PI: Heather Tulloch
Co-PI: Helen Robert

Spontaneous Coronary Artery Dissection (SCAD) is a serious condition that causes heart attacks. It primarily affects young women without traditional risk factors like high blood pressure. Our research has shown that women with SCAD face higher rates of mental health challenges, such as anxiety and depression, compared to men with SCAD. These mental health issues can complicate recovery and worsen heart health.  Cardiac rehabilitation programs often do not address the unique challenges faced by women, particularly those with SCAD. Many women struggle to participate due to barriers like caregiving responsibilities and difficulties managing anxiety related to their heart condition.  To address these needs, we bring together an international team of diverse women who have experienced SCAD and healthcare experts and trainees, including psychologists, cardiologists, and nurses. First, we will analyze new data on the psychological symptoms and needs of diverse women with SCAD, review the research on interventions for women and chronic disease, and survey patient and clinical experts on potential intervention components. Next, we will bring together patient and clinician experts to create a tailored psychological intervention for women with SCAD, including a facilitator guide and patient workbook. We will then plan for pilot testing of the intervention.   

PI: Peter Liu

Co-PIs: Jillianne Code; Marc Bains

The PATIENT FOCUS study aims to understand how patients, caregivers, and healthcare providers work together to shape research priorities in brain and heart health. Brain and heart conditions, like heart failure and stroke, often occur together and share common risk factors, yet research and care for these conditions are often disconnected. This study focuses on a Priority Setting Partnership (PSP) protocol, which brings patients, caregivers, and researchers together to identify the most important questions that need answers in brain-heart health.  Unlike other projects that simply carry out the PSP, this study examines how participating in the process affects patients' abilities to contribute to research and make their voices heard. We want to learn how patients' knowledge, experiences, and confidence (called "agency") grow through their involvement. We also aim to find ways to improve the PSP to make it more inclusive and impactful.  The insights gained will help guide future research in brain-heart health, ensuring it focuses on the needs of patients. Additionally, this work will benefit initiatives and organizations like the Brain-Heart Interconnectome (BHI) and HeartLife Foundation by strengthening patient engagement strategies and building partnerships between patients, researchers, and healthcare providers to improve care and outcomes.

PI: Christopher Sun

Co-PIs: Gordon McGregor; Nancy Myers

Mental and brain-related disorders like depression, dementia, schizophrenia, and ADHD are often hard to diagnose, relying heavily on patient self-reports and clinician judgment. This can lead to errors, delayed treatment, and worse outcomes. Meanwhile, studies suggest there is a strong connection between the heart and brain health. Changes in heart rhythms (measured by an electrocardiogram [ECG]) may offer subtle clues about underlying mental conditions.    This research will use data from the University of Ottawa Heart Institute and The Royal Ottawa Hospital to link ECG records with verified mental health diagnoses. By applying advanced artificial intelligence (AI) methods to these combined datasets, we aim to identify ECG patterns that predict who is at risk for certain mental and neurological disorders, well before they would typically be diagnosed. This will help create a trustworthy, easy-to-use diagnostic tool that can improve early detection, guide clinicians, and ultimately lead to better patient care.    More broadly, this project aims to strengthen collaboration between UOHI and The Royal and lay the foundation for a long-term brain-heart AI research program.

PI: Michel Shamy

Co-PIs: Gary Boon; Yan Xu

Patients need to give informed consent to participate in research. However, long and complex consent forms can make this difficult. This challenge is greater in research for brain and heart interconnected conditions that arise suddenly like acute stroke, myocardial infarction and cardiac arrest. These conditions render patients incapable of consenting for themselves, and treatment must occur quickly. Research design involving heart and brain conditions is improving, and new methods like platform adaptive trials can provide faster results by testing multiple treatments at once. However, these new designs also create more challenges for getting informed consent.  This project aims to understand the best way informed consent can be collected in platform adaptive trials for brain and heart emergencies. The team will learn from patients, caregivers, and experts to find out what important information researchers should share for consent to be truly informed and how best to do this. Participants in a stroke platform adaptive trial will be surveyed about their experiences giving consent. The goal is to create guidelines and a consent template for researchers and ethics review organizations across the country. While this work focuses on stroke, it is also applicable to emergency heart conditions and many other scenarios.  

