“Canada, historically, has led the world in neuroscience… It’s strong in research and I think it’s getting stronger in its ability to translate that research into everyday improvements in healthcare.”
The word “science” covers a lot of ground. If Dr. Ryan D’Arcy were to chart that ground and identify its most fertile feature, it would be this: science’s ability to be applied to real-life situations and bring about practical, tangible, positive changes.
Ryan is one of the world’s foremost neuroscientists. As Group Leader and Senior Research Officer for the National Research Council’s (NRC) Institute for Biodiagnostics (IBD) in Halifax, Nova Scotia, he’s been the brains behind a number of significant neuroscientific discoveries and inventions. He played a key role in developing and creating NeuroTouch, a three-dimensional, touch-sensitive brain simulation that enables surgeons to rehearse patient-specific virtual surgeries in a highly realistic environment. He also founded the award-winning team that built the Halifax Consciousness Scanner (HCS), a portable, reliable device that can quickly determine neurological function. And he’s leading the way in exploring the controversial realm of white matter in the brain.
Those are just three examples of Ryan’s extraordinary contributions to the field of neuroscience. If you read his extensive résumé, you’ll find a long list of achievements to complement those developments. He has published more than 125 works, including papers, chapters and patents, and is the recipient of many awards, such as several Nova Scotia Discovery Awards, two NRC Outstanding Achievement Awards (one for Public Awareness, the other for Community Involvement and Capacity Building) and the 2011 Public Service Award of Excellence (PSAE) for NeuroTouch.
Ryan is making his peers, and his country, very proud with his forward-thinking approach and his devotion to improving lives through scientific discovery. Case in point: his cutting-edge research with Trevor Greene, the retired Canadian Forces captain who suffered a devastating brain injury while serving in Afghanistan in 2006. Ryan has been working with Trevor and his extraordinary wife Debbie Lepore Greene since 2009, tracking Trevor’s progress and studying how his brain is—amazingly—rewiring itself to compensate for the missing and damaged tissue. Their goal is to use Trevor’s success as an example not only of what the brain is capable of, but also of the fact that there is great value in what Ryan calls “brain hope” (more on that a little later).
It was Trevor who recommended Ryan to me. We’d been emailing to arrange Trevor’s upcoming joint Kickass Canadians profile with Debbie (which will be an absolute honour for me to write), and he was keen to bring attention to the amazing work of his good doctor. “Ryan got in touch with me shortly after (Peace Warrior, the documentary about my recovery from the attack in Afghanistan) aired, and he had such a kickass idea about doing such cool, original research,” says Trevor.
I couldn’t agree more. Ryan’s ideas and accomplishments are very cool. If you had the notion that scientists can only be found locked away in the bowels of a university lab (as he jokingly suggests more than once during our interview), I cite his career as an example of taking science out into the wide world, giving it a face and—best of all—bringing its findings to bear in very real, very meaningful applications that have already helped countless people worldwide.
Food for thought
Ryan is considered a world leader in diagnostic imaging of the brain. He’s come a long way from his days of dissecting dogfish brains for his high school biology class. Born and raised in Williams Lake, British Columbia, he left to attend Vancouver Island’s Brentwood College School, where he took an immediate liking to biology and physics. “I always liked to take things apart to try and figure out how they worked,” he says.
After graduating high school in 1990, he went on to immerse himself thoroughly in the world of the mind. He picked up a BSc from the University of Victoria in 1996, an MSc (in 1998) and PhD (in 2002) in Neuroscience from Dalhousie University. Then he did a Postdoctoral Fellowship in Magnetic Resonance Imaging (MRI) at IBD in Winnipeg, Manitoba, before moving to Halifax, Nova Scotia in 2003, where he transitioned to head up NRC’s Atlantic biodiagnostics team.
These days, he splits his time among a number of roles. In addition to his ongoing work with NRC, he’s Associate Professor, Radiology, Psychology/Neuroscience and Anatomy/Neurobiology at Dalhousie University. He’s an accomplished speaker, travelling frequently to deliver talks at conferences around the world. Most important of all, he says, he’s a devoted father to five-year-old son Rhys. “He’s the top priority in everything,” says Ryan.
Putting Canada on the map
When it comes to setting priorities at work, Ryan is equally as decisive. “The goal has always been to take research from the lab and use it to help patients,” he says. “That’s what I always loved about the imaging technologies that we (at NRC) develop. They’re translational. Our research allows us to create technologies that can have an immediate impact on people’s lives.”
According to him, that approach is something the global medical and health communities need; it’s also something Canada needs to cement its reputation as a leader in the field—not only in research, but in delivering practical, tangible tools and results. “Canada, historically, has led the world in neuroscience, and it’s within the top five countries (in the field) no matter how you count it,” he says. “Neuroscience is a Canadian strength, no question about it. It’s strong in research and I think it’s getting stronger in its ability to translate that research into everyday improvements in healthcare. That’s exactly what I’m attempting to do.”
