THINK. LEARN. DISCOVER.
SUMMER 2026
Exercise & Sports Medicine
The Other Side of Exercise as Medicine Muscle Dysmorphia, Exercise Addiction, and Men’s Mental Health
Don’t Sweat It Debunking the Alleged Consequences of Exercise on Heart Health
Redefining Graduate School Through Mentorship and Community
Student-led initiative
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| IMS MAGAZINE SUMMER 2026 EXERCISE AND SPORTS MEDICINE
IN THIS ISSUE Letter from the Editors................................... 4 Director’s Message........................................ 6 Contributors................................................... 7 Infographic................................................... 10 Features....................................................... 12 BMC Showcase............................................ 20 Viewpoints................................................... 24 SciComm Showcase.................................... 34 Student Spotlight......................................... 36 Alumni Spotlight.......................................... 38 Faculty Spotlight.......................................... 40 Diversity in Science..................................... 42 IMS Events................................................... 44 Travel Bite.................................................... 45 Book Review................................................ 46 ChatGPD....................................................... 47 Raw Talk....................................................... 48
MAGAZINE STAFF EDITORS-IN-CHIEF: Beatrice Acheson Kristen Ashworth Kyla Demkiv Nayaab Punjani EXECUTIVE EDITORS: Jasmine Amini Carmen Chan Mya Chronopoulos Sara Corvinelli Alyona Ivanova Anna Mouzenian Anita Rajkumar Lizabeth Teshler DESIGN EDITORS: Ravneet Jaura (Co-Director) Jinny Moon (Co-Director) Anthony Bortolin Allison Conwell Qingyue Guo Sarah Kung Athena Li Vicky Lin Josip Petrusa Vanessa Recine Kevin Trinh Sabrina Viloria Laura Wu Raymond Zhang PHOTOGRAPHY TEAM: Jino Lim (Director) Eliza McCann (Director)
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SOCIAL MEDIA TEAM: Lizabeth Teshler (Director) Lielle Ronen Abigail Wolfensohn JOURNALISTS & EDITORS: Aria Afsharian Tesam Ahmed Melina Alborzi Avni Bhargava Carmen Chan Ilakkiah Chandran Tiffany Chien Nicole Chu Ezgi Coskun Anthaea-Grace Patricia Dennis Clarize Donato Eryn Lonnee Josephine Machado Sabeeka Malik Areej Mir Kinjal Parekh Pamela Plant Gisany Ravichandran Eesha Rehman Stephanie Rizza Rianna Sarbajna Rebecca Smythe Omer Syed Sarah Topa Alicia Tran Serena Trang Priya van Oosterhout Rivka van Klei Annanya Walia
FEATURE INFOGRAPHIC By Athena Li, MScBMC Candidate (2T6)
Copyright © 2026 by Institute of Medical Science, University of Toronto. All rights reserved. Reproduction without permission is prohibited. The IMS Magazine is a student-run initiative. Any opinions expressed by the author(s) are in no way affiliated with the Institute of Medical Science or the University of Toronto.
COVER ART By Josip Petrusa, MScBMC Candidate (2T6) FOLLOW US ON SOCIAL MEDIA! www.imsmagazine.com @IMSMagazine @IMSMagazine IMS MAGAZINE SUMMER 2026 EXERCISE AND SPORTS MEDICINE |
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LETTER FROM THE EDITORS
Letter from the
EDITORS
#WeAre26, a motto shared around the world as Canada co-hosted the FIFA World Cup this summer, captured the spirit of a city that came together to watch games with screens visible at every restaurant, hospital, and research site, cheering on our favourite teams. Following suit from this sports-focused summer, this issue explores exercise and sports medicine. The viewpoint articles cover an array of topics from the effects of exercise on men’s mental health and exercise addiction, to the caveats of creatine supplementation, to the social media phenomenon of “SkinnyTok”, to challenges in the treatment of peripheral nerve injuries, and finally, the potential for exercise regimens to improve symptoms of multiple sclerosis—addressing both societal perspectives on exercise and its therapeutic benefits. This issue also features research in the field of exercise and sports medicine at the Institute of Medical Science (IMS). Musician, violinist, and research scientist Dr. Michael Thaut, is examining the intersection of rhythm and movement for neurorehabilitation. Clinician scientist Dr. David Wasserstein is exploring potential diagnostic tools and therapeutics for knee injuries. Dr. Dmitry Rozenberg is applying exercise rehabilitation to treat chronic lung disease, addressing gaps for treatment by medication alone. Lastly, Dr. Jack Goodman is untangling the benefits and risks associated with intense exercise on cardiovascular health. As the academic year comes to a close, we also see some transitions in our executive team at the IMS Magazine. We want to thank Executive Editors Jasmine Amini and Anna Mouzenian on their contributions to the magazine and wish them the best of luck as they defend their master’s (MSc) theses and pursue their future goals. We also bid farewell to Kyla Demkiv, Editor-in-Chief of the magazine since Fall 2023, who is transitioning into her role as one of the Student Ambassadors at IMS. Kyla has been a pillar of the magazine, building up the magazine to the engagement and strong team we have today, and we wish her the best of luck in her new role. Kyla shares some parting words: “Being a part of the IMS Magazine has been one of the most fulfilling and rewarding experiences during my graduate studies. The students, staff, faculty, and alumni that I’ve met, the articles that I wrote, and playing a part in the growth of our team have provided me with many skills that I’m excited to use in the future, as well as incredibly fond memories. I am so grateful for the talented team of writers, editors, executives, and designers that have worked collectively as a unit to drive the magazine forward each and every issue. To my Co-Editors-in-Chief (EICs) Nayaab and Kristen, as well as the previous EICs that I’ve had the privilege of working with, thank you for making this experience full of joy and support. Lastly, to the IMS leadership team, including SAFE Committee Chairs Sarah Topa and Dr. Samantha Anthony, previous IMS Director Dr. Mingyao Liu, and current IMS Director Dr. Lucy Osborne, thank you for believing in the IMS Magazine and your constant support for our new ideas and initiatives. This experience has really emphasized what’s possible when different groups from multiple levels come together, and I’m so grateful for having a part to play in this.” — Kyla Demkiv
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| IMS MAGAZINE SUMMER 2026 EXERCISE AND SPORTS MEDICINE
LETTER FROM THE EDITORS
Following this transition, we welcome our new Editor-in-Chief Beatrice Acheson, our former features executive editor. She shares some words as she moves into this role: “In 2024 I began my graduate journey at IMS. In my undergraduate degree and now my MSc, I have learned that the University of Toronto, no matter how much time you spend here, feels vast. This vastness enables the diversity of experiences and wealth of opportunities available to us, though it can also contribute to a sense of being very small in a very large place. I have also learned that every large institution is ultimately defined by its smaller communities. I was lucky to find IMS Magazine early in my graduate career. Not only has the magazine provided me with my own tight-knit community within a much larger academic realm, but it has also given me a means of understanding and communicating the many stories emerging from our vibrant research environment. I am thrilled to step into this role, grateful to our existing team for everything they have done to support my transition, and excited to share the sense of curiosity, community, and connection that IMS Magazine has given me with all of you.” — Beatrice Acheson Kyla, we will miss you dearly, but we know we will continue to see you around and you will embrace the vision of the IMS Magazine in what you do. Beatrice, we welcome you to the EIC team and we look forward to seeing everything you will accomplish! We would like to continue to thank our amazing team of journalists and editors, as well as the Design Team for their tremendous work to help bring our vision to life. To the outgoing Co-Directors Jinny and Ravneet, we want to thank you for your support this past year and we wish you the best for your next steps. We hope you all enjoy this new issue of the magazine! Sincerely, Kyla Demkiv
Kristen Ashworth
Nayaab Punjani
Kyla is a PhD student studying the mechanism of action of novel therapies for lymphoma under the supervision of Dr. Armand Keating, Dr. John Kuruvilla, and Dr. Rob Laister.
Kristen is a PhD student studying the use of a human-based retinal organoid model to investigate cell therapies for genetic eye disease under the supervision of Dr. Brian Ballios at the Krembil Research Institute.
Nayaab is a PhD student examining a neuroprotective drug therapy for cervicallevel traumatic spinal cord injury at the Krembil Research Institute under the supervision of Dr. Michael Fehlings.
@kylatrkulja
@K_Ashworth01
@nayaab_punjani
Beatrice Acheson Beatrice is an MSc candidate in the laboratory of Dr. Peter St George-Hyslop at the Tanz Centre for Research in Neurodegenerative Diseases, where she is working to uncover the mechanisms underlying microglial dysfunction in Alzheimer’s disease. @bea.acheson
IMS MAGAZINE SUMMER 2026 EXERCISE AND SPORTS MEDICINE |
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DIRECTOR’S MESSAGE
DIRECTOR’S
Photo Credit: Dr. Lucy Osborne
MESSAGE Dear IMS Community,
This summer season in Toronto marked a historic gathering of various nations for the FIFA 2026 World Cup co-hosted by Canada. In alignment with this event, this issue of the IMS Magazine placed a particular focus on exercise and sports medicine—highlighting IMS research on the rehabilitative effects of exercise in different organ systems, as well as the intersection of health, mental health, and society within sports medicine. This issue features four faculty exploring the benefits of exercise in the context of various conditions. Dr. Michael Thaut is capitalizing on the neural connection between rhythm and movement to generate novel strategies for rehabilitation for motor impairment and neurologic disorders. Dr. David Wasserstein, clinician scientist and the Schatzker Joint Preservation Initiative at the Holland Bone & Joint Program and Sunnybrook Health Sciences Centre, is exploring novel methods of assessing knee function after injury alongside innovative treatment options in hopes of improving patient outcomes. Dr. Dmitry Rozenberg, respirologist at University Health Network, is harnessing the power of exercise rehabilitation to help people with chronic lung disease, as well as caregivers, to regain function and independence. Finally, Dr. Jack Goodman hopes to uncover the clinical consequences of intense exercise to help determine when high-level training promotes cardiovascular health—and when it may pose risks. Alongside our faculty, this issue places a spotlight on three members of our IMS community. Dr. Sean Rourke, recipient of the 2026 University of Toronto President’s Impact Award, speaks about his journey towards transforming access to testing, diagnosis, and treatment for human immunodeficiency virus (HIV) and sexually transmitted and bloodborne infections (STBBIs). The IMS Magazine also spotlights former Editor-in-Chief and alumna Suraiya Mangra, on her transition to industry as the first and only Global Trials Associate at Johnson & Johnson. Current PhD candidate Ilakkiah Chandran speaks on the importance of mentorship throughout her graduate journey from involvement in the Peer-to-Peer Mentorship Program, to the ChatGPD podcast, and teaching. This issue also highlights written work from the Science Communicators modular course focusing on the impact of blocking the kynurenine pathway on improved memory and reduced anxiety following traumatic brain injury. I would like to take this time to welcome new Editor-in-Chief Beatrice to the team, as well as thank Kyla for her contributions over the years to improving science communication, as she transitions out of this role. Furthermore, I would like to congratulate the outgoing Design Team Co-Directors Jinny and Ravneet and designers for their work this past year. I would like to thank continuing Editors-in-Chief Kristen and Nayaab, as well as the larger team of IMS Magazine journalists, editors, and photographers who contributed to the compilation of this issue. I wish all current and incoming IMS students the very best for this upcoming academic year. Sincerely, Dr. Lucy Osborne Director, Institute of Medical Science
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| IMS MAGAZINE SUMMER 2026 EXERCISE AND SPORTS MEDICINE
DR. LUCY OSBORNE Director, Institute of Medical Science Professor of Medicine, University of Toronto
CONTRIBUTORS
Contributors
Summer 2026
Journalists Eryn Lonnee is a first-year MSc student at the Centre for Addiction and Mental Health under the supervision of Dr. Vanessa Gonçalves. Her research aims to understand the effects of co-occurring major depressive disorder and cannabis use disorder on mitochondrial health. Outside of school, Eryn enjoys spending time with friends, playing guitar, and going to the theatre. @erynpl Melina Alborzi is a first-year MSc student at Toronto General Research Institute, supervised by Dr. Dmitry Rozenberg and Dr. Kirsten Wentlandt. Her research uses a qualitative approach to examine caregiver wellbeing in cardiopulmonary disease. Outside of research, Melina volunteers with a community hospice program, enjoys running and painting, and trying new recipes. @melina.alborzi Aria Afsharian is a secondyear MSc student at St. Michael’s Hospital under Dr. Andras Kapus. His project focuses on antiviral signalling regulation. Having been with IMS Magazine for nearly 2 years now, he is thrilled to continue his passion of spreading accessible science to a wider audience. Other than the lab, Aria enjoys working out and reading. Eesha Rehman is a first year MSc student at Centre of Addiction and Mental Health (CAMH) working under the supervision of Dr. Erin Dickie. Her research examines functional connectivity patterns in a clinical youth population with psychosis spectrum symptoms (PSS). Outside of research, she loves solving puzzles, collecting stickers, and journaling.
Gharaza Nasir is a second-year MSc student at the Toronto General Hospital Research Institute, working under the supervision of Dr. Arndt Vogel. Her research utilizes patient-derived xenograft (PDX) models to investigate tumour dynamics and evaluate potential therapeutic strategies for cholangiocarcinoma. In her free time, Gharaza enjoys working out, playing video games, and spending time with friends and family. @g.harazanasir Sabeeka Malik is a second-year MSc student at the SickKids Research Institute, working under the supervision of Drs. Jacob Vorstman and Andreas Schulze. Her research aims to determine effective substrate reduction therapy drug candidates for Mucopolysaccharidosis III (Sanfilippo Syndrome), a lysosomal storage disease. Outside of the lab, Sabeeka enjoys reading and playing card games with her friends. Areej Mir is a first-year MSc student at Women’s College Hospital working under Dr. David Lim. Her research focuses on studying disparities in breast cancer presentation, treatment and care among immigrants in Ontario. She has a strong passion for health-equity focused research. She is thrilled to be a part of IMS Magazine, helping to share stories that make health research more accessible and engaging for all audiences. Outside of academics, she enjoys volunteering in her community, exploring Toronto’s food scene, and curating creative content online. Annanya Walia is a first-year MSc student at the Princess Margaret Hospital, working under the collaborative supervision of Dr. Armand Keating, Dr. Rob Laister, and Dr. John Kuruvilla. Her research focuses on the characterization of computationally designed cyclic peptides for the development of novel bispecific therapies for lymphoma. Outside of research, she enjoys baking, basketball, and discovering hidden food spots around the city.
