“The brain is everything”

Five questions for Donald Stuss, president and scientific director of the Ontario Brain Institute by Jenny Hall

Donald Stuss is a professor of psychology and medicine at the University of Toronto, where he holds the title University Professor — the highest honour U of T bestows on its faculty — and a senior scientist at Baycrest’s Rotman Research Institute.
A pioneer in the study of the frontal lobe, he’s recently taken the helm of the newly-formed Ontario Brain Institute (OBI), where he serves as president and scientific director. Here, he’s tasked with coordinating and accelerating brain discovery
and innovation in Ontario, which is home to more brain scientists than any other jurisdiction in Canada.

Why is research into the brain important?

The brain is everything. It’s important for two major reasons. First, if you want to optimize people’s quality of life, it will come primarily through the quality of their brain function. That’s true whether they’re healthy or have disorders. Second, there
is no greater cost to society, both direct and indirect, than the cost that’s incurred
by brain disorders.

Why is the creation of the OBI important? 

The OBI is integrating basic research into care, and patient advocacy groups
into research, so research discovery will have much more rapid impact on
patients. OBI will bring industry to the table to accelerate cures and discovery. And because it works across institutions, it will maximize the impact of research.

I’ll give you an example. Say researchers are going to look at the genetics of Alzheimer’s disease. They used to study a group of 100 or 200 patients. Now researchers are publishing studies looking at 8,000. If Ontario wants to be a
leader, it has to increase the number of patients in its studies. OBI can help with
that by having researchers and clinicians work together.

What are your goals?

In this initial stage of development of OBI, we are starting with three diseases: cerebral palsy, epilepsy and neurodevelopmental disorders. That last one is a category that includes autism, attention deficit disorder, obsessive compulsive disorder and intellectual disability.

It will be important to extend these programs to other brain disorders, both neurological and psychiatric.

The idea is that a disease is not just a single thing. What is the relationship between autism and attention deficit disorder, for example? There are relationships between them — some are behavioural, some are genetic. We are setting up the system so we can actually start to look at the relationships across diseases. This system will also enable us to study how the underlying mechanisms influence the initiation and progression of disease.

The integrative nature of the data is key. The comprehensiveness of our data will provide the power to understand these relationships. And it may be that a cure or a treatment will be found for five per cent of the population, but you would never find it without having tested the entire population to find that five per cent.

So is the goal a cure for some percentage of the population? 

Goal number one is treatment — improving the quality of life for individuals and families. But if you set up the discovery system properly so you’re studying the mechanisms of disease, you can potentially also look for something that stops the development of the disease — or significantly slows its progression. The OBI is getting people to work together across the province, across disciplines, across institutions. We’re combining data. We’ll be able to ask things in the future that we don’t know to ask now. Because we’ve set the data up properly, we’ll actually be able to go back to it in the future. And as our understanding of diseases unfolds, people will be able to ask more and better questions.

How much do we understand about the brain right now?

A lot more than we did a long time ago. But do we know enough? No. We need to know a lot more about the brain itself — and then apply that knowledge to more fully understand brain disorders.