Banking on research
The new Brain BioBank at Robarts Research Institute is home to a program that conducts detailed cognitive and behavioural testing on patients with a neurodegenerative disease and allows them to donate their brain tissue to research after death
By Ashley Rabinovitch
Dr. Elizabeth Finger traces her passion for cognitive neurology back to her neurology rotation in medical school, when she treated patients such as a young copywriter from Manhattan who was struggling to use the letters ‘j’ and ‘k’ correctly. Strangely enough, the patient turned out to have a small, benign brain tumour in his occipital cortex.
“This ability to make a connection between such a specific region of the brain really sparked my curiosity in how our more complex behaviours arise from brain activity,” reflected Finger.
During the next two decades, that curiosity blossomed into a high-impact career at the forefront of cognitive neurology. Finger joined the faculty of Schulich Medicine & Dentistry in 2007, attracted to the opportunity to use the School’s world-class neuroimaging technology in her research.
“There is still so much we don’t know about neurodegenerative diseases, but one of the most valuable sources of new information is brain tissue from patients who have died of a neurodegenerative disease.”
—Dr. Elizabeth Finger
Although she spent most of her early career using functional brain imaging to understand the neural basis of cognitive and behavioural issues like aggression, empathy deficits, and poor emotional regulation, she has since expanded her focus to unravelling the mysteries of neurodegenerative diseases like Alzheimer’s and frontotemporal dementia (FTD).
“I still remember the day a colleague invited me to attend a caregiver support group for family members of patients suffering from FTD,” remembered Finger. “They were so interested in learning about how my brain imaging work could make a difference for their family members. That was a pivotal moment for me.”
In the absence of proven treatments to stop or slow the progression of neurodegenerative diseases, Finger resolved to leverage her expertise to improve the quality of life for those who suffer.
“There is still so much we don’t know about neurodegenerative diseases, but one of the most valuable sources of new information is brain tissue from patients who have died of a neurodegenerative disease,” she explained.
“Clinicians can’t conduct brain biopsies on living patients because of potential morbidities, so the only chance of examining actual neurons in brain tissue in the lab is after the patient’s death.”
In Finger’s experience, family members of people suffering from neurodegenerative diseases, as well as the patients themselves, are highly motivated to help those who come after them.
With their support, Finger will join a group of colleagues at Robarts Research Institute, including Drs. Stephen Pasternak, Lee Cyn Ang, and Qi Zhang, to formally launch the Brain BioBank, a program that integrates detailed cognitive and behavioural testing and brain imaging from patients with a neurodegenerative disease and allows them to donate their brain tissue to research after death.
The Brain BioBank formally launched in September 2021, but a sizable number of clinical patients have already enrolled in the program.
Outside of the Brain BioBank collaboration, Finger is running at least a dozen projects related to neurodegenerative diseases. She and her team are in the thick of a multi-site clinical trial that tests how the hormone oxytocin, delivered by nasal spray, can boost pro-social behaviours and modulate aspects of emotional processing in patients with clinical dementia.
“In previous studies, we have identified a clear connection between oxytocin and brain activity, but now we’re trying to see if we can actually change emotional experience or behaviour,” Finger explains. “It’s exciting to see potential for treating symptoms even in the later-stage of neurodegeneration.”
Finger is also an active participant in the Genetic Frontotemporal Dementia Initiative (GENFI), a wide-scale research collaboration between researchers from Canadian and European institutions that follows patients and their presymptomatic family members in cases where there is a known genetic mutation that causes FTD.
During the past six years, Finger and her team have met with a number of local families in Southwestern Ontario to administer cognitive testing, behavioural questionnaires, and brain scans. “Our goal is to disentangle the complexity of early symptoms by measuring the first subtle changes in patients who carry a mutation,” she said.
Finger finds personal and professional satisfaction in helping the loved ones of patients with neurodegenerative diseases understand and cope with their family member’s condition.
“On the flipside, that satisfaction has its limits because we still don’t have many, if any, effective treatments,” she acknowledged.
As she continues to push the bounds of research in collaboration with her colleagues and students at Robarts, her vision is clear: “I want to remain on the front lines of the fight to treat and cure neurodegenerative diseases. Every day, we move a little closer toward the goal of making life better for the next generation of patients.”
