Dr. Krista Lanctôt leads a large interdisciplinary research team whose work has focused on understanding how neuropsychiatric symptoms, such a mild cognitive impairment and mood disorders, interfere with cardiac rehabilitation. The overarching theme of her work is to understand the neurobiologic basis of these symptoms as risk factors for poor response, and use this information to develop targeted interventions. For example, her work has shown links between these symptoms and inflammation, oxidative stress and lipid aberrations. Dr. Lanctôt's team uses a variety of tools including neuroimaging, lipidomics, pharmacogenetics and neuropsychiatric assessments to unravel the link between dysfunction in various cellular and molecular processes and manifestation of these symptoms in a cardiac rehabilitation population. In addition, her group has run clinical trials of dietary, pharmacologic and exercise interventions for these symptoms.

Each year tens of thousands of Canadians are diagnosed with coronary artery disease (CAD) which poses a serious risk to their health and well-being. Depression and associated symptoms of cognitive impairment are common neuropsychiatric symptoms in CAD and have a major negative impact on treatment outcomes and life expectancy. Dr. Lanctôt's work has also shown their negative impact on cardiac rehabilitation outcomes. Understanding the neurobiology of these symptoms may allow us to predict response to cardiac rehabilitation and, on a broader level, may lead to the development of novel therapies.
 

Exercise as a Primer for Excitatory Stimulation Study in Vascular Cognitive Impairment No Dementia (EXPRESS-V)

Study Status: Active
Study Purpose: The purpose of this study is to compare the effects of exercise and brain stimulation on memory performance in patients at risk of cognitive decline and enrolled in cardiac rehabilitation.
Background: People with vascular conditions are at risk of having memory problems, and these memory problems increase the risk for further cognitive decline. Brain stimulation has been used to improve mood and memory. Transcranial direct current stimulation (tDCS), a type of brain stimulation, is believed to work best on brain cells that are active or “primed” before stimulation.
Study Methods: Participants must be 50 years of age or older. Participants are randomly assigned to either an exercise therapy or non-exercise control group. If randomized to an exercise group, participants will exercise at Toronto Rehab every weekday for 2 consecutive weeks and receive tDCS following each exercise session. If a participant is randomized to a non-exercise controls group, their tDCS sessions will be held at Sunnybrook every weekday for 2 consecutive weeks. The study also involves a screening/baseline visit, an end-of-study visit and a 1-month post-study visit. During these 3 visits, participants’ blood is drawn and they complete a cognitive assessment.
Health Conditions: Diabetes,Heart disease and disorders,Veins, Blood vessel disorders

 

Memory and Antioxidants in Vascular Impairment Trial (MOVE-IT)

Study Status: Completed
Study Purpose: Our study investigates whether the antioxidant supplement, N-acetylcysteine, is a safe and effective therapy to improve cognition in patients with heart conditions and early memory problems.
Background: People with coronary artery disease are at risk for developing memory problems. As people age, their brains can be affected by oxidative stress and reduced levels of glutathione. Glutathione acts as an antioxidant to protect cells from this damage. Studies show that N-acetylcysteine (NAC), which boosts glutathione, can help protect cells from oxidative stress. Our results may help answer the question of whether NAC, a safe and widely available health supplement, can delay the onset of dementia.
Study Methods: Participants must be aged 55 – 80 years old with coronary artery disease. Patients will be randomized to receive either NAC supplements or a placebo for 24 weeks while participating in a supervised exercise program. They will complete cognitive tests and mood questionnaires at the start and end of the study to compare the effects of NAC. Blood will be drawn and a magnetic resonance imaging (MRI) brain scan will be completed.
Health Conditions: Diabetes,Heart disease and disorders,Veins, Blood vessel disorders

 

Combining Exercise and Brain Stimulation to Improve Memory: The EXACT Study

Study Status: Active
Study Purpose: This study looks at whether combining physical exercise with electrical currents applied to the brain (transcranial direct current stimulation) can help improve memory in people with mild cognitive impairment and mild Alzheimer’s Disease.
Background: Mild cognitive impairment and Alzheimer's Disease are conditions that involve memory difficulties. Transcranial direct current stimulation is a type of brain stimulation. It may help improve these memory difficulties. However, it works better on active brain areas. This study looks at if combining exercise and applying current to important parts of the brain can help improve memory in people with Mild Cognitive Impairment or Alzheimer's Disease.
Study Methods: Eligible participants will be randomly put into one of 3 groups: 1. Exercise and transcranial direct current stimulation 2. Usual Treatment and transcranial direct current stimulation 3. Exercise and sham transcranial direct current stimulation Participants in an exercise group will undergo exercise, followed by either sham or active transcranial direct current stimulation. People who are randomly put in the usual treatment group will get written information about exercise from the Canadian Physical Activity Guidelines for older adults. They will also receive the same amount of transcranial direct current stimulation as the other groups. Memory and behaviour will be measured. Blood samples for biomarker testing will be collected.

 

For a list of Dr. Lanctôt's publications, please visit PubMed or Scopus.
Affiliate Scientist, KITE (TRI)

Senior Scientist, Evaluative Clinical Sciences, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute
Director, Neuropsychopharmacology Research Program, Sunnybrook Health Science Centre
Professor, Department of Psychiatry, University of Toronto
Professor, Department of Pharmacology and Toxicology, University of Toronto
Full Member, School of Graduate Studies, University of Toronto
Executive Director, MORE research group, Sunnybrook Research Institute