Ryan is doing more than making an attempt. He’s succeeding, and at an astonishing rate. Take his work with NeuroTouch, which he calls “a story for Canada to be very proud of.” Around 2008, he and a team of scientists began developing what he describes as the surgical equivalent of a flight simulator. NRC amalgamated some of the best neurosurgeons in the country, drawing from more than 20 clinical neurosurgical sites and six technical NRC sites. Together they created a brain surgery simulator.
Working from MRIs of real people, Ryan’s group provided the development team with the critical data needed to build a virtual brain surgery simulator. The first of its kind, NeuroTouch enabled surgeons to practise patient-specific surgeries before performing them on the actual patient.
Ryan likens the approach to having a pilot carry out the flight you’re about to take—down to details such as the turbulence you’ll encounter—even before liftoff. “(NeuroTouch) looks like you’re operating on a patient,” he says. “The brain is rendered and it looks graphically how it would when exposed. It pulses and bleeds. What’s really cool about the technology is that it also has haptic feedback. You can pick up instruments and touch the brain. The brain is soft. You can actually touch the skull, and it’s hard. Not only is it visually realistic, but you can interact with it and perform a surgery.”
In 2009, he and his team put NeuroTouch to the test for the first time. They ran a trial on Ellen Wright, a patient at the Queen Elizabeth II Health Sciences Centre in Halifax who had a benign tumour near the part of her brain that controls speech. She wanted the tumour removed, but was very worried about losing her speech in the process. NeuroTouch allowed the surgical team to determine the outcome of her surgery even before bringing Ellen into the operating room.
Because it was the debut performance for NeuroTouch, Ryan says the neurosurgeon residents were understandably skeptical of the technology. But after a brief introduction, they were sold. “I have pictures of them lined up, clamoring over each other to get onto the instrument.”
When Ryan and Dr. David Clarke, the surgeon who performed the procedure, met with Ellen the night before her actual surgery, she didn’t ask the usual question posed to countless surgeons: “How many times have you done this before?” Instead, she asked, “How did my virtual surgery go?” The answer? “Perfectly.”
“It was incredibly anxiety-relieving for her,” says Ryan. “The next day, we went into the OR, did the surgery, and it went just as well as the simulation.” In fact, neither her speech nor her sense of humour were damaged by the operation. “After her surgery, she said, ‘I’m talking. I’m not sure if my husband’s happy about that.’”
When Ellen was discharged, her success story made big news, catapulting NeuroTouch to fame. The simulator was exhibited at the inaugural USA Science & Engineering Festival in 2010, and its makers were soon fielding countless invitations to demonstrate the technology at world-class organizations across the globe.
“Canada went out and took a lead role (with NeuroTouch),” says Ryan. “We made tremendous strides. We went from dealing with a problem that had never been addressed in any way, shape or form, to being the world leader in it right away.”
The Halifax Consciousness Scanner
As proud as Ryan is of NeuroTouch, his proudest medical achievement is his work with the Halifax Consciousness Scanner (HCS), which offers a new way to diagnose brain status following trauma. Prior to the HCS, brain damage was assessed using tests like the Glasgow Coma Scale (GCS). The GCS focused on behavioural responses (e.g. the ability to move or speak) and provided a quick, simple way of evaluating brain status after injury. But, as Ryan says, it proved to be inaccurate as often as 50 percent of the time.
Based on his work in graduate school, he knew that using EEG to measure brain waves was a much more accurate way to assess a person’s functional status than was using their behavioural responses. “A lot of times, (thinking and behavioural responses) can basically de-couple,” he says. “For example, if you think of Lou Gehrig’s disease, someone could be completely cognitively and mentally intact, but unable to provide any behavioural response—either communication or motor—to show otherwise.”
He’d seen many patients benefit from EEG measurements in cases where people who might otherwise have been dismissed as vegetative were proven to be far more consciously aware than was previously assumed. There was no question as to the effectiveness of brain wave assessment. The challenge lay in making this advance accessible to people beyond the isolated and restricted lab setting.
Ryan conceived of the HCS to bring these technological advances to people everywhere. He knew that testing brain function was “at the top of the critical care cascade,” playing a key role in determining the direction of continued care. He wasn’t about to sit idly by while patients were potentially misdiagnosed by the GCS. Moving full steam ahead, he led his team in developing a portable EEG device that would allow rapid, straightforward, accurate assessment.
Today, Ryan is frequently called upon to travel across Canada, bringing his portable HCS to test people whose status of conscious awareness is unknown. He describes an early case in Nova Scotia, where he’d been asked to do an assessment on an adult male patient. “The patient was assumed to be completely vegetative, but the family felt that he was still in there, possibly conscious,” says Ryan. “We did the test and determined that the patient was definitely not vegetative… His brain waves showed that he understood speech just like you or I do. When I had the chance to tell the results to his mother, it was clear that this information was critical for her to know. It was just remarkable to see that. It’s tremendously rewarding.”