Alicia Tran is a first-year MSc student working under the supervision of Dr. Lihi Eder at Women’s College Hospital. Her research explores sex differences in response to advanced therapies in patients with psoriatic arthritis. Outside of the lab, she enjoys exploring Toronto with her sister, vintage shopping, and baking new recipes. @aliciaxtran Kareena Thakur is a first year MSc student conducting research under the supervision of Dr. David Cescon at the Princess Margaret Hospital. Her research explores the use of liquid biopsies to detect circulating tumour DNA in the blood of patients with metastatic breast cancer as a tool for early detection of treatment response and progression. Outside of research, she enjoys swimming, travelling, and taking super long walks with her dog. @kareenaathakur Gisany Ravichandran is a first-year MSc student at Sunnybrook Research Institute working under the supervision of Dr. Andrew Lim. Her research aims to identify sleep physiological features associated with cognitive resilience in older adults with and without dementia. Outside of research, she enjoys exploring different coffee shops, playing board games, and travelling with her friends. @gisanyravi Rebecca P. Smythe is a firstyear MSc student at Women’s College Hospital working under the supervision of Dr. David Lim. Her research aims to better understand the lived experiences of transgender and gender diverse (TGD) individuals navigating breast cancer care, in Canada. Outside of her work Rebecca enjoys reading, travelling, and spending time with loved ones. @beckyysmythe
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CONTRIBUTORS
Journalists (cont.) Stephanie Rizza is a first-year MSc student working under the supervision of Dr. Yaping Jin. Her research focuses on estimating and validating the prevalence of glaucoma and age-related macular degeneration in Canada, with the goal of informing public-health planning and resource allocation to improve outcomes for individuals with vision-threatening diseases. Beyond research, she enjoys hiking, skiing, spending time outdoors and planning her next travel adventure. Tiffany Chien is a PhD student in the Department of Medical Biophysics working at the Mouse Imaging Centre. Under the supervision of Dr. John Sled & Dr. Jason Lerch, her research aims to investigate how maternal autoantibodies affect offspring brain and behavior development. She is also a science writer for RawTalk Podcast. In her free time, she enjoys reading, running, and travelling the world with her husband. @tiffanycblum Avni Bhargava is a recent graduate of the Department of Human Biology at the University of Toronto. She is currently studying for the MCAT and intends to apply to medical school in 2027. Alongside her Bachelor of Science degree, Avni has earned a Certification of Recognition in American Sign Language and works as a part time tutor-mentor supporting Deaf and hard of hearing students. Passionate about accessibility in healthcare and education, she hopes to combine these interests throughout her future in medicine. @avnii.i Nicole Chu is a second year medical student at the University of Toronto Temerty Faculty of Medicine. She is the Co-Executive Producer for Raw Talk Podcast, and loves storytelling and simplifying research so that people from all backgrounds can understand. In her free time, she does Chinese dance with Yun Dance Crew!
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Ezgi Coskun is a secondyear MSc student investigating the therapeutic benefits of kynurenine 3-monooxygenase inhibition on traumatic brain injury and posttraumatic epilepsy-related symptoms under the supervision of Dr. Aylin Y. Reid at the Krembil Research Institute. Outside the lab, Ezgi likes reading fiction and discovering new coffee shops. Rivka van Klei is a firstyear Master’s student at the Centre for Addiction and Mental Health, where she studies the biopsychosocial factors that contribute to increased dementia risk in individuals with a history of depression. Outside the lab, Rivka loves spending time outdoors—biking, hiking, and enjoying nature. During the winter months, you’ll more likely find her indoors, gathered with friends for cozy karaoke and board-game nights. @rivka_zeng_vanklei
Copy Editors Omer Syed Serena Trang Gisany Ravichandran Priya van Oosterhout Kinjal Parekh Clarize Alarcon Donato Tesam Ahmed Anthaea-Grace Patricia Dennis Josephine Machado Rianna Sarbajna
Editorial Board Executive Editors
Alyona Ivanova is a PhD student investigating the molecular signature of glioblastoma using spatial -omics technologies at the Hospital for Sick Children under the supervision of Dr. Sunit Das. Alyona is a professional figure skater and a model. Alyona is a Creative Director of Panoramics - A Vision Inc. She enjoys traveling, cooking, and reading. @_alyonaivanova_
| IMS MAGAZINE SUMMER 2026 EXERCISE AND SPORTS MEDICINE
Lizabeth Teshler is a PhD student supervised by Dr. Brian Feldman at The Hospital for Sick Children. Her research investigates how to improve the clinical examination of musculoskeletal health for people with Hemophilia. Outside of research, she loves biking, spending time outdoors, and exploring new cities. Jasmine Amini is a secondyear MSc student working under the supervision of Drs. Daphne Korczak and Samantha Anthony at the Hospital for Sick Children. Her research interests lie in social media use and family functioning among youth with an acute self-harm or suicide-related concern. Outside of academia, Jasmine enjoys reading, volunteering, and exploring Toronto. @Jasmine_amini9 Sara Corvinelli is a PhD student supervised by Dr. Jacques Lee at the Schwartz/ Reisman Emergency Medicine Institute. Her thesis is exploring innovative ways to improve delirium recognition for older people who seek emergency care. When she’s not researching, Sara enjoys ballet, nature walks, and spending time with loved ones. Anna Mouzenian is a second-year MSc student working under the supervision of Dr. Victor Tang and Dr. Daniel Felsky at the Centre for Addiction and Mental Health. Anna is investigating the use of wearable devices to predict outcomes for substance use disorders. In her free time, she enjoys dancing, hiking and pilates. Carmen K. Chan is a PhD student exploring the molecular mechanisms of obesity and type 2 diabetes, focusing on immunometabolism. She is co-supervised by Dr. Cynthia Luk (St. Michael’s Hospital) and Dr. Daniel Winer (Toronto General Hospital Research Institute). Outside of the lab, Carmen can be found playing the piano, tending to her (many) houseplants, or taking a long walk by the waterfront.
CONTRIBUTORS Anita Rajkumar is a secondyear MSc student at Women’s College Hospital, working under the supervision of Dr. Joanne Kotsopoulos. Her research aims to understand hormonal contraceptive use and breast cancer risk among BRCA carriers. In her free time, Anita enjoys reading, running, and trying new restaurants. Mya Chronopoulos is a firstyear MSc student supervised by Dr. Caleb Browne at the Centre for Addiction and Mental Health where she is exploring how serotonin and dopamine coordinate in the mesolimbic dopamine system to shape motivation/reward-seeking behaviour. Outside of the lab, she enjoys early morning pilates classes, spending time with family, and traveling.
Photography Team Jino Lim is a first-year MSc student under Dr. Katharine Dunlop’s supervision at St. Michael’s Hospital. His research focuses on multivariate analysis on structural magnetic resonance imaging data for Major Depressive Disorder (MDD). In his free time, you can find Jino fish keeping or reading literature!
Eliza McCann is a first-year MSc student working under Dr. Clement Hamani at the Sunnybrook Research Institute. Her research focuses on Deep Brain Stimulation as a treatment for Post-Traumatic Stress Disorder. In her spare time, she likes to read, spend time with her friends, and cook.
IMS Design Team The IMS Design Team is a group of 2nd-year MSc students in the Biomedical Communications (BMC) program. Turning scientific research into compelling visualizations is their shared passion, and they are thrilled to contribute to the IMS Magazine.
2T7 Design Team (incoming)
@myachronopoulos
Social Media Team Lielle Ronan is a second-year MSc student in Dr. Andrew Sage’s Lab at the Latner Thoracic Surgery Research Labs in PMCRT. Her research investigates smoking damage in donor lungs to improve post-transplant outcomes using Ex-Vivo Lung Perfusion (EVLP). Aside from research, she loves painting, baking, running, and trying local restaurants in Toronto. Abigail Wolfensohn is a second-year MSc student in Dr. Mojgan Hodaie’s lab at Toronto Western Hospital. She is researching how the brain’s waste-clearance system functions in people with trigeminal neuralgia, a chronic facial pain condition. In her free time, she enjoys outdoor activities, puzzles, trying new restaurants, and playing the piano.
Allison Conwell (Co-Director)
@allies_digital_ portfolio allisonconwelldesign.com
Sabrina Viloria (Co-Director) @sabi.sciart
Anthony Bortolin
Sarah Kung
@bortolin.visuals anthonybortolin.com
@arbyskcl sarahkung.my portfolio.com/work
sabrinaviloria.ca
Vanessa Recine
Kevin Trinh
Laura Wu
kevintrinh. framer.website
laurawu.ca
@kvn.scrblz
@valeitta vanessarecine. myportfolio.com
@wulaurart
2T6 Design Team
Ravneet Jaura (Co-Director)
Jinny Moon (Co-Director)
@artby_reetu ravneetjaura.com
@jmoon.vis jinnymoon.ca
Vicky Lin
@viyxlin www.vickylin.ca
Qingyue Guo @qiy_o_0
Athena Li
@athna.stomosis
liathena101.wixsite.com /portfolio
Josip Petrusa
Raymond Zhang
josippetrusa.com
helloimraymond.github.io
@jpetrusavisuals
@rayz_the_roof
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INFOGRAPHIC
Beyond the Break:
Four Common Sports Injuries & Emerging Treatments Rotator Cuff Injuries in Baseball
The rotator cuff is a group of muscles and tendons that hold the shoulder in its socket. During a pitch, the arm’s internal rotation velocity can exceed 7,000 degrees per second.1 Over a career, that tremendous repeated stress can injure the tendon; rotator cuff pathology accounts for almost half of all shoulder injuries seen in college baseball players.2 Surgeons are using resorbable collagen implants placed over the repaired tendon to promote new tissue growth. Clinical trials show that the strategy reduces retear rates compared to standard rotator cuff repair alone.3
ACL Tears in Basketball The anterior cruciate ligament (ACL) is one of the knee’s main stabilizers. Injury typically occurs in a non-contact fashion. Most tears happen when a player jumps and lands, as the knee buckles inwards.4 Female athletes are diagnosed with ACL tears two to three times more often than male athletes, a gap partly explained by differences in joint looseness, muscle support around the knee, and landing mechanics.5 A new option called BridgeEnhanced ACL Restoration (BEAR) repairs the athlete's ligament. A sponge-like implant is soaked in the patient's own blood and placed between the torn ends of the ligament, allowing the body to regrow the original ligament.6 Clinical trials show outcomes comparable to traditional reconstruction, and early data suggests it may lower the long-term risk of complications.7 10 | IMS MAGAZINE SUMMER 2026 EXERCISE AND SPORTS MEDICINE
Compiled by Mya Chronopoulos
INFOGRAPHIC
Traumatic Brain Injury in Boxing
Repeated blows to the head can cause both acute concussions and a cumulative, longer-term condition now known as chronic traumatic encephalopathy (CTE). Roughly 17% of people who sustain repetitive concussions or mild traumatic brain injuries go on to develop CTE, and the majority of confirmed CTE cases have been in boxers.8 Because CTE can only be confirmed after death, emerging science is focused on catching brain injury in the moment. Blood tests that measure GFAP and UCH-L1— two proteins released when brain cells are damaged— can now flag a possible traumatic brain injury within hours, helping determine who needs urgent imaging and who can be safely monitored.9
Pelvic Bone Stress Injuries in Running Long-distance runners place a large amount of repetitive load on the bones of the pelvis. When bone can’t keep pace with that stress, tiny cracks called bone stress injuries can form. Pelvic stress fractures make up only a small share of all stress fractures overall, but they occur disproportionately in distance runners and triathletes,11 affecting as many as one in five competitive runners over time.12 Because these injuries are notoriously slow to heal with rest alone, researchers have explored ways to actively stimulate bone repair. Low-intensity pulsed ultrasound (LIPUS)—a small, wearable ultrasound device used daily at home—is being studied for its ability to speed bone healing in athletes with stress fractures, though evidence on its benefit is still mixed.13 In more resistant cases, some clinicians have paired LIPUS with teriparatide, a bone-building medication normally used for osteoporosis, to help jump-start healing.14
References 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14.
Zaremski JL, Wasser JG, Vincent HK. Mechanisms and Treatments for Shoulder Injuries in Overhead Throwing Athletes. Current Sports Medicine Reports. 2017;16(3):179–88. Vargas L, Charen D, Huang HH, Poeran J, Colvin A. Analysis of Common Shoulder Injuries in Collegiate Baseball Players. The Physician and Sportsmedicine. 2021 June 23;50(5):1–6. Hurley ET, Twomey-Kozack J, Doyle TR, et al. Bioinductive Collagen Implant Has Potential to Improve Rotator Cuff Healing: A Systematic Review. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2024 Sept;41(2):333-342. Gill VS, Tummala SV, Boddu SP, et al. Biomechanics and situational patterns associated with anterior cruciate ligament injuries in the National Basketball Association (NBA). British Journal of Sports Medicine. 2023 Nov;57(21):1395–9. Cosgarea A. ACL Tears in Female Athletes: Q&A with a Sports Medicine Expert [Internet]. John Hopkins Medicine. 2023 [cited 2026 July 7]. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/acl-injury-or-tear/acl-tears-in-female-athletes-qa-with-a-sports-medicine-expert Anterior Cruciate Ligament (ACL) Program [Internet]. Boston Children’s Hospital. 2016 [cited 2026 July 7]. Available from: https://www.childrenshospital.org/services/anterior-cruciate-ligament-program/research-innovation Shah AK, Neijna AG, Retzky JS, et al. Indications, Techniques, and Outcomes of Bridge-Enhanced ACL Restoration (BEAR). Current Reviews in Musculoskeletal Medicine. 2025 Feb 12;18:140-148. McKee AC, Cantu RC, Nowinski CJ, et al. Chronic Traumatic Encephalopathy in Athletes: Progressive Tauopathy After Repetitive Head Injury. Journal of Neuropathology & Experimental Neurology. 2009 July;68(7):709–35. Pignataro G, Fernandez MS, Candelli M, et al. Blood-Based Biomarkers for Traumatic Brain Injury: A New Era in Diagnosis and Prognosis. International Journal of Molecular Sciences. 2025 Dec;26(24):12158–8. Our focus on neuroscience [Internet]. DRG Neuroscience. 2025 [cited 2026 July 7]. Available from: https://www.drg-diagnostics.de/278-1-TBI.html Kahanov L, Eberman LE, Games KE, et al. Diagnosis, treatment, and rehabilitation of stress fractures in the lower extremity in runners. Open Access Journal of Sports Medicine. 2015 March;20(5):6. Yoder K, Bartsokas J, Averell K, McBride E, Long C, Cook C. Risk factors associated with sacral stress fractures: a systematic review. Journal of Manual & Manipulative Therapy. 2013 Dec;23(2):84–92. McDaniel M, Eltman NR, Pan J, et al. Evaluation of Low-Intensity Pulsed Ultrasound on Stress Fractures to Reduce the Time to Return to Sport or Activity in the Physically Active Population: A Systematic Review. Cureus. 2023 Nov;15(11): e49129. Nozaka K, Shimada Y, Miyakoshi N, et al. Combined effect of teriparatide and low-intensity pulsed ultrasound for nonunion: a case report. BMC research notes. 2014 May;7:317.
