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About the Institute

Profile of Brenda Banwell

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Dr. Brenda Banwell

Dr. Brenda Banwell, MD

  • Senior Associate Scientist, Neurosciences & Mental Health
  • Staff Neurologist, Neurology
  • Associate Professor, Paediatrics (Neurology)

1. Where are you from?/Where did you study?
I was born in Winnipeg and have lived in Canada most of my life. I went to medical school and completed my paediatrics residency at the University of Western Ontario. I came to SickKids for my paediatric neurology residency and then completed a neuromuscular research fellowship at the Mayo Clinic in Rochester, Minnesota. I have been on staff at SickKids since 1999.  

2. What are you researching right now?
My major focus of research is multiple sclerosis (MS) in children. Specifically, our interest is in understanding what factors determine MS outcome in children with a first attack of the immune system of the brain or spine.

At the first level, we look at what clinical findings at the time of a first attack distinguish those children who go on to develop MS from those who don’t have any further attacks. We look at factors like age, sex, severity of the initial attack, whether they are critically ill or mildly affected at that first episode and how fast they recover. Then we look at what we call etiologic determinants - what the child might have been born with or experienced in their early childhood that might have led them to experience that first event and specifically whether those that develop MS have different risk factors than the children who don’t. Genetically we look at genes that are important in how our immune system behaves. We then look at the immune cells themselves in partnership with my main laboratory collaborators in Montreal. Our interest is in understanding how the immune cells of children at the time of the initial illness behave, and to see whether abnormal immune cell behavior persists over time in children subsequently diagnosed with MS.

We also do very detailed MRI studies of the brain and we use these studies to look at inflammation- the hallmark of acute demyelination; as well as new inflammation and neurodegeneration- the findings that characterize MS. Neurodegeneration is visualized by loss of brain size, and by changes in how well the communication pathways in the brain are maintained. We have some wonderful healthy children who help us out with our studies, as it is critical to compare the brain findings of children with demyelination to the normal age- expected brain features.

We are very interested in understanding why some children with an initial demyelinating attack do not develop MS. Does the ability to recover from the initial attack play an important role? Understanding the children who don’t develop MS, despite having had that first attack, may hold very valuable clues as to what we should be doing to help other children.

3. Who is your all time favourite scientist, and why?
My favorite scientists in history are Banting and Best for their discovery of insulin. These scientists were able to research diabetes, a human condition, explore the mechanisms of the disease, the basic chemistry of the pancreas and how it makes insulin. They were then able to figure out a way to provide insulin which lead to a dramatic effect on human health. These are Toronto-based scientists, so it’s a nice story to have had such an important discovery at our own university.

In a more general sense, because I’m a clinician-scientist, my favorite scientists are those who practice bedside medicine but then take that experience and expertise and translate that into a shared body of knowledge that teach others. Some do it by lecturing in a classroom, some do it by publishing textbooks, some do it by really closely evaluating each of their patients and then working in a laboratory to understand the basic mechanisms of health and illness.

4. What in your opinion is the single most important scientific breakthrough, and why?
I’m going to say Watson and Crick’s discovery of DNA.  Understanding how genetic information leads to human health and disease is probably the most pivotal thing I can think of. The ability of a genetic test to inform on the risk of a disease, to make a diagnosis and lead to new therapy; the ability to do a blood test for some investigations as opposed to a test that is more intrusive. This information continues to be so valuable.

5. What are you major interests outside the lab?
First and foremost, I’m a wife and a parent. My family is the most wonderful part of my life. I have three daughters aged 16, 13 and 9. In terms of my own personal interests, I am very involved in fitness. I teach spinning, I swim competitively for a masters swim club and I run.

6. Why science?
I have an innate incapacity to sit still. I like to ask questions and I always have. I’m sure my parents would say that I have been like this since before I turned a year old. I used the word “why” quite liberally as a young child. I like to figure things out and I like to be part of groups that are working to solve a problem. I enjoy the challenge of taking what you know and bringing it to a new level, a new understanding or a complimentary expertise. I loved science classes from the early days in high school all the way to university. Science drew me in right from the beginning and it has always been what I’ve most enjoyed.

