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AnnuAl RepoRt The Centre for Stroke Recovery by MikeJenny

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									AnnuAl
RepoRt
2005-2006
Table of Contents
Welcome from Rocco Rossi, CEO of Heart and Stroke Foundation of Ontario         2
Welcome from Co-Directors                                                       4
Welcome to the Centre’s Newest Member                                           6
Celebrating Members’ Achievements                                               8
Overview of Research Integration and Collaboration                              10
Research Themes                                                                 14
        (1) Physical Rehabilitation                                             15
        (2) Cognitive Rehabilitation                                            18
        (3) Cellular and Molecular Therapies                                    22
Delivering True Collaboration                                                   24
        Granulocyte-Colony Stimulating Factor In Ischemic Stroke Trial (GIST)   25
        Therapy for Enhanced Stroke Recovery Project                            25
        White Matter Project                                                    26
Stroke Survivor Finds A New Normal Life                                         27
HSFCSR 4th Annual General Meeting                                               28
Staff and Members                                                               32
        Partner Institutions                                                    33
        Co-Directors                                                            33
        Core Members                                                            35
        Associate Members                                                       37
        Management of the Centre                                                40
        Newly-purchased Assets                                                  40
Audited Financial Statements                                                    42
Appendices: Members’ Awards                                                     44
Appendices: Members’ Publications                                               48
2



    Welcome from
    Rocco Rossi, Ceo of
    Heart and Stroke
    Foundation of ontario




    Heart and Stroke Foundation Centre for Stroke Recovery   Annual Report 2006
I have heard it said that fortune favours the bold. Certainly, that’s the way it’s
been all year at the Heart and Stroke Foundation Centre for Stroke Recovery.
But then boldness was built into the very concept of the Centre.


It was a world first, when the Heart and Stroke Foundation of Ontario created a
decentralized research and rehabilitation centre located within three centres in
already existing facilities. That way, the Centre could create a synergy between
some of the best and brightest minds in the province. It also provided the
opportunity for the highest degree of collaboration and innovation between the         Rocco Rossi, CEO
research participants from their different centres.                                    Heart and Stroke Foundation
                                                                                       of Ontario

A bold step, a unique challenge. Both of these have been triumphantly met. Congratulations to Sunnybrook
Health Sciences Centre, to Baycrest, Rotman Research Institute and Kunin-Lunenfeld Applied Research Unit,
both in Toronto, and to the Ottawa Health Research Institute.


I must also warmly congratulate the government of Ontario for their continuing commitment to stroke
recovery. Their donation of $5 million from the Ministry of Research and Innovation is the largest gift the
Centre has received to date and is one of the largest gifts ever received by the Foundation. Donations like this
one allow Centre researchers to develop tomorrow’s treatments today.


Currently, the Centre is developing the ability to save crucial brain cells after a stroke. Much is being learned
about the plasticity of the brain and its ability to establish new pathways that restore function lost to stroke
damage. Noone should doubt the importance of this work. Each year, there are about 50,000 strokes and
over 15,000 stroke-related deaths in Canada, making it the third leading cause of death.


Through my work with the Heart and Stroke Foundation I have met many recovering stroke patients and
their families. Their courage and commitment has left an indelible impression on my mind. And yes, I have a
personal interest because my own family underwent the loss of two beloved members.


So this year I decided to make my own bold statement about stroke. I kayaked a 480-km route from Toronto
to Ottawa and raised $150,000 for the Centre for Stroke Recovery. It felt good.


But strength and boldness of a whole different order are displayed by stroke patients on the road to recovery.
The long-term goal of the Centre is to be with them every step of the way with world class treatments.


At the Centre for Stroke Recovery, researchers, rehabilitation professionals, and stroke survivors are setting the
agenda — and changing it for the better, so that more and more stroke survivors can become stroke thrivors.
4



    Welcome
    from
    Co-Directors




    Heart and Stroke Foundation Centre for Stroke Recovery   Annual Report 2006
The Heart and Stroke Foundation Centre for Stroke Recovery is based on
partnership, collaboration, and research integration. Our strength is our people
and our members are internationally recognized scientists who take part in
the Centre for the unique translational opportunities made possible by our
unique working model. The key to our success is the collaborative spirit that
leverages the talents and expertise of every one of our researchers.


We would like to thank our partner institutions, Baycrest, Rotman
Research Institute and Kunin-Lunenfeld Applied Research Unit, Sunnybrook            Dr. Antoine Hakim, OHRI
                                                                                    HSFCSR Scientific Director
Health Sciences Centre and the Ottawa Health Research Institute, for their
support and ability to share resources and solutions with one another. It is
only with your participation that we can fulfill our vision of a comprehensive
model of stroke research.


We are at an important crossroads now, and need a significant investment
in capital to make more significant headway into stroke science. We are so
grateful to our partners at the Heart and Stroke Foundation of Ontario, who
are spearheading the efforts to raise $25,000,000 on behalf of the Centre.


This new funding will permit the Centre to continue to build a critical mass        Dr. Sandra Black, Sunnybrook
                                                                                    HSFCSR Co-Director
of top scientific experts and clinicians, with a bank of complementary skills
— essentials for advancement. It will also establish the infrastructure necessary
to tackle the next frontier in research and to continue making breakthrough
discoveries and treatments.


All in all, we are looking at another successful year ahead. Thank you for
being a part of our success.




                                                                                    Dr. Donald Stuss, Baycrest
                                                                                    HSFCSR Co-Director
6



    Welcome
    to the Centre’s
    newest Member




    Heart and Stroke Foundation Centre for Stroke Recovery   Annual Report 2006
The Centre is thrilled to welcome Dr. Hsiao-Huei Chen, our newest recruit.
Dr. Chen is studying the molecular mechanisms involved in the specialization
and maturation of specific nerve cells with the goal of devising strategies to
treat stroke. Prior to the Centre, she was a Senior Research Associate at the
Cardiovascular Institute at the University of Pittsburgh.


Using laboratory models of congenital problems in neural development
combined with techniques of experimental embryology and electrophysiology,
Dr. Chen will focus her research on defining the genetic control of neuronal     Hsiao-Huei Chen

development. For example, Dr. Chen is investigating a gene (LMO4) in sensory
and motor neurons, and researching the role this gene may have in neuronal
identity and control of synapse network formation. This knowledge is also
relevant to understanding neuron apoptosis (programmed cell death) and how
its control may promote recovery from brain ischemia.


In adults, brain ischemia caused by stroke is one of the most common causes
of death and disability in North America. Understanding mechanisms that
can limit injury from ischemic insult in the brain and spinal cord would be
beneficial to devise strategies to improve recovery from these cerebrovascular
accidents. Cerebral ischemia triggers acute inflammation that exacerbates
primary brain damage. Paradoxically, some pro-inflammatory cytokines can
be neuroprotective. Another focus of Dr. Chen’s laboratory is to understand
how genetic and molecular factors influence neuron survival from stroke.


She hopes to devise new strategies for treating stroke by studying molecular
mechanisms involved in neuronal differentiation and development.
8



    Celebrating
    Members’
    Achievements




    Heart and Stroke Foundation Centre for Stroke Recovery   Annual Report 2006
It was a remarkable year for many of our Members, whose accomplishments and awards will
continue to inform the work at the Centre. In 2006, we celebrated some key milestones:


Appointments and Awards
Antoine Hakim, Scientific Director
Appointed Scientific Director of the Centre at the Advisory Board of Directors meeting.


Paul Albert, Core Member
Appointed Associate Director of Neuroscience, OHRI and Director of the Neuroscience Graduate Program,
University of Ottawa.


Sandra Black, Co-Director
Received $2 million for the Deborah Ivy Christian Brill Chair in Neurology, Department of Medicine at the
University of Toronto starting July 1, 2006.


Deirdre Dawson, Associate Member
Awarded a Research Supervision Award from the University of Toronto’s Department of Occupational Therapy.


David Park, Core Member
Received a Heart and Stroke Foundation five-year salary award of $89,750 per year and named OHRI
Researcher of the Year.


Leo Renaud, Core Member
Named the first Dr. J. David Grimes Research Chair at the University of Ottawa.


Donald Stuss, Co-Director
Received two fellowships in the past year: Fellow of the Canadian Association of Health Sciences and Fellow
of the American Association for the Advancement of Science.


Peter Stys, Core Member
Senior author on a paper recently published in the prestigious journal Nature entitled “NMDA receptors
mediate calcium accumulation in myelin during chemical ischemia” (Nature, 2005).
10



     overview of
     Research Integration
     and Collaboration




     Heart and Stroke Foundation Centre for Stroke Recovery   Annual Report 2006
The Centre’s primary objective is to develop a comprehensive program of integrated, translational research
that includes molecular biology, laboratory models and clinical studies. This will pave the way for designing
and testing novel post-stroke interventions and therapies more quickly.


Our approach to developing new therapies and improving therapies already in use is grounded in
rigorous scientific principles. Our progressive model of research integration and collaboration will
lead to:

n	   Making more effective, customized rehabilitation and treatment for as many patients as possible;

n	   The ability to save crucial brain cells during and after a stroke;

n	   Enhancing brain plasticity and establishing new connections in the brain, after a stroke;

n	   The ability to transfer responsibility from damaged to undamaged pathways in the brain, and even from
     one hemisphere to the other;

n	   Faster, more complete functional recovery for as many patients as possible.


The Centre’s specific research goals include:

n	   Modifying current physical therapies and determining appropriate intensity to optimize recovery;

n	   Enhancing repair strategies in laboratory models and testing them in patients post-stroke;

n	   Transforming the brain’s environment to enable post-stroke repair using endogenous repair elements like
     stem cells, pharmacotherapy and rehabilitation interventions;

n	   Identifying molecular targets that lead to neuronal cell death after stroke, and modulating molecular
     activity to promote neuronal survival;

n	   Establishing recovery markers using imaging, electrophysiology, and behaviour that objectively and
     quantitatively assess the success of any recovery intervention applicable to laboratory and human
     studies, and;

n	   Identifying novel genes, and associated protein products, that play a role in brain repair.
12


     Research
     Integration
     and Collaboration




                HSFCSR Approach to Optimized Stroke Recovery
                                                            VISIon
                         to establish a program of excellence in brain recovery research in ontario
                          that would be globally competitive and would have a realistic likelihood
                               of leading to effective functional improvements after a stroke.


                                                         objeCtIVeS

        1. Generate CapaCity                2. Foster Collaborations          3. inCrease researCH FunDinG

            to complement existing               to foster collaborations         to ensure HSFCSR researchers
         HSFCSR strengths by acquiring          between researchers that       capture the operating funds required
         the necessary equipment and           accelerate the development        to make significant advances in
           recruiting top researchers                of new therapies             their stroke recovery research



                                                     ReSeARCH tHeMeS

                                           CellulAR AnD MoleCulAR tHeRApy
                                                 pHySICAl ReHAbIlItAtIon
                                                CognItIVe ReHAbIlItAtIon




     Heart and Stroke Foundation Centre for Stroke Recovery                                           Annual Report 2006
Intervention is required at various levels for optimized stroke recovery, including pharmacological,
physical and cognitive therapies. To that end, research is being conducted at several facilities.


The role of our partner institutions
Centre scientists at the Ottawa Health Research Institute are attempting to better understand how to
manipulate the molecular and cellular mechanisms involved in brain repair. They test these ideas in models
of stroke, and when appropriate, bring them to the patient for further evaluation.


At Toronto’s Sunnybrook Health Sciences Centre, clinical researchers are designing specialized sensorimotor
physical therapies, testing pharmaceutical interventions and examining the influence of small vessel white
matter disease. Sunnybrook researchers are also developing methods to quantify brain tissue loss and
patterns of brain activity.


Experts at Baycrest in Toronto are developing and validating cognitive behavioural therapies while novel
advanced techniques and technologies are being pursued in the Centre to assist the optimization and
development of rehabilitation strategies.
14



     Research themes




     Heart and Stroke Foundation Centre for Stroke Recovery   Annual Report 2006
The work at the Centre is organized into three broad research themes;

(1) Physical Rehabilitation
(2) Cognitive Rehabilitation
(3) Cellular and Molecular Therapies

Theme I: PHYSICAL REHABILITATION
A stroke often leaves a patient with physical
                                                                    P H YS I C A L R E H A B I L I TAT I O N
limitations that restrict their coordination
and mobility and can have a negative                      therapy for enhanced
impact on daily activities. Our team                    Stroke Recovery project      Rehabilitation pharmacology
is investigating physical rehabilitation                                             exercise in Stroke
strategies to improve a stroke patient’s                                             physical therapy to Improve
function. Combination approaches, such                                               Movement Control
                                                                                     Stroke Imaging
as the coupling of pharmaceuticals and
                                                                                     biomarker battery (StRIbb)
physical therapy, are also being studied.


Currently, typical physical rehabilitation is only recommended for the three months following a stroke, but we
are looking for ways to improve patients’ quality of life beyond that time frame. Through the investigation of
individual differences to stroke recovery we are hoping to identify methods that could be useful on a larger
scale over a longer period of time.


Key projects in this theme include:
n	   Future rehabilitation strategies will also be enhanced by technological advances, such as the use of remote
     measurement and observation equipment. Too many rehabilitation programs confine conditioning and
     observation to the clinic or lab. We can see and record what happens when the patient is in an unnatural
     and predictable setting; but how they fare outside the clinic setting, and throughout the rest of their day,
     is less clear.

n	   Remote measurement tools will allow researchers to observe patients interacting in almost any setting, and
     collect valuable data. This helps to identify norms for each patient unique to their daily lives, making it
     possible to tailor a program to complement each patient’s unique life and needs.

n	   We envision many benefits to be derived from these tools, and we are devoting considerable resources
     to both develop and employ these advanced technologies. This includes our own prototypes for a Digital
     Personal Therapist, a Tilting Chair and the iWalker.

n	   Physical rehabilitation is also being explored in combination with other interventions; a current example
     is the combination of rehabilitation and pharmacology, which is being explored in both human and
     laboratory studies.

n	   We are also applying electrophysiological equipment to some physical rehabilitation programs, looking
     for short-term changes in the central nervous system. The results will inform a treatment trial in
     stroke survivors.
16



     Research
     themes




     n	   We are also studying aerobic exercise and the benefit it may have on stroke survivors, including overall
          improvement in walking ability, cardiovascular fitness, and a decreased risk of suffering a recurrent stroke.
          However, exercise is more difficult for stroke survivors, who are often left with restricted movement,
          motor control and endurance. They are therefore less able to perform the strenuous activity required to
          boost heart rates and stretch cardiovascular output. The Centre is working towards translating a cardiac
          rehabilitation program that is suitable for use in stroke survivors.

     n	   This theme also includes study of the role that the central nervous system plays in controlling balance and
          walking. We are also examining the correlation between cognitive difficulties and problems with gait in
          people with sub-cortical vascular disease. Better understanding of both systems, and drawing comparisons
          between healthy adults and stroke survivors, will lead to improved physical rehabilitation techniques.

     n	   The Centre is also working to maximize the role that a patient plays in the control and direction of their
          rehabilitation. We are devising novel techniques that increase the patient’s ability to control the affected
          limb by using bilateral and constraint-induced training.

     n	   Bilateral training is a really exciting approach that facilitates improvement in the affected limb through the
          simultaneous use of the unaffected (normal) limb. By contrast, constraint-induced training forces the patient
          to use the affected limb only, thereby strengthening it out of necessity and repetition.

     n	   Currently under development, the Stroke Imaging Biomarker Battery (STRIBB)’s objective is to select the
          best and most effective minimalist standard imaging assessment for use with stroke patients. STRIBB will
          standardize advanced measurement and imaging techniques that are proposed in human intervention trials
          aimed at improving stroke recovery.

     n	   The Centre will be using advanced brain imaging technologies (such as fMRI) to measure the progress of
          our physical rehabilitation work. Individual test data will be mapped over the long term, and will influence
          the development of physical rehabilitation strategies involving motor control. fMRI technology may assist in
          distinguishing the effects on neural networks from different rehabilitative strategies.




     Heart and Stroke Foundation Centre for Stroke Recovery                                            Annual Report 2006
Theme I: Achievement Highlights
n	   Drs. Black, Gao, Sahlas and colleagues published “A new visual rating scale for white matter
     hyperintensities” (Stroke, 2005);

n	   Drs. Gladstone, McIlroy, Graham, Black and colleagues published the STARS study on
     amphetamine coupled with physiotherapy in the journal Stroke, 2006.




                                 Personal Digital Therapist




Tilting Chair                    iWalker
18



     Research
     themes




     Theme II: COGNITIVE REHABILITATION

     Through the use of cognitive
                                                                         C O G N I T I V E R E H A B I L I TAT I O N
     rehabilitation, the Centre is determining
     the best type of rehabilitation for those
                                                              the White Matter project
     suffering a decline in cognitive functions                                              goal Management training
     as a result of vascular disease in the                                                  Rehabilitation in the Real World
                                                                                             for executive Dysfunction
     brain’s white matter.
                                                                                             Virtual Reality and Cognitive
                                                                                             Rehabilitation
     To combat or slow cognitive decline                                            Cognitive profiles of
                                                                                    limb Apraxia
     members of the Centre devised an
                                                                                    Stroke and Cognition battery
     innovative cognitive rehabilitation
     training method that focuses upon
     building memory, psychosocial and
     planning skills. A complementary study to assess the effectiveness of each training method is being
     completed as well.


     Our researchers are also working on quantifying white matter damage in stroke patients or those with
     vascular risk factors using computerized segmentation techniques and diffusion tensor imaging. If successful,
     results from this study could facilitate rehabilitation treatments to improve stroke patients’ cognition and
     participation in social and work activities.


     Earlier pilot work on the effects of normal aging that strongly supports this direction of research has been
     published in a series of papers in the Journal of the International Neuropsychological Society.




     Heart and Stroke Foundation Centre for Stroke Recovery                                                   Annual Report 2006
Key projects in this theme include:
n	   Goal Management Training (GMT) is a promising cognitive approach to rehabilitation that the Centre is
     pursuing. This technique teaches stroke patients to monitor and evaluate their performance and introduces
     systematic strategies by breaking down goals into smaller, more realistic tasks.

n	   Two exciting techniques being developed in the Centre are the Multiple Errands Test and the Cognitive
     Orientation to Daily Occupational Performance rehabilitation protocol. Both of these approaches employ
     use of day-to-day tasks and scenarios, such as planning, organizing, handling money and shopping.
     These techniques have the potential to help patients with problems with attention and planning, promoting
     compensatory skills that can make up for the skills they lost as a result of stroke.

n	   Our scientists are also developing specialized cognitive compensatory strategies for patients with apraxia,
     a condition describing the loss of skilled motor control, most commonly linked with left-brain strokes.
     Apraxia can deter rehabilitation, so patients with this condition require special intervention to develop
     alternate strategies.

n	   We are examining the function and intricacies of the brain’s circuitry beyond our current understanding, in
     order to optimize the pursuit of Theme II. For example, we have shown that targeted attention rehabilitation
     (such as feedback or periodic tones) is related to specific brain regions, a finding that will be used to
     optimize cognitive rehabilitation techniques. Our investigation will help us to develop better rehabilitation
     strategies for all stroke patients.

n	   The Centre is part of a multi-national project that hopes to shed light on the course of recovery after stroke
     and other neurological disorders. Baycrest scientist, Dr. A. Randall McIntosh is leading this investigation,
     which utilizes functional imaging and mathematical models. This project links experts from Canada, US,
     Germany, Australia and England, and is funded by the JSF McDonnell Foundation.

n	   Many stroke patients experience a decline in attention and executive function, and the Centre is looking
     into ways to combat this. We are studying the frontal lobes, a specific part of the brain thought to be
     associated with attention and executive function, and we are exploring the effects of stroke in a brain
     region now thought to play a role in cognition, called the cerebellum. We are investigating the role of the
     frontal lobes in relation to emotion and insight, because damage to them has been associated with an
     inability to make appropriate self-reflective inferences, which can impede recovery. Because functional
     restriction impedes functional recovery from stroke, the intent is to optimize cognitive strategies to help
     alleviate these difficulties.

n	   Centre scientists are developing the comprehensive Stroke and Cognition Assessment Battery and Point of
     Care Case Record database. This useful tool not only retains patient information but has been developed to
     be used as an assessment tool as well. The 20-minute neuropsychological assessment battery is carried out
     on a tablet PC and has been designed for use with stroke patients.
20



     Research
     themes




                                        fMRI machine




     Heart and Stroke Foundation Centre for Stroke Recovery   Annual Report 2006
n	   In addition to typical database entries, such as demographics and patient history information, the database
     includes sections to enter nursing and medical/neurological examinations resulting in a more complete
     electronic record of the patient. This unique Stroke and Cognition Assessment Battery is a pilot project that
     is being designed for use on stroke patients throughout the country.

n	   A project being developed in the Centre involves the creation of virtual-reality rehabilitation tools based on
     both cognitive and physical therapies. Advanced imaging techniques, such as functional MRI, are proving
     useful in this process. If successful, this technique will enable researchers to construct safe but realistic
     environments and situations in the lab or clinic, to observe and measure patient performance. The data
     collected will facilitate development of useful interventions that will help patients regain as much normal
     function as possible.

Theme II: Achievement Highlights
n	   Drs. Stuss, Graham, and colleagues published a paper on Clustered fMRI of speech
     production and Age-related reorganization of the functional neuroanatomy of speech production
     (Neuroimage, 2006) and;

n	   Drs. Ween, Black, and Stuss have developed a Stroke and Cognition Assessment Battery; over 200
     people tested.
22



     Research
     themes




     Theme III: CELLULAR AND MOLECULAR THERAPIES
     This theme is focused on devising
                                                              C ELLU LAR AN D MOLEC U LAR TH ERAPI ES
     cellular and molecular therapies
     that could help repair damaged
                                                                gISt project
     brain tissue, prevent further                                             neuronal protection and generation
     tissue loss, and even regenerate                                          Influence of preconditioning and
     brain cells. This area holds great                                        Inflammation on Recovery from Stroke
     promise, and will be a major focus                                        Serotonergic System
                                                                               and neuroprotection
     of the Centre’s future studies.
                                                                               Controlling Apoptosis

     But in order to create the best
     therapies and interventions, we
     must have a complete understanding of neural mechanisms and systems. We are investigating therapeutic
     interventions at the basic science level to ensure that they are valid and appropriate. For example, a focus in
     the Centre is to better understand programmed cell death and gene expressions following tissue injury. We
     are investigating the effects of injury to the cell’s chemical and molecular environment and its relationship to
     the brain’s energy status affected by a stroke.


     To advance our neuroregenerative approach to brain injury, the Centre is studying stem cell migration and
     proliferation. Studies illuminating the cell cycle of these neural precursor cells, and the makeup of specific
     proteins, are being pursued to advance strategies related to neuronal generation and protection.


     This Theme also includes the pursuit of neuroprotection techniques – techniques that protect brain cells,
     especially neurons. The end result could be the ability to protect neurons during or following a stroke.




