Exploring the Brain Heart Connection

Dr. Krista Lanctôt works at the crossroad of several scientific and academic disciplines, as highlighted by her cross-appointments as a Professor of Psychiatry, and of Pharmacology & Toxicology, at the University of Toronto. Dr. Lanctôt is a Senior Scientist, Evaluative Clinical Sciences, at the Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute.

She holds the Bernick Chair in Geriatric Psychopharmacology, reflecting her specialty in Neuropsychopharmacology, or the impact of drugs on the human mind.

Dr. Lanctôt’s research group delves into many areas of science, including but not limited to: neuropsychiatric symptoms; neuroimaging; contributors to metabolism; as well as medication, neurostimulation, diet and exercise as interventions to help promote brain health.

Interventional research at the early stage of major cognitive disorders has become a key focus, as this stage of disease may provide an optimal therapeutic window in which the brain can be protected from harmful effects. The connection between the heart and the brain is central to much of this work.

The heart’s primary function is to pump blood throughout the body, delivering oxygen and nutrients to organs and tissues, and removing carbon dioxide and other waste products from those same places. Cerebrovascular diseases (CVDs) can affect this blood flow, and the blood vessels in the brain, either through vessel narrowing, blockage or ruptures.  When fresh blood pumping from the heart cannot reach the brain properly, the brain is prevented from doing its work of regulating most mechanisms of the body, such as memory and thinking.  

Individuals with CVDs and/or coronary artery disease (CAD) are at particularly risk of having memory problems and other forms of cognitive impairment. This is a population that Dr. Lanctôt has focused on in several recent research initiatives.

Memory and Antioxidants in Vascular Impairment Trial (MOVE-IT) was a 6 month randomized controlled trial to evaluate the safety and efficacy of N-Acetycysteine (NAC – a safe and widely available health supplement), as an add-on therapy to improve cognition, in conjunction with exercise.  

MOVE-IT recruited participants who:

• Had very early cognitive changes and mild cognitive impairment
• Had a history of cardiovascular disease and/or have cardiovascular risk factors
• Were starting their cardiac rehab program at Toronto Rehab-Cardiac

Participants were randomized to receive either NAC supplements or a placebo for 24 weeks while participating in a supervised exercise program. Study results will help answer the question of whether NAC can be added on to an exercise intervention to improve cognitive response. At the date of publication, results from this study are being analyzed.

A second heart-related study, Exercise as a Primer for Excitatory Stimulation Study in Vascular Cognitive Impairment No Dementia (EXPRESS-V), is recruiting participants who have cardiovascular risk factors and/or CAD, and who may be at risk of memory decline. These participants are being recruited mainly through the cardiac rehab program at Toronto Rehab. Dr. Lanctôt and her team are using a non-invasive form of brain stimulation called transcranial direct current stimulation (tDCS) in combination with aerobic exercise to see if this combined approach can improve memory performance.

Cognitive impairment and dementia symptoms can be caused by a myriad of factors, which are often overlapping. This article focused on the brain heart connection explored by Dr. Lanctôt and colleagues. With “Nine in 10 Canadians have at least one risk factor for heart conditions, stroke or vascular cognitive impairment”, according to Heart & Stroke¹, understanding this relationship will be key to maintaining the brain health of Canadians.

1. https://www.heartandstroke.ca/articles/connected-by-the-numbers