PI: Vignan Yogendrakumar

Co-PIs: Andre Lafrance; Mireille Ouimet

An ischemic stroke occurs when a blood vessel in the brain is blocked by a clot. Patients who have had a stroke are at risk of both another stroke and new heart disease. As such, doctors routinely organize extensive testing with hopes of identifying the underlying cause of stroke to inform future treatments. Yet, in many instances doctors cannot identify the cause and are unable to optimize preventative treatments. This uncertainty leaves patients feeling frustrated and anxious about the possibility of experiencing another stroke or heart attack. By studying the blood clots that cause a stroke, we may better identify the cause of disease and improve our ability to predict the risk of heart disease or stroke. In the PROSPER pilot study, we will collect clots from patients who have presented to hospital for emergency stroke care. These clots will be analyzed using next-generation technologies and we will follow participants for up to a year to determine which type of clots are associated with the highest risk of stroke or heart disease. This information can then be used to develop new medications and personalized treatment, with the aim to prevent future stroke, heart attacks, or heart failure. 

PI: Jennifer Reed

Co-PIs: Ann-Marie Julien; Natalia Jaworska

Brain health can change across the lifespan through damage/deteriorations to brain structures, declines in brain function and cognitive processes with age, and worsened mental health. These processes are key contributors to disability and one of the leading causes of death worldwide, with women disproportionally more affected by certain brain conditions than men. Heart disease, which is the leading cause of premature death in Canadian women, also increases the risk of developing brain conditions, likely due to brain-heart coupling. Aerobic exercise may prevent brain health declines. Yet, the effect of different exercise intensities and strategies remains unclear. This project aims to assess the effect of different types of exercise (3x/week, 12 weeks, high-intensity-interval training [HIIT] vs. moderate-intensity continuous training [MICT]) on brain activity in areas involved with memory and learning (i.e., hippocampus and frontal-cortex mediated functions), cerebral blood flow, neurocognitive function, and cardiac function. We hypothesize that HIIT will lead to greater improvements in these outcomes compared to MICT. Our proposal will leverage the resources of a recently launched RCT assessing virtually-delivered exercise programs for women with heart disease. This proposal includes patient partners, Indigenous engagement strategies, and knowledge translation (KT) activities including patients, healthcare professionals, caregivers, researchers, and community members.

PI: Georg Northoff

Co-PI: Sarah Cantin

Music is a powerful stimulus which affects the mind (mood/emotions, thoughts), brain (neuronal speed), and heart (variability). Therefore, music is an ideal therapeutic intervention for brain-heart conditions, including depression and anxiety where brain-mind are too slow (depression) or too fast (anxiety) while the heart is abnormally variable. However, results of music therapy are mixed showing high inter-individual variability. To achieve better and especially immediate therapeutic benefits, we propose a novel patient-centred and brain-heart-based precision music intervention for depression/anxiety in both mental and heart/cardiac disorders. The speed of the subjects' preferred music pieces will be manipulated both slower and faster; together with the original, their effects on the subjects' brain electrical waves (EEG), heart activity (ECG), and emotions, thoughts and movements will be measured. These combined heart-brain-mind results serve to determine the subject's optimal speed for each piece; the selected pieces will then be included in a playlist for therapeutic intervention (2x day for 10min with assessment of immediate effects on emotion, thoughts, and movement). Mid-term effects on depression and anxiety severity will be determined after 3 and 6 weeks. This protocol is based on successful pilot data showing 30-50% immediate reduction of depression/anxiety symptoms after a single personalized music intervention.

PI: Mehrdad Golian

Co-PI: Tesia Ann Kennedy

This project focuses on vasovagal syncope (VVS), a common condition that leads to sudden, temporary loss of consciousness, often resulting in falls and reduced quality of life. VVS happens due to reduced blood flow to the brain and is linked to misguided autonomic cardiovascular responses. Although generally considered harmless, frequent episodes can require treatment, including invasive procedures like pacemakers. Key mechanisms that trigger VVS include the baroreceptor reflex and hyperactive heart response to brain input, which regulates heart rate and blood pressure, and central serotonin pathways, although the latter's connection to VVS is not well established. This study aims to assess the effectiveness of cardioneuroablation (CNA), a novel technique that involves using focused and deliberate radiofrequency energy delivery to target culprit nerve groups in the heart, potentially reducing the occurrence of syncope without need for a pacemaker. By evaluating a sham-controlled CNA in patients with recurrent reflex syncope, the study aims to establish CNA ablation globally as a viable alternative that could improve patient outcomes and satisfaction by decreasing the frequency of syncopal episodes without needing a pacemaker for life.