7. Why SickKids?
First of all, SickKids is a world-class clinical, research hospital. SickKids supports physicians so that they can be a researcher and a clinician at the same time.  I started the paediatric MS clinic in October of 1999, and I was provided every possible support to make sure the project succeeded. I was able to take the time to create our paediatric MS program and time to attend conferences in order to learn what I needed to successfully launch a program. SickKids supports the two wonderful nurses that provide exceptional care to children in our clinics. I have been encouraged to present our work at national and international conferences where I represent SickKids and my field. I’ve recently been appointed as the Research Chair of the International Pediatric MS Study Group , which has representatives from 40 different countries.

You have to work in an institution that values leadership outside its own doors in order to really excel in your field. SickKids allows you to take your ideas, build them locally, expand then nationally and then launch them internationally.

8. What is the most controversial question in your field right now?
Chronic Cerebrospinal Venous Insufficiency (CCSVI) is unquestionably the most controversial area in MS right now. The question relates towhether or not the blood flow from the brain, through the neck and into the spine is abnormal in MS. It has been an enormous controversy for just over a year and has led to patients seeking “liberation therapy” (a procedure that uses a catheter to open the area of narrowing). The procedure is being offered in countries such as Egypt, Polland, Russia and Costa Rica. Canadian researchers have not felt that sufficient evidence exists to offer this procedure here. I have one of the seven North American grants to look at blood flow in MS patients. Ours is the only paediatric study.

9. What are you reading right now?
I’m just starting a book called About Alice by Calvin Trillin. It is a story written about a woman with Alzheimer’s disease. My grandmother suffered from Alzheimer’s and this book is said to be a very moving portrayal of the experience of an individual going through changes, not understanding them and trying to move on with her life through them.

The most interesting book I recently finished was called Middlesex by Jeffrey Eugenides. It is a fictional book written about an individual who has a genetic complement that would be male, XY, but has a genetic condition where the Y chromosome is non-functional. This individual grew up looking more female than male initially but failed to go through puberty. In mid-adolescence, early-adulthood the individual made the decision to portray himself as male because he had always internally felt that way. The book looks at what this was like for a very traditional Greek family to experience this and it looks back in time on how this genetic mutation followed the family and how it was hidden in a small town in Greece.

10. If you could give one piece of advice to someone considering a research career, what would it be?
Make sure you love what you’re doing. I work an enormous number of hours, as does everyone I know here at SickKids. I’m never supposed to be in only one place at a time and there is always more than one thing on my to-do list.

It is so important to love what you’re doing. You have to fundamentally feel valued and know that what you’re doing improves the care or understanding of children and their families. It is a difficult balance sometimes to be both a bedside doctor and a researcher, but the work is highly rewarding, very exciting and always very interesting. I’ve never had a single day where I’ve said: I don’t have anything to do today. Or I haven’t learned anything new today. This very high-energy environment suits me very well.

My second piece of advice would be to find a great mentor. Nothing excites someone more than someone with whom they can bounce ideas back and forth with, someone who sees their potential, someone that can drive your curiosity. This mentor doesn’t have to be in the same area as you it is more important that they represent the type of person that you wish to emulate.

11. What does The Research & Learning Tower mean to you?
Space! That would be my spontaneous answer.

Seriously though, what I think it means and has to mean is synergy. We are a research hospital and this research tower is not a separate building, it’s an extension and part of our primary institution. We deliver clinical excellence because we look at the evidence to support what we do. The Research & Learning Tower will be a very visible reminder to families that come here that their child is receiving amazing care because the people that are offering such care are both bedside physicians as well as world-class researchers. We must always ensure that we continually work to not only do our best, but also to prove what the best really is.

March 2011