Designed by Athena Li
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FEATURE
Rewiring the Brain Through Music How Dr. Michael Thaut is Driving Our Understanding of Music’s Role in Motor Rehabilitation By Eryn Lonnee
W
hen a musician plays an instrument, their fingers, arms, and body move in carefully coordinated ways to make sound. From plucking strings on a guitar to striking a drum, each instrument demands a complex series of motor patterns that must be refined through practice. Over time, these movements become automatic; as the expected sound is produced, neural connections are formed and strengthened, and each repetition requires less conscious effort. This process reflects a fundamental neuroscience principle: “neurons that fire together, wire together,” meaning that repeated use strengthens connections between brain cells involved in the same task. Even without specialized music training, humans are predisposed to move to music.1 Many of the brain’s motor areas for timing and coordination play critical roles in rhythm perception and production, including the basal ganglia, cerebellum, and premotor cortex.2 This is due to a common need for timing and prediction, as both music and movement require the brain to anticipate future events to stay on beat or coordinate actions smoothly. This shared neural circuitry reflects the strong connection between the auditory and motor systems, allowing auditory cues to guide and refine movement by stimulating activity in motor regions.
For Dr. Thaut, understanding the relationship between music and movement was not a purely academic interest; as a “professional violinist in [his] first life,” he was intrigued by how musicians can synchronize intricate movements with precise auditory cues. His experiences inspired him to leverage the neural connection between rhythm and action to treat motor impairments. This question shaped Dr. Thaut’s research and led him to develop Neurologic Music Therapy (NMT), a system of neuroscience-based treatment interventions that employ music and rhythmic exercises to rehabilitate sensorimotor, language, and cognitive deficits. 3
NMT techniques such as rhythmic auditory stimulation (RAS) seek to overcome this limitation by using a strong rhythmic beat to jump-start motor function.3 RAS relies on a phenomenon called auditory-motor entrainment, where the brain’s auditory system spontaneously synchronizes neuronal firing to a strong beat. Because the auditory system is heavily connected to the brain’s motor areas, motor signals synchronize to the beat, effectively “lock[ing] the motor system,” explains Dr. Thaut. The steady beat provides the motor system with a consistent movement cue and a predictable time constraint in which the movement must occur (i.e. before the next beat), helping the brain overcome timing and signaling deficits within the motor system. Auditory cueing is especially effective for cyclical movements like walking, where the beat cues each step. Patients with profound gait impairments from PD or stroke experience vast, immediate improvements in their walking when exposed to RAS, thanks to auditory-motor entrainment.5
Motor impairment is a hallmark symptom of many disorders, including Parkinson’s disease (PD), stroke, and cerebral palsy. These conditions involve damage to or dysfunction of the brain’s movement systems, causing slow, inaccurate, and inconsistent execution of motor commands. Dr. Thaut describes this as “an optimization problem,” in which the brain is unable to turn neural signals into effective and timely movements.4
Dr. Thaut’s team is now working to uncover the biochemical drivers of entrainment-related motor improvement. In a study published in Frontiers in Neuroscience, they examined dopamine uptake—a neurotransmitter critical to motor function—during a finger-tapping task with and without RAS.6 They found that dopamine uptake was reduced when participants were exposed to RAS compared to when they
Dr. Michael Thaut, a professor of both music and medicine at the University of Toronto, has spent over three decades researching how to leverage the connection between rhythm and motor function to treat movement disorders and impairments.
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FEATURE
(This is for spotlight photos! Delete this later.)
Michael Thaut, PhD, MMus Professor of Music, Faculty of Music, Faculty of Medicine Photo Credit: Jino Lim
completed the task with no auditory support. This implies rhythmic input may act as a substitute for dopaminergic messaging, thereby reducing the amount of dopamine needed to complete the tapping task. Dr. Thaut believes this may explain why patients with PD—a condition characterized by degeneration of dopaminergic neurons, and subsequent dysregulation of dopamine, in critical motor areas of the brain—experience such immense benefits from RAS therapy. As Dr. Thaut explains, “the [facilitation] effect of rhythmic stimulation is very significant in enhancing the ability to exercise or recover physical function.” Dr. Thaut is also a global leader in sonification research. In motor rehabilitation, sonification involves converting a patient’s movements into Graphic design by Josip Petrusa
sound, allowing for real-time auditory feedback of the motor system. As a patient moves, specialized sensors can translate their motion into changes in pitch, volume, or tone. This immediate musical feedback drives neural activity and promotes new connections within the shared auditory-motor pathway, helping the brain to rapidly relearn or strengthen motor functions. This concept is critical for an NMT technique developed by Dr. Thaut called Therapeutic Instrumental Music Performance (TIMP), where functional movements are paired with musical instruments to practice and strengthen motor abilitiy.3 In TIMP, instruments are strategically placed to help patients strengthen targeted movements; for example, a xylophone might be placed in front of a patient so they can practice reaching. When the movement is executed correctly, the patient creates sound with the instrument. Dr. Thaut has successfully utilized TIMP to improve motor function in patients with cerebral palsy, stroke, and PD, and his team is working to optimize the benefits of TIMP therapies.5 Beyond motor rehabilitation, sonification has been applied to improve exercise and sport performance. Dr. Thaut has consulted with sports teams (e.g. in rowing) to improve synchronicity and form. Across the world, neurologic music therapy is practiced by over 3000
therapists, with neuroscience-based training becoming more common each year.3 Within Canada, RAS is even recommended by the Canadian Heart and Stroke Best Practices guidelines for gait rehabilitation;7 however, Dr. Thaut believes that the future of NMT lies in expanding its access. “The basic mechanisms are well established… I think one of the most interesting challenges is not so much new discoveries, [but rather] how do we get those interventions into different parts of the world, such as low- and middleincome countries.” By improving access to NMT knowledge and training, Dr. Thaut hopes that more people will be able to experience the incredible benefits of music-based motor rehabilitation.
References 1. Thaut MH. Rhythm, music, and the brain: Scientific foundations and clinical applications. 1st ed. New York and London: Routledge; 2008. 2. Grahn JA, Watson SL. Perspectives on rhythm processing in motor regions of the brain. Music Ther Perspect. 2013;31(1):25–30. 3. Academy of Neurologic Music Therapy. What is neurologic music therapy [Internet]. Academy of Neurologic Music Therapy; 2026 [cited 2026 May 26]. Available from: https://nmtacademy.co/ nmt-system-of-standardized-techniques/ 4. Thaut MH. The discovery of human auditory–motor entrainment and its role in the development of neurologic music therapy. Prog Brain Res. 2015;217:253-66. 5. Braun Janzen T, Koshimori Y, Richard NM, et al. Rhythm and music-based interventions in motor rehabilitation: Current evidence and future perspectives. Front Hum Neurosci. 2021;15:789467. 6. Koshimori Y, Strafella AP, Valli M et al.. Motor synchronization to rhythmic auditory stimulation (RAS) attenuates dopaminergic responses in ventral striatum in young healthy adults:[11C]-(+)PHNO PET study. Front Neurosci. 2019;13:106. 7. Canadian Heart&Stroke. Canadian stroke best practices [Internet]. Toronto: Canadian Heart&Stroke; 2026 [cited 2026 May 26]. Available from: https://www.strokebestpractices.ca/recommendations
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FEATURE
Young Heart, Older Knee Recovery for Active Patients
By Jino Lim
I
njury is an inherent part of sport at every level of competition, and knee injuries are among the most common injuries sustained by athletes.1 Beyond their physical impact, these injuries often require expensive surgery and rehabilitation.1,2 The knee is a hingelike joint connecting the femur, tibia, and patella, and its stability depends on ligaments, such as the anterior cruciate ligament (ACL), which is particularly vulnerable to rupture.3 Despite advances in treatment, fundamental questions remain about how the joint changes after injury, which factors influence long-term outcomes, and what defines a successful recovery beyond a patient’s return to sport. Dr. David Wasserstein, assistant professor at the University of Toronto and an orthopaedic surgeon at Sunnybrook Health Sciences Centre, hopes to answer some of these questions through a better understanding of the factors that shape recovery after injury. As part of the Schatzker Joint Preservation Initiative, Dr. Wasserstein is focused on a surprisingly simple goal: “We want to help people keep moving,” he says. His path to the operating room was anything but direct. Dr. Wasserstein studied environmental toxicology at Western University, and air pollution research introduced him to clinical studies and population-level questions. This exposure to epidemiology—the study of patterns, risks, and outcomes across populations—shaped his approach to medicine. Dr. Wasserstein believes that
before developing solutions, clinicians must understand the problem they are trying to solve. That same curiosity led him toward a field where clinical decision-making, biomechanics, and patient outcomes intersect. Following his undergraduate and master’s degrees in toxicology, he completed medical school and a residency in orthopaedic surgery at the University of Toronto, a fellowship in sports medicine in Toronto and at Vanderbilt University, and a Master of Public Health at the University of Waterloo. Now, in his clinical practice, Dr. Wasserstein combines clinical assessment with objective measures of function to understand recovery after knee injury. The knee is a “joint that makes sense,” he says. Symptoms, physical examination, and imaging often point to the same diagnosis, which in turn guides treatment. Because the joint’s mechanics can be quantified, recovery can be captured in objective measures—including strength, joint mechanics, and time to return to activity. Despite the knee’s suitability for objective measurement, not every injury follows a direct path to treatment. Acute anterior cruciate ligament (ACL) tears are frequently missed at the initial presentation, particularly in emergency rooms or primary care settings, where diagnostic accuracy among initial treating physicians can be as low as 9.8%.4 Delayed diagnosis may result in secondary structural changes that complicate subsequent treatment and increase the
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risk of chronic ACL deficiency.5,6 Despite their clinical significance, these secondary changes remain poorly understood. This gap in understanding motivates one of Dr. Wasserstein’s current research projects. Many patients with chronic ACL deficiency are encouraged to strengthen the surrounding muscles, but a chronically injured knee is difficult to treat with rehabilitation alone. He explains that clinicians still do not fully understand how prolonged instability alters the mechanics of the joint, or which reconstructive approach will yield the best outcomes. Dr. Wasserstein explains, “We don’t actually know, as an orthopaedic sports medicine community, what’s the best thing to do for them. We don’t have a model to study that.” To address this, his team is developing a cadaveric model of the chronic ACL-deficient knee to test how changes in bone morphology, contact pressure, and reconstructive choices affect mechanics. The model will enable his team to compare reconstructive approaches directly, as well as to test novel treatment approaches. Dr. Wasserstein is also transforming recovery of ACL tears through markerless motion capture, a method of measuring knee function after injury. The technique combines standard video cameras with computer algorithms that track the body’s joints frame by frame, reconstructing how the knee moves without any sensors attached to the patient. Traditional gait laboratories provide detailed
FEATURE
Wasserstein aims to better understand which patients with a chronically deficient ACL injury benefit most from surgery.
David Wasserstein, MD, MSc, MPH, FRCSC Schatzker Joint Preservation Initiative at the Holland Bone & Joint Program, Sunnybrook Health Sciences Centre. Photo Credit: Jino Lim
biomechanical data, but require specialized facilities, reflective markers, and lengthy testing sessions that can take one to two hours to complete, limiting their use in routine clinical care.7 Markerless motion capture produces gait analyses with accuracy comparable to conventional marker-based systems.8 “Now we can acquire pretty good quality data in five minutes or less,” he says. This technology makes objective biomechanical assessment feasible during routine clinic visits, reduces patient burden and dropout rates, increases participation in research studies, and lowers barriers to multicentre collaborations. By combining these advances with imaging and patient-reported outcome measures, Dr. Graphic design by Raymond Zhang
Dr. Wasserstein applies the same patientcentred perspective to recovery across a range of knee conditions. Another current project focuses on osteotomy, a joint preserving realignment procedure used in active patients with medial knee osteoarthritis and varus alignment.9 In these patients, the knee is angled inward, concentrating body weight on the damaged inner compartment.5 During surgery, the bone is cut and realigned to shift load toward healthier cartilage. An effective osteotomy can improve function, reduce pain, and redistribute load across the knee—and is the only surgery we have proven to delay arthritis progression. Success after surgery is typically evaluated through measures of bone healing or surgical complications, but Dr. Wasserstein asks a different question: how do patients really function after surgery? “The classic surgical outcomes are probably insufficient,” he says. Imaging may show a technically successful operation, but that does not necessarily mean patients return to the activities that matter most to them. By integrating imaging, gait biomechanics, and patientreported outcomes, Dr. Wasserstein hopes to identify why some patients recover exceptionally well, while others struggle despite an apparently successful surgery. Movement data and patient experience can offer
complementary—not interchangeable— views of recovery. Sports medicine, he emphasizes, is “not just about young athletes.” It is about helping people of all ages remain active throughout their lives—including those who are, as Dr. Wasserstein puts it, “a young person at heart, but with a bit of an older person’s knee.” Through better models and a deeper understanding of the knee, Dr. Wasserstein hopes to preserve what matters most to patients: the ability to keep moving. For Dr. Wasserstein, it all comes back to a single question: “How do we keep [people] active? That’s the main goal.” References 1. Joseph AM, Collins CL, Henke NM, et al. A Multisport Epidemiologic Comparison of Anterior Cruciate Ligament Injuries in High School Athletics. J Athl Train. 2013 Dec 1;48(6):810–7. doi:10.4085/1062-6050-48.6.03 2. M de L, LJ D, R T. A 7-year study on risks and costs of knee injuries in male and female youth participants in 12 sports. Scand J Med Sci Sports. 2000 Apr;10(2). doi:10.1034/j.1600-0838.2000.010002090.x PubMed PMID: 10755279. 3. Sanders TL, Maradit Kremers H, Bryan AJ, et al. Incidence of Anterior Cruciate Ligament Tears and Reconstruction: A 21-Year Population-Based Study. Am J Sports Med. 2016 Jun 1;44(6):1502–7. doi:10.1177/0363546516629944 4. Bollen SR, Scott BW. Rupture of the anterior cruciate ligament — a quiet epidemic? Injury. 1996 Jul;27(6):407–9. doi:10.1016/0020-1383(96)00033-2 5. Noyes FR, Schipplein OD, Andriacchi TP, et al. The anterior cruciate ligament-deficient knee with varus alignment: An analysis of gait adaptations and dynamic joint loadings. Am J Sports Med. 1992 Nov 1;20(6):707–16. doi:10.1177/036354659202000612 6. Lohmander LS, Englund PM, Dahl LL, et al. The Long-term Consequence of Anterior Cruciate Ligament and Meniscus Injuries: Osteoarthritis. Am J Sports Med. 2007 Oct 1;35(10):1756–69. doi:10.1177/0363546507307396 7. Simon SR. Quantification of human motion: gait analysis—benefits and limitations to its application to clinical problems. J Biomech. 2004 Dec 1;37(12):1869–80. doi:10.1016/j.jbiomech.2004.02.047 8. Kanko RM, Laende EK, Davis EM, et al. Concurrent assessment of gait kinematics using marker-based and markerless motion capture. J Biomech. 2021 Oct 11;127:110665. doi:10.1016/j.jbiomech.2021.110665 9. Brouwer RW, Huizinga MR, Duivenvoorden T, et al. Osteotomy for treating knee osteoarthritis. Cochrane Database Syst Rev. 2014 Dec 13;2014(12):CD004019. doi:10.1002/14651858.CD004019.pub4 PubMed PMID: 25503775; PubMed Central PMCID: PMC7173694.
