Robert Bartha hopes his latest research will allow him to travel back in time when it comes to aggressively attacking neurodegenerative diseases such as Alzheimer’s, ALS and Parkinson’s.
“Our ultimate goal is to try to find ways of early diagnosis. Understanding what’s changing in the brain allows us to start looking back in time,” said Bartha, a Medical Biophysics professor in the Schulich School of Medicine & Dentistry. “If we can identify markers of a disease, whether it be imaging, genetic or cognitive – or some combination of those – it will allow us to possibly predict five or 10 years before somebody goes on to get symptoms of a neurodegenerative disease, and potentially, intervene.”
Bartha will lead the imaging platform of the Ontario Neurodegenerative Disease Research Initiative (ONDRI) Integrated Discovery Program, which aims to understand the commonalities and distinguishing characteristics of five neurodegenerative disorders: Alzheimer’s, Parkinson’s, ALS, frontotemporal lobar dementia and vascular cognitive impairment.
Along with the Robarts Research Institute, more than 20 participating clinical, academic and research centres in Hamilton, Kingston, Ottawa and Toronto are taking part in the study, the first of its kind in the world to collect large amounts of data on a spectrum of neurodegenerative disorders.
“It’s the most complex long-term observational study in the world,” said Schulich Dean Michael Strong, who is heading up the provincial program. “It brings together a large group of more than 50 investigators from across the province of Ontario, four patient advocacy groups and the industrial sector. No one else is putting this all together – the commonality of these neurodegenerative diseases – which makes this tremendously unique.”
ONDRI aims to enrol 600 participants across the province in 2015 who will participate in an array of assessments. These include magnetic resonance imaging and positron emission tomography brain scans, eye tracking, blood and gait analysis and cognitive testing.
All of the collected data is being entered into a central database expected to answer a variety of different research questions related to diagnosis and treatment of these disorders.
“Being able to correlate these structural and functional brain changes, with these other measures of disease progression, is completely new, and we will be doing it across different diseases in a standardized way, following patients over time,” said Bartha, whose lab focuses on early onset Alzheimer’s. “We will be able to pinpoint the differences – and similarities – between the neurodegenerative diseases. This vast amount of data will become an important resource for scientists to answer a variety of different research questions, which will ultimately improve diagnosis and lead to better treatments.”
While not all centres are up and running yet, Bartha added some early imaging results are complete. And he likes what he sees.
“It’s looking really good,” he said. “I’ve never been part of something this significant before, something that has this much detailed information available. And with this study, there is going to be so much data. That’s never a bad thing but, at the same time, you have to start thinking carefully how you’ll manage that, who are the best people to start looking at the data and what are the important questions we want to be asking.”
The Ontario Brain Institute (OBI) will invest $19 million in new funds during the next five years to fund ONDRI. Partner institutions and donations will contribute another $9.5 million to the program, bringing the total investment to $28.5 million.
Donald Stuss, OBI scientific director and University of Toronto psychology and medicine professor, said there’s an ever-growing need for high-quality research focused on neurodegenerative diseases and ONDRI takes traditional research to the next level.
“Just think of it, breaking down silos, not just between the institutions and researchers, but between diseases. This is a unique group and initiative,” Stuss said. “ It’s a new way to look at the complexity of the diseases for each person – a person-centered approach. It’s turning convention on its head. Instead of studying what’s unique, you study what the common thread is.
“It’s important with neurodegenerative disorders to find if there might be more similarities between these diseases than there are differences, and we need to know that. This is research that will have an impact.”
Bartha added while you can search, and find, mounds of research data on individual neurodegenerative diseases, what hasn’t been done before is this type of standardized cross-sectional analysis.
“We’re going to make direct comparisons between the different groups and really come to understand what’s the same and what’s different,” he said. ”The benefit being is, if you start to understand where the disease is happening, what is the process, what is the timeline and how they compare, you can act.”
The question, added Bartha, is, right now, can we intervene? The answer is not very well.
“In these cases, we don’t have the drugs. But I think what’s important to understand is once we know more about what the changes are – and what they are over time – we can start testing drugs affectively,” he said. “Using these markers in clinical trials, with new drugs, is really important. Right now, most of the drugs that have been tried have been tried very late in the disease, when there is a huge amount of neurodegeneration in the brain. Having any impact at that point is very difficult.
“What we need to do is to start drugs earlier on, when the disease process is just starting. That’s when I think it will have a real effect. But we need to know what to look for first.”
Bartha said he is thrilled to be playing a role in such a large and intricate project which, while still in its infancy, is already seeing collaborations being made.
“This is kind of a new era of research, in a way, where we’re doing these large scale studies and pooling all the data for so many to use,” he said. “The hardest part is starting it, but once it gets rolling it will be an enormous resource. It will just keep building and building.”