PI: Karen Bouchard

Co-PI: Jenny Milne; Kerri-Anne Mullen

The World Health Organization has declared that loneliness (i.e., a feeling of isolation/disconnection, even when surrounded by others) is one of the greatest contemporary threats to health and wellbeing. The highest rates of loneliness are observed among those who are <55 years of age and who are confronting a chronic condition. Heart failure (HF) is a rising epidemic that results in high burden of physical and emotional symptoms. How loneliness is experienced by those who are facing early onset HF, particularly those who are from diverse communities, has been unexplored. Understanding loneliness in this population would help to address two urgent public health crises in tandem. Using a Canada-wide survey and interviews with people with HF, we will: characterize loneliness among adults (<55 years) with HF; identify factors associated with loneliness; and, explore experiences of loneliness and potential supports to alleviate it. A Steering Committee, involving patients with HF, will guide the research program and activities. We will use the results from this study to develop a patient-informed and culturally-relevant 'program' targeting loneliness. The program components, including the context of delivery, content, dose, timing, and outcomes of interest will be determined at a 'co-design event' following completion of this study.

PI: Erin Mulvihill

Co-PI: Josee Chenier

This project was co-developed with Josée Chénier, a patient partner living with diabetes who is also going through perimenopause. Josée shared her personal struggles during this hormonal transition, including poor sleep, unintended weight gain, memory issues, and challenges managing her diabetes. She also expressed concerns about how these changes might increase her risk of heart and brain diseases.  Josée's experiences reflect what many women face during menopause. Hormonal changes can lead to weight gain around the abdomen, insulin resistance, sleep problems, and low-grade inflammation, all of which raise the risk of heart disease and the dysregulated metabolism may increase neuroinflammation linking to brain conditions like Alzheimer's. Despite these risks, there are no treatments specifically designed to protect menopausal women from these health issues.  Diabetes medications like GLP-1 receptor agonists (e.g., Ozempic) have shown promise in reducing inflammation, improving insulin resistance, and protecting the brain. Newer drugs, such as tirzepatide (e.g., Mounjaro), might offer even greater benefits. Inspired by Josée's insights, this research will use a mouse model of menopause combined with sleep disruption to explore whether these therapies could protect female's hearts and brains during menopause, addressing a significant gap in women's health care.  

PI: Michael Schlossmacher

Co-PIs: Sarah Jane Batten; Juan LI

Timely access to diagnosis, treatment and specialists is a major challenge in our healthcare system, with delays negatively impacting individuals with Parkinson disease (PD) and those with other brain disorders. We recently developed a simple-to-use prediction tool ("PREDIGT2.0") to measure PD risk. Our ultimate goal is to empower family doctors to confidentially initiate treatment for PD before the initial assessment by a neurologist. PREDIGT2.0 includes a self-reported questionnaire and simplified smell test[1-3]. We piloted it in 162 study participants and found that it differentiated PD from healthy subjects and from other neurological conditions with 97% and 81% accuracy, respectively[4]. While promising, we seek to improve its accuracy to differentiate PD even better with a second biomarker. Cardiac abnormalities represent such a marker. Orthostatic hypotension[5-7] and reduced heart rate variability[8-10] represent features of Parkinson's; they may occur either silently, or noticeably impact patients. Both parameters can be measured easily.  We hypothesize that their integration into our existing PREDIGT2.0 model will improve the differentiation of PD versus other neurological diseases (->"PREDIGT3.0"). This, to ultimately empower family doctors to begin routine treatment for PD with confidence, based on easy-to-obtain results. We have the team, necessary resources and community engagement to test this hypothesis.  