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FEATURE
Trained to Breathe: Dr. Dmitry Rozenberg’s Case for Exercise as Medicine in Advanced Lung Disease By Melina Alborzi
F
or people with chronic lung disease, breathlessness can make even simple daily movements exhausting. Remarkably, one of the most powerful treatments is not medication but exercise, which improves symptoms, daily function, and quality of life. Dr. Dmitry Rozenberg, a respirologist and clinician-scientist at University Health Network and an associate professor at the University of Toronto, studies how exercise can help people with chronic lung disease regain function and independence. He began his training in kinesiology at York University and went on to complete medical school at the University of Ottawa, followed by internal medicine and respirology training in Toronto. His education in exercise and fitness assessment provided the foundation for a pivotal three-month rotation at West Park Healthcare Centre, where, under the mentorship of Dr. Roger Goldstein and team, he discovered the transformative effects that exercise can have on advanced lung disease. Patients were able to walk a greater distance and manage their daily activities easier post-rehabilitation. This early experience shaped the trajectory for his career. The principles of exercise training have similar applications to patients and athletes: muscles and the heart adapt to demands placed on them, building muscle strength with increasing demand.1 Like medications, exercise can be prescribed at a defined dose, frequency, and intensity. In chronic
lung disease, however, dose and frequency depend heavily on the patient’s starting point: how much breathlessness they feel and how low their blood oxygen drops during activity.1 These features of breathlessness are especially pronounced in advanced lung diseases, such as chronic obstructive pulmonary disease (COPD) and interstitial lung disease, promoting a self-perpetuating cycle of inactivity. Breathlessness can discourage movement, which can contribute to muscle weakness and earlier fatigue limiting activity.2 Symptoms often extend beyond the lungs; patients may experience anxiety, poor sleep, and weight loss, as the extra effort of breathing requires more calories than most patients can replace.2 Exercise directly addresses loss of strength and stamina. Dr. Rozenberg’s research evaluates how exercise can be prescribed most effectively for individuals with chronic lung disease. In a study of lung transplant candidates, Dr. Rozenberg and colleagues measured muscle mass and physical function. Low body muscle mass was observed in 16 percent of patients, but strength deficits were far more prevalent: half of the study group had low quadriceps strength and nearly half performed poorly on physical function tests, even when muscle mass was normal.3 The findings suggest that skeletal muscle strength and function may be important prognostic markers, as quadriceps strength was associated with post-transplant hospital length of stay.3 Physical inactivity, low
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oxygen, and inflammation can all reduce muscle strength and endurance, which exercise training can help offset. To assess whether targeted training restores muscle function, Dr. Rozenberg’s team enrolled transplant candidates with advanced lung disease in an aerobic exercise and resistance training program, measuring performance through simple tasks like rising from a chair five times, balance, and 4-meter walk test. Participants demonstrated meaningful improvement in physical performance, with the greatest benefit seen in those who were frail, or physiologically vulnerable, at the start of the program.4 These findings challenge the notion that frailty is an inevitable consequence of advanced lung disease and demonstrate that even patients needing transplant can regain strength and function through exercise. Frailty, however, can be difficult to measure consistently in the clinical setting, and its utility for predicting transplant outcomes is evolving. In a study led by Dr. Rozenberg, frail patients had worse physical function before lung transplant than non-frail patients. However, after transplant, they showed greater improvement, gaining about 191 metres in six-minute walk distance compared to 129 metres in the non-frail group, with greater quality of life gains and no increase in hospital stay or one-year mortality.5 This suggests that frailty alone should not exclude a patient from transplant and may even identify those who stand to benefit the most.
FEATURE
less leg fatigue for the same total workload, as rest periods allowed for recovery.7
Dmitry Rozenberg, MD, PhD, FRCPC Respirologist and Clinician-Scientist, University Health Network, Associate Professor, Department of Medicine, University of Toronto, National Sanatorium Association Chair in Respiratory Rehabilitation, West Park Healthcare Centre. Photo Credit: Dr. Dmitry Rozenberg
Delivering exercise to patients with advanced lung disease poses a particular challenge. Patients with interstitial lung disease, who make up about 60% of lung transplant candidates, often have significant oxygen desaturation as diseased lungs may be unable to transfer oxygen efficiently into the bloodstream due to thickened lung tissue or decreased oxygen delivery.6 In collaboration with Dr. Lisa Wickerson, Dr. Rozenberg has explored ways to adapt exercise for these patients: cycling in intervals, rather than continuously, resulted in smaller drops in blood oxygen levels and Graphic design by Qingyue Guo
These studies focused on making exercise safer for patients with advanced lung disease, but the COVID-19 pandemic introduced a new challenge: delivering care outside of the clinic. Until 2020, much of Dr. Rozenberg’s research took place in the clinic, but the pandemic shifted it into patients’ homes. He recently completed a pilot randomized controlled trial testing a home-based program for patients with COPD that goes beyond standard rehabilitation. The program pairs physical exercise with cognitive training, delivered entirely through videoconference, to target the cognitive and multitasking challenges that often accompany COPD alongside its physical symptoms.8 Dr. Rozenberg has also turned his focus to informal caregivers, who often neglect their own health while managing patients’ oxygen, medications, transportation, and appointments. He is co-leading a feasibility trial combining exercise, nutrition counselling, and stress management for caregivers, exploring how improving their wellbeing may, in turn, benefit the patients they support. Access remains a central concern throughout Dr. Rozenberg’s work. COPD is a leading cause of hospital admission in Canada; however, most patients who could benefit from pulmonary rehabilitation may not attend. Dr. Rozenberg asks, “Why are individuals with lung disease not coming to
these centres?” His solutions are practical: telerehabilitation and home-based assessments for those unable to travel and more accessible patient resources. One ongoing project is a national pulmonary rehabilitation portal, which lists over 200 pulmonary rehabilitation programs across Canada for patients and providers.9 When asked what sustains and fuels him, Dr. Rozenberg does not point to a result. He has a focused goal: making exercise a routine, accessible part of care for the many patients with chronic lung disease who may otherwise not receive it. References 1. Gloeckl R, Zwick RH, Fürlinger U, et al. Prescribing and adjusting exercise training in chronic respiratory diseases – expert-based practical recommendations. Pulmonology. 2023;29(4):306-314. doi:10.1016/j.pulmoe.2022.09.004 2. Soriano J, Kendrick P, Paulson K et al. Prevalence and attributable health burden of chronic respiratory diseases, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet Respiratory Medicine. 2027; 8: 585-596. 3. Rozenberg D, Singer LG, Herridge M, et al. Evaluation of skeletal muscle function in lung transplant candidates. Transplantation. 2017;101(9):2183-2191. 4. Wickerson L, Rozenberg D, Gottesman C, et al. Pre-transplant short physical performance battery: response to pre-habilitation and relationship to pre- and early post-lung-transplant outcomes. Clin Transplant. 2020; 34(12):e14095. 5. Rozenberg D, Mathur S, Wickerson L, et al. Frailty and clinical benefits with lung transplantation. J Heart Lung Transplant. 2018;37(10):1245-1253. 6. Valapour M, Lehr CJ, Skeans MA, et al. OPTN/SRTR 2018 annual data report: lung. Am J Transplant. 2020;20(Suppl s1):427-508. doi:10.1111/ajt.15677 7. Wickerson L, Brooks D, Granton J, et al. Interval aerobic exercise in individuals with advanced interstitial lung disease: a feasibility study. Physiother Theory Pract. 2021;37(9):1034-1042. 8. Rozenberg D, Shore J, Camacho Perez E, et al. Feasibility of a home-based cognitive-physical exercise program in patients with chronic obstructive pulmonary disease: protocol for a feasibility and pilot randomized controlled trial. JMIR Res Protoc. 2023;12:e48666. doi:10.2196/48666.PMID: 37436794. 9. Lung Health Foundation, UHN West Park Healthcare Centre. Canadian Pulmonary Rehabilitation Portal [Internet]. [cited 2026 Jul 14]. Available from: https://www.canadianpulmonaryrehab.com/ en/index.html
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FEATURE
Don’t Sweat It: Debunking the Alleged Consequences of Exercise on Heart Health
By Aria Afsharian
I
n the lead-up to the 2026 FIFA World Cup, eyes were on Danish footballer Christian Eriksen after he collapsed on the field from cardiac arrest during a match against Ukraine. This was not new for Eriksen, as he suffered a similar incident in 2021.1 While Eriksen recovered from both incidents, highly publicized cardiac events have fueled concerns about the safety of vigorous exercise. Understanding when exercise benefits the heart—and when it may be harmful—is a major focus of Dr. Jack Goodman, Professor Emeritus of Cardiac Health and Exercise in the Faculty of Kinesiology at the University of Toronto and adjunct scientist in the Mount Sinai Hospital Division of Cardiology. Dr. Goodman’s early research aimed to understand how cardiovascular health impacts exercise performance and heart function. He initially investigated how cardiovascular disease affects the body’s response to exercise.2,3 Now, Dr. Goodman examines how sustained vigorous exercise influences the heart, distinguishing normal physiological adaptations from pathological changes. In a 2010 study, Dr. Goodman and his team assessed the effects of acute exercise on heart function.4 Participants performed 150 minutes of high- and lowintensity exercise while heart function was assessed with echocardiography, in which ultrasound is used to image the heart. Following high-intensity exercise, participants showed reduced ventricular contractility, lower left ventricular
ejection fraction (i.e. blood pumped out from the ventricle) and reduced ventricular wall deformation, indicating a temporary reduction in cardiac efficiency known as “cardiac fatigue.” To explore the mechanistic explanation for this effect, the team examined whether changes in hormonal responsiveness contribute to reduced contractility during exercise. Catecholamines like norepinephrine increase heart rate and contractility by acting on β-adrenergic receptors, enhancing cardiac output (CO) during stress.4 To assess β-adrenergic responsiveness, participants were administered the synthetic catecholamine dobutamine before and after exercise, with heart function assessed via echocardiography. Pre-exercise dobutamine treatment produced the expected increase in CO, while postexercise dobutamine did not, suggesting that high-intensity exercise leads to cardiac fatigue partially through dampened β-adrenergic sensitivity. Importantly, this phenomenon appears to be a temporary physiological adaptation with Dr. Goodman emphasizing that, “there is still no evidence that these responses have long-term adverse cardiac consequences.” To further understand the distinction between acute physiological change and lasting pathology, Dr. Goodman also investigated whether high-intensity exercise has clinically relevant, long-term effects on cardiac structure. Athlete’s heart (AH) refers to a set of morphological
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changes to the heart in athletes who engage in long-term intensive training, including enlargement of ventricular chambers, increased wall thickness, and lower resting pulse.5 Despite similarities to some forms of heart disease, AH is typically a normal adaptation and not pathological.5 To investigate whether long-term exerciseinduced cardiac remodelling carries clinical consequences in middle-aged athletes, Dr. Goodman and colleagues performed a comprehensive study comparing longstanding (>10 years) endurance athletes who exercised for the recommended amount to a control group of recreational athletes with similar long-standing history.6 Both groups received a physical examination, underwent graded exercise testing and echocardiogram (ECG) assessment, along with cardiac imaging to assess cardiac structure and function. Endurance athletes showed cardiac remodelling, but there were substantial heterogeneity and variability within and between groups. Given past reports of exercise inducing ventricular fibrosis in athletes, cardiac MRI was used to determine if fibrosis was present in either group.7 Indeed, there was evidence of ventricular fibrosis in 25% of athletes, regardless of training history, but all had perfectly normal cardiac function. Their overarching findings were that cardiac adaptation to long term exercise is not uniform across individuals, even those with similarly high training exposure, and that presence of focal fibrosis in some areas are unlikely to have clinical relevance but may simply
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Jack Goodman, MSc, PhD Faculty of Kinesiology and Physical Education, University of Toronto. Photo Credit: Dr. Jack Goodman
be a ubiquitous physiological outcome of long-term exercise warranting further study. Endurance training promotes cardiac remodelling, but these changes are highly individualized. Whether these structural changes lead to adverse clinical outcomes remains unknown. Another avenue of research that attempts to bridge the effects of intensive exercise and adverse cardiac outcomes is atrial fibrillation (AF), the most common agerelated cardiac arrhythmia that causes rapid abnormal contractions of the upper Graphic design by Vicky Lin
heart chambers.8 AF is associated with well-established risk factors such as hypertension and obesity. Surprisingly, it is also more prevalent among endurance athletes who lack traditional risk factors. Studies by Dr. Goodman and collaborators suggest that AF in athletes may be linked to elevations in proinflammatory markers (e.g., IL6 and TNFα), in addition to markers for extracellular matrix remodelling and atrial fibrosis.9 Studies suggest an exercisedependent increase in some of these markers, but a direct cause-and-effect model between prolonged exercise, AF and cardiac pathology is yet to be uncovered. Dr. Goodman suggests that numerous factors are likely at play, and much more research is required to understand all of the potential mechanisms. How can we make sense of exerciserelated cardiac events and provide the public a sensible and reassuring message that vigorous exercise is healthy, yet also answer the fundamental question, “how much is too much?” Dr. Goodman says that “far more people die at home than they do playing sports,” adding that “there is irrefutable evidence that adhering to an active lifestyle that includes vigorous exercise is the single largest influencer in reducing all-cause mortality, cardiovascular disease, and certain forms of cancer.” Sudden cardiac events in athletes are extremely rare and typically occur in individuals with known or occult cardiac conditions. Exercise may act as a trigger, but it is not the underlying cause. While there are
certainly cardiac conditions where exercise must be used judiciously, the claim that exercise poses a risk because of incidents like Eriksen’s greatly misrepresents the overall risk-benefit profile of physical activity, overlooking its significant cardioprotective effects.
