at new roles for some of the genes linked to Parkinson’s. For this we looked outside the brain, and studied protein functions, for example, in the immune system. We would get comments saying, “This is an interesting effort, but what does it have to do with Parkinson’s?” And now we have labs pursuing these very leads we helped develop! I think we’ve been able to ask these novel questions and think outside the box, in large part due to the community support and the inspiration we obtain from patients and their loved ones. Another strength of Ottawa is the highly collaborative environment that we all work in, such as between research labs and institutions, across fields, and in the bridging of clinical and basic research. I love it.

Parkinson's Research at The Ottawa Hospital

Q: How does community support for research ultimately help patients?

A: For us, it is motivation, it is having that community context, it is having people with lived experience who trust us in tackling complex (and complicated) topics and who support us generously. They, in the short run, are truly excited about our discoveries when we report back to them. Over time we have learned that this has energized them as well. In the long run, this is all about helping the patient. We want to deliver for them. In sum, with community support, you can ask the novel questions. Any research discovery that gets moved closer to the cause or a better marker of the illness is going to have a big impact for future therapy.

“With community support, you can ask the novel questions. Any research discovery that gets moved closer to the cause or a better marker of the illness is going to have a big impact for future therapy.”

– Dr. Julianna Tomlinson
Go behind the scenes with Dr. Tomlinson
in episode 34 of Pulse Podcast.

Listen Now:

Dr. Julianna Tomlinson is the Senior Laboratory Manager in Dr. Michael Schlossmacher’s lab at the Ottawa Hospital Research Institute.

The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.

 

Dr. Michael Schlossmacher, The Ottawa Hospital

Growing up in Austria, Dr. Michael Schlossmacher couldn’t have foreseen his future as a physician-scientist conducting groundbreaking Parkinson’s research at The Ottawa Hospital. His career started with medical school in Vienna, followed by graduate studies in human biology. By the late 1980s, he found himself in Boston pursuing post-doctoral work on Alzheimer’s disease. In 2006, The Ottawa Hospital Research Institute (OHRI) recruited Dr. Schlossmacher to their team, and he opened a new laboratory as a member of the Parkinson’s Research Consortium Ottawa early the following year. His work is dedicated to improving the lives of individuals with neurodegenerative diseases.

Keep reading to learn how he got to where he is today and about the role philanthropic support has played in his research.

Q: What were your interests as a child?

A: As a young child, my favourite thing was sharpening pencil crayons of different colours. I thought maybe I’d be a pencil sharpener later in life. I also loved building things, LEGO trucks and miniature train sets. In middle school and high school, my weakest subjects were biology and English. My focus between the ages of 10 to 18 were soccer and track and field, but when I sustained a significant knee injury, I became interested in anatomy and how to repair things. From a very young age, I was interested in how things went awry.

Q: How did you decide to study medicine, biology and later, neuroscience?

A: I don’t remember the precise decision making. I just knew I was fascinated with the notion of health and disease. It was more like a gut feeling. My parallel interest was art, so in the beginning, I pursued both medicine and art school. I wound up doing a combination of anatomy instruction, drawing, and studies

My fascination with biology really took off when I started pathology — learning in a more structured manner what all the diseases of the body were, and how organ disfunction evolves into disease.

After medical school, I decided to go through more structured scientific training and moved to Boston, Massachusetts on a Fulbright scholarship at Harvard University. After I met my wife, I took on a job as a research assistant in an Alzheimer’s research lab because I ran out of money, thus learning on the job.

In 2006, The Ottawa Hospital Research Institute (OHRI) recruited Dr. Schlossmacher to their team, and he opened a new laboratory as a member of the Parkinson’s Research Consortium Ottawa early the following year.

Q: What are the most promising Parkinson’s discoveries happening right now?

A: The first one, and it’s not yet mainstream, is to see that Parkinson’s is similar to other diseases that occur later in life, whereby multiple factors have to work together: there’s a genetic component; there’s a series of environmental factors; there’s the sex effect, males are more affected; and then there is this progression in risk with every year we live longer. It’s true for every other disease whether it’s breast cancer or coronary disease, that these factors all work together. We have to think more holistically.

Number two is that inflammation is very important. We now know that people with chronic inflammation from hepatitis B, hepatitis C, inflammatory bowel disease (such as Crohn’s disease), or skin conditions like rosacea — all these conditions increase, measurably, the risk for Parkinson’s disease. Chronic inflammation, wherever it sits in the body, seems to promote the development of Parkinson’s.

Q: How is donor support important for your research?

A: Philanthropic support is critical in particular in the early phases of research. It helps us develop results that can be used to effectively raise money from other sources. We once looked at how much money we raised through our Parkinson’s Research Consortium, and every dollar raised through philanthropy leveraged $10 to $15 from federal and foundation sources. We are so grateful for these gifts!

