For people living with Alzheimer’s and other dementias, time is the enemy.
In the early stages of these devastating diseases, symptoms may be subtle. Individuals may be more forgetful than usual or have trouble learning new things.
As their disease progresses, they experience greater cognitive difficulties and memory loss. They may lose their ability to find their way home, to pay bills, to read, write or complete everyday tasks. They may exhibit confusion, erratic behaviour and personality changes. Eventually, they may no longer recognize their loved ones.
This loss of cognitive functioning is a reality for the estimated 600,000 Canadians living with Alzheimer’s disease and other dementias. Since age is a leading risk factor and our population is aging, that number is expected to climb to more than 1.7 million by 2050, meaning there is a growing and urgent need for therapeutic options.
Having witnessed the ravages of these diseases in countless patients, renowned Canadian neurologist Dr. Sandra Black now sees a light at the end of the tunnel.
In fact, it’s an exciting time to be working in the field, she says.
“We could be entering a whole new era,” says Dr. Black, senior scientist and director of The Dr. Sandra Black Centre for Brain Resilience and Recovery at Sunnybrook Research Institute.
“We may be very close to having some treatments for Alzheimer’s disease that would be disease-modifying,” she says. “I hope we’re going to be in a similar situation as what happened in acute stroke, which has been transformed into a treatable condition if caught early enough and is often preventable if risk factors are managed.”
During her nearly 40-year career, Dr. Black has been at the forefront of advances in understanding and treating stroke, Alzheimer’s disease and other neurodegenerative diseases. One of the country’s most accomplished scientists, Dr. Black has received numerous awards for her work, including being appointed as an Officer to the Order of Canada and the Order of Ontario.
With more than 600 publications to her name, Dr. Black is renowned clinically and scientifically in Canada and is an influential leader and collaborator in international initiatives.
As the inaugural scientific director of the Dr. Sandra Black Centre for Brain Resilience and Recovery at Sunnybrook Research Institute, Dr. Black leads some of the top minds in stroke, Alzheimer’s and dementia research. Now, as life-changing therapies for these pernicious disorders are becoming available, the leading-edge work she and her colleagues are doing is especially important.
A life-long desire to help others
Dr. Black helped usher in the modern era of stroke care. During her training, stroke was still a “dead-end” disease, she says. But in the 1990s, as the first woman to head a division of neurology in Canada, she made sure that Sunnybrook was among the first Canadian hospitals to implement the revolutionary clot-busting medication tPA.
“Gradually, the need to treat early led to important system changes in Ontario and other provinces and a whole new way to change the future of stroke,” she says.
Recognized as one of the world’s leading experts on dementia and Alzheimer’s disease, Dr. Black hopes to see the same progress happen in dementia prevention and treatment.
“As we get into what I think is going to be a transformative period in our field, my dream is that we will have treatments for Alzheimer’s disease that are disease-modifying and meaningfully slow disease progression,” she says. “We are very close to that now with a number of promising ongoing clinical trials.”
Dr. Black inherited her desire to help others while growing up in Sault Ste. Marie, Ont. Her father was a physician. Her mother, who was a community activist supporting social services and promoting music and the arts, was appointed a member of the Order of Canada in 1985. Dr. Black and her three siblings (two physicians and a choral director and teacher) are similarly motivated, she says. “Our parents modelled duty of care.”
In fact, Dr. Black’s prestigious research career grew out of her work as a physician caring for people with stroke, Alzheimer’s, Parkinson’s and other degenerative nervous system diseases.
“I do what’s called research embedded in care, [which means] learning from patients by studying them as consenting partners and correlating behavioural patterns with changes in the brain seen on imaging, now enhanced by advances in genetics and blood biomarkers,” she says.
This concept was the genesis of the landmark Sunnybrook Dementia Study of more than 1600 patients, which contributed to developing international consensus criteria for Alzheimer’s and several different types of dementia. This study has proven to be valuable to other researchers in the field, generating and contributing to more than 190 peer-reviewed publications in highly regarded international journals.
As a teacher and mentor, Dr. Black has also nurtured the talents of dozens of scientists and researchers. Her prowess in this area has earned outstanding mentorship awards from U of T’s Institute of Medical Sciences and department of medicine.
Dr. Jennifer Rabin
Dr. Jennifer Rabin, a neuropsychologist and scientist in the Harquail Centre for Neuromodulation and also the Dr. Sandra Black Centre for Brain Resilience and Recovery in Sunnybrook’s Hurvitz Brain Sciences Research Program, says she returned to Toronto from Harvard Medical School in part “because it’s the home of Dr. Sandra Black.”
Dr. Rabin credits her colleague with helping guide her through the complicated process of setting up her own research program, where she is currently studying dementia risk factors in people of South and East Asian origin. Dr. Black is “a luminary in the field, and also the warmest and nicest person you will ever meet,” says Dr. Rabin. “No matter how busy she is, she will always find the time for you.”
Dr. Maged Goubran
Dr. Maged Goubran is a Sunnybrook scientist who specializes in medical biophysics, computational neuroscience and artificial intelligence (AI). Since joining Dr. Black’s lab as a research associate from Stanford University, he has become one of her close collaborators, applying machine learning techniques to quantify magnetic brain imaging data in correlation with cognitive deficits and outcomes. These AI models are “trained” using patient data meticulously collected and processed as part of the Sunnybrook Dementia Study and can give key regional brain measures in a matter of minutes.
“I don’t think I’ve ever worked with anyone who has the same level of dedication, genuine care and support for her trainees and patients,” says Dr. Goubran. “It’s so inspiring.”
A new hub for multidisciplinary expertise
As a lifelong proponent of collaboration and cooperation, Dr. Black has high hopes for what will be accomplished at Sunnybrook’s under-construction Garry Hurvitz Brain Sciences Centre, a state-of-the-art facility for patient care and research that is quite unique in Canada.
In bringing together experts across disciplines – from Alzheimer’s disease, ALS, dementia and stroke to mental health and mood disorders – the Garry Hurvitz Brain Sciences Centre will be well positioned to develop the next generation of novel treatments, she says. “By housing our clinics and some research space together in one building, it will allow us to interact more often and more closely.”
Dr. Black points out that “none of this would have been possible without philanthropy.” While the active industry-sponsored trials cover their costs, donations are needed to help support the teams needed for numerous investigator-driven studies that are typically underfunded.
“For example, philanthropic donation to our cognitive neurology unit allowed us to accelerate the development of our very unique, personalized brain imaging pipeline,” she adds.
With so many promising developments happening at Sunnybrook in the field of dementia research right now, philanthropy is more crucial than ever, says Dr. Black. She’s encouraged by the generosity of those who are supporting the Garry Hurvitz Brain Sciences Centre and the work she and her team are doing at the Dr. Sandra Black Centre for Brain Resilience and Recovery.
It’s the kind of work that could be life-changing for thousands of Canadians in the years to come.
“I think donors [appreciate] the optimism I have about the future,” she says. “I’m still very active, and we’ve attracted some brilliant young leaders in the fields of stroke and cognitive and movement disorders, some early and mid-career and others still in training, poised to become very talented, next-generation clinicians and research scholars.”
To learn more on how you can support Sunnybrook’s Garry Hurvitz Brain Sciences Centre and help invent the future of brain health, visit Sunnybrook.ca/brain