     Heart and Stroke Foundation Centre for Stroke Recovery                                        Annual Report 2006
Key projects in this theme include:
	n	   In pilot mode, the Centre’s GIST Project (see multi-site projects) will ultimately test whether mobilized bone
      marrow cells can relocate to sites of acute injury, help stimulate repair of the damaged brain, and promote
      recovery of function in stroke patients.

n	    Decreased oxygen to the brain can cause cell death following a stroke. We are working towards
      improving brain cell survival in the face of ischemic distress resulting from a lack of oxygen and blood flow
      to the brain.

n	    Centre scientists have shown that a gene called “DJ-1” is critical for the brain’s response to a stroke
      because it activates a survival pathway. At present, we are confirming that lack of this signal worsens stroke
      outcome, while increasing it could promote better neuronal survival and functional recovery.

n	    Defective genetic or cellular responses to stroke may exacerbate cell death. This may be caused by trigger
      molecules, an abnormal inflammatory response to the stroke, or as a result of defective gene expression
      (that is, a gene being “turned on” when it should remain “off” or similarly, a gene “turning off” when
      it needs to remain “on”). The resulting cascade of events marks neurons to die (commonly known as
      programmed cell death or apoptosis) even though actual cell death may take place hours or days later.

n	    The control of cellular division, specifically mitochondrial fission, is another promising neuroprotective
      therapy in development. Mitochondrial fission has been associated with cell death, and inhibiting it could
      decrease loss of tissue and function.

n	    Centre researchers are investigating the application of preconditioning, a technique normally used to boost
      the brain’s resistance against stroke, to control the deleterious effects of inflammation.

n	    We are also examining genetic or protein expression as ways to confer neuroprotection. Centre scientists
      are investigating the newly discovered HALO protein and how its over-expression may protect against the
      stress to the brain as a result of oxygen deprivation.

Theme III: Achievement Highlights
n	    Dr. Hsiao-Huei Chen is researching LM04, a recently-discovered gene that impacts ischemic cell death
      and recovery;

n	    Dr. Peter Stys was Senior author on a paper recently published in Nature entitled “NMDA receptors mediate
      calcium accumulation in myelin during chemical ischaemia” (Nature, 2005).
24



     Delivering true
     Collaboration




     Heart and Stroke Foundation Centre for Stroke Recovery   Annual Report 2006
Our integrative approach allows us to leverage the combined outcomes of all three scientific Themes to
pursue some very promising multi-disciplinary projects:


Granulocyte-Colony Stimulating Factor In Ischemic Stroke Trial (GIST)

The purpose of the GIST project is to explore the use of stem cells to assist in recovery from a stroke.
Ten years’ worth of research suggests that stem cells from the bone marrow can differentiate into central
nervous system cells. The Gist project will determine whether stem cells from the patient’s bone marrow
can be mobilized using granulocyte-colony stimulating factor (G-CSF) to support recovery.


The bone marrow stem cells are then presumed to migrate to the site of the damage in the brain, to assist
in recovery. Neuronal regeneration and stem cell proliferation are being examined as well, in support of the
GIST trial. The pilot project will include an evaluation of the safety and feasibility of using stems cells, relying
on molecular imaging and cognitive assessment to test for benefits.


If successful, the data collected will allow for the design of a larger trial to examine the structural, functional,
physiological and behavioural effects of G-CSF induced increases in circulating bone marrow cells on the
recovery of brain function following acute ischemic stroke.


Therapy for Enhanced Stroke Recovery Project
One of the Centre’s major goals is to develop therapies for stroke recovery that will benefit survivors. It is
imperative that development of therapies runs parallel to identification and understanding of influential
factors, such as lesion location and severity. Designing optimized rehabilitation requires a full knowledge of
systems, how they interact with each other, how they react to injury, and how they can influence recovery.
Projects in the Centre are targeting a better understanding of these systems. Individual differences can have
a dramatic effect on recovery and intervention needs to be designed with personalized treatments. For
example, our project on the identification of individual determinants for recovery will help us to identify
important variables, and how they can be controlled to maximize recovery from stroke.


Our multi-centre rehabilitation pharmacology project, involving amphetamine coupled with physiotherapy,
investigates the coupling in both human and laboratory models. This study exemplifies the unique advantage
of the Centre’s collaborative approach, as it is entirely dependent upon the successful integration of different
disciplines focused on one goal.


In one of our laboratory studies, we are investigating the impact of premorbid risk factors (such as stress,
and high-fat diet) on stroke recovery. Results can then be translated to develop better physical and
cognitive interventions.
26


     Delivering true
     Collaboration




     The White Matter Project
     This project seeks to identify treatments that encourage recovery in those who suffer white matter damage as
     a result of a stroke.


     The brain is comprised of grey matter segments, connected via white matter fibres. During a stroke, damage
     can occur to any part of the brain’s anatomy, so a better understanding of how damage to any part can affect
     function is essential for optimizing treatment and rehabilitation.


     Centre scientists have been researching the selective vulnerability of different parts of the brain, the best
     ways to protect them from ischemic damage and their relationship to various types of cognitive functions,
     such as attention and memory – functions often affected by a stroke.


     From the Centre’s basic science research program, this study will identify the most effective treatment relative
     to the severity and location of vascular brain disease in patients often overlooked for treatment.


     The White Matter Project incorporates the strategies from the Cognitive Rehabilitation theme, along with
     molecular approaches from the Molecular and Cellular Therapy theme. This is a significant example of the
     type of work that the Centre’s multidisciplinary approach enables.




     Heart and Stroke Foundation Centre for Stroke Recovery                                        Annual Report 2006
   A Stroke survivor finds a new “normal” life

At 45, Lynne Collins was a vibrant and confident woman. She was living the
life that she always knew she would. As a Senior Systems Analyst at Canadian
Tire, and an active member of the community, she was an accomplished career
woman and wife. A health crisis was the furthest thing from her mind.

One evening, while enjoying a celebratory dinner with friends, Lynne found
herself feeling very unwell. As she describes it, “my left hand hit the table, and
my right hand immediately fell on top of it. The next thing I remember is waking
up in the hospital.”                                                                      Lynne Collins


Fortunately for her, she was admitted to Sunnybrook Hospital (what SHSC was referred to at the time), and
she came to the attention of Dr. Sandra Black. Dr. Black’s research focus was in the area of stroke, so she
took an immediate interest in Lynne’s case.

Once Lynne was stabilized, it became clear that she had suffered a massive hemorrhagic stroke, damaging
the entire right side of her brain. As a result, Lynne was almost completely paralysed on the left side of her
body, a common outcome in patients who suffer severe right-brain trauma.

Fortunately, Lynne was able to tap into the specialized stroke care offered at Sunnybrook, and Dr. Black’s
expertise. She underwent intensive physical and cognitive therapy in an effort to regain some of her lost
motor control.

Because her stroke had been so severe, the possibility of Lynne regaining 100% of her lost function was,
and is, remote. But Sunnybrook’s outstanding team, and its eventual partnership in the Centre for Stroke
Recovery, helped Lynne progress far beyond what doctors initially predicted.

Since her stroke, Lynne has taken part in many of Dr. Black’s research projects, and continues to participate
in studies for the Centre for Stroke Recovery. Recently, Lynne participated in numerous Centre projects,
including a study on cardiac rehabilitation programs in stroke patients, and in multiple brain imaging studies
using functional magnetic resonance imaging.

While she is still far from being her normal self, she says she has “ as close to a normal life as possible. And if
that’s not 100%, that’s ok, too.”

As Valerie Closson, the Centre’s Research Coordinator, tells it, Lynne is an ideal research participant. Her
long-term involvement and consistent willingness to participate with the Centre allow Centre researchers to
compile valuable data over the long term.

For Lynne, participation in Centre studies is extremely fulfilling. She is willing to offer whatever she can, so that
future stroke survivors might have a better prognosis. The Centre has also helped her to cope with her stroke.

“There’s life after stroke. I didn’t want to sit at home feeling sorry for myself. It may be too late for me, but
what I’m doing will help others.”

And that’s exactly what the Centre is aiming to do.
28



     HSFCSR 4th Annual
     general Meeting




     Heart and Stroke Foundation Centre for Stroke Recovery   Annual Report 2006
The Centre hosted its 4th Annual General meeting on May 5, 2006 at the picturesque Vaughn Estates on
Sunnybrook Campus in Toronto. This was another successful gathering, well-attended by Members, Associate
Members and external partners alike. The session was enlivened by the presence of the External Scientific
Advisory Committee, Advisory Board members as well as colleagues from the Heart and Stroke Foundation of
Ontario, a key funding partner.


Dr. Antoine Hakim, the newly-appointed Scientific Director, kicked the meeting off with an overview of the
Centre’s past success and an outline of the road ahead. He was ably assisted by co-Directors Drs. Sandra
Black and Donald Stuss.


Rocco Rossi, CEO of the Heart and Stroke Foundation of Ontario, also spoke, re-iterating HSFO’s deep
commitment to the Centre’s work and vision. He reinforced the importance of the Centre’s interdisciplinary
and translational research, and spoke about HSFO’s commitment to spearhead the effort to raise $25 million
in support of the Centre’s A Mind To Give Campaign.


Dr. Bryan Kolb, Professor of Psychology and Neuroscience at the Canadian Centre for Behavioural
Neuroscience at University of Lethbridge, and a recent addition to the Centre’s External Scientific Advisory
Committee, was the keynote speaker. His compelling presentation, “Understanding the changing brain:
Searching for strategies to treat the uninjured brain” outlined the assumptions for brain recovery, the principles
of brain plasticity, and some of the current methods being used to alter brain recovery. He touched upon
experiential, pharmacological and hormonal treatments. In the afternoon, discussion expanded upon the
current status of each of the Centre’s research themes. Key discussions included:

n	   Dr. William McIlroy described the Stroke Imaging Biomarker Battery (STRIBB) currently in development.
     He also highlighted ongoing projects within the Theme on Physical Rehabilitation, such as aerobic
     training following stroke, bilateral sensorimotor training and remote monitoring and data acquisition
     collection systems.

n	   Dr. Charlie Thompson gave an update on the Influence of Pre-morbid Risk Factors in Stroke Recovery
     project. He later described some basic science research completed on G-CSF and stem cell factors in a
     laboratory study.

n	   Dr. Donald Stuss gave an overview of current projects in Cognitive Rehabilitation, as well as the White
     Matter Project. Dr. Nicole Anderson described one of the studies on focal attentional rehabilitation.

n	   Attendees were given an overview of the Multiple Errands Task — a naturalistic assessment of executive
     function — by Dr. Deirdre Dawson.

n	   An Ontario Ministry of Health Long-Term Care-funded project known as the Stroke and Cognition
     Assessment Battery was described by Dr. Jon Ween. Its current status and future possibilities were outlined,
     including expansion of sites involved and incorporation of an imaging component.

n	   Dr. Mike Sharma gave an update on the current status of the Granulocute-Colony Stimulating Factor
     (G-CSF) in Ischemic Stroke Trial (GIST). He outlined the current status of the project and stated that pending
     institutional research ethics approval, enrolment should be started soon.
30


     HSFCSR 4th Annual
     general Meeting




     n	   Dr. Matthew Hogan described the brain imaging component of the study, including anatomical and
          functional Magnetic Resonance Imaging, Computed Tomography Angiography, and Computed Tomography
          Perfusion imaging.

     n	   Dr. Hsiao-Huei Chen described her research on neuroprotection and the involvement of a specific
          gene (transcription cofactor LMO4), on mediating gene expression and promoting tolerance to
          neuronal ischemia.

     n	   Dr. Antonio Colavita described his work using C. elegans to identify neuronal genes (e.g. hif-1) involved in
          adapting to hypoxic conditions, a situation in which the environment is devoid of oxygen, which occurs in
          ischemic stroke.

     Dr. Hakim concluded the gathering on a note of optimism, and a reinvigorated sense of purpose, looking
     ahead to a brighter future for stroke science.


     ESAC participation and report
     The AGM was enriched by the participation of the External Scientific Advisory Committee (ESAC). The ESAC
     functions as an unbiased overseer of the Centre’s operations and progress, assessing the quality, productivity,
     direction and relevance of the Centre’s research relative to our mission.

     Based on its findings, the ESAC will also provide guidance on policy, scientific strategies, and the future
     direction of the Centre.