It also allows our research initiatives to explore ideas outside of the mainstream — to challenge dogmas, to shake the tree, to rattle your colleagues with new concepts. Philanthropic support has allowed us to make several important discoveries here in Ottawa that have influenced the field.

Philanthropy has the potential to transform research activities in a lab by amplifying the energy and invigorating scientists; plus, supporting talented trainees fuels their drive to develop creative ideas.

Dr. Michael Schlossmacher is a physician-scientist conducting groundbreaking Parkinson’s research at The Ottawa Hospital.

The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.

The Ottawa Hospital was fortunate to welcome renowned neurosurgeon Dr. John Sinclair back to Ottawa 2005, following two fellowships at Stanford University in California. As the Director of Neurosurgical Oncology and the Director of Cerebrovascular Surgery, he is an expert resource for our patients facing brain tumours, including glioblastoma multifome.

Dr. Sinclair is an innovator and always on the lookout for the latest treatment options for our patients. It was this drive that helped bring the CyberKnife, Advanced Awake Craniotomy techniques and most recently Fluorescence-Guided Surgery to our hospital. With tools like these at their disposal, Dr. Sinclair and his colleagues have increased survival rates for our brain tumour patients.

Q: Why did you choose to work at The Ottawa Hospital?

A: I grew up in Ottawa. The sense of community here is strong. I wanted to be a part of that community. I felt that I could make a difference by helping to develop outstanding care for our patients in the community and beyond. I have treated a number of patients who I have known from my years growing up in Ottawa. There is a bond that builds trust and hope in patients when you have a common connection. Ottawa is that connection for me.

Q: As the Director of Neurosurgical Oncology what, in your opinion, sets The Ottawa Hospital apart from other hospitals?

A: The thing that sets us apart is the incorporation of awake surgery and advanced mapping for the resection of most brain tumours and more recently Fluorescence Guided Surgery. These innovations place us alongside our Ottawa Hospital colleagues in cancer treatment and research within the complementary specialties of neuro-oncology, neuroradiology, neuropathology, neurophysiology and neurological oncology. These two advances in particular have allowed a wider scope of a patient centered focus as we collaborate closely through all aspects of care and treatment.

Q: You were instrumental in bringing the community-supported fluorescence-guided microscope to our hospital. This microscope illuminates malignant brain tumours during surgery allowing you to successfully remove more of the tumour. How has this microscope impacted our patients with brain cancer?

A: Without this microscope, we would not be able to do Fluorescence Guided Surgery (FSG). FSG allows for maximal safe resection of malignant tumours which in research has proven to increase length of time to recurrence and overall survival rates. Without a doubt, this offers our patients a better chance to fight against brain cancer.

Q: Another piece of equipment made possible thanks to donor support is the CyberKnife. How has the CyberKnife technology helped patients of The Ottawa Hospital over the past decade?

A: Over the past decade, we have been able to treat thousands of patients using CyberKnife. It allows for a targeted approach to radiation treatment resulting in decreased side effects and decreased risk to the patients. This precision treatment also typically allows for shorter treatment time resulting in viewer visits to the hospital.

Q: You removed Stefanie Scrivens’ grade 2 oligodendroglioma brain tumour through a successful awake surgery, and she didn’t need chemo or radiation. What made this incredible outcome possible?

A: Using advanced subcortical mapping during Stefanie’s surgery allowed us to provide maximal resection of the tumour, taking a rim of “normal” tissue where the tumour had been. This was done in hopes of removing any microscopic tumour cells that extended beyond the tumour. By doing so we were able to indefinitely postpone radiation and chemotherapy.

Q: The Ottawa Hospital has incorporated Canada’s advanced brain mapping techniques to help during awake brain surgery. How does this mapping system help brain surgeons?

A: Traditional approaches to awake craniotomy deal with basic brain function; speech and movement. In many cases this is sufficient. Advanced cortical and subcortical mapping allows testing of advanced brain function that can impact higher brain function, such as cognition, personality and visual perception. The ability to map these functions allows us to safely preserve brain function; improving outcomes and the quality of life for patients. With basic mapping it is often necessary to leave a portion of tumour behind rather than continuing surgery in these eloquent areas.

Q: The Ottawa Hospital is currently working towards the creation of a new, state-of-the-art health and research centre to replace the aging Civic Campus. What will this new hospital campus, which will be the most technologically advanced facility in Canada, mean for your patients?

A: The new hospital campus will allow us to build from our strong foundation, a centre that will provide our patients with multidisciplinary care that will bring together all facets of healthcare. A centre like this will attract world-class physicians and care teams. It will help to advance treatment and research within our community. In doing so we will be able to provide a centre of excellence. This is a perfect opportunity to really bring patient care to the highest level.

Q: What message do you want to convey to your patients with brain tumours?

A: Quoted statistics often reflect dated technology and treatment protocols and new advances in treatment are always occurring and evolving. Our patients need to keep that hope and our community must foster that through continued support of The Ottawa Hospital in order for this to become a reality in the years to come.