References 1. Douglas S. Danish soccer player Christian Eriksen recovering in hospital after again collapsing during match [Internet]. CBC. 2026 [cited 2026 July 8]. Available from: https://www.cbc.ca/sports/christian-eriksen-soccer-collapses-9.7226741 2. Goodman JM, Pallandi DV, Reading JR, Plyley MJ, Liu PP, Kavanagh T. Central and Peripheral Adaptations After 12 Weeks of Exercise Training in Post-Coronary Artery Bypass Surgery Patients. Journal of Cardiopulmonary Rehabilitation . 1999;19(3). 3. Hepple RT, Mackinnon SLM, Goodman JM, Thomas SG, Plyley MJ. Resistance and aerobic training in older men: effects on Vo2 peak and the capillary supply to skeletal muscle. Journal of Applied Physiology. 1997 Apr 1;82(4):1305–10. 4. Banks L, Sasson Z, Busato M, Goodman JM. Impaired left and right ventricular function following prolonged exercise in young athletes: influence of exercise intensity and responses to dobutamine stress. Journal of Applied Physiology. 2010 Jan 1;108(1):112–9. 5. Stefano Palermi, Cavarretta E, Flavio D’Ascenzi, Castelletti S, Ricci F, Vecchiato M, et al. Athlete’s Heart: A Cardiovascular Step-By-Step Multimodality Approach. Reviews in Cardiovascular Medicine. 2023 May 19;24(5):151–1. 6. Banks L, Bentley RF, Currie KD, Vecchiarelli E, Aslam A, Connelly KA, et al. Cardiac Remodeling in Middle-Aged Endurance Athletes and Recreationally Active Individuals: Challenges in Defining the “Athlete’s Heart.” J Am Soc Echocardiogr. 2020 Feb 1;33(2):247–9. 7. Banks L, Altaha MA, Yan AT, Dorian P, Konieczny K, Deva DP, et al. Left Ventricular Fibrosis in Middle-Age Athletes and Physically Active Adults. Medicine & Science in Sports & Exercise. 2020 May 29;52(12):2500–7. 8. Vecchiarelli E, Bentley RF, Connelly KA, Dorian P, Yan A, Mak S, et al. Atrial fibrillation in middle-aged athletes: Impact on left atrial, ventricular and exercise performance. Sciarra L, editor. PLOS ONE. 2024 Mar 13;19(3):e0294367. 9. Dorian D, Gustafson D, Quinn R, Bentley RF, Dorian P, Goodman JM, et al. Exercise‐Dependent Modulation of Immunological Response Pathways in Endurance Athletes With and Without Atrial Fibrillation. Journal of the American Heart Association. 2024 Mar 19;13(6).
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BMC SHOWCASE
Master of Science in
Biomedical Communications Paternal Preconception Health: The Hidden Key to Future Generations
Ravneet Jaura Ravneet Jaura is a biomedical communicator, where her Master’s Research Project focused on communicating the importance of paternal preconception health towards young males. She created a 2D/3D animation that focuses on epigenetics and how through this phenomenon the father’s health prior to conception affects pregnancy and long-term health of offspring. Combining her unique experience as a scientist and researcher, Ravneet aims to communicate science with accuracy. Ravneet is particularly interested in storytelling through infographic visualization and animation. More of Ravneet’s work can be found at: www.ravneetjaura.com. 20 | IMS MAGAZINE SUMMER 2026 EXERCISE AND SPORTS MEDICINE
BMC SHOWCASE
FacialPalsyPath
Ella Eberhardt Ella Eberhardt is a medical and scientific illustrator with an MSc in Biomedical Communications from the U of T with an interest in the world of patient education. FacialPalsyPath was created in collaboration with Dr. Kevin Zuo, a surgeon at Toronto Western Hospital. It encompasses an interactive patient education webpage alongside three posters which are mounted in the Facial Paralysis Clinic. She is always excited to create resources where people feel seen and supported.
Graphic design by Ravneet Jaura
IMS MAGAZINE SUMMER 2026 EXERCISE AND SPORTS MEDICINE | 21
BMC SHOWCASE
Translating Trauma: Visualizing the Neurobiology of Trauma for Clinical and Public Education
Jinny Moon Translating Trauma is a multimedia psychoeducational module developed with the Trauma Therapy Program at Women’s College Hospital. Using animation, illustration, and graphic narrative, it translates the neurobiology of trauma and plasticity for adults with histories of childhood interpersonal trauma and the clinicians who support them. The project balances scientific fidelity, cognitive accessibility, and trauma-informed care to make complex biological processes more understandable, emotionally supportive, and relevant to experiences of adaptation and healing. 22 | IMS MAGAZINE SUMMER 2026 EXERCISE AND SPORTS MEDICINE
BMC SHOWCASE
Master’s Research Project: Decoding Genetics | An Educational Animation on Techniques Used by the Precision Child Health Initiative at SickKids Hospital
Eve Higgins Eve is a biomedical illustrator and animator with a background in biomedical science and research. She combines scientific knowledge with visual storytelling to make science seen, understood, and remembered. She is particularly passionate about molecular biology, mechanisms of action, and the stories behind how things work at the cellular level. Her work focuses on translating novel research and complex medical concepts into visuals that make science easier to understand and connect with for broader audiences.
Graphic design by Ravneet Jaura
IMS MAGAZINE SUMMER 2026 EXERCISE AND SPORTS MEDICINE | 23
VIEWPOINT
The Other Side of Exercise as Medicine: Muscle Dysmorphia, Exercise Addiction, and Men’s Mental Health
By Melina Alborzi
S
omewhere between wellness podcasters Joe Rogan and Andrew Huberman, the gym became a form of therapy, especially for young men. Social media has fueled an explosion of trends in exercise culture: 6 a.m. lifting sessions, push-pull-legs routines, bulking and cutting cycles, and tracking macros to the gram. Layered onto these regimens is a growing obsession with optimization that promotes taking pre-workout and creatine, and herbal supplements like ashwagandha and tongkat ali, which claim to boost testosterone, energy, and recovery. On the surface, these are fitness trends, but increasingly they function as a framework for mental health and self-regulation. For some men, these routines bring genuine physical and mental relief, providing a sense of control and structure. However, for others, even the most disciplined habits at the gym may not provide the comfort or healing they hoped for. The societal pressure to look a certain way, fuelled by social media and fitness culture, risks turning exercise and health into unhealthy obsession. The effects of exercise on mental health have been a topic of research interest for decades. A 2024 study found that exercise, particularly walking, jogging, yoga, and strength training, significantly reduces depressive symptoms.1 Another study directly compared the effect of exercise to antidepressants and
found comparable efficacy.2 Evidence from a group of randomized trials in Sports Medicine found that resistance training significantly improves anxiety symptoms in both healthy adults and those with mental illness.3 Exercise triggers the release of brain chemicals that support the formation of new neural connections, improve sleep, sharpen focus, and help the body mitigate stress.4 It also builds self-efficacy and interrupts rumination, which is why the American College of Sports Medicine ranked “Exercise for Mental Health” sixth on its 2026 global fitness trends list.4 There is no doubt that exercise benefits both mental and physical health. For many, the gym is one of the few places that offers a sense of control and agency. The problem is not the gym, or exercise itself, but the fixation that can grow around it. Research on the risks of today’s exercise trends is growing. One risk that has emerged is a condition called muscle dysmorphia, a subtype of body dysmorphic disorder, characterized by a preoccupation with insufficient muscularity. The condition disproportionately affects boys and young men.5 The clinical features of muscle dysmorphia are very similar to what fitness culture rewards: strict training schedules, detailed diet tracking, body checking, and prioritizing the gym over relationships, school, and work. It is increasingly difficult to distinguish between healthy discipline and harmful obsession.
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Muscle dysmorphia prevalence is rising. The Canadian Study of Adolescent Health Behaviours suggests that 25.7 percent of men in their national sample were at clinical risk for muscle dysmorphia.6 In Canadian youth, muscle dysmorphia symptomatology has been prospectively linked to suicidal ideation and non-suicidal selfinjury. Another study from the same group, published in 2025, found that viewing muscularity-oriented content on social media—muscular bodies, supplement marketing, and content featuring muscle-building drugs—was independently associated with muscle dysmorphia in boys and men.7 These numbers show that for a growing number of Canadian men, the pursuit of an ideal body through exercise has become a mental health crisis. Another increasingly common problem is exercise addiction, which affects an estimated 8.1% of general exercisers.8 The condition shares many clinical characteristics with muscle dysmorphia. Diagnostic features include using exercise as the primary tool to regulate emotions, a growing need for more exercise to feel the same psychological effect, and feeling distress when unable to train. These are not quirks of a dedicated gym-goer, rather they are the criteria for addiction itself. A 2025 metaanalysis found that exercise addiction was significantly associated with eating disorders, obsessive-compulsive symptoms, depression, anxiety, body
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image disturbance, and emotional dysregulation.8 Exercise addiction is often overlooked due to society’s positive associations with exercise and health, but excessive exercise can have significant physical and psychological consequences. The pharmacological industry has taken advantage of this new, potentially unhealthy obsession with selfoptimization. Testosterone Replacement Therapy (TRT) is a treatment originally indicated for men with clinically low testosterone, but its use has expanded well beyond this indication. Testosterone plays a critical role in building muscle mass, strength, and energy, which makes it an appealing target for men chasing the same physique and performance ideals that fitness culture rewards.9 Online platforms now promote it as a solution for fatigue, low mood, and physical performance, often implying that bigger, leaner, and more energetic bodies are just a prescription away. TRT use among men under 25 rose by 120% and among men aged 25-34 by 86% between 2018 and 2022.10 A study in European Urology Focus found that 80 to 85% of men discontinue testosterone therapy within one year because it was prescribed without necessity and failed to produce the expected benefits.11
often present in young men who are exposed to fitness-focused social media feeds, predatory marketing from pharmacological companies, and the pressure to buy solutions to “fix” their appearance. Exercise is undoubtedly beneficial for mental health, but the “gym-astherapy” framing treats it as a complete solution. Exercise is medicine, but like any medicine, it needs the right dose, the right context, and support systems. The rise in muscle dysmorphia, exercise addiction, and off-label testosterone use is what happens when we expect exercise alone to be responsible for mental wellbeing. Missing a workout feels like failure, and tiredness becomes a problem that must be fixed by TRT. These trends suggest that the relationship between exercise, appearance, and men’s mental health is more complex than the classic “look good, feel good” narrative. Exercise is an effective tool, but its benefits are not guaranteed when it is entangled with a culture that equates physical optimization and psychological wellbeing.
References 1. Noetel M, Sanders T, Gallardo-Gomez D, Taylor P, Del Pozo Cruz B, van den Hoek D, et al. Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials. BMJ. 2024;384:e075847. 2. Recchia F, Leung CK, Chin EC, Fong DY, Montero D, Cheng CP, et al. Comparative effectiveness of exercise, antidepressants and their combination in treating non-severe depression: a systematic review and network meta-analysis of randomised controlled trials. Br J Sports Med. 2022;56(23):1375–80. 3. Gordon BR, McDowell CP, Lyons M, Herring MP. The Effects of Resistance Exercise Training on Anxiety: A Meta-Analysis and Meta-Regression Analysis of Randomized Controlled Trials. Sports Med. 2017;47(12):2521–32. 4. (ACSM) ACoSM. The Future of Fitness: ACSM Announces Top Trends for 2026. 2026 [Available from: https://acsm.org/top-fitnesstrends-2026/. 5. Nagata JM, Hur JO, Murakami K, Ganson KT, He J, Murray SB, et al. Muscle dysmorphia in adolescents and young adults. Lancet Child Adolesc Health. 2026;10(2):122–34. 6. Ganson KT, Hallward L, Cunningham ML, Rodgers RF, Murray SB, Nagata JM. Muscle dysmorphia symptomatology among a national sample of Canadian adolescents and young adults. Body Image. 2023;44:178–86. 7. Ganson KT, Testa A, Rodgers RF, Nagata JM. Associations between muscularity-oriented social media content and muscle dysmorphia among boys and men. Body Image. 2025;53:101903. 8. Wang X, Yang X, Tao T, Dong D, Yu D. The association between exercise addiction and mental health problems: A systematic review and meta-analysis. J Affect Disord. 2026;393(Pt A):120026. 9. Vingren JL, Kraemer WJ, Ratamess NA, Anderson JM, Volek JS, Maresh CM. Testosterone physiology in resistance exercise and training: the up-stream regulatory elements. Sports Med. 2010;40(12):1037–53. 10. Selinger S, Thallapureddy A. Cross-sectional analysis of national testosterone prescribing through prescription drug monitoring programs, 2018-2022. PLoS One. 2024;19(8):e0309160. 11. Bandari J, Ayyash OM, Emery SL, Wessel CB, Davies BJ. Marketing and Testosterone Treatment in the USA: A Systematic Review. Eur Urol Focus. 2017;3(4-5):395–402.
These behavioural and pharmacological patterns are closely connected. Body dissatisfaction, compulsive routines, and turning to medication or supplements Graphic design by Allison Conwell
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Creatine Supplementation Separating Fact from Fiction
By Sabeeka Malik
W
alk into a gym, scroll through FitnessTok, or talk to a student athlete, and one supplement is almost guaranteed to come up: creatine. Creatine is one of the most widely used dietary supplements in the fitness world and is praised for its ability to enhance strength and performance.1 Some view it as an essential addition to any serious athlete’s routine, while others warn about its health risks. Research, however, shows that creatine is safe, and may even have benefits beyond athletic performance. Creatine is an endogenous amino acid derivative that is synthesized in the liver, kidneys, and pancreas.2 Creatine can also be obtained through the diet, mainly from meat and fish.3 After uptake or synthesis, creatine travels through the bloodstream to tissues with high energy demands, including skeletal muscle, the brain, and the heart.2 Short-duration energy production during high intensity anaerobic activities such as weightlifting, sprinting, and football relies on creatine. At rest, creatine kinase (CK) facilitates the conversion of adenosine triphosphate (ATP) and creatine into phosphocreatine (PCr) and adenosine diphosphate (ADP).2,3 During periods of high energy demand, PCr acts as a phosphate reserve allowing the regeneration of ATP from ADP. This is achieved by CK, which transfers a phosphate from PCr back to ADP, restoring ATP and regenerating creatine.2,3 As resynthesis of ATP from PCr and ADP
is quicker than the production of ATP from oxidative phosphorylation and other glycolytic processes, this process is critical during periods of brief, high-intensity energy demands.2 Several studies have been conducted to determine the benefits of creatine supplementation for enhancing exercise and sports performance. A meta-analysis reviewing data from randomized controlled trials (RCTs) and biochemical and physiological studies, found evidence to support the use of creatine for enhancing muscular strength and power, increasing capacity for high-intensity training, and improving recovery times.1 The performance enhancing effects of creatine supplementation are attributable to increases in intracellular PCr.1 Importantly, while creatine supplementation can enhance high intensity exercise performance, it is not a cure-all for athletes as it is less effective for improving endurance performance.1 Endurance training requires strenuous physical efforts for long intervals. As such, it relies heavily on aerobic energy, which requires higher sustained ATP yields over extended periods of time. Therefore, for aerobic activities requiring endurance, like long-distance running, cycling, or swimming, creatine supplementation does not have the same benefit. Despite its advantages, there are common misconceptions about creatine supplementation, suggesting potential
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health risks associated with its usage. One such misconception is the effect of creatine supplementation on kidney function. These concerns are due to an observed increase in creatinine (the natural waste product of creatine and PCr) in the blood and urine, after creatine supplementation.4 Increased creatinine levels can be indicative of an underlying renal issue. However, increased levels alone are not a definitive sign of poor kidney function. For instance, increases are also observed in individuals with meat-rich diets.4 Currently, there is no evidence to suggest creatine supplementation negatively impacts renal function.5 There are also controversies surrounding the effects of age and sex on the benefits of creatine supplementation. Most studies have been conducted in adult males, leading to skepticism about the reproducibility of results in females and adolescent populations. In the past several years, however, many studies have been conducted focusing on the effects of creatine supplementation in females. Despite sex differences, research shows creatine supplementation increases PCr stores in females, as well, leading to comparable benefits to those observed in males.1,4 While research on the effects of creatine supplementation in adolescents is still limited, emerging studies indicate that creatine is not harmful and has similar benefits in children and adolescents.4 Overall, current evidence suggests that age and sex have little impact on the benefits of creatine.