     The Committee is comprised of internationally renowned experts in science and medicine:

     n	   Dr. steven C. Cramer: Assistant Professor in the Departments of Neurology and Anatomy & Neurobiology
          at the University of California, Irvine;

     n	   Dr. bryan Kolb: Professor of Psychology and Neuroscience, Canadian Centre for Behavioural
          Neuroscience, University of Lethbridge, Lethbridge;

     n	   Dr. William Milberg: Associate Professor of Psychology in the Department of Psychiatry at Harvard
          Medical School, and the Associate Director for Research of the Brockton/West Roxbury Geriatric Research
          Education and Clinical Center;

     n	   Dr. rajiv ratan: Burke Professor of Neurology and Neuroscience, Weill Medical College of Cornell
          University and Executive Director Burke/Cornell Medical Research Institute.

     Heart and Stroke Foundation Centre for Stroke Recovery                                          Annual Report 2006
The Centre welcomed the members of the External Scientific Advisory Committee, a cabinet of external
experts who are called upon to review the Centre’s progress and achievements on an annual basis. This
review is integral to the Centre’s pursuit of excellence and innovation, and is part of our effort to remain
transparent, accountable and focused.


Last year, the ESAC Report expressed confidence in the Centre’s innovative working model, confirming that
we are at the global forefront of stroke science. The Committee also made key recommendations, which were
integrated into the goals we set for this past year.


This year, the report found that the Centre has once again made important progress; both in the
establishment of a collaborative framework, and in research progress:

n	   This year, the Centre’s improved the ability of its investigators to collaborate within and between
     institutions, as well as between projects. This “near-unique strength” continues to set the Centre apart
     from the rest of the research community. It is also relevant to the advancement of stroke recovery, which
     synthesizes input from a multitude of different scientific perspectives.

n	   The Centre was praised for efforts to build a database to centralize and house all research data.
     The database’s multiple dimensions, and its potential to compile genotyping, anatomy, behavior, and
     functional imaging data, generated interest and enthusiasm. This database, in combination with an
     improved web forum, will go a long way in facilitating teamwork.

n	   The Centre’s level of innovation and research scope left a positive impression. Of particular note is the
     development of standard outcome measures of function and cognition; measures that could be applied
     across a range of studies.

n	   The Centre’s study of affective behavior work is also a unique strength – the Centre is pioneering this type
     of study, as it is unlike any work elsewhere.

n	   On the whole, the Centre draws upon the strengths of a productive faculty, complementary resources across
     sites, and its ability to locate and persuade patients willing to take part in studies.


The ESAC report also recommended ways for the Centre to build on success:
n	   Maximize the Annual General Meeting, an once-a-year opportunity for all Investigators to convene.
     Shorten the official proceedings and offer more opportunity for working sessions and smaller meetings.

n	   Promote smaller meetings of investigators, organized around a specific topic. Consider using conference
     technology to enable virtual collaboration.

n	   Continue developing an infrastructure to support the achievement of translational goals, including
     established expertise in biostatistics and clinical trials.

n	   Develop an administrative core: a hub that provides administrative function support to all three sites,
     thereby streamlining resources and eliminating duplication where possible.

The Centre thanks the Committee for their overview and comments. We look forward to implementing these
recommendations in the coming years.
32



     Staff and Members




     Heart and Stroke Foundation Centre for Stroke Recovery   Annual Report 2006
Partner Institutions
Heart and Stroke Foundation of Ontario;
Ottawa Health Research Institute (OHRI);
Sunnybrook Health Sciences Centre;
Baycrest, Rotman Research Institute and Kunin-Lunenfeld Applied Research Unit


Co-Directors

The Co-Directors all have prestigious backgrounds and have dedicated their careers to research. But the real
strength lies in their collaborative nature and joint vision. They are working together to better understand the
most effective means of promoting and sustaining stroke recovery.


Dr. antoine Hakim, scientific Director, MD, PhD, FRCPC, OHRI:
Dr. Hakim began his medical career as an engineer. During his PhD studies in Biomedical Engineering in the
United States, he used an engineering model to quantitate cerebral glucose metabolism through the pentose
phosphate pathway. This and his exposure to premedical courses, led him to be strongly attracted to the
healing discipline. At the age of 29, he started his medical training at The Albany Medical College in Albany,
New York because a number of the Canadian medical schools he applied to considered him too old to start
a new career!


After a year of internship in the United States, he began his residency training in Neurology at the Montreal
Neurological Institute, which he completed in 1979. He then qualified to practice neurology in Canada and in
the United States.


Dr. Hakim stayed at the Montreal Neurological Institute until he was approached by Dr. John Seely, Dean of
the Faculty of Medicine at the University of Ottawa to come to Ottawa as Head of Neurology and Director of
the proposed Neuroscience Research Institute.


In 1995, the Ottawa General Hospital honoured him as Researcher of the Year. More recently, a number
of investigators across Canada asked Dr. Hakim to lead a proposal to establish a Network of Centres of
Excellence in Stroke. This was approved in 1999 and led to the establishment of the Canadian Stroke
Network. CSN was renewed in 2005 with an enhanced budget.


In 2000, he received the Award of Excellence by the Canadian Stroke Consortium. In 2002, he became the
Senior Director of the Centre for Stroke Recovery and in 2005 he was appointed the Scientific Director.
In 2005 he received the Career Achievement Award of the Ottawa Life Sciences Council. Dr. Hakim continues
to support scientific discovery aimed at improving health and quality of life.
34

     Dr. sandra black, Co-Director, MD, FRCP(C), Sunnybrook:
     Dr. Black holds the Brill Chair in Neurology in the Department of Medicine at the University of Toronto.
     She has been Head of the Division of Neurology at Sunnybrook Health Sciences Centre since 1995. She is
     Medical Director of the Regional Stroke Program for North and Eastern Greater Toronto Area. She also directs
     the LC Campbell Cognitive Neurology Research Unit. As well, she is a Senior Neuroscientist at Sunnybrook’s
     Research Institute and at the Rotman Research Institute at Baycrest.


     Dr. Black obtained her medical and neurological training at the University of Toronto and completed her
     postdoctoral research at the University of Western Ontario in Behavioural Neurology and Stroke prior to
     taking up her full-time appointment at Sunnybrook in 1985. She also pursued graduate work in the history
     and philosophy of science at Oxford University.


     Dr. Black’s research has focussed on the cognitive sequelae of stroke and stroke recovery, the differential
     diagnosis of dementia, and the use of neuroimaging techniques to elucidate brain-behaviour relationships
     in stroke and dementia. She has over 200 publications and has been actively engaged in treatment trials for
     Stroke, Alzheimer’s disease and Vascular Dementia.


     In 2001, she received the Inaugural Mel Silverman Award for Outstanding Mentorship by the Institute of
     Medical Science, University of Toronto. In 2002, she became a Co-Director in the Centre for Stroke Recovery


     Dr. Donald t. stuss, Co-Director, PhD, C.Psych, Baycrest:
     Dr. Stuss is Vice-President of Research at Baycrest. He is a University Professor in the University of Toronto in
     many departments including Psychology, Medicine, and Rehabilitation Science. He is also cross-appointed in
     the Research Program in Aging at Sunnybrook Health Sciences Centre.


     Dr. Stuss completed his graduate studies at the University of Ottawa and postdoctoral training at the Aphasia
     Research Centre in Boston. He practised as a Clinical Neuropsychologist for many years at the Ottawa General
     Hospital and as a Professor in the University of Ottawa before coming to Baycrest in 1989. He has also been
     a visiting professor at the University of Melbourne, Australia and University of California Los Angeles.


     Dr. Stuss’ main research themes include the specification of frontal lobe brain-behaviour relationships,
     the role of different frontal regions in neuroanatomical functional systems, and the rehabilitation of these
     functions. Overall, Dr. Stuss’ vision includes an interdisciplinary approach. His research is conducted so that
     many disciplines are included as he tries to assist in the cognitive rehabilitation of the entire individual
     and thus expertise and research involves a number of difference disciplines such as: Neuropsychology,
     Neurorehabilitation, Behavioural Neurology, etc. The research is conducted so that its application can also be
     widespread from Normal Aging to disease populations such as Stroke, Dementia and Psychiatric disorders.
     He has contributed to over 120 journal publications, over 40 book chapters and 4 published books. In 2002,
     he became a Co-Director in the Centre for Stroke Recovery.




     Heart and Stroke Foundation Centre for Stroke Recovery                                         Annual Report 2006
Core Members
n	   Dr. paul albert, research scientist, OHRI: With expertise in the molecular neurobiology of intracellular
     signaling, Dr. Albert has a particular focus on the dopamine and serotonin systems of the brain and their
     roles in mental illnesses such as depression and schizophrenia.

n	   Dr. Hsiao-Huei, research scientist, OHRI: The Centre’s newest recruit is examining molecular
     mechanisms involved in neuronal differentiation and development with the goal of devising strategies to
     treat stroke. Prior to the Centre she was Senior Research Associate at the Cardiovascular Institute at the
     University of Pittsburgh.

n	   Dr. antonio Colavita, Geneticist, OHRI: A geneticist who uses Caenorhabditis elegans, a small worm,
     to address fundamental questions in neurobiology, Dr. Colavita’s current laboratory research focuses on
     discerning the genetic and molecular mechanisms involved in axon branch formation and outgrowth.

n	   Dr. David Gladstone, stroke researcher, Sunnybrook: Dr. Gladstone is Director of Inpatient Stroke
     Services and Co-Director of the Regional Stroke Prevention Clinic at Sunnybrook. His research includes the
     clinical epidemiology of stroke, clinical trial design, transient ischemic attack management, knowledge
     translation in stroke prevention, outcome measures in stroke recovery, and the investigation of neuro-
     restorative interventions to improve post-stroke recovery.

n	   Dr. simon Graham, research scientist, Sunnybrook: Dr. Graham is a Senior Scientist in Imaging
     Research at Sunnybrook and at Baycrest. He is the Academic Director of the 3T Imaging Facility at
     Sunnybrook and an Associate Professor in the Department of Medical Biophysics, University of Toronto. He
     joined Sunnybrook in 1998 as a physicist specializing in functional Magnetic Resonance Imaging (fMRI).
     His focus is on developing new fMRI methods that improve the capability to examine patients, particularly
     strategies to correct for head motion, which facilitates investigation of the elderly and patients with
     neurodisability. He is also utilizing virtual reality technology in the magnet to develop more ecologically
     valid tests to facilitate and evaluate stroke recovery.

n	   Dr. Matthew Hogan, physicist and neurologist, OHRI: Dr. Hogan is a trained physicist and neurologist
     with an interest in cerebral ischemia and human brain imaging, He is involved with radiotracer and imaging
     techniques that will further enhance links between the Toronto and Ottawa research groups. His expertise
     will be applied directly to assessing neuroprotection and recovery in laboratory models, as well as to
     human imaging studies of recovery.

n	   Dr. brian levine, research scientist, Baycrest: A Senior Scientist at Baycrest and an Associate Professor,
     Departments of Psychology and Medicine (Neurology) at the University of Toronto, Dr. Levine’s research
     focuses on assessment of prefrontal and executive functioning in patients with stroke and other types
     of brain injury. In particular, he studies strategic self-regulation of behaviour and its relationship to
     neuroimaging findings and real life behaviour.
36

     n	   Dr. William Mcilroy, neurophysiologist, Sunnybrook: A neurophysiologist studying motor control and
          adaptation, Dr. McIlroy holds a Canada Research Chair and is a Senior Scientist and an Associate Professor
          in the Graduate Department of Rehabilitation Science and the Department of Physical Therapy at the
          University of Toronto. Dr. McIlroy is Site Co-director for the Heart and Stroke Foundation Centre for Stroke
          Recovery at Sunnybrook and Principal Investigator of a longitudinal study of stroke recovery using fMRI,
          evoked potentials and quantitative behavioural measures. He has helped to develop reliable quantitative
          techniques and measurement of stimuli and motor function, and is pursuing studies in the recovery of
          ambulation and the role of exercise.