Speaking of tremendous rewards, Ryan’s ongoing work with Trevor and Debbie has borne some incredible results. Ryan contacted the couple in 2009 after hearing an orthopedic specialist in Peace Warrior tell them she didn’t think Trevor would be able to walk again. Knowing that his injury was in his brain and not his legs, Ryan was determined to do everything he could to accurately assess whether or not Trevor could in fact become ambulatory.
Peace Warrior producer Sue Ridout put Ryan in touch with the Greenes, and he approached them with the suggestion of using functional MRI (fMRI) to track Trevor’s functional brain changes throughout his recovery (a concept called “plasticity”). Their goal, says Ryan, was “to use Trevor as an example for others and to prove to the medical community that a recovery is possible well beyond the limits defined by conventional wisdom.”
Ryan uses Trevor’s legs to illustrate his point. Trevor’s injury occurred in the part of the brain that dictates motor control for leg movement. “If you’re a rehabilitative specialist, you can only measure changes related to gross improvements in movement,” says Ryan. So far, Trevor has shown significant improvements in his leg movements. But his brain needs to reconnect more circuits before he’ll be able to walk on his own.
Ryan is optimistic. Thanks to fMRI, he has concrete evidence that Trevor’s neural networks are reconfiguring themselves in a way that should allow continued recovery of motor control over his legs. “His brain is rewiring, so we’re going to see changes in (his circuitry) before we actually see new leg movements appear,” says Ryan. “Many people have asked if I thought that (Trevor’s) medical specialists dismissed (his chances of walking again) too quickly. I always say that I think it was the responsibility of the researchers to provide people doing rehab with better measures. That was my goal in collaborating with Trevor and Debbie. We wanted to use brain imaging and looking at functional changes to provide a better measure, so we can motivate other patients and medical teams dealing with major brain injury to keep rehabilitating, and even to optimize treatment to get better results.”
His innovative work with the Greenes isn’t the only way Ryan’s breaking new ground in his field. He says his proudest scientific achievement is in discovering the activation of white matter—something that’s constantly overlooked in favour of grey matter, despite the fact that it comprises about half of the total tissue in the brain. In Ryan’s mind’s eye, that means the vast majority of current literature about how the brain functions is missing half the picture.
“That’s significant because all of our brain processing is done in networks—really complex architectures,” he says. “It’s localized at low levels, but when you’re thinking about the things most people care about, like language or memory, those functions are all very distributed neural networks. To understand how that works and to be able to really look at it, you need to understand not only the dots, but the lines that connect the dots.”
He describes the scientific community’s resistant to exploring white matter function as “a really interesting entrenchment story in science.” Because of the strongly held bias that activation in white matter was too far below the detection threshold, and that the metabolic demand for brain activity was primarily linked to grey matter, white matter was “basically dismissed as being invisible.” When evidence of white matter activity did surface in routine studies, Ryan says that it was dismissed as an artifact and would be removed from the findings. “That’s how entrenched the field was.”
Ryan, however, prefers a more freethinking approach. In 2006, he and his team began a series of experiments “to reveal that we could systematically manipulate white matter activation in order to show that it is not an artifact.” He’s excited about what this new wave of studies can mean for the healthcare community. As he says, many diseases, including multiple sclerosis, are known to have a fundamental effect on white matter. Even diseases that haven’t traditionally been considered white matter diseases, such as Alzheimer’s and stroke, are becoming increasingly linked to damage in white matter. “If you could get a better way of measuring the function of white matter, you could not only learn more about the brain in terms of its networks, but you’d actually have a powerful way to start measuring things like impairments in multiple sclerosis or Alzheimer’s.”
He’s aware that he’ll have to continue swimming against the tide for the foreseeable future, as many of his peers still resist exploring—or even considering—white matter activation. “It’s been a big fight and we’re still not done,” says Ryan. “We’re still working on it. But it’s been a lot of fun. It’s pure science in the sense that we knew we were charting an unknown territory and we were being called fools to do it, but so far we’re convincing a lot of people and we’re definitely making progress.”
Charting the future
Going forward, Ryan has big plans for the future. On top of making a case for the importance of white matter, he’s working on expanding the HCS into assessing concussions, “trying to (adapt it to become) a device that can wind up in hospitals and ambulances and hockey arenas and nursing homes everywhere.” He’s also working on developing a virtual operating theatre for NeuroTouch, to make the simulations even closer to real life. And he’ll continue working with the Greenes, building on the idea of “brain hope, the flip side of false hope, through which recovery from brain injury—no matter how small—can be driven by research and used to empower people towards change. In this regard, Trevor’s incredible recovery will hopefully serve as an inspiration for as many people as possible.”
If you were to create a scan of Ryan’s life and map out his achievements—both past and future—as landmarks along the way, you would likely find a huge array of paths and highways. Such is the nature of work that’s so varied and complex. But although you might see many routes leading to and from each landmark, you’d also see that each one shares a common destination: the betterment of humankind.
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To contact Ryan, email [email protected] or [email protected], or visit his LinkedIn profile.