by Tim Hornyak
Cuba may be better known for its cigars than its medical technology, but the communist state may provide some high-tech equipment for a local research project on patients recovering from coma.
Following a recent trip to Cuba by a delegation of Concordia faculty led by Rector Frederick Lowy, Department of Psychology Professor Jacinthe Baribeau said the medical technology at the Cuban Neuroscience Center is impressive.
Baribeau, the lead investigator of a new three-year clinical study measuring brain waves in comatose and recovering coma patients, was faced with a 10-per-cent shortfall in a $200,000 grant awarded to her team last year by Canada's Medical Research Council. Cuban neuroscientists approached her with grant interest, so she decided to shop around for an averaging and signal-to-noise extraction machine in Cuba.
"They have the engineering, and they have the neuroscience expertise to build these machines," said Baribeau, who is Director of Concordia's Laboratory of Human Neurophysiology and Neuropsychology. "Our grant allows us to buy separate units for the research, but not the one smaller, more compact system with the U.S. dollars required.
"Cuba can afford to make these machines more cheaply, probably because of labour costs, and because they have expertise that has been a priority in their country for many years."
Pending a successful import of the machine and delays for certification by the Canadian Standards Association, Baribeau and her team of researchers would add the Cuban equipment to her set-up to analyze the brain's averaged "evoked potentials" (EPs) in about 50 coma patients at Charles Lemoyne Hospital on the South Shore.
In addition to transmitting information via genetic and biochemical means, the brain's neurons also communicate through electricity, and brain waves describe the flow of electric current between different parts of the brain. EPs are measurements of brain-wave amplitude, frequency and timing.
Specific areas of the brain emit characteristic signals according to specific tasks, such as recognizing one's name. Hooking patients up to a series of electrodes similar to those used in an electroencephalogram (EEG) enables scientists such as Baribeau to measure the response of brain cells to various stimuli.
"Lots of cells are acting at the same time, and we have to find the best way to figure out which cells are important and at what time they're most relevant," Baribeau said. "We want to ignore the cells that aren't relevant to the exact process we're studying. This is why evoked potential averaging methods are so crucial."
Still a poorly understood phenomenon, coma may result from cardiovascular events such as stroke, but it is more often associated with car accidents and other trauma to the frontotemporal and sub-cortical area of the brain. Comas often last for months, and outcomes range from recovery with a combination of physical, psychological and intellectual impairments to death.
Baribeau's past research, however, has demonstrated that a proactive approach to mental stimulation during rehabilitation improves a patient's chances for long-term recovery compared to traditional physical and occupational therapy.
"Coma is that great natural defence mechanism that helps the body heal itself," Baribeau said. "It puts all the extra functions that aren't necessary to sleep, and focuses on healing itself, so there is 'spontaneous recovery' during coma. Now we want to see how we can track that recovery, and at what level patients can receive information from the outside world."
Baribeau hopes that using EPs to monitor brain-cell response to stimuli as patients are in and emerging from coma will yield new treatment protocols in the future.
"Do coma patients experience things?" asks Baribeau. "Do they hear their names when we call them? Is there information processing going on in deep coma? There's little knowledge of it currently. If we know we can reach them, we will try even more to reach them during their coma, and give them support."
Baribeau said that securing the Cuban equipment for her research will be an imaginative, cost-effective way to deal with cutbacks in government funding, departmental facilities and hospital staff that many scientists face now. On top of fundraising, grant management, teaching, training assistants and conducting research, Baribeau must tackle technical hurdles such as finding and training technicians to program the lab's sophisticated brain-wave equipment.
"Every researcher in the Department of Psychology, especially those in the Drummond Science Building doing human research, has to work with time constraints for grants, incomplete funds and no clerical or engineering help," Baribeau said. "We're all -- the Dean, myself, the Director of International Academic Co-operation -- trying to find opportunities to solve problems in a creative manner."
A delegation from Concordia visited Cuba recently to renew old ties and establish new ones.
The visit, from April 25 to May 2, was made by Rector Frederick Lowy and Professors Jacinthe Baribeau (Psychology), S. Twareque Ali, Josˇ Garrido (both Mathematics and Statistics) and Balbir Sahni, Director of the Centre for International Academic Cooperation (CIAC).
Baribeau, who is also Director of Concordia's Lab of Human Neurophysiology and Neuropsychology, met with researchers at the Cuban Neurosciences Centre (CENIC). See story, page 1.
Ali and Garrido gave a workshop on wavelets and differential equations with mathematicians from the University of Havana.
This was a second edition of a successful workshop given in April 1998 by Professor Ali. There have been a number of Cuban graduate students in Concordia's graduate Mathematics program, and Ali wants to increase that accessibility.
"Given the difficult financial circumstances facing Cuban universities," Ali wrote in a brief recently, "their library holdings, journal subscriptions and access to electronic media are extremely limited. There has also been a significant brain drain from Cuba to other Latin-American countries or to the West in the past several years."
Last summer the two universities agreed to increase faculty and student exchanges in mathematics and statistics, and more of these have already taken place.
An agreement was also renewed between Concordia and Cuba's Asociacion de Linguistas. Every summer, Concordia's TESL Centre plays host to several Cuban teachers of English as a second language.
The Concordia delegation were given two days of presentations on higher education in Cuba, including the status of new information technology, the agricultural and natural sciences, the managerial sciences, and biotechnology.
Rector Frederick Lowy signs an agreement with his counterpart at the University of Havana while Professors Jacinthe Baribeau, Balbir Sahni, Twareque Ali and Josˇ Garrido look on.