     n	   Dr. David park, research scientist, OHRI: Dr. Park was one of the first to demonstrate the role of cell
          cycle modulators in neuronal death and has demonstrated that inhibiting cyclin-dependent kinases helps
          protect against stroke-induced damage. His primary area of expertise is in the signaling mechanisms that
          control neuronal death processes. Dr. Park’s research focuses on studying how death signaling molecules
          (such as cell cycle elements, calpains, p53, c-Jun kinase, Bax and caspases) interact to
          regulate the death process found occurring in neurodegenerative conditions including stroke and
          Parkinson’s disease.

     n	   Dr. leo renaud, research scientist, OHRI: Dr. Renaud is a scientist with a career of research expertise
          in cellular neurophysiology, particularly in the study of neurotransmission in the brain and spinal cord.
          He holds the inaugural Grimes Research Chair.

     n	   Dr. luc sabourin, Molecular biologist, OHRI: Dr. Sabourin is a molecular biologist who identified a
          novel transcription factor upregulated by brain pre-conditioning that can confer neuroprotection and plays
          a role in neurogenesis. His current focus is to identify gene targets and signaling systems that regulate the
          expression of this factor in order to pharmacologically manipulate these pathways following stroke.

     n	   Dr. Michael sharma, stroke neurologist, OHRI: Director of the Clinical Stroke Program at the Ottawa
          Hospital, Dr. Sharma is an active stroke neurologist who has effectively organized and currently guides the
          Stroke Care program in Ottawa, which serves a million citizens in the Eastern Ontario Region. He is helping
          to lead the GIST project and has been developing pharmacoeconomic models of stroke and stroke care in
          Ontario.

     n	   Dr. ruth slack, research scientist, OHRI: Dr. Slack has extensive expertise in the identification of
          molecular mechanisms that regulate stem cell self-renewal, progenitor numbers and neurogenesis
          (the development of neuronal cells). Much of her research focuses on primary neural stem and progenitor
          cells and on their genetic manipulation to dissect the molecular mechanisms by which neural precursor
          cells generate neurons. This knowledge is being used to facilitate the regeneration of brain after acute injury.

     n	   Dr. richard staines, neurophysiologist, Sunnybrook: Dr. Staines is studying sensorimotor control during
          recovery from stroke. He received an NSERC Canada Research Chair in Sensorimotor Control in 2004 and is
          now an Assistant Professor with the Department of Kinesiology at the University of Waterloo, and also has
          a cross-appointment to the Department of Medicine (Neurology) at the University of Toronto. He has been
          a key player in longitudinal studies of recovery in stroke patients using fMRI and evoked potentials, and
          currently leads a study on bilateral training for arm recovery.




     Heart and Stroke Foundation Centre for Stroke Recovery                                           Annual Report 2006
n	   Dr. peter stys, neuroscientist, OHRI: Dr. Stys is a world leader in the detailed study of
     pathophysiological mechanisms of white matter injury in stroke and trauma. He has extensive expertise
     in electrophysiological recording methods in central myelinated axons and has developed advanced
     microscopic imaging techniques aimed at understanding the fundamental processes governing nerve
     fibre damage.

n	   Dr. Charlie thompson, research scientist, OHRI: Since joining the OHRI, Dr. Thompson has acquired
     expertise in laboratory models of preconditioning stroke and in the assessment of cognitive and motor
     recovery from stroke. He has a background in electrophysiology and molecular control of apoptosis, and Dr.
     Thompson has also developed ways to use cultured cells to reveal the molecular mechanisms involved in
     the induction of ischemic tolerance in the brain by preconditioning.

n	   Dr. Jon Ween, stroke neurologist, (Klaru), Baycrest: Dr. Ween runs the Louis and Leah Posluns
     Stroke and Cognition Clinic in Baycrest’s Brain Health Centre. He also attends on the acute stroke service
     at Sunnybrook Health Sciences Centre and with the province-wide Tele-Stroke service in Ontario. He is a
     scientist within the Kunin-Lunenfeld Applied Research Unit (KLARU) at Baycrest. His research interest is in
     stroke-related cognitive syndromes, stroke outcomes and neural network reorganization.

Associate Members
n	   Dr. Michael alexander, Clinician scientist, Baycrest: Dr. Alexander has directed Neurological
     Rehabilitation programs affiliated with Boston University (Boston VAMC 1979-1985; Braintree Hospital,
     1985-96) and Beth Israel Deaconess Medical Center (1996-present). He is currently investigating cognitive
     deficits due to cerebellar lesions and the profiles of cognitive recovery after cardiac arrest.

n	   Dr. nicole anderson, research scientist, (Klaru), Baycrest: An example of integrated science
     networking, Dr. Anderson’s research (along with Drs. Stuss, Winocur, Dawson, and Schweizer) focuses on
     developing rehabilitation techniques to improve processes mediated by discrete regions within the frontal
     lobes, on developing and validating a group memory intervention for individuals with white matter disease,
     and on developing an ecologically valid measure of executive functioning.

n	   Dr. Harry atkins, Hematologist and senior scientist, OHRI: After earning his MD in 1983 from the
     University of Ottawa, Dr. Atkins was a fellow in Hematology at the University of Washington from 1988
     to 1990. He worked as a post-doctoral research fellow at the Ontario Cancer Institute, and joined Ottawa
     Hospital as a Clinician-Scientist in 1995. Through the Centre, Dr. Atkins participates in a project that tests
     the role hematopoietic stem cells can play in the recovery of neurological function following a stroke.
     Naturally, Dr. Atkins’ expertise in stem cells and regenerative medicine is invaluable to help to stimulate the
     development of the GIST Project.

n	   Dr. Mark bayley, Clinician scientist, Sunnybrook: Dr. Bayley is a specialist physician in Physical
     Medicine and Rehabilitation and currently the Medical Director of the Neuro Rehabilitation Program at
     Toronto Rehab. He is also an Assistant Professor at University of Toronto and appointed as a Scientist at
     Toronto Rehab. He is one of the Principle Investigators on the Canadian Stroke Network funded SCORE
     project (Stroke Canada Optimization of Rehabilitation by Evidence) which is developing the best practice
     guidelines in stroke and studying the ideal strategies for knowledge translation to get the best rehabilitation
     evidence into practice.
38

     n	   Dr. Dina brooks, physical therapist, Sunnybrook: Dr. Brooks completed her Master’s Degree in
          Physiology while working part time as a physiotherapist and went on to complete her PhD at the University
          of Toronto, where she is currently an Associate Professor in the Department of Physical Therapy.
          Her doctoral research focused on sleep apnea; which is a major risk factor for stroke. She is developing
          an exercise program aimed at stroke patients in rehabilitation, with the goal of improving recovery through
          better fitness. Dr. Brooks co-leads the aerobic training post-stroke project with Dr. McIlroy.

     n	   Ms. Cynthia Danells, research physical therapist, Sunnybrook: Ms. Danells has conducted clinical
          evaluations, assisted in data collection and patient recruitment for Centre-related studies. She provides
          structured physical therapy for ongoing intervention studies and has recently published on “pushing” after
          stroke, an important impediment to ambulation she found in 63% of stroke patients with moderate-to-
          severe hemiparesis.

     n	   Dr. Deirdre Dawson, research scientist (Klaru), Baycrest: Dr. Dawson’s overall focus of research is
          to improve real-world outcomes for stroke sufferers. She has been further developing two projects: 1) the
          Multiple Errands Test (MET) to allow us to identify the types of errors and strategies people make who have
          executive dysfunction as a result of stroke, and 2) Validation of the Cognitive Orientation to Occupational
          Performance (CO-OP) approach to complex daily tasks.

     n	   Dr. susanne Ferber, research scientist, Sunnybrook: Dr. Ferber is an Assistant Professor in the
          Department of Psychology at the University of Toronto. Dr. Ferber’s work speaks to the basic principles
          of the neural representation of visual perception and visually-guided action. Her long-term research goal
          is to understand the cognitive and neural processes that support awareness of perception. To examine
          this relationship, Dr. Ferber’s research program comprises diverse methodological approaches, such as
          the investigation of cognitive impairments in neurological patients (e.g., patients with spatial neglect or
          simultanagnosia), cognitive experiments in healthy individuals, and the examination of brain activity with
          functional neuroimaging techniques (fMRI).

     n	    Dr. William Gage, research scientist, Sunnybrook: Dr. Gage completed his post-doctoral fellowship
          with Dr. William McIlroy at Toronto Rehabilitation Institute and HSFCSR at Sunnybrook. He is an Assistant
          Professor in the School of Kinesiology and Health Science at York University, in Toronto. His research is
          focused in two areas: understanding the control of arm movements in balance and the impact of stroke
          on this control, and the application of sensor systems in monitoring human movement and understanding
          activity levels of patients with stroke during the subacute and chronic stages of recovery. As co-PIs, Dr. Gage
          and Dr. McIlroy were recently successful with their CIHR — Institute for Aging (CHRP) funding application to
          develop a completely wireless, wearable kinematic sensor system to quantify patient activity profiles, and
          use this information to extend and intensify therapeutic opportunities for patients with stroke.

     n	   Dr. Fu-Qiang Gao, senior image analyst, Sunnybrook: A research radiologist, Dr. Gao was responsible
          for developing the image processing stream for localization of stroke lesions for several Centre-related
          projects. He is integral in developing the lesion localization and volumetrics program and ensuring that
          lesions are being properly identified and quantified.

     n	    Dr. stephen Hill, post-Doctoral Fellow, Sunnybrook: Dr. Hill completed his doctorate on the recovery
          responses of trunk perturbations during locomotion and is completing a post-doctoral fellowship in
          biomechanics with Dr. William McIlroy at Toronto Rehab and HSFCSR at Sunnybrook.




     Heart and Stroke Foundation Centre for Stroke Recovery                                           Annual Report 2006
n	   Dr. Jonathan Marotta, research scientist, Sunnybrook: Dr. Marotta is an Assistant Professor in the
     Department of Psychology, and Lab Director of the Neuropsychology of Vision Perception and Action Lab
     at the University of Manitoba. Insight from Dr. Marotta’s research about hemispatial neglect will help in
     the development of sophisticated diagnostic tools and more theoretically-motivated approaches to the
     rehabilitation of patients with this common disorder. This research will also assist in the development of
     more efficient control systems for robotic-assistance devices for the impaired.

n	   Dr. neelesh nadkarni, post-Doctoral Fellow, Sunnybrook: Dr. Nadkarni is continuing his clinical and
     research fellowship in Gait, Cognition and Stroke in the elderly. He is concurrently pursuing his PhD in
     Medical Science and Neuroscience on gait disorders at the Institute of Medicine, University of Toronto.
     His thesis project involves studying gait patterns, executive dysfunction and subcortical ischemic
     vascular disease.

n	   Dr. paul oh, Clinical scientist, Sunnybrook: Dr. Oh is Medical Director of the Cardiac Rehabilitation and
     Secondary Prevention Program at the Rumsey Centre of Toronto Rehab. He is also a staff physician in the
     divisions of Clinical Pharmacology and General Internal Medicine, Department of Medicine at Sunnybrook.
     Currently, he is working with Dr. McIlroy in the area of exercise training and stroke recovery.

n	   Dr. eric roy, research scientist, Sunnybrook: Dr. Roy is a Professor in the Departments of Kinesiology
     and Psychology at the University of Waterloo and also holds academic appointments at the University of
     Toronto. Dr. Roy’s research is aimed at understanding the neurocognitive and neuromotor mechanisms
     governing how skilled movements are learned and controlled. One of his focuses is apraxia, a disorder in
     limb gesturing and tool use. He has developed a cognitive neuropsychological model of apraxia to identify
     disruptions at different stages of gesture production which can be related to the location of stroke injury in
     the brain.

