Professor Sandra Black is a world-renowned physician and researcher recognized for her work in dementia and stroke diagnosis and treatment. She is a University of Toronto Professor of Neurology, and a senior scientist and program director of the Hurvitz Brain Sciences Research Program at the Sunnybrook Research Institute. Professor Black is also the executive director of the Toronto Dementia Research Alliance (TDRA), and held the inaugural Deborah Ivy Christian Brill Chair in Neurology at Sunnybrook Health Sciences Center and University of Toronto (2006-2017). In 2015, she was appointed as an Officer to the Order of Canada for her contributions to stroke and dementia research. Professor Black is internationally recognized particularly for work showing relationships between silent stroke and Alzheimer’s Disease.
We were fortunate to interview Professor Black and ask her questions about her research.
What is the most rewarding part of being a researcher?
One of the most rewarding aspects of being a researcher for Dr. Black is to be on the front line of new treatments and discoveries. For example, she does clinical trials, some sponsored by drug companies to test out new treatments for dementia, and some to repurpose existing drugs when they may be potentially useful in another disease, for which they were not initially intended. For example, some high blood pressure medications may be preferable for hypertensive Alzheimer’s Disease (AD) patients, so Dr Black is conducting a trial to compare the effectiveness of two commonly use blood pressure drugs that are equally good for hypertension control in slowing down brain shrinkage in AD. Dr. Black explained that as a researcher, you are always learning and collaborating with others to help understand mechanisms and improve care. She finds it rewarding to be able to “give back” adding new knowledge to the field and sharing it with others.
What is your latest research study about dementia?
Dr. Black is very optimistic about the future of dementia research and research for other mental and neurological conditions. She describes it as a very “interesting era” and an “exciting time” in dementia research. She is currently involved in a clinical trial that is investigating how to remove and slow amyloid protein depositing in the brain in people before they have any memory symptoms. Participants come in for a monthly infusion aimed at removing amyloid protein from the brain and preventing its accumulation, which can eventually lead to memory loss and dementia. It is a double –blind controlled trial meaning patients are randomized to active drug or placebo without anyone knowing which drug they are on, unless of course some problem arises.
How have you seen dementia treatment and research evolve in your years of working as a researcher?
At the beginning, Dr. Black explained how the focus of research was on learning the causes and components of the dementing illness, examining the proteins in the brain, and investigating the pathology. However, as the disease has become increasingly prevalent with an aging population, research and treatment has intensified and advanced. Dr. Black in collaboration with other research colleagues and radiologists helped developed an MRI protocol in her clinic long ago which allowed them to scan the brain and quantify brain shrinkage and also small vessel disease, which shows up as small strokes or as white spots and patches on MRI scans. Additionally, she has been involved in researching the genetic and hereditary side to dementia. There have also been advancements in using PET scans to see protein deposits in the brain that previously were only able to be seen at autopsy. Now, there is also research into vascular risk factors and lifestyle choices that contribute to the development of Alzheimer’s disease and stroke. For example, hypertension control is important for preventing dementia developing, and a history of a high level of physical exercise especially in teen age and through all the decades of life was found to be associated with better performance on cognitive tests, when those same people were assessed in their 80s.
Congratulations on receiving the Order of Canada for your research! Have you seen your research impact the way that dementia is diagnosed and treated?
Dr. Black explained that in the past, dementia research had been focused primarily on the amyloid protein, which deposits in the brain and can be associated with dementia. However, coming from a research background in stroke and dementia, Dr. Black wanted to better understand the role of other factors, such as the brain’s blood vessels, in developing dementia. She began to explore how the brain builds resilience and tries to combat the gradual loss of functional neural networks in neurodegenerative diseases such as Alzheimer’s by careful quantitative assessments of clinical and brain imaging in a research partnership with her memory clinic patients, also including genetics, and her team’s findings have influenced other research and treatment approaches earning her the well-deserved appointment to the Order of Canada.
Read more about Professor Black’s work:
