Training tomorrow's top talent

KITE's focus on innovation and collaboration is helping a new crop of researchers develop cutting-edge strategies that will lead to patients living more fulsome lives.

Dr. Jennifer Campos knows it's her job to support a very special group. She oversees some of the world's most accomplished scientific trainees, who are all devoted to furthering rehabilitation research that will improve the lives of aging Canadians and those who have experienced an illness or injury.

“The calibre of KITE trainees is extremely high,” says Dr. Campos, Canada Research Chair in Multisensory Integration and Aging, and the Chief Scientist of the Challenging Environment Assessment Laboratory at KITE. “And it's truly unique and exceptionally valuable to have trainees from so many different and complementary disciplines working together and learning from each other under one roof.”

KITE, the research arm of the Toronto Rehabilitation Institute, is truly interdisciplinary. Scientific trainees include biomedical engineers, computer scientists, kinesiologists, psychologists, health policy researchers and nurses, leading to unique collaborations not often possible at other academic institutions, she explains.

KITE's trainee program gives people the power to solve rehabilitation challenges by developing innovative approaches to prevention, diagnostics and therapeutics, and improving quality of life for older adults.

Here are the stories of three trainees who are developing leading-edge research right now.

Giving voice to people with ALS

As a person who stutters, second-year PhD student Anna Huynh knows how challenging communication can be. It's one of the reasons why she wants to develop better ways of assessing the speech of patients with Amyotrophic Lateral Sclerosis (ALS) – and determining the speed at which their disease is progressing. Huynh hopes to create practical tools for clinicians so that people with ALS can receive earlier support around communication and swallowing. Current assessments, she says, are not sensitive enough at detecting changes in the muscles that control speech and swallowing – leaving patients without adequate support.

“As a result, some people are living their lives and they can't share their thoughts and opinions,” explains Huynh, whose work is supported by a KITE-TD Scholarship. “They can also choke on food or water and develop aspirational pneumonia. Having proper assessments is important to inform clinicians as to what to do next.” To that end, she and her team are in the process of finessing a new, more-sensitive method of identifying speech and swallowing challenges in patients with ALS, by assessing their functioning from different angles to pinpoint any issues. She hopes the tool, which will be used by speech-language pathologists and neurologists when assessing patients, can help people enjoy a better quality of life.

Huynh says that her colleagues have been very supportive.

“I was drawn to the people at KITE,” she says. “It makes a difference when you enjoy spending time with the people that you're working with every day. It helps to brainstorm and figure things out together.”

Reducing seizures in patients with epilepsy

Kramay Patel exemplifies the pioneering KITE trainee. When the pandemic hit in 2020, he organized a network of 700 mask sewers in the Greater Toronto Area to ensure 15,000 masks were delivered – initially to healthcare workers and later to community groups. “We inspired many others around the country,” he says.

When he's not doing community outreach, Patel, a PhD student, studies how various techniques can help regulate the brain in neurological conditions such as epilepsy. “About 30 per cent of epilepsy patients don't respond to medication,” he says. “In those patients, the primary job is identifying what part of their brain is causing these seizures.” As a result, many end up in hospitals and have electrodes implanted in their brains. Patel says that because of KITE's unique access to patients, his team can have these patients perform a series of behavioural tasks over their multi-week period of hospitalization. “We can record activity from inside of their brain on a regular basis, with incredible precision,” he explains.

It's truly unique and exceptionally valuable to have trainees from so many different and complementary disciplines working together and learning from each other under one roof. – Dr. Jennifer Campos

The results have driven the creation of a brain computer interface that helps patients learn to control individual neurons in their brain. Participants are asked to play a game that requires them to move an object on the screen. The catch: the object only moves when the activity of a single neuron in their brain changes. Within 40 minutes, says Patel, most participants gain the ability to reliably control the object on the screen, and hence control the single neuron in their brain. Patel and his colleagues are the first to show that humans can control individual neurons in parts of the brain that are commonly involved in epilepsy. He believes that eventually, this ability to control specific neurons will help patients manage disorders like epilepsy. Next is pre-clinical work in animal models to determine exactly which parts of the brain are involved in facilitating that type of learning.

Patel says the end goal of his research is for epilepsy patients to develop the ability to use their mind to control the parts of their brains responsible for seizures. In addition, those with memory issues could potentially regulate the parts of their brains responsible for retaining information, and those with anxiety might manage their symptoms.

According to Patel, the most valuable aspect of working at KITE, where he's been since 2013, is the ability to do pre-clinical and clinical work. “I can ask questions that I couldn't have asked,” he says. “You have access to diverse populations. That's been very helpful.”

Helping patients speak hands-free

When she finished her undergraduate courses in Serbia and Italy, Nevena Musikic had options to study at Europe's top research institutions. But Musikic, a KITE PhD candidate who focuses on how artificial intelligence (AI) can help cancer patients, chose Toronto's world-class research hub because it offered myriad opportunities to collaborate, as well as access to patients. “I thought it would be the perfect location for growth,” she says. “Everyone is at the top level.”

Musikic's instincts weren't wrong. She says she's enjoyed the hands-on aspects of her research, collaborating with engineers, doctors and patients to help those who've had their larynx removed speak more clearly. “We're working with patients who have lost their larynx to cancer,” says Musikic. Unfortunately, many can no longer speak and rely on ineffective technology. “The solutions currently available require hands to activate the voice, and are of low quality and sound robotic,” she notes. “Our goal was to develop a system that would practically address voice control and voice quality.”

151: Number of trainees at KITE, including fellows and graduate students.

Musikic says that her research looks at using physiological signals coupled with AI to recognize when and how the patient wants to speak. She and her team have designed a prototype that they hope will utilize the parts of the throat that are still functioning, allowing patients to speak as naturally as possible – and without needing to use their hands. With her device, patients without a larynx will be able to speak while performing another task, such as holding a child, she says. How? By using AI to determine when someone intends to speak. Then, at the exact moment they want to talk, the device will start producing the artificial voice. This will help open up a world of possibilities for them. “Their quality of life now is compromised – they have a lot of difficulties performing day-to-day activities. Imagine you have to hold your neck to speak?” she says.

She's optimistic about the freedom her research offers patients. There aren't many options for patients who have trouble speaking – and this device could be transformational. “Speech is an essential part of daily life and because of that we are highly motivated to make a difference for laryngectomy patients,” she says.

Dr. Campos is constantly impressed by the research accomplishments and contributions of KITE trainees. “At KITE, we prioritize the translation of research from the lab to real life,” she explains. “It is inspiring to witness the commitment of this next generation of researchers who are motivated to make a difference in the world.”

This story is part of The Game Changers, a storytelling campaign featuring some of the groundbreaking research, innovative ideas and incredible people we have working behind the scenes to redefine the future of rehab at UHN. The series will run monthly through the rest of 2022 putting a spotlight on every corner of KITE, from our trainees, staff and scientists, to our labs, clinics and even the operating room.