n	   Dr. Demetrios James sahlas, Clinician investigator, Sunnybrook: Dr. Sahlas is Director of the
     Secondary Stroke Prevention Clinic and co-Medical Director of the Neurodoppler Laboratory at Sunnybrook.
     His current research interests include neuropathological correlation of vascular cognitive impairment, MR
     direct thrombus imaging with neurosonological monitoring, and neuroimaging of ischemic white matter
     employing MR diffusion tensor imaging and spectroscopy.

n	   Dr. tom schweizer, post-Doctoral Fellow, Baycrest: Dr. Schweizer (along with Drs. Stuss and Alexander)
     is investigating the role of the cerebellum in cognitive processing. He is also investigating the functional
     and anatomical connectivity of frontal and cerebellar regions and how they interact to guide cognition.

n	   Dr. Gordon Winocur, research scientist, Baycrest: Dr. Winocur investigates non-biological factors
     (eg. psychosocial, environmental) that affect cognitive decline in old age and evaluates their value to
     rehabilitate cognitive function in older adults and brain-damaged individuals, including stroke patients. He
     co-leads the Therapy for Enhanced Stroke Recovery project and on the White Matter Project, investigating
     a cognitive rehabilitation program (with funding from the McDonnell Foundation) in patients with vascular
     brain disease. In addition to being a Professor in the department of Psychology at the University of Toronto,
     he is a Senior Scientist at the Rotman Research Institute at Baycrest, and since 2004 has been the interim
     Vice-President of Research at Baycrest.
40

     n	   Dr. Karl Zabjek, research scientist, Sunnybrook: Dr. Zabjek completed his doctorate on postural
          control and recently completed a post-doctoral fellowship with Dr. McIlroy at Toronto Rehab and HSFCSR
          at Sunnybrook on the cortical control of compensatory balance reactions. Currently, Dr. Zabjek is an
          Assistant Professor in the Department of Physical Therapy at the University of Toronto. In addition, he is a
          Scientist at Bloorview Kids Rehab, and an Adjunct Scientist at Toronto Rehab. He is especially interested in
          understanding the cortical contributions to the control of compensatory balance reactions, instrumentation
          of assistive devices with advanced vision and biosensors that enhance mobility.

     Management of the Centre
     n	   natasha Hollywood, Coordinator: Ms. Hollywood oversees the management and administration of the
          Centre, including communications, budget planning and recruitment. She responds to the needs of the
          partner institutions and maintains effective liaison within the Centre. She orchestrates meetings, workgroups
          and lab tours for the Scientific Directors, Site Directors, Advisory Board of Directors, Researchers and Donors.

     n	   Farrell leibovitch, regional Coordinator: Mr. Leibovitch assists the Centre Coordinator and the Site
          Directors for activities in the Toronto division of the Centre. Within the defined overall Centre budget he
          manages the Centre resources at the Toronto sites. He contributes to scientific writing for Centre-wide
          communications. He is also responsible for patient and public inquiries, lab tours, data management and
          analysis for the Toronto sites, and supports the Centre Coordinator in facilitating collaboration between the
          Toronto and Ottawa scientists.

     Newly-purchased Assets
     The Centre has purchased some new equipment since its inception that we believe will help bring us closer
     to our goals. Having dedicated equipment increases the number and quality of tests that the Centre can
     administer. Our collaborative model allows the partner institutions to share the cost and the access to this
     equipment, thereby saving precious funding. Each asset has been carefully vetted and researched prior to
     purchase, to make sure that all purchases are mission-critical, and to maximize use.

     n	   Magnetic Resonance Imaging: With substantial assistance from Baycrest donors, the Centre contributed
          to the purchase of a new state-of-the-art MR Scanner, Siemens Trio (3T), which is expected to be up and
          running in the Summer of 2006. The addition of fMRI technology (functional magnetic resonance imaging)
          at Baycrest gives researchers and clinicians a critical leg up in the study of the human brain and the
          discovery of treatments for memory and mood disorders, and cognitive problems caused by stroke. Having
          access to fMRI along with other imaging techniques (such as EEG and MEG) in the same facility will enable
          scientists to perform a more complete assessment of brain function. Also, researchers will not have to
          compete for fMRI time at other facilities.

     n	   Transcranial Magnetic Stimulator: Now, the integrity of the brain’s white matter following a stroke can be
          tested using controlled magnetic pulses. The effect on the movements that a brain region controls, such
          as the one that moves the index finger, can be measured along with how movement of varying intensity
          and duration affects intracortical inhibition and facilitation. This equipment will be useful to both the White
          Matter Project and the Therapy for Enhanced Stroke Recovery Project.




     Heart and Stroke Foundation Centre for Stroke Recovery                                           Annual Report 2006
n	   Oxygen Glucose Deprivation Chamber: The oxygen-glucose deprivation chamber provides researchers with
     a model of how the brain responds to stroke. After cultured brain cells are sealed in the chamber, normal
     air is replaced with nitrogen and CO2 and normal medium is replaced with glucose-free medium. This
     mirrors the oxygen and nutrient depravation in cells in the brain during a stroke. The chamber is being
     used to study the molecular basis of ‘preconditioning’, a treatment known to increase the brain’s tolerance
     to oxygen deprivation. This allowed the identification of several factors that act to increase the tolerance of
     the brain to ischemia and may provide targets for the therapeutic treatment of stroke. This equipment was
     specifically purchased for application towards the Therapy for Enhanced Stroke Recovery Project.

n	   Multiphoton Imaging System: A key advantage of multiphoton microscopy is its ability to image deep
     within tissue samples such as brain slices, and is useful for accurately visualizing and characterizing
     stem cells and the outgrowth of their processes as they make connections with neighboring cells — a
     process essential for post-stroke repair. In addition, this imaging system is being used to investigate the
     mechanisms of cellular damage in models of stroke in white matter. Thus, this imaging system is being
     used for the White Matter Project and the Stem Cell Project.

n	   Electrophysiology Rig: Used primarily in the Therapy for Enhanced Stroke Recovery Project, the
     Electrophysiology Rig records the activity and images intracellular calcium shifts in neurons in brain slice
     preparations, using the confocal capability of the instrument (LSM 510).

n	   Zeiss Axioplan2 Microscope: The primary imaging workstation consists of a fluorescence equipped Zeiss
     Axioplan2 microscope, an Apotome for deconvolution and a dedicated computer running image acquisition
     and processing software (Axiovision 4.0). This unit is primarily being used in the Therapy for Enhanced
     Stroke Recovery Project.
42



     Audited
     Financial
     Statements                     KPMG LLP
                                    Chartered Accountants
                                                                                                              Telephone (613) 212-KPMG (5764)
                                                                                                              Fax       (613) 212-2896
                                    Suite 2000                                                                Internet  www.kpmg.ca
                                    160 Elgin Street
                                    Ottawa, ON K2P 2P8
                                    Canada




     AUDITORS' REPORT

     To The External Advisory Board of the Heart and Stroke Foundation Centre for Stroke Recovery
     and the Ottawa Health Research Institute.


     We have audited the schedule of revenue, expenditures and accumulated surplus of the Heart
     and Stroke Foundation Centre for Stroke Recovery for the year ended March 31, 2006, prepared
     in accordance with the accounting principles disclosed in note 1 as stipulated in the Memorandum
     of Understanding dated February 28, 2002. This financial information is the responsibility of the
     management of the Centre Our responsibility is to express an opinion on this financial information
     based on our audit.

     We conducted our audit in accordance with Canadian generally accepted auditing standards.
     Those standards require that we plan and perform an audit to obtain reasonable assurance
     whether the financial information is free of material misstatement. An audit includes examining,
     on a test basis, evidence supporting the amounts and disclosures in the financial schedule. An
     audit also includes assessing the accounting principles used and significant estimates made by
     management, as well as evaluating the overall presentation of the financial information.

     In our opinion, the schedule presents fairly, in all material respects, the revenue, expenditures and
     accumulated surplus of the Heart and Stroke Foundation Centre for Stroke Recovery for the year
     ended March 31, 2006 in accordance with the basis of accounting described in note 1.

     This report is intended for the use of the External Advisory Board of the Heart and Stroke
     Foundation Centre for Stroke Recovery and the Ottawa Health Research Institute and is not
     intended for general use. KPMG LLP assumes no responsibility or liability for damages incurred
     by any other entity or person resulting from the use of, or reliance on, this report.




     Chartered Accountants



     Ottawa, Canada

     June 22, 2006


                                         KPMG LLP, a Canadian limited liability partnership is the Canadian
                                            member firm of KPMG International, a Swiss cooperative.



     Heart and Stroke Foundation Centre for Stroke Recovery                                                                                     Annual Report 2006
HEART AND STROKE FOUNDATION CENTRE FOR
 STROKE RECOVERY
Schedule of Revenue, Expenditures and Accumulated Surplus

Year ended March 31, 2006, with comparative figures for 2005

                                                                                                 2006                      2005

Revenue:
   Research grants                                                                       $ 1,296,500             $ 1,298,500
   Interest                                                                                   32,107                  17,792
                                                                                           1,328,607               1,316,292

Expenditures:
   Direct costs:
        Scientific personnel                                                                  950,268                  873,616
        Research supplies and equipment                                                       140,690                  413,733
   Indirect costs:
        Administrative personnel                                                                92,264                  40,319
        Administrative supplies                                                                 55,949                  51,658
                                                                                             1,239,171               1,379,326

Excess (deficiency) of revenue over expenditures                                               89,436                  (63,034)

Accumulated surplus, beginning of year                                                        817,717                  880,751

Accumulated surplus, end of year                                                         $    907,153            $     817,717

See accompanying notes to the schedule of revenue, expenditures and accumulated surplus.

Notes to Schedule of Revenue, Expenditures and Accumulated Surplus
Year ended March 31, 2006

The Heart and Stroke Foundation Centre for Stroke Recovery was established by the Heart and Stroke Foundation of Ontario, the Ottawa
Health Research Institute, the Sunnybrook and Women’s Health Sciences Centre and Baycrest Centre for Geriatric Care (the “Sites”) under
a Memorandum of Understanding dated February 28, 2002. The objectives of the Centre are to promote recovery after stroke.
1. Significant accounting policies:
  (a) Basis of accounting:
      The schedule of revenue, expenditures and accumulated surplus of the Heart and Stroke Foundation Centre for Stroke Recovery
      (the “Centre”) reports the sources of funds and the expenditures of the Centre for the year ended March 31, 2006.
  (b) Revenue and expenditures:
      Revenue and expenditures are reported on an accrual basis with the exception of research grants revenue, which is recorded
      in the period in which funds are received. General eligibility criteria for expenditures of the Centre and its reporting requirements
      are described in The Heart and Stroke Foundation Centre for Stroke Recovery Memorandum of Understanding dated
      February 28, 2002.
  (c) Use of estimates:
      The preparation of the schedule of revenue, expenditures and accumulated surplus requires management to make estimates and
      assumptions that affect the reported amounts of revenue and expenditures during the period. Actual results could differ from
      these estimates. These estimates are reviewed annually and as adjustments become necessary, they are recognized in the
      schedule of revenue, expenditures and accumulated surplus in the period in which they become known.
2. Comparative figures:
  Certain 2005 comparative figures have been reclassified to conform with the financial schedule presentation adopted for 2006.
44



     Appendices
     our Members’
     Awards




     Grants:
     albert, paul
     Canadian Institutes of Health Research (CIHR)                                   2002–2005   $125,000/yr
     Transcriptional Regulators of the 5-HT1A Gene

     CIHR                                                                            2003–2006   $95,000/yr
     Coupling Domains of the 5-HT1A Receptor

     Ontario Mental Health Foundation                                                2003–2007   $70,000/yr
     Regulation of Dopamine D2 Receptors

