Dr. Guy Rouleau, Director of The Neuro (Montreal Neurological Institute-Hospital), sits at the desk once used by Dr. Wilder Penfield, the pioneering neurosurgeon who founded the institute exactly 90 years ago.
“It’s inspiring to sit there and look back at the history of The Neuro, and how it all started with Penfield,” Rouleau said.
It was Penfield who convinced the Rockefeller Foundation to fund a ground-breaking institute on the side of Mount Royal that would bring together clinicians and scientists from different disciplines, bridging the gap between laboratory research and patient care.
Marrying fundamental research and clinical neuroscience
“The worlds of research and medicine are completely different and often there is not a lot of exchange between the two. This was especially true in the 1930s,” said Rouleau. “Penfield’s vision to marry clinical neuroscience and fundamental research was groundbreaking.”
Suitably inspired, the Rockefeller Foundation donated $1.2 million – one of its largest grants at the time – for the creation of the Montreal Neurological Institute, which opened its doors on Sept. 27, 1934.
Over the past nine decades, The Neuro has become a world leader in neurological research and clinical care. It has consistently made history with groundbreaking contributions to our understanding of the brain and nervous system not only by Penfield, by also by such luminaries as Dr. Herbert Jasper and Brenda Milner.
One of the biggest, one of the best
Today, The Neuro is Canada’s largest clinical and research centre specializing in neuroscience and one of the largest in the world, with 1,500 multidisciplinary staff members and trainees, including faculty members, clinician scientists, neurosurgeons, neurologists, neuropsychologists, nurses, allied health professionals, clinical trainees, master’s and doctoral candidates and post-doctoral fellows.
Research teams and clinical programs are pushing for breakthroughs in neurological disorders ranging from epilepsy, Alzheimer’s disease, brain tumours and multiple sclerosis, to stroke, Parkinson’s Disease and neuromuscular diseases.
The Neuro delivers exceptional care to thousands of patients and is a critical referral centre for the most challenging neurological pathologies and for patients lacking definitive diagnoses. In 2022, there were more than 35,000 outpatient clinic visits, 1,900 hospital stays, more than 25,000 diagnostic scans and 3,729 surgical procedures.
Don’t mess with success
The secret to such prolonged success? Don’t stray from Penfield’s blueprint.
“We’ve been nurturing this unique synergy for 90 years,” said Rouleau.
Among The Neuro’s most important innovations is the McConnell Brain Imaging Centre (BIC), widely recognized as one of the world’s premier neuroimaging centres, and an example of successfully combining research and clinical practice. One of the largest, multimodal brain imaging service platforms in the world, and the largest in Canada, the BIC is dedicated to advancing our understanding of brain functions and dysfunctions, as well as to the treatment of neurological diseases with imaging methods.
Rouleau points to partnership with patients as an essential driver of The Neuro’s activities, with the majority of patients participating directly or indirectly in the research projects.
“If a patient has a problem, we go to the lab or the bench to try and fix it. When you figure out something you go back to the patient.” said Rouleau. “Patient care is at the core of everything we do.”
Setting sail
Dr. Maiya Geddes illustrates what it means to be a clinician scientist. Geddes is a neurologist scientist at The Neuro, Killam Scholar and an Assistant Professor in the Department of Neurology and Neurosurgery at McGill. She is also a clinician who works primarily with patients who have cognitive and behavioural disorders.
Asked how her lab and clinical work inform one another, Geddes, quoted another eminent member of the McGill medical community, Dr. William Osler, who famously said, “To study the phenomena of disease without books is to sail an uncharted sea, while to study books without patients is not to go to sea at all.”
“It’s the difference between looking at maps and sailing,” said Geddes. “At some point you have to actually hit the water.”
The Geddes Lab for Motivational Neuromedicine is a cognitive neuroscience research program focused on understanding the neurobiological mechanisms underlying motivational resilience and vulnerability in aging and Alzheimer’s disease. Her lab combines cutting-edge behavioral and multi-modal neuroimaging techniques, including machine learning methods.
In addition, she designs and leads innovative behavioural clinical trials with the goal of enhancing the adoption of healthy lifestyles to prevent dementia.
Translational research
“There is data from the Canadian Longitudinal Study on Aging that suggests we could prevent or delay up to 50 per cent of new dementia cases with changes in lifestyle,” said Geddes. “My research is translational, focusing on ways to motivate older adults to better adhere to beneficial behaviours.”
“Merging disease prevention with treating pathology is critical,” she said. “In medicine, we often focus on vulnerability; we usually see people in times of crisis. But think about the enormous benefit to the population if we could prevent dementia and cognitive impairment in aging.”
The fertile confluence of clinic and lab inspires Geddes, who said every time she works with patients she gets ideas for new research projects.
“You don’t know what the questions and problems are unless you are in the clinic, in the emergency room or in the hospital seeing it play out in real time. Back at the lab, my job is to answer those questions and solve those problems,” she said.
History in the hallways
Geddes is in the early stages of her career, and she appreciates the people who have blazed the trail before her.
“There’s something very beautiful about walking into The Neuro and seeing the foyer, the first floor,” she said. “There’s an historical connection, a connection between past and future, which makes this place so special,” she said.
And, of course, there are the people.
“Hands down, the best thing about working here is the people: the patients, the students and the collaborators,” said Geddes. “Working with people who are excited about what they do is energizing. We spark each other’s creativity.”
For Rouleau, too, it’s the people who make the place:
“I work with some of the very best scientists and doctors in the world who are doing amazing things. Our staff is incredibly dedicated. We are a diverse group, but in the end we’re all working toward the same goal: to help our patients.”
Visit The Neuro’s anniversary website.