Dr. Fahad Alkherayf is a skull base surgeon at The Ottawa Hospital.

Dr. Fahad Alkherayf is the Director of the Clinical Research Program in the Neurosurgery Division of The Ottawa Hospital. As a neurosurgeon, he specializes in minimally invasive surgeries, which use much smaller incisions than traditional surgeries. As a result, they can mean less pain, lower chance of infection, and quicker recovery time. As part of a highly skilled team at The Ottawa Hospital, Dr. Alkherayf is broadening the horizons in neurosurgery treatment and research — not just in Ottawa, but across Canada.

Q: How did you decide to go into the field of neurosurgery?

A: In my Grade 7 science class, we learned about the human body and how all the systems function together. It really started my interest in medicine, especially the brain. There were three of us in that class who were very close friends, and we shared this interest. All three of us became doctors: one is a psychiatrist, one a radiation oncologist. I went to medical school based on this, and during my schooling I spent time in neurosurgery and realized this would be my future.

Q: What have you learned since becoming a neurosurgeon?

A: I have learned that despite what the textbooks show and say about the brain, in real life each patient is unique, and what works for one patient might not work for another. This has inspired me to individualize each of my patients’ care.

Neurosurgery is also evolving at a fast pace, and a lot of the equipment we now use was not invented or used when I started in the field. A lot of historical neurosurgical procedures have been replaced with modern techniques.

Q: You used minimally invasive surgery to remove a meningioma tumour from behind Michele Juma’s eye. How did these new techniques help her?

A: Michele came to see me almost blind because the tumour was attached to her optic nerve. Identifying the margin between the tumour and the nerve without causing damage to her nerve was one of the biggest challenges in her surgery.

This type of tumour is not new, the presentation is not new, but the treatment is relatively new. We used to do craniotomies, which involve a big incision in the skin. You need to remove part of the skull, go underneath the brain, lift the brain up, and then work all the way to the centre and remove the tumour, aiming not to injure any of the structures around it. The challenge with that is it’s a long path, and it’s through a really big incision. We know with these, there is a higher risk of inuring the optic nerve.

With patients like Michele, now instead of going through the old, traditional way — going through the scope, and lifting the brain up — we go through the nose.

Minimally invasive skull base surgery uses a narrow scope with a light to access and remove tumours through the nose.

Q: You also use a unique technique you call “vision monitoring” during certain minimally invasive surgeries like Michele’s. Can you talk about that and what else The Ottawa Hospital is doing in neurosurgery that is exciting or groundbreaking?

Continuous evoked visual potential goggles are used by surgeons during some brain and skull surgeons to monitor a patient’s vision and avoid damaging the optic nerve.

A: The vision monitoring is teamwork where a neurophysiologist continuously monitors any changes in the patient’s vision during the surgery. This technique is done by applying goggles — similar to swimming goggles — over the patient’s eyes, which send signals through their eyes, and then we record the response from the patient’s vision centre. This allows the neurophysiologist to monitor any changes to the patient’s vision happening during the surgery. This live feedback helps the surgeon to achieve maximum resection (or removal) of tumours while minimizing the risk of injury to the visual pathway.

I am proud that this technique was significantly modified by our team here at The Ottawa Hospital. In addition to this unique technique, at The Ottawa Hospital we have advanced equipment including 3D endoscopes, along with techniques to inject the tumour with certain dyes to allow the tumour to be better visualized during the surgery.

Q: The Ottawa Hospital is currently working towards the creation of a new, world-class health and research centre to replace the aging Civic Campus. How will this new hospital campus, which will be the most technologically-advanced facility in Canada, make a difference for our neuro patients?

A: The new Civic Hospital will have the state-of-the-art technology that will advance the focus on individualized patient care.

The “one-model-fits-all” approach is changing in neurosurgery. Current research is focussing on individualized patient care. I see a future where each patient will have their surgery planned specific to their situation and needs — where artificial intelligence techniques would be part of planning for patient surgery.

Q: Why did you choose to work at The Ottawa Hospital instead of a different hospital?

A: One of the biggest advantages of The Ottawa Hospital is that all of us are connected. What happened in Michele’s case, for example, is that everything could go very quickly, because we are all in one centre. We are more advanced because we’re able to work as a group. We have brought all the expertise under one umbrella here.

I am a strong believer that the key thing for success is having a collaborative and supportive work environment. Of the many offers I received early in my career, The Ottawa Hospital, together with The Ottawa Hospital Research Institute, were the right fit for me. This kind of workplace, and the great city of Ottawa, was the best decision for my family.

Q: Where would we find you outside of work?

A: Depending on the time of year, you can find me playing soccer, hiking, camping with the kids, or taking care of the garden.

Q: What is something about you people might not know?

A: I have arachnophobia.

Sign up to receive updates on the transformational care taking place right here at our hospital, inspiring patient stories, and the latest research discoveries impacting healthcare for you, your loved ones, and our community.