     CIHR                                                                            2004–2007   $95,000/yr
     Regulation of Cell Proliferation by Inhibitory G Proteins

     black, sandra
     Heart and Stroke Foundation of Canada/Alzheimer Society of Canada/CIHR/Pfizer   2005–2008   $119,950/yr
     In Vivo Characterization of Subcortical Vascular Cognitive Impairment
     Using Advanced High Field MR Techniques

     Heart and Stroke Foundation of Ontario (HSFO)                                   2004–2007   $45,000/yr
     Neuropsychological Profiles and Neuroanatomic Correlates of
     Limb Apraxia (Co-PI Dr. Eric Roy)

     Alzheimer’s Association (US)                                                    2003–2006   $80,000 US/yr
     MRI Hyperintensities and Executive Deficits in Alzheimer’s Disease:
     A Quantitative Neuroimaging-behavioural Analysis

     CIHR                                                                            2003–2008   $181,000/yr plus
     In Vivo Brain Mapping in the Dementias: A Longitudinal Brain-                               $11,000 equip
     Behaviour Study of Dementia with a Focus on Cerebrovascular Disease

     Alzheimer Society of Canada                                                     2003–2005   $75,000/yr
     Alzheimer’s Disease With and Without Subcortical Ischemic
     Vasculopathy: A Quantitative Brain Imaging-Behavior Study

     CIHR                                                                            2003–2005   $10,000
     FASTER — Fast Assessment of Stroke and Transient Ischemic
     Attack to Prevent Early Recurrence
     $408,275 overall, $10,000 projected at Sunnybrook

     Colavita, antonio
     Natural Sciences and Engineering Research Council of Canada (NSERC)             2005–2010   $34,500/yr
     Genetic Analysis of Axon Initiation and Outgrowth in C. elegans

     CIHR (New Investigator Grant)                                                   2004–2007   $119,000/yr
     Genetic and Molecular Analysis of a Peptide N-glycanase
     Involved in C. elegans Axon Branching


     Heart and Stroke Foundation Centre for Stroke Recovery                                      Annual Report 2006
Gladstone, David
Canadian Stroke Network (CSN) Networks of Centres of Excellence                   2001–2007   $60,000/yr
Canadian Stroke Registry

HSFO (Salary)                                                                     2006–2009   $64,000/yr
Clinician Scientist Award

Graham, simon
NSERC                                                                             2005–2010   $40,000/yr
Motion Correction in Magnetic Resonance Imaging: External Monitoring Approaches

CIHR                                                                              2005–2010   $125,000/yr
Centre for Research Using Magnetic Resonance

HSFO                                                                              2005–2007   $24,290/yr
Virtual Reality for Stroke Recovery: Initial fMRI Studies

CIHR                                                                              2005–2006   $148,800/yr
Virtual Reality Technology for Assessment and Rehabilitation of Behaviour

HSFO                                                                              2003–2006   $69,340/yr
Improved fMRI of Stroke Recovery

CIHR                                                                              2003–2006   $63,350/yr
Functional MRI and MEG of Neurovascular Coupling in the Somatosensory Cortex

Hakim, antoine
HSFO                                                                              2003–2005   $53,000/yr
Molecular Mechanisms of Neuroprotection

Canadian Stroke Network (CSN)                                                     2003–2005   $117,000/yr
Molecular Mechanisms of Preconditioning

CSN (Networks of Centres of Excellence)                                           2003–2005   $35,000/yr
Stimulating Plastic Processes to Facilitate Functional Restitution after Stroke

Hogan, Matthew
Canadian Foundation for Innovation (CFI)                                          2003–2006   $55,785/yr
Quantitative Cerebral Perfusion in Stroke

Ontario Research & Development Challenge Fund                                     2001–2007   $330,000/yr
BRAIN: Behavioral Research and Imaging Network
Ottawa Lead Investigator: Dr. M.J. Hogan

levine, brian
CIHR                                                                              2003–2006   $203,931
Self-Regulation of Behaviour in Patients with Frontal Lobe                                    $3,000 equip
Brain Disease: Neuropsychology, Neuroimaging and Functional Outcome

National Institute of Child Health and Human Development,                         2002–2007   $1,348,215US
National Institutes of Health
Functional Neuroanatomy of Cognition in Traumatic Brain Injury:
Executive Functioning, Memory, and Rehabilitation

Mcilroy, William
CIHR                                                                              2006–2009   $169,000
The Personal Therapist: A smart ambulatory monitoring system
to facilitate recovery following stroke. (co-PI Dr. William Gage)

CIHR                                                                              2006–2009   $240,000
Early Exercise Intervention after Stroke: Improving sensorimotor
recovery, aerobic capacity, and functional walking. (co-PI Dr. Dina Brooks)

Canadian Physiotherapy Association                                                2005–2006   $5,000
BE Schnurr Memorial Fund Research Grant
The influence of hands-on facilitation and therapist technique
on movement symmetry in sub-acute stroke patients
46

     CFI                                                                                    2004–2007   $150,000
     Intelligent Design for Adaptation, Participation and Technology (iDAPT):
     Innovative Rehabilitation for People in Challenging Environments
     (co-PI Dr. Fernie and Steinfeld; funding of $150K for iWalker project part
     of larger $5M infrastructure project)

     CIHR                                                                                   2003–2006   $191,000
     Early Exercise Intervention after Stroke: Influence on Functional
     Capacity, Sensorimotor Recovery and Risk of Future Strokes (co-PI Dr. Dina Brooks)

     CIHR (Canada Research Chair)                                                           2002–2007   $100,000/yr
     Maximizing Functional Recovery following Stroke:Translation of Knowledge to Practice

     NSERC                                                                                  2003–2008   $30,000/yr
     Central Nervous System Control of Dynamic Stability

     CIHR                                                                                   2000–2005   $486,086
     Understanding cortical reorganization following stroke:
     The role of somatosensory systems in sensorimotor recovery

     park, David
     Heart and Stroke Foundation of Canada                                                  2006–2011   $87,950/yr
     Salary Award

     HSFO (Salary)                                                                          2006–2008   $68,000/yr
     Oxidative stress and schemic death

     Parkinson Society Canada                                                               2005–2006   $45,000
     DJ-1 and PD

     Michael J. Fox Foundation (Operating)                                                  2004–2006   $125,000/US/yr
     Role of Neuroinflammation in Parkinson’s Disease

     Michael J. Fox Foundation, US Army (Operating)                                         2004–2006   $140,000/US/yr
     Regulating Dopaminergic Development in Mammalian Systems

     HSFO (Operating)                                                                       2004–2009   $80,000/yr
     Mechanisms of Delayed Death in Stroke

     CIHR (Operating)                                                                       2004–2009   $118,000/yr
     Mechanisms of Calpain Mediated Dopamine Loss in PD

     CIHR (Operating)                                                                       2001–2006   $114,000/yr
     Role of Cell Cycle in Neuronal Death Evoked by DNA Damage and B-amyloid Toxicity

     renaud, leo
     CIHR (Operating)                                                                       2003–2006   $143,265
     Neurostasis: A Novel Therapeutic Technique of Selective Brain Hypothermia

     HSFO                                                                                   2005–2008   $62,000/yr
     Suprachiasmatic nucleus efferents

     sabourin, luc
     CIHR                                                                                   2003–2008   $719,875
     Molecular Regulation of the Ste20-like kinase SLK

     CSN                                                                                    2003–2005   $314,000
     Molecular Mechanisms of Neuroprotection

     Premier’s Research Excellence Award (PREA)                                             2002–2007   $150,000
     Molecular Regulation of Cellular Migration and Invasiveness by SLK

     CIHR (Scholar Award)                                                                   2001–2006   $250,000
     Characterization and Molecular Regulation of SLK a Novel Ste20-related Kinase




     Heart and Stroke Foundation Centre for Stroke Recovery                                             Annual Report 2006
slack, ruth
Heart and Stroke Foundation of Canada (Operating)                                   2006–2009   98,632/yr
Regulation of Mcl1 to treat Stroke

CIHR (Operating)                                                                    2004–2008   $109,862/yr
Apoptosis Inducing Factor in Neuronal Injury

HSFO (Operating)                                                                    2003–2006   $89,000/yr
The Role of SIVA in P53 Neuronal Injury

CIHR (Operating)                                                                    2002–2007   $139,000/yr
The Role of the Rb Family in Neurogenesis

staines, richard
NSERC Canada Research Chair in Sensorimotor Control,                                2005–2010   $100,000/yr
Tier II. University of Waterloo
Sensorimotor Control: Modulation, Adaptation and Implications for Stroke Recovery

CFI, Canada Research Chair (Infrastructure Operating Funds)                         2005–2006   $130,130
Sensorimotor Control Laboratory: An Integrative Neuroimaging
Approach to Basic Mechanisms and Implications for Stroke Recovery

CIHR                                                                                2003–2006   $72,000/yr
Bilateral Sensorimotor Training after Stroke: Understanding
and Promoting Physiological Mechanisms of Recovery

NSERC                                                                               2002–2007   $32,000/yr
Multimodal Sensory Information and Human Motor Control:
The Role of Sensory Gating and Sensorimotor Integration

stuss, Donald
CIHR                                                                                2005–2010   $270,444
The fractionation and localization of attentional and language
processing in the cerebellum

CIHR                                                                                2003–2008   $649,190 plus
Frontal lobes: Fractionation and Localization of Anterior Attentional                           $15,098 equip.
and Emotional Processing

CIHR (Group Grant)                                                                  2003–2008   $2,000,000 plus
CIHR Brain and Aging Group at the Rotman Research Institute                                     $74,425 equip.
James S. McDonnell Foundation, McDonnell 21st,                                      2002–2005   $1,000,000 US
Century Collaborative Activity Award (Operating)
Brain Recovery: Return of Cognitive and Social Function

stys, peter
CSN                                                                                 2006–2008   $71,430
Neuroprotection: Preventing cell death and neuronal damage from stroke

CSN Studentship Jasmine Hasselback                                                  2006        $5,000
Non-linear optical techniques for the study of axonal pathophysiology

thompson, Charlie
CSN                                                                                 2006–2008   $71,430
Preventing Cell Death and Neuronal Damage

Children’s Hospital of Eastern Ontario (CHEO) Research Institute
Pathophysiology of Delayed Brain Damage After Intraoperative Brain Injury           2005–2006   $29,787

Ween, Jon
Ontario Ministry of Health and Long-Term Care                                       2004–2006   $600,000
Collaborative Development of an Affect - Behavior - Cognition
Assessment Battery & Point of Care Case Record for Implementation with
Wireless Device Technology in the Local Stroke Care Continuum
(co-PIs with Drs. Black and Stuss)
48


     ouR MeMbeRS’
     publICAtIonS




     Adkin AL, Quant S, Maki BE, Mcilroy We. Cortical responses associated with predictable and unpredictable compensatory
     balance reactions. Exp Brain Res. 2006 Jan 18: 1-9 [Epub ahead of print].

     alexander M, stuss Dt. Frontal injury: impairments of fundamental processes lead to functional consequences.
     J Int Neuropsychol Soc. 2006 Mar; 12(2): 192-3.

     alexander Mp, stuss Dt, Shallice T, Picton TW, Gillingham S. Impaired concentration due to frontal lobe damage from two
     distinct lesion sites. Neurology. 2005 Aug 23; 65(4): 572-9.

     Behl P, Stefurak TL, black se. Progress in clinical neurosciences: cognitive markers of progression in Alzheimer’s disease.
     Can J Neurol Sci. 2005 May; 32(2): 140-51. Review.

     Bocti C, Rockel C, Roy P, Gao F, black se. Topographical patterns of lobar atrophy in frontotemporal dementia and Alzheimer’s
     disease. Dement Geriatr Cogn Disord. 2006; 21(5-6): 364-72. Epub 2006 Mar 3.

