Medicine care team

Administrative Assistant: Marivel Magsino
Phone: 416-480-6100 ext. 64866
Email: Marivel.Magsino@sunnybrook.ca

Education:

• B.Sc., 1996, pure and applied science, York University, Canada
• PhD, 2002, neuroscience, University of Toronto, Canada
• MD, 2004, U of T, Canada

Appointments and Affiliations:

• Clinician-scientist, Evaluative Clinical Sciences, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute
• Director, Sunnybrook stroke research unit
• Medical director, North & East GTA Regional Stroke Program
• Associate professor, neurology, department of medicine, U of T
• Director, U of T Stroke Research Network
• Vice-chair of Research, Canadian Stroke Consortium

Research Focus:

• Cerebrovascular disease
• Vessel wall imaging
• Magnetic resonance imaging
• Stroke in pregnancy
• Stroke in the young
• Gerontology and neurodegenerative disorders

Research Summary:

As a clinical trialist with interest and expertise in large-scale, impactful clinical trials, Dr. Swartz been involved in field-changing studies, including the ESCAPE trial (demonstrating effectiveness of endovascular therapy for stroke), ESCAPE NA-1 trial (showing that neuroprotection may be possible in hyperacute stroke). He is the co-PI of the AcT trial (Alteplase compared to Tenecteplase) a CIHR-funded, pragmatic registry embedded RCT, and leads a cognitive outcome sub-study (AcT-Cog). Dr. Swartz is also the lead neurologist on the steering committee for the ROMA trial (an international cardiac surgery trial comparing outcomes with different surgical grafting techniques) and co-PI for the cognitive outcome sub-study (ROMA-Cog).

The long-term effects of stroke are not mediated through motor impairment alone. Thus, Dr. Swartz and his team explored the rationale for and barriers to identifying common comorbidities after stroke. He built a team of collaborators to address some of these barriers and, funded by HSF Canada (”post-stroke triage DOC: screening for Depression, Obstructive sleep apnea, and Cognitive impairment”), designed a novel evidence-based screening battery. The research team showed that screening can be performed in less than 6 minutes in almost all stroke prevention clinic patients and that the resulting data can help to rapidly categorize people into low- intermediate- and high-risk groups to facilitate both clinical care and research protocols. The DOC studies are not only important on their own; they also provide a mechanism to collect rich data on specific sub-populations, for example stroke in younger adults. The team has screened over 10,000 patients across 8 stroke centers to determine the utility of the screen for predicting clinically important outcomes (e.g. mortality, recurrent stroke, institutionalization), demonstrating success in large-scale data acquisition. They are now examining the heart-brain connection and the indirect impact of vascular disease on cognition by applying DOC screening in cardiac and heart failure clinics.

Through several team grants, Dr. Swartz is exploring the foundations of vascular cognitive impairment seeking methods to limit its impact and improve functional abilities with aging and after stroke. The Ontario Brain Institute Integrated Discovery Neurodegeneration Program ONDRI (Funded, PI: Strong; OBI; 2014-2018, $28.5 million) seeks to identify biomarkers (neuropsychological, imaging, genetic, ocular and gait) of neurodegeneration across multiple diseases and centres. Dr. Swartz helped to co-write the first phase grant and design the protocol, served on the executive of this team grant and led the Vascular Cognitive Impairment team, and now is the PI on the second phase of the project (Funded, PI: Swartz, Masellis, Munoz; OBI; 2018-2023) in which they have explored detailed endophenotyping of aging and neurodegenerative diseases, developed tools and linkages to study aging and neurodegeneration in the community with remote wearable monitoring and understand the impact of aging and neurodegeneration on individuals and health systems. This project builds on and complements Dr. Swartz’s independent research projects by collecting detailed, multi-modal data on a sample of patients and comparing these data across diseases. Similarly, Dr. Swartz also led the VCI component of the BEAM study (Validation of ocular measure as potential biomarkers for early detection of brain amyloid and neurodegeneration) (Funded, PI: SE Black, Brain Canada) and is collaborating on the Canadian Consortium on Neurodegenerative diseases and Aging (CCNA) VCI platform.

Selected Publications:

See current publications list at PubMed.

Related News and Stories:

• COVID-19 Brain Fog (November 2, 2021)
• How to care for those living with dementia during COVID-19 (April 1, 2020)
• SRI scientists top the national average in successful CIHR project grants: Over a dozen projects approved (June 2, 2017)
• Scientists capture tri-council funding: Operating grants support work in brain sciences and cancer research (July 15, 2014)
• Broken sleep heightens Alzheimer's risk (Aug. 30, 2013)
• Tick tick tick . . . time is brain (Oct. 29, 2010)
• Think Again: A pair of researchers approaches Alzheimer's disease with new perspective (SRI Magazine, 2008)

Related Links:

• Ontario Neurodegenerative Disease Research Initiative (ONDRI) 
• Depression, Obstructive Sleep Apnea & Cognitive Impairment (DOC)
• Alteplase Compared to Tenecteplase: QuICR & OPTIMISE Registry-linked Randomized Controlled Trial (acT)