PI: Greg Silasi

Co-PIs: Kareen McCaughan; Angela Auriat

Growing evidence suggests an association between cardiovascular disease (CVD) and cognitive impairment. Cardiac-emboli are a proposed mechanisms linking heart disease and brain function. Cardiac-emboli are small occlusions that form in the heart and travel throughout the body, blocking blood flow in smaller vessels. The occlusions which end-up in the brain can result in covert lesions, which occur without obvious symptoms but impair cognition as they accumulate.  Women undergoing menopause transition have a significant increase in the risk of developing CVD. Despite the clear impact of reproductive aging on women's health, most pre-clinical CVD research is completed in male animals and even fewer studies address menopause. We will utilize a pre-clinical mouse model of cardiac-emboli, by injecting small microspheres, that can be localized throughout the body. Using advanced imagining, we will track how cardiac-emboli alter brain function, and we will relate these to cognition. We will address the importance of age, sex, and menopause, comparing brain injury and cognition across groups. Individuals living with CVD have highlighted the impact that cognitive decline has on their quality of life. Understanding how cardiac-emboli affect brain health is an important step towards improving the lives of CVD patients.    

PI: Paul Albert

Co-PIs: Catherine Goodenough; Ruth Slack

The brain serotonin system touches all parts of the brain.  Reduced serotonin leads to anxiety, depression, and loss of memory with increasing age.  Heart disease often leads to depression, and Alzheimer's disease causes loss of memory, but the role of serotonin is unclear.  We hypothesize that heart and Alzheimer's disease lead to loss of serotonin, which impacts both the brain and the heart. We predict that novel antidepressants that mimic serotonin can reverse depression, improve memory and help to improve heart health.  In BHI mouse models of heart failure and Alzheimer's disease, we will examine brain serotonin networks, heart function, and behavior over time.  We will treat these mice with antidepressants that target the serotonin system to see if serotonin networks are rescued.  We expect that both heart and Alzheimer's disease mice will show increasing anxiety and depression that may precede loss of memory.  A loss of serotonin networks will also occur over time.  Antidepressant treatment will reverse the loss of serotonin, and improve behavior and memory.  These studies will provide a path to new treatments that can protect the brain from heart disease and may reverse the decline in brain and heart function occurring as Alzheimer's disease progresses.

PI: Kyoung-Han Kim
Co-PI: Sailendra Sarma

People living with neurodevelopmental conditions, such as autism spectrum disorder (ASD), are more likely to have irregular heartbeat and other heart conditions, including those that decrease function. Meanwhile, individuals born with congenital heart disease later receive autism diagnoses at rates well above the population average. These bidirectional links suggest shared biological pathways between the brain and heart. 

Research shows that the brain and heart communicate through various pathways, including blood pressure and hormones like adrenaline. However, the genetic mechanisms linking neurodevelopmental conditions and abnormal heart rhythms remain largely unknown. 

In our recent study, we identified several new genes that are expressed in both the heart and brain and are associated with ASD, suggesting that the same genetic factors may be responsible for health issues in both organs. When expression of these genes is disrupted, it may disturb both brain signals and heart rhythm. Building on these findings, our proposed study will investigate how these shared genes and pathways influence both heart and brain function. By doing so, we hope to uncover new strategies to prevent and treat these interconnected conditions.

PI: Rebecca Robillard

Co-PI: Ilona Skerjanc

Concussions often result in insomnia, which can in turn alter brain and heart functions. There are some indications that treating insomnia can lead to better post-concussion recovery. This project aims to create and evaluate a digital self-help tool to deliver cognitive-behavioral therapy for insomnia tailored to people with persisting post-concussion symptoms. This sleep intervention will be co-developed with patients.   70 participants with post-concussion insomnia will test the sleep intervention through a six-week program. Their brain and heart activity will be measured during sleep at home with user-friendly portable monitors before, during and after treatment. Advanced analyses will evaluate how changes in brain-heart functions at different steps of the treatment may relate to reductions in insomnia and post-concussion symptoms.    Results will be shared through national networks and social media campaigns to help people who experienced a concussion and their healthcare providers understand how restoring sleep may help recovery. After the study, the intervention will be made available for free. Ultimately, the project aims to facilitate recovery by offering accessible, evidence-based sleep treatments adapted to brain and heart challenges following concussions.