     Bocti C, Swartz RH, Gao FQ, sahlas DJ, Behl P, black se. A new visual rating scale to assess strategic white matter
     hyperintensities within cholinergic pathways in dementia. Stroke. 2005 Oct; 36(10): 2126-31.

     Chamelian L, Bocti C, Gao FQ, black se, Feinstein A. Detecting cognitive dysfunction in multiple sclerosis with a magnetic
     resonance imaging rating scale: a pilot study. CNS Spectr. 2005 May; 10(5): 394-401.

     Chen H-H, Mullett, S.J., and Stewart, A.F.R. TEF-1 transcription factors interact with hypoxia inducible factor 1 alpha and
     modulate the hypoxic response in cardiac myocytes. J Biol Chem 2005.

     Clarke P, black se. Quality of Life Following Stroke: Negotiating Disability, Identity, and Resources.
     J Appl Gerontol August 2005; 24: 319-336.

     Crocker SJ, Hayley SP, Smith PD, Lamba WR, Callaghan SM, slack rs, park Ds. Stress-Activated MAP Kinase Signaling in
     Nigral Dopamine Neurons Modifies Axotomy-Induced c-Jun Expressio and Neurodegeneration in vivo.
     J. Neurochem. 2006; 96(2): 489-99.

     Darvesh S, Leach L, black se, Kaplan E, Freedman M. The behavioural neurology assessment.
     Can J Neurol Sci. 2005 May; 32(2): 167-77.

     Dawson Dr, Cantanzaro AM, Firestone J, Schwartz M, stuss Dt. Changes in coping style following traumatic brain injury and
     their relationship to productivity status. Brain Cogn. 2006 Mar; 60(2): 214-6.

     Dawson Dr, Markowitz M, stuss Dt. Community integration status 4 years after traumatic brain injury: participant-proxy
     agreement. J Head Trauma Rehabil. 2005 Sep-Oct; 20(5): 426-35.

     Donnan GA, Davis SM, Hill MD, Gladstone DJ. Patients with transient ischemic attack or minor stroke should be admitted to
     hospital: for. Stroke. 2006 Apr; 37(4):1137-8. Epub 2006 Mar 16. Review.




     Heart and Stroke Foundation Centre for Stroke Recovery                                                      Annual Report 2006
Dubrowski A, roy ea, black se, Carnahan H. Unilateral basal ganglia damage causes contralesional force control deficits: a
case study. Neuropsychologia. 2005; 43(9):1379-84.

Ferguson KL, McClellan KA, Vanderluit JL, MacIntosh MC, Schuurmans C, Polleux F, slack rs. A cell-autonomous requirement
for the Rb protein in neuronal migration. EMBO J. 2005 Nov 24; Dec 21; 24(24): 4381-91.

Fernandez-Duque D, black se. Attentional networks in normal aging and Alzheimer’s disease.
Neuropsychology. 2006 Mar; 20(2):133-43.

Fernandez-Duque D, black se. Impaired recognition of negative facial emotions in patients with frontotemporal dementia.
Neuropsychologia. 2005; 43(11): 1673-87. Epub 2005 Mar 16.

Gilboa A, Ramirez J, Kohler S, Westmacott R, black se, Moscovitch M. Retrieval of autobiographical memory in Alzheimer’s
disease: relation to volumes of medial temporal lobe and other structures. Hippocampus. 2005; 15(4): 535-50.

Gladstone DJ, Aviv RI, Jahromi B, black se, Baryshnik D, Caratao RN, Fox AJ. Turning a Stroke into a TIA: Curative
Thrombolysis with Combined Intravenous and Intra-arterial tPA. Can J Emerg Med 2006; 8: 54-7.

Gladstone DJ, Danells CJ, Armesto A, Mcilroy We, staines Wr, Graham sJ, Herrmann N, Szalai JP, black se. Subacute
Therapy with Amphetamine and Rehabilitation for Stroke Study Investigators. Physiotherapy coupled with dextroamphetamine
for rehabilitation after hemiparetic stroke: a randomized, double-blind, placebo-controlled trial. Stroke. 2006 Jan; 37(1): 179-85.

Holroyd-Leduc JM, Liu BA, Maki BE, Zecevic A, Herrmann N, black se. The role of buspirone for the treatment of cerebellar
ataxia in an older individual. Can J Clin Pharmacol. 2005 Fall; 12(3): e218-21. Epub 2005 Oct 24.

Lamba W, Munoz DG, Prichett-Pejic W, park Ds, and Woulfe J. MPTP induces intranuclear rodlet formation in mibrain
dopaminergic neurons. Brain Res. 2005; 1066(1-2): 86-91.

Leblanc GG, Meschia JF, stuss Dt, Hachinski V. Genetics of vascular cognitive impairment: the opportunity and the challenges.
Stroke. 2006 Jan; 37(1): 248-55. Epub 2005 Dec 8. Review.

Lee J-H, Mraz R, Zakzanis KK, black se, Snyder PJ, Kim SI, Graham sJ. “Spatial Ability and Navigation Learning in a Virtual
City”, Annual Review of CyberTherapy and Telemedicine: A Decade of VR, 2005; 3: 151-158.

Lindsay MP, Kapral MK, Gladstone DJ, Holloway R, Tu JV, Laupacis A, et al. The Canadian Stroke Quality of Care Study:
establishing indicators for optimal acute stroke care [editorial]. CMAJ 2005; 172(3): 363-5.

Massa PT, Aleyasin H, park Ds, Mao X, Barger SW. NFKappaB in neurons? The uncertainty principle in neurobiology.
J Neurochem. 2006; 97: 607-618.

McKee SC, thompson Cs, sabourin la, Hakim aM. Regulation of expression of early growth response transcription factors
in rat primary cortical neurons by extracellular ATP. Brain Res. 2006; 1088(1): 1-11.

Micu I, Coderre E, Jiang Q, Ridsdale A, Zhang L, Woulfe J, Yin X, Trapp BD, McRory JE, Rehak R, Zamponi GW, stys pK. NMDA
receptors mediate calcium accumulation in myelin during chemical ischemia. Nature, 2005 Dec 21; [Epub ahead of print].

Moscovitch M, Rosenbaum RS, Gilboa A, Addis DR, Westmacott R, Grady C, McAndrews PM, levine b, black se, Winocur G,
Nadel L. Functional Neuroanatomy of Remote Episodic, Semantic and Spatial Memory: A Unified Account Based on Multiple
Trace Theory. J Anat. 2005; 207: 35-66.

Ni Z, Karaskow E, Yu T, Callaghan S, Der S, park Ds, Xu Z, Pattenden S, Bremner R. Apical Role for BRG1 IN Cytokine-Induced
Promoter Assembly. Proc Natl Acad Sci, USA (Track II) 2005; 102(41): 14611-6).

Niechwiej-Szwedo E, Inness EL, Howe JA, Jaglal S, Mcilroy We, Verrier MC. Changes in gait variability during different
challenges to mobility in patients with traumatic brain injury. Gait Posture. 2006 Feb 18 [Epub ahead of print].

O’Hare MJ, Kushwaha N, Zhang L, Aleyassin H, Callaghan SM, slack rs, Vincent I, albert p, park Ds. Differential Roles of
Nuclear and Cytoplasmic Cdk5 in apoptotic and excitotoxic death. J. Neurosci. 2005; 25(39): 8954-66 (highlighted in issue
of 6J Neurosci).
50

     Oz M, Yang KH, O’Donovan MJ, renaud lp. Presynaptic angiotensin II AT1 receptors enhance inhibitory and excitatory
     synaptic neurotransmission to motoneurons and other ventral horn neurons in neonatal rat spinal cord. J Neurophysiol. 2005
     Aug; 94(2): 1405-12.

     Peters KR, Rockwood K, black se, Bouchard R, Gauthier S, Hogan D, Kertesz A, Loy-English I, Beattie BL, Sadovnick AD,
     Feldman HH. Characterizing neuropsychiatric symptoms in subjects referred to dementia clinics.
     Neurology. 2006 Feb 28; 66(4): 523-8.

     Picton TW, stuss Dt, Shallice T, alexander Mp, Gillingham S. Keeping time: Effects of focal frontal lesions.
     Neuropsychologia. 2006; 44(7): 1195-1209. Epub 2005 Nov 2.

     Rashidian J, Iyirhiaro G, Aleyasin H, Vincent I, Callaghan SM, slack rs, During M, park Ds. Multiple cyclin-dependent kinases
     signals are critical mediators of ischemia/excitotoxic neuronal death in vitro and in vivo. Proc Natl Acad Sci, USA (Track II)
     2005; 102(39): 14080-5. (Highlighted on Science online, Sci, Aging Knowl Environ. Vol 2005, issue 38 pp.nf74, Sept 21, 2005).

     renaud lp. Distinguished Scientist Award. Vasopressin: a Neuropeptide with multiple roles, from antidiuresis to neural
     regulation of monogamy. Clin Invest Med. 2006 Feb; 29(1): 48-54.

     Rockwood K, black se, Song X, Hogan DB, Gauthier S, MacKnight C, Vandorpe R, Guzman A, Montgomery P, Kertesz A,
     Bouchard RW, Feldman H. Clinical and radiographic subtypes of vascular cognitive impairment in a clinic-based cohort study.
     J Neurol Sci. 2006 Jan 15; 240(1-2): 7-14. Epub 2005 Oct 5.

     Richter TA, Kolaj M, renaud lp. Low voltage-activated Ca2+ channels are coupled to Ca2+-induced Ca2+ release in rat
     thalamic midline neurons. J Neurosci. 2005 Sep 7; 25(36): 8267-71.

     Roman GC, Wilkinson DG, Doody RS, black se, Salloway SP, Schindler RJ. Donepezil in vascular dementia: combined analysis
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     Heart and Stroke Foundation Centre for Stroke Recovery                                                    Annual Report 2006
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52
Site Leaders Committee
Dr. Antoine Hakim, Scientific Director
Dr. Sandra Black, Co-Director
Dr. Donald Stuss, Co-Director

Partners
Heart and Stroke Foundation of Ontario
Ottawa Health Research Institute
The Ottawa Hospital
The Ottawa Hospital Foundation
University of Ottawa
Rotman Research Institute, Baycrest
Baycrest’s Louis and Leah Posluns Centre for Stroke and Cognition
Baycrest Centre Foundation
Sunnybrook Health Sciences Centre
University of Toronto

Advisory Board of Directors
Mr. Martin Rothstein, Chair
Mr. Peter Cameron, The Garfield Group
Mr. Rocco Rossi, Heart and Stroke Foundation of Ontario
Mr. Stuart Schipper, Fallbrook Holdings Limited
Mr. James Morrisey, Ernst & Young
Ms. Laura Syron, Heart and Stroke Foundation of Ontario
Mr. Luc Vanneste, Scotiabank
Dr. Ron Worton, Ottawa Health Research Institute
Dr. Antoine Hakim, Ex-officio

External Scientific Advisory Committee
Dr. steven C. Cramer: Assistant Professor in the Departments of Neurology and Anatomy & Neurobiology
at the University of California, Irvine
Dr. bryan Kolb: Professor of Psychology and Neuroscience, Canadian Centre for Behavioural Neuroscience,
University of Lethbridge, Lethbridge
Dr. William Milberg: Associate Professor of Psychology in the Department of Psychiatry at Harvard Medical School,
and the Associate Director for Research of the Brockton/West Roxbury Geriatric Research Education and Clinical Center
Dr. rajiv ratan: Burke Professor of Neurology and Neuroscience, Weill Medical College of Cornell University and
Executive Director Burke/Cornell Medical Research Institute

Contact Us
Heart and Stroke Foundation Centre for Stroke Recovery
451 Smyth Road, Room 2411
Ottawa ON K1H 8M5
(613) 562-5800 ext 8299

                               www.heartandstroke-centrestrokerecovery.ca

								
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