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There is also a misconception that when starting creatine supplementation, a “loading phase” is required before entering a “maintenance phase.” A “loading phase” is when individuals initially take a greater dosage (e.g., 20-25 grams/day, often broken down into four to five smaller doses throughout the day) for a short period of time. Then, in the “maintenance phase”, smaller doses are taken (e.g., 3-5 grams/ day). For someone considering starting creatine supplementation this can sound very intense. However, many studies demonstrate that a lower creatine dose, without a preliminary “loading phase”, is sufficient to increase cellular PCr stores.4 Importantly, creatine is not only relevant to performance enhancement, but it is also fundamental to cellular energy homeostasis. The importance of creatine is demonstrated by the consequences of its deficiency, which can arise due to genetic defects. Creatine synthesis relies on two key enzymes: L-arginineglycine amidinotransferase (AGAT) and guanidinoacetate N-methyltransferase (GAMT).2 Cellular uptake is mediated by the creatine transporter (CRT).2,3 Creatine deficiency disorders (CDDs)—a group of three rare genetic disorders (AGAT deficiency, GAMT deficiency, and CRT deficiency)—cause developmental delays and cognitive dysfunction.6 Because creatine supplementation has been shown to improve symptoms, it is part of standard treatment extending creatine’s use beyond recreational contexts and into therapeutic ones.6 Graphic design by Sabrina Viloria
Increasing evidence suggests that creatine may be relevant in health and disease. The brain, which accounts for nearly 20% of total resting energy expenditure, relies on continuous ATP supply to support neuronal function. Therefore, the ratio of PCr to creatine is critical for meeting energy demands.7 Recent studies suggest that creatine supplementation may improve cognition, especially memory, attention, and processing speed.2,8,9 There are conflicting studies regarding creatine’s effect on cancer. Some studies have shown that creatine may enhance the activity of anti-tumour CD8+ T-cells and promote tumour apoptosis pathways.10 In contrast, others have shown that, due to its role in increasing ATP levels (which benefit proliferating cancerous cells), creatine may lead to cancer progression and metastasis.10 Some preliminary research shows that inhibiting the creatine transporter has promising therapeutic benefits in mitigating cancer progression.11 Taken together these studies suggest that creatine plays a complex role in cancer progression. Creatine is a well-studied compound with strong evidence supporting its efficacy in enhancing high-intensity exercise performance through increased PCr availability and faster ATP regeneration. Its benefits in strength, power, recovery, and even certain cognitive functions make it a valuable supplement for both athletes and the general population. Beyond the gym and CDDs, creatine research is
evolving fast, and creatine is proving to be a promising compound with potential benefits across different fields.
References 1. Wax B, Kerksick CM, Jagim AR, et al. Creatine for exercise and sports performance, with recovery considerations for healthy populations. Nutrients. 2021;13(6):1915. doi:10.3390/nu13061915. 2. Bonilla DA, Kreider RB, Stout JR, et al. Metabolic basis of creatine in health and disease: a bioinformatics-assisted review. Nutrients. 2021;13(4):1238. doi:10.3390/nu13041238. 3. Kreider RB, Stout JR. Creatine in health and disease. Nutrients. 2021;13(2):447. doi:10.3390/nu13020447. 4. Antonio J, Candow DG, Forbes SC, et al. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? J Int Soc Sports Nutr. 2021;18(1):13. doi:10.1186/s12970-021-00412-w. 5. Naeini EK, Eskandari M, Mortazavi M, et al. Effect of creatine supplementation on kidney function: a systematic review and meta-analysis. BMC Nephrol. 2025;26:622. doi: 10.1186/s12882025-04558-6 6. Mercimek-Andrews S, Salomons GS. Creatine Deficiency Disorders. In: Adam MP, Bick S, Mirzaa GM, et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 2009 Jan 15 [updated 2025 Aug 7]. Available from: https://www.ncbi.nlm.nih. gov/books/NBK3794/. 7. Forbes SC, Cordingley DM, Cornish SM, et al. Effects of creatine supplementation on brain function and health. Nutrients. 2022;14(5):921. doi:10.3390/nu14050921. 8. Marshall S, Kitzan A, Wright J, et al. Creatine and cognition in aging: a systematic review of evidence in older adults. Nutr Rev. 2026;84(2):333-344. doi:10.1093/nutrit/nuaf135. 9. Xu C, Liu P, Li Y, et al. The effects of creatine supplementation on cognitive function in adults: a systematic review and meta-analysis. Front Nutr. 2024;11:1453467. doi:10.3389/fnut.2024.1453467. 10. Geng Y, DeLay SL, Chen X, et al. It is not just about storing energy: the multifaceted role of creatine metabolism on cancer biology and immunology. Int J Mol Sci. 2024 Dec 11;25(24):13273. doi: 10.3390/ijms252413273. 11. Abdollahzadeh M, Ghodsi R, Taherzadeh Z, et al. Targeting creatine and creatine kinase in cancer: exploring potential therapeutic strategies. Curr Drug Targets. 2025;26(11):739-756. doi: 10.2174/01 13894501373936250609114913.
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Can Resistance Training Help the MS Brain Repair its Wiring? By Areej Mir
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ntil recently, people living with multiple sclerosis (MS) were advised against exercise. This caution is largely attributed to Uhthoff ’s phenomenon, in which physical exertion raises body temperature and temporarily worsens neurological symptoms. While these symptoms mimic disease activity, they are reversible once body temperature normalizes, distinguishing them from a true MS relapse.1 MS is an autoimmune-mediated disease of the central nervous system (CNS) that impacts vision, sensation, coordination, and cognition.2 The site and severity of CNS damage vary between patients, meaning that MS can affect people differently. Many people are first diagnosed with relapsing-remitting MS, where symptoms flare and then partly or fully improve, while others develop a more progressive course over time.3 Recently, clinical researchers have begun to separate temporary, exerciserelated symptoms from actual disease worsening. This distinction has prompted a re-evaluation of exercise in MS and challenged the assumption that physical activity worsens disease. A 2023 review of the safety profile of exercise training in multiple sclerosis suggests that exercise is safe, with no clear increase in relapse risk or serious adverse events compared with not exercising.4 Despite initial assumptions, emerging evidence shows that when appropriately prescribed, exercise is beneficial for people with MS.5,6,7
In MS, immune cells attack myelin, the fatty sheath that protects our nerves ensuring that signals travel efficiently. When myelin is damaged, signals from the brain to the body slow or become blocked. During MS disease activity, immune cells in the CNS release inflammatory molecules, called cytokines and chemokines, that can further injure myelin. They may also limit the ability of the brain to initiate repair.6 This damage is especially impactful for motor function. The motor cortex may send a command to lift the foot, grip an object, or stabilize the trunk, but the message may arrive late or inconsistently. While the body’s muscles remain intact, the nervous system cannot always recruit them with precision.6,7 Critically, heat can worsen this by disrupting signalling in demyelinated fibres. The increase in body temperature associated with exercise leads to temporarily exacerbated symptoms, but exercise itself is harmless.1 Importantly, while some medications can slow MS activity, there is no cure for MS. As the assumptions surrounding MS and exercise have shifted, researchers are now turning to exercise as a possible strategy to improve motor function and plasticity.⁸ Part of the benefits of exercise for MS lie in the muscles’ ability to release hormones and signaling molecules.9 In the last two decades, researchers have found that contracting muscles release hormones called myokines. Myokines act locally or distally via the bloodstream and can travel into the CNS.10 In the CNS, myokines
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perform two critical functions: they act as “peacekeepers” to calm the immune system, and they stimulate the brain’s native repair cells.3,11 Specifically, muscle-derived myokines like Interleukin-6 (IL-6) shift the immune environment toward a resting state by stimulating anti-inflammatory mediators (such as IL-10) and suppressing inflammatory factors like tumour necrosis factor (TNF).3,10 Myokines reduce the biological pressure that impedes natural repair by silencing the immune cells that normally attack myelin. Resistance training may be particularly beneficial because it puts muscles under mechanical tension. That tension triggers intracellular pathways, resulting in a coordinated burst of exercise-induced signals, known as exerkines.3 Beyond regulating inflammation, specific exerkines such as Brain-Derived Neurotrophic Factor (BDNF), irisin, and Insulin-like Growth Factor 1 (IGF-1) actively support nervous system adaptation.3,11 BDNF promotes neuronal survival and repair, and helps the brain adjust and rewire synaptic connections after damage. Irisin facilitates muscle-brain communication, while IGF-1 is heavily involved in cellular growth, including the survival of the cells responsible for producing new myelin.3 In MS, chronic neuroinflammation leads to the breakdown of the blood-brain barrier, which controls what cells enter the CNS.12 During inflammatory activity, hyperactive immune cells cross into the CNS and contribute to demyelination.
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The release of beneficial exerkines during exercise helps mitigate this effect by changing the behavior of nearby circulating immune cells and blood vessels before they even reach the brain.12 While one lifting session may not block an MS flare, repeated training helps create a less inflammatory systemic environment, which reduces stress on vulnerable neural tissue. Additionally, in a 2018 clinical trial, participants with relapsing-remitting MS completed 24 weeks of progressive resistance training.13 The trial demonstrated that resistance training improved strength and function, and MRI findings suggested increased cortical thickness in several regions. Cortical thickness refers to the thickness of the brain’s outer layer, which supports movement, sensation, cognition, and other functions. Because cortical thinning in MS can reflect neurodegeneration, preserved or increased cortical thickness after training may suggest a protective effect of exercise on brain structure.13 While cortical thickness is not direct evidence of remyelination, it is a surrogate measure that may suggest improvement in these patients. Importantly, these new findings do not suggest a “train harder at any cost” approach; MS is a diverse disease that requires personalized treatments. Many factors, such as heat sensitivity, fatigue, and medication effects should shape the type of training program utilized. What appears most beneficial is structured, progressive resistance training. This Graphic design by Laura Wu
approach targets major muscle groups and promotes planned progression with adequate rest. Cooling strategies can be employed to mitigate increased body temperature, and supervision is advised when balance impairments or disability make training riskier.
Weightlifting is not a “universal remedy” for MS, nor is it a substitute for neurologic care or disease-modifying treatment. Its importance is likely additive to existing treatment options. Resistance training takes advantage of the muscle’s ability to act as a signaling organ that regulates inflammation, supports neuroplasticity, and creates a favourable environment for myelin repair. MS damages communication between the brain and the body. Exercise asks that system to communicate again, repeatedly, under a controlled load. While resistance training cannot reverse the disease on its own, these repeated signals may help engage biological pathways involved in repair and
adaptation. In that sense, strength training may represent more than rehabilitation—it may help create the conditions necessary for neurological recovery. References 1. Opara JA, Brola W, Wylegala AA, et al. Uhthoff ’s phenomenon 125 years later: what do we know today? J Med Life. 2016;9(1):101–105. 2. National Institute of Neurological Disorders and Stroke. Multiple sclerosis (MS) [Internet]. Bethesda: National Institute of Neurological Disorders and Stroke; 2025 [cited 2026 Apr 27]. Available from: https://www.ninds.nih.gov/health-information/disorders/ multiple-sclerosis-ms 3. National Multiple Sclerosis Society. Immune-mediated disease and MS [Internet]. New York: National Multiple Sclerosis Society; [date unknown] [cited 2026 Apr 27]. Available from: https://www. nationalmssociety.org/understanding-ms/what-is-ms/how-ms-affects-the-brain/immune-mediated-disease 4. Learmonth YC, Herring MP, Russell DI, et al. Safety of exercise training in multiple sclerosis: an updated systematic review and meta-analysis. Mult Scler. 2023;29(13):1604–1631. 5. Alifarsangi A, Khaksari Haddad M, Rajizadeh MA. Exercise-induced exerkines in multiple sclerosis: emphasizing the pivotal role of myokines. Brain Res Bull. 2025;231:111565. 6. Florindo M. Inflammatory cytokines and physical activity in multiple sclerosis. ISRN Neurol. 2014;2014:151572. 7. Jensen SK, Michaels NJ, Ilyntskyy S, et al. Multimodal enhancement of remyelination by exercise with a pivotal role for oligodendroglial PGC1α. Cell Rep. 2018;24(12):3167–3179. 8. Gonzalez-Andrade F, Alcaraz-Alvarez JL. Disease-modifying therapies in relapsing-remitting multiple sclerosis. Neuropsychiatr Dis Treat. 2010;6:365–373. 9. Hoffmann C, Weigert C. Skeletal muscle as an endocrine organ: the role of myokines in exercise adaptations. Cold Spring Harb Perspect Med. 2017;7(11):a029793. 10. Nara H, Watanabe R. Anti-inflammatory effect of muscle-derived interleukin-6 and its involvement in lipid metabolism. Int J Mol Sci. 2021;22(18):9889. 11. Kostka M, Morys J, Małecki A, et al. Muscle–brain crosstalk mediated by exercise-induced myokines: insights from experimental studies. Front Physiol. 2024;15:1488375. 12. Ortiz GG, Pacheco-Moisés FP, Macías-Islas MÁ, et al. Role of the blood-brain barrier in multiple sclerosis. Arch Med Res. 2014;45(8):687–697. 13. Kjølhede T, Siemonsen S, Wenzel D, et al. Can resistance training impact MRI outcomes in relapsing-remitting multiple sclerosis? Mult Scler. 2018;24(10):1356–1365.
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Exercise in the Era of SkinnyTok By Annanya Walia
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Is this rage bait?” one user commented under a TikTok video titled, “Liv Schmidt is the goal.” Schmidt is a social media influencer who gained virality due to her “What I eat in a day to stay skinny” and “Living slim in the city” videos on TikTok. She is also a brand ambassador for “SkinnyTok,” a social media movement that idealizes thinness. The video, posted by a male influencer, highlights a smaller body type as universally desirable amongst women, promoting unhealthy, culturally reinforced body ideals. The video goes on to argue that women fail to achieve these aesthetic ideals due to a lack of discipline. What was intended as a shared sentiment on behalf of women quickly unravelled, as most comments challenged his claims. Yet, this is not the first time such content has drawn backlash online, as Schmidt’s TikTok account was banned in late 2024 after growing criticism for perpetuating unhealthy eating behaviours and unrealistic body standards.1 However, the crackdown on misleading, weight-related content is only a band-aid solution in the age of “biohacking,” a term describing the use of self-experimentation based on anecdotal evidence to optimize physical performance and appearance. Despite a brief reprieve as bodypositivity gained mainstream traction, the pendulum has again swung the other way, with greater emphasis on thinness, evident in trends on SkinnyTok
and the growing popularity of GLP-1 medications.2 The pursuit of thinness is increasingly reframed through the language of athleticism, metabolic health and anti-inflammation. The emphasis on thinness is only one manifestation of a broader optimization culture on social media, which promotes multi-step anti-aging routines, restrictive diets, and supplement regimens as pathways to achieve “perfect” health, often with limited or selectively interpreted evidence. Social media has transformed thinness into a medicalized pursuit of health optimization, blurring the boundary between aesthetic ideals and evidence-based wellness. Social media has increasingly normalized pharmacological methods of achieving aesthetic ideals when discipline and lifestyle-related measures fail. There is a plethora of TikTok anecdotes in which influencers describe their experiences with GLP-1s, claiming these drugs quiet “food noise,” enable “clean eating,” and allow one to “listen to the body’s hunger cues.” In reality, GLP-1 medications work by quenching appetite without distinguishing between legitimate hunger cues and obsessive food-related thoughts.3 For people with a history of anorexia or malnutrition, these drugs can undo years of progress.4 The problem is not GLP-1 use, as they have been clinically validated to combat obesity and decrease the risk of lifestyleassociated health disorders, but the way that social media portrays these
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medications as lifestyle enhancements rather than medical interventions.3 The social media discourse on longevity is similar in that it reframes the anti-aging paradigm to be optimization-focused, interlinking medical interventions with lifestyle aspirations. Videos such as those titled “7 ways to live longer” and “Biohacking for women,” often promote structured practices including sleep tracking, red light therapy, cold exposure, continuous glucose monitoring and supplement stacking as strategies for lifespan extension.5 The sheer volume of longevity-focused content on TikTok creates the impression that thousands of individuals have decoded the secret to increasing life expectancy, often without any integration of complex aging biology. Underlying these prescriptive routines is a recurring theme in which longevity is presented as a proactive, scientific pursuit in contrast to anti-aging, which is viewed as a more cosmetic counterpart. Both concepts converge on similar aesthetic endpoints: markers of youthfulness like lean physiques, smooth skin, and muscular definition. Individuals positioned as “health optimization” experts on social media are rarely evaluated by clinical or physiological health outputs, but by how closely their appearance aligns with the ideals they promote. In this way, the longevity discourse on social media can reduce the complex biological process of aging to visible indicators of youthfulness, effectively merging evidence-based medicine with the medicalization of appearance.
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Some physicians have criticized biohacking for reducing health to the pursuit of optimized biological metrics. Doctor Mike, a physician and prominent health educator on YouTube, highlights the contradiction of promoting exercise as essential for health while simultaneously discouraging sports participation or training intensity to avoid injury and to preserve one’s “athletic score.”6 This biohacking mindset restricts exercise primarily for the purposes of maximizing physiological markers rather than as a source of enjoyment, strength or overall wellbeing. In this way, biohacking influencers position aging as a disease and promote routines, practices and products as therapies. On social media, normal physiological processes can be recast into problems requiring continual intervention. As a result, the pursuit of health shifts from maintaining well-being to an ongoing project of self-optimization.7 Health cannot be defined simply by a number on a scale, ever-changing visual standards, or obsessive biometric tracking that is detached from clinical necessity. Clinical measures of health consider functional and physiological capacity, as assessed by body mass index, cardiovascular parameters, oxygen consumption, and metabolic markers, none of which can be inferred solely from appearance.8 Additionally, the optimization-focused culture overlooks a critical determinant of health, which is the psychological burden caused by the constant monitoring, analyzing and disciplining of the body to pursue evolving ideals. Graphic design by Kevin Trinh
These social and psychological implications extend beyond the adoption of specific health practices. Compulsivity and perfectionism in health-associated behaviours, whether meal planning, sleep tracking or biomarker optimization, can promote anxiety and social withdrawal.9 Deviating from self-imposed lifestyle restrictions can instigate feelings of failure, further reinforcing compulsive biohacking behaviours. Likewise, maintaining a hyperoptimized, longevity-centric routines can diminish enjoyment in social settings as health-related anxiety dictates everyday choices.9 Within this framework, health becomes an ideal to be relentlessly pursued and perfected, rather than serving to support overall wellbeing. Despite their potential harm, videos like “Liv Schmidt is the goal” continue to circulate on social media. Although social media platforms now issue disclaimers about disordered eating content, and audiences are increasingly aware of “skinny propaganda,” the discourse itself has not disappeared. Modern wellness culture has reframed beauty as evidence of discipline, optimization and superior health. In this framing, pseudoscience becomes the guiding logic behind these interventions and is repackaged as a scientific pursuit. In this process, health becomes less about physical and mental wellness and more about performance and physiological perfection.
References 1. Maheshwari S. Liv Schmidt and the return of skinny culture on TikTok [Internet]. New York (NY): The New York Times; 2024 Sep 20 [cited 2026 Jun 2]. Available from: https://www.nytimes. com/2024/09/20/style/liv-schmidt-tiktok.html 2. LaMotte S. What is SkinnyTok and why are experts concerned? [Internet]. Atlanta (GA): CNN; 2025 May 16 [cited 2026 Jun 2]. Available from: https://www.cnn.com/2025/05/16/health/what-isskinnytok-wellness 3. Brennan D. Weight-loss drugs: What you should know [Internet]. Rochester (MN): Mayo Clinic; 2025 Aug 14 [cited 2026 Jun 2]. Available from: https://communityhealth.mayoclinic.org/featured-stories/weight-loss-drugs 4. Dennis K. GLP-1 medications and eating disorders [Internet]. New York (NY): National Eating Disorders Association; [date unknown] [cited 2026 Jun 2]. Available from: https://www.nationaleatingdisorders.org/glp-and-eating-disorders/ 5. Charlap S. Getting extra blood tests like biomarkers [Internet]. San Francisco (CA): Medium; 2026 Feb 2 [cited 2026 Jun 2]. Available from: https://medium.com/@scharlap_807/getting-extra-bloodtests-like-biomarkers-9d2129b31462 6. Doctor Mike. Biohacking is getting out of hand [Internet]. San Bruno (CA): YouTube; 2024 Jul 10 [cited 2026 Jun 2]. Available from: https://www.youtube.com/watch?v=EBAwZLxs_OE 7. Hill A. The troubling rise of longevity fixation syndrome: “I was crushed by the pressure I put on myself ” [Internet]. London (UK): The Guardian; 2026 Feb 8 [cited 2026 Jun 2]. Available from: https:// www.theguardian.com/society/2026/feb/08/the-troubling-rise-oflongevity-fixation-syndrome-i-was-crushed-by-the-pressure-i-puton-myself 8. Mora S, Redberg RF, Cui Y, Whiteman MK, Flaws JA, Sharrett AR, et al. Ability of exercise testing to predict cardiovascular and all-cause death in asymptomatic women: a 20-year follow-up of the lipid research clinics prevalence study [Internet]. Dallas (TX): American Heart Association; 2000 Sep 26 [cited 2026 Jun 2]. Available from: https://www.ahajournals.org/doi/10.1161/01. cir.102.13.1591 9. Horovitz O, Argyrides M. Orthorexia and Orthorexia Nervosa: A Comprehensive Examination of Prevalence, Risk Factors, Diagnosis, and Treatment. Nutrients. 2023; 15(17):3851. https://doi. org/10.3390/nu15173851
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VIEWPOINT
Is it Just Nerves?
By Eesha Rehman
I
t can start with a feeling of numbness or burning. Then, a sudden sharp, shooting pain dashes across a limb. Even the weight of a blanket feels like thousands of tiny needles. This is the reality of living with a peripheral nerve injury (PNI). Every day, athletes push their bodies to the limit. All it takes is a fall, collision, or repetitive movement to cause a PNI. These injuries are invisible but debilitating, and may lead to muscle weakness, numbness, pain, and autonomic dysfunction. Unlike broken bones and torn ligaments, nerve injuries are often difficult to recognize, diagnose, and treat. Although they account for a small proportion of sports injuries, delayed diagnosis and limited access to specialized care can leave athletes with lifelong pain, weakness, or loss of function.
swelling that gradually compresses nerves, leading to chronic entrapment injuries. PNIs represent only 5.7% of sports related injuries, though it is thought that PNIs are underrepresented due to poor recognition and diagnosis. Additionally, their impact is far more devastating than their frequency suggests.3 Without proper intervention, these injuries can become permanent, lifealtering conditions.
The peripheral nervous system connects the brain and spinal cord to the rest of the body, and enables sensation, muscle control, and perception of and interaction with the environment.1 The peripheral nervous system is essential not just to athletic performance, but to quality of life; when it is damaged, sensation and movement are impacted.
Nerve damage is notoriously difficult to treat. Nerves are precisely organized structures and biologically prioritize signal transduction over regeneration.3 Therefore, nerve regrowth occurs at an extremely slow pace, growing at a rate of around one millimeter per day.4 Moreover, during the regeneration process, there are various vulnerabilities that can impede a full and complete recovery. For instance, axonal misdirection, i.e. failure of the nerve to regrow and contact their original target organs or muscles, results in poor functional recovery.4 Diagnoses and treatments require high levels of accuracy and precision to ensure proper recovery. Such requirements are particularly important for athletes, who utilize the peripheral nervous system for peak performance and coordination.
PNIs may result from sudden trauma or repetitive overuse. Acute injuries— like those caused by forceful tackles, fractures, and dislocations—can stretch, compress, or sever a nerve.2 Repetitive motions common in sports like baseball, swimming, and cycling may cause tissue
Diagnostic challenges are partially attributable to the inability to adequately visualise PNIs. Unlike a fractured bone, nerve damage cannot be detected with standard imaging techniques like x-ray.5 To overcome such limitations, classification systems have been
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implemented to standardize severity and predict recovery. These systems combine clinical examination, sensory testing, electromyography, and advanced imaging to understand the state of the injured nerve.5 Seddon’s classification system, the most widely used, divides PNIs into three tiers: neuropraxia, or temporary disruption of nerve signalling; axonotmesis, in which nerve fibers are damaged but the surrounding structures remain intact; and neurotmesis, the complete severing of the nerve.6 Urgency of intervention increases with injury severity, meaning that standardized classification systems are critical to quality clinical care.
Increasingly, advanced imaging techniques like magnetic resonance imaging (MRI) and high-resolution ultrasound are being used to diagnose PNIs given their ability to provide detailed images of injured nerves and surrounding tissues, improving diagnostic accuracy.7 Despite their utility in assessing PNIs, such tools remain underused in Canada as long wait times and limited access often delay access.8 Without timely imaging and subsequent diagnosis, patients are at greater risk of delayed treatment or misdiagnosis, which risk the development of permanent nerve damage.
VIEWPOINT
Even with a diagnosis, surgical treatment options for PNIs are limited, leading patients to rely solely on pain management, anti-inflammatory drugs, or physical therapy in hopes of achieving recovery.7 Surgery is reserved for severe PNIs like complete transections or injuries that persist despite rehabilitation. Surgical interventions like nerve grafts and direct repair are promising, but are associated with risk of infection, graft rejection, and improper regeneration of nerves.7 Treatment challenges are exacerbated by limited access to specialized care. Currently, only four clinics in Canada specialize in PNI, causing long wait times for assessment and surgery.9 A recent Ontario study reported median wait times of 27-45 days.9 Because successful nerve regeneration relies on timely intervention, even a week of delay can reduce the likelihood of a full recovery.10 Some patients opt to seek alternative care abroad, shouldering heavy medical fees to feel relief from the pain of nerve injury. Emerging treatments aim to bypass invasive surgical intervention in hopes of improving access to care and enhancing recovery. These novel interventions are shifting PNI care towards a personalised approach. One promising avenue is the dual use of biological agents alongside stimulation modalities, in which the patient receives a localized delivery of neurotrophic factors and pluripotent stem cells.11 The treatment is delivered in tandem with non-invasive electric Graphic design by Anthony Bortolin
stimulation to support axonal growth and neurotrophic signalling. Less invasive than traditional surgical approaches, this dual support system promotes and assists nerve recovery and reduces the chance of adverse outcomes from graft rejection and nerve misalignment. Overcoming the barriers to effective treatment of peripheral nerve injury is critical to restoring quality of life, especially for athletes, as the consequences of peripheral nerve injury extend beyond physical pain. Sports are often central to their identity and livelihood. Losing the ability to compete—or even to perform daily activities—can take a profound toll that alters the trajectory of an athletic career. Treatment of PNIs requires an interdisciplinary, dynamic team of healthcare workers to share the weight of care and support the recovery of athletes. Sports medicine is an integrative field that requires professionals with surgical, rehabilitation, and pharmaceutical expertise to generate personalized plans. Every injury is different, and so is every person. Thus, each injury requires a combination of therapies that best aligns with recovery. While peripheral nerve injuries are less common than other sports injuries, their consequences may be lifelong. Delayed diagnoses, limited access to specialized care, and the biological challenges of nerve regeneration mean that even minor
injuries can have lasting effects. Advances in imaging and treatment modalities offer hope for improved recovery after PNI but implementing such innovations requires a shift toward accessible, specialized care. The translational gap between diagnoses and treatment results in worsened functional outcomes.10 Early intervention for PNIs can significantly reduce the possibility of permanent and debilitating health consequences. PNIs are more than just nerves and require a network of support to assist patients in their return to normal activity. References 1. Radić B, Radić P, Duraković D. Peripheral nerve injury in sports. Acta Clin Croat. 2018 Sep;57(3):561–9. doi:10.20471/ acc.2018.57.03.20 2. Hirasawa Y, Sakakida K. Sports and peripheral nerve injury. Am J Sports Med. 1983 Nov-Dec;11(6):420-6. doi: 10.1177/036354658301100607. 3. Sheddon H. Three types of nerve injury. Brain. 1943 Dec 1;66(4):237–88. doi:10.1093/brain/66.4.237 4. Sunderland S. A classification of peripheral nerve injuries producing loss of function. Brain J Neurol. 1951 Dec;74(4). doi:10.1093/ brain/74.4.491 5. Farag JI, McDougall AN, Catapano M. Common sports-related nerve injuries seen by the electrodiagnostic medical consultant. Muscle Nerve. 2025 May;71(5):715-731. doi: 10.1002/mus.28298. 6. Baradaran A, El-Hawary H, Efanov JI, et al. Peripheral Nerve Healing: So Near and Yet So Far. Semin Plast Surg. 2021 Aug;35(3):204210. doi: 10.1055/s-0041-1731630. 7. Lorei M, Hershman E. Peripheral nerve injuries in athletes. Treatment and prevention. Sports Med Auckl NZ. 1993 Aug;16(2). doi:10.2165/00007256-199316020-00005 8. Dong Y, Alhaskawi A, Zhou H, et al. Imaging diagnosis in peripheral nerve injury. Front Neurol. 2023 Sep 14;14. doi:10.3389/ fneur.2023.1250808 9. Saggaf M, Novak CB, Baltzer HL, Anastakis DJ. Ontario wait times for delayed surgical treatment of traumatic peripheral nerve injury. Can J Surg. 2021 Nov 25;64(6):E636-E643. doi: 10.1503/cjs.011920. 10. Shay B, Moulin D. Peripheral nerve damage (peripheral neuropathy) [Internet]. Canadian Cancer Society; 2023 [cited 2026 Jun 8]. Available from: https://cancer.ca/en/treatments/side-effects/peripheral-nerve-damage 11. Aldali F, Tang L, Yang Y, et al. Peripheral nerve repair: innovations and future directions. J Transl Med. 2026 Feb 4;24(1). doi: 10.1186/ s12967-025-07567-z.
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SCICOMM SHOWCASE
New Research Suggests Blocking a Pathway in the Brain Can Help Treat Traumatic Brain Injury Symptoms By Ezgi Coskun
B
locking a single enzyme in the brain may reduce anxiety-like behaviours and memory problems after traumatic brain injury (TBI), according to new research from Dr. Aylin Y. Reid’s lab at the University Health Network (UHN).1 In a rat model of TBI, blocking indoleamine 2,3 dioxygenase 1 (IDO1), an enzyme that activates the kynurenine pathway after injury,2 improved postinjury behavioural outcomes.1 The findings suggest that targeting this pathway may represent a potential therapeutic strategy for the millions of people affected by TBI each year.
Canadian Hospitals Injury Reporting and Prevention Program, approximately 45% of reported head injuries were TBI (291,465 cases), and 15% of these cases involved children from the age of 5 to 19 participating in sports.4
Each year, over 50 million TBI cases are reported worldwide.3 The most common causes of TBI include falls, vehicle accidents, and sports.4 According to the
When Emma*, a 13-year-old high school student from London, Ontario collapsed during a football tournament two years ago; her parents experienced their worst
Despite its prevalence, there is no definitive treatment for TBI. Many survivors continue to struggle after injury, experiencing anxiety, memory problems, mood changes, and in severe cases, post-traumatic epilepsy (PTE), which is characterized by recurrent and spontaneous seizures.5
fear. “We just thought it was a concussion,” her mother said. “But then the memory issues and anxiety started, then seizures. She was a perfect A-student before.” What Emma and her family went through reflect what many TBI survivors face: untreated neurological diagnoses, loss of independence, and decreased quality of life. To better understand these long-term effects and develop treatments for patients like Emma, researchers in Dr. Reid’s lab are investigating the biological pathways contributing to neurological dysfunction after TBI. The team chose to study the kynurenine pathway, a major metabolic pathway that breaks down tryptophan to produce metabolites that regulate inflammation, oxidative stress, and communication between brain cells.6 According to Dr. Reid, the lab chose this pathway because “[it] has been implicated in a number of neurological disorders. Activation of this pathway can lead to increased inflammation and oxidative stress in the brain. While there is evidence that activity in this pathway is increased after TBI, no one had tried targeting this pathway with drugs after injury to see if it led to improvement.” The researchers focused on IDO1 because it acts as a key gatekeeper in the biochemical pathway that becomes overactive after the injury.2 After a TBI, inflammation acts as a defense mechanism to protect the brain. This inflammation influences how the body processes the amino acid tryptophan.
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SCICOMM SHOWCASE
Tryptophan is the building block of serotonin, our “happy” neurotransmitter that regulates mood, sleep, learning, memory, and seizure susceptibility.7,8 However, following TBI, inflammation increases activity of the kynurenine pathway, diverting more tryptophan away from neuroprotective serotonin production and toward the generation of kynurenine metabolites, some of which are neurotoxic.2 Studies have shown that an imbalance between neuroprotective and neurotoxic tryptophan metabolites is associated with psychological disorders as well as PTE.1,2 The IDO1 enzyme drives this shift,2 and acts as a guard that opens the door to the kynurenine pathway. During inflammation, production of IDO1 increases. This makes the kynurenine pathway more active, producing more downstream metabolites like neurotoxic quinolinic acid, which has been shown to increase after TBI.2 Using a rat model of TBI, Dr. Reid’s team showed that blocking the IDO1 enzyme, which catalyzes the first step of the kyneurenine pathway, reduced the production of neurotoxic tryptophan metabolites and improved anxiety-like behaviour and memory in male rats after injury.1 These findings suggest that excessive activation of the kynurenine pathway through IDO1 may contribute to long-term neurological symptoms observed after TBI. Graphic design by Qingyue Guo
“TBI is a complicated disorder and can cause very different outcomes from one person to another,” Dr. Reid explained. “So far there are no treatments that are effective at improving neurological outcomes after TBI. Our work with IDO1 inhibition after TBI supports a role for the kynurenine pathway in some of the negative outcomes after TBI, and shows promise as a target for new treatments.” Dr. Reid emphasized that this research is still in its early stages. “There is still a lot to learn, such as how individual parts of this pathway contribute to outcomes, and whether there are any negative effects to targeting this pathway,” she said. Building on this work, the team is replicating their studies in female rats and investigating whether the benefits observed after IDO1 inhibition are the result of increased activity in the kynurenine pathway or from shunting tryptophan toward serotonin production. The lab is also exploring the impact of IDO1 inhibition on additional TBI symptoms. With support from the Canadian Institutes of Health Research, the lab is investigating whether targeting this pathway could help prevent seizures and the development of PTE, while also developing brain imaging approaches to identify biomarkers that may help clinicians assess injury severity earlier and more accurately. Together, these insights could improve both treatment and diagnosis of TBI.
Although the research is still in early stages, it provides insight into the biochemical mechanisms underlying longterm symptoms after TBI and highlights a promising avenue for future therapies. The ultimate goal is to translate these findings into treatments that will improve patients’ quality of life after injury. “The future of this area of research lies in developing a drug that can ameliorate the adverse effects of TBI in both the shortand long-term,” said Marawan Sadek, the research assistant who led the study in Dr. Reid’s lab. Sadek added that, “such a drug would be beneficial in reducing, or ideally eliminating, the memory, motor, and mood deficits caused by severe TBI.” Disclaimer *Name changed for privacy reasons.
References 1. Sadek M, Stover KR, Liu X, et al. IDO-1 inhibition improves outcome after fluid percussion injury in adult male rats. J Neurosci Res. 2024; 102(5):e25338. 2. Meier TB, Savitz J. The Kynurenine Pathway in Traumatic Brain Injury: Implications for Psychiatric Outcomes. Biol Psychiatry. 2022; 91(5):449–58. 3. Yu T, Liu X, Sun L, et al. Clinical characteristics of post-traumatic epilepsy and the factors affecting the latency of PTE. BMC Neurol. 2021; 21(1):301. 4. Canada PHA of. Traumatic Brain Injuries - Canada.ca [Internet]. 2024 [cited 2025]. Available from: https://health-infobase.canada. ca/brain-injuries/ 5. Kureshi N, Clarke DB, Feng C. Association between traumatic brain injury and mental health care utilization: evidence from the Canadian Community Health Survey. Inj Epidemiol. 2023; 10(1):16. 6. Savitz J. The kynurenine pathway: a finger in every pie. Mol Psychiatry. 2020; 25(1):131–47. 7. Sourbron J, Lagae L. Serotonin receptors in epilepsy: Novel treatment targets? Epilepsia Open. 2022; 7(2):231–46. 8. Li Y, Hu N, Yang D, et al. Regulating the balance between the kynurenine and serotonin pathways of tryptophan metabolism. FEBS J. 2017; 284(6):948–66.
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STUDENT SPOTLIGHT
Redefining Graduate School Through Mentorship and Community By Alicia Tran
G
raduate school may be defined by academic productivity on the surface, but many students find deep meaning in the people and communities that support them along the way. For Ilakkiah Chandran—a PhD candidate at the Institute of Medical Science (IMS)—mentorship has become both a guiding force throughout her own graduate journey, and an opportunity to support others navigating similar experiences. Through her involvement in the Peer-to-Peer (P2P) Mentorship Program, the ChatGPD podcast and her work as an educator, Ilakkiah has helped foster a strong sense of connection and support among students at IMS. Like many students entering graduate studies, Ilakkiah initially believed that graduate school was exclusively about research. She describes beginning her journey with “blinders on,” believing she needed to dedicate all her time and energy solely to completing her thesis. Her perspective quickly shifted after taking the Graduate Professional Development (GPD) course led by Dr. Pamela Plant, a skills-based course designed to prepare students for a variety of career trajectories. One conversation with Dr. Plant particularly resonated with Ilakkiah. “You are more than your thesis,” she told her—a reminder that personal growth and identity extend far beyond academic work. This advice marked an important turning point in how she approached her graduate journey and her role within the broader IMS community. One hallmark of the GPD course is the opportunity for students to practice
presenting their work in the format of a Three Minute Thesis (3MT). The 3MT is a research communication exercise where students explain their thesis work to a general audience in three minutes using a single static PowerPoint slide. With the skills she gained through the course, Ilakkiah later participated in the IMS annual 3MT Competition. During the competition, she noticed a fellow graduate student had presented their work using a traditional academic research poster rather than the concise storytelling format expected in a 3MT presentation. Although seemingly small, this moment highlighted a larger gap: students not enrolled in the GPD course may have fewer opportunities to develop core competencies in graduate school, such as scientific communication and presenting to general audiences.
sense of support and belonging that shaped her own experience at IMS.
Motivated by this observation, Ilakkiah began exploring ways to support students in building these skills within the IMS community. After sharing this gap with Dr. Plant, she was connected to the P2P Mentorship Program at IMS, a student-led initiative dedicated to supporting students as they transition into graduate school. The program’s mission resonated with Ilakkiah, who recognized how influential mentorship, professional development opportunities, and supportive peer networks had been throughout her graduate journey. Drawing on these experiences, Ilakkiah was inspired to take an active role in supporting the P2P team, contributing to initiatives that help students build connections and navigate the complex landscape of IMS. Through her involvement, she aims to create the same
While strengthening communication within the program was an important first step, Ilakkiah also recognized the need to connect students with specialized resources. Ilakkiah has helped establish collaborations with library liaisons and experts from the Centre for Graduate Mentorship and Supervision to deliver workshops focused on research communication, academic writing, and graduate student support. These sessions provide both mentors and mentees with practical guidance in areas that may be overlooked in research training, including preparing for a first Program Advisory Committee meeting and crafting research abstracts for grant applications. By expanding access to these resources, the program helps students develop professional skills with greater support and clarity.
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For the past three years, Ilakkiah has played a key role in the marketing and communications side of P2P. Her responsibilities include developing new materials for mentors and mentees, highlighting upcoming workshops, and promoting events to the broader IMS community. One initiative she helped introduce was the P2P monthly newsletter, designed to create a more centralized form of communication for mentors and mentees. The newsletter provides updates about professional development opportunities and resources, alongside conversation prompts designed to make mentor-mentee meetings feel less intimidating.
STUDENT SPOTLIGHT
Ilakkiah Chandran PhD Candidate, Institute of Medical Science Photo Credit: Ilakkiah Chandran
Ilakkiah recalls one of the most rewarding aspects of being involved in P2P has been the opportunity to connect with other changemakers across IMS. “There are so many student leaders, and I think that speaks to the fact that students care for other students,” she says. Ilakkiah describes IMS as a uniquely collaborative graduate community where students actively work together to support one another. “Everyone brings different experiences,” she reflects, “we all have something valuable to contribute to the community.” For Ilakkiah, this sense of collaboration is one of the defining strengths of the graduate student experience at IMS. Ilakkiah’s commitment to mentorship also extends to an innovative IMS initiative: the ChatGPD Podcast. Created by Dr. Plant and led in partnership with graduate student leaders at IMS, the podcast features alumni Graphic design by Vanessa Recine
from a range of career paths to reflect on their unique journeys, key lessons learned along the way, and how their experiences at IMS have helped shape their careers. As part of the production team, Ilakkiah connects with alumni guests, prepares interview questions, and promotes episodes to the IMS and broader biomedical science community. “A lot of us are guilty of feeling the pressure to have everything figured out,” Ilakkiah explains. The podcast aims to show students that there is no single “correct” path after graduate school and that success can take many different forms.
anyone can do anything,” Ilakkiah shares, “it’s just a matter of putting yourself out there to do it.” She remains committed to helping students develop confidence in their abilities and feel empowered to explore opportunities that may initially appear daunting.
The ChatGPD Podcast has resonated strongly with students, many of whom have shared that hearing alumni stories expanded their perspectives on future career possibilities. Beyond career exploration, Ilakkiah believes the podcast has strengthened connections between alumni and current students, helping to create a stronger sense of belonging and becoming an avenue for connection within IMS.
Ilakkiah’s involvement with P2P, ChatGPD, and teaching continues to be guided by a common goal of helping students feel supported and connected during an experience that can often feel isolating. These roles have also reinforced her understanding of leadership as something quiet, consistent, and built on showing up for others behind the scenes. Ilakkiah traces this instinct back to the example set by her parents. “For as long as I can remember, I’ve watched my parents show up for their loved ones and their community, with their time, resources, and any help they can offer,” she says. Their compassion and selflessness are a constant reminder that the true measure of success is a reflection of one’s character and commitment to uplifting those around them.
In addition to her work with P2P and ChatGPD, Ilakkiah is a teaching assistant and course instructor at the University of Toronto, where she mentors undergraduate and graduate students navigating many of the same uncertainties she once experienced herself. Students often approach her with self-doubt about applying for internships, graduate programs, or other professional opportunities. As an educator, she has developed meaningful relationships with her students and frequently encourages them to believe in their own potential. “I truly believe
Above all, Ilakkiah emphasizes the importance of having a strong support network throughout graduate school, whether through family, mentors, supervisors, friends, or peers. Her journey highlights that mentorship is not only about guidance—it is about creating spaces where students feel encouraged to grow, ask questions, and realize they do not need to navigate their graduate experience alone. In many ways, cultivating this sense of community may be one of the most valuable lessons graduate school can offer.
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ALUMNI SPOTLIGHT
More Than One Path: Highlighting the Journey of IMS Alumna Suraiya Mangra By Kareena Thakur
T
here are certain people in our lives who endure the hardest parts of life, so that we do not have to. Through everything they build, and everything they refuse to give up, we realize they leave something of themselves within us. For Institute of Medical Science (IMS) alumna Suraiya Mangra, the beginning of her story belongs to her greatgrandmother: “the matriarch” of her family who immigrated from Trinidad to Canada without knowing how to read or write in English. She built a home and a life for her family through many difficulties, making her challenges with dementia even more disheartening. In the following months, Suraiya often wondered “what causes dementia?” and “what makes people more vulnerable?” prompting her to explore this further. These questions sparked an interest to volunteer at the Markhaven Home for Seniors, specializing in Alzheimer’s disease (AD) and dementia care. She found the opportunity to be rewarding, particularly to see the gratitude on residents’ faces as she spent time with them. At the same time, the facility’s large volume of patients showed her the extent of additional support needed in the field of geriatric care. It so happens that these preliminary experiences would eventually lead to a graduate career spent trying to understand, and ultimately improve, what happens to the brain as it ages. Suraiya was accepted to study psychology at the University of Toronto Scarborough
(UTSC). However, in her final year of high school, personal difficulties prevented her from starting undergraduate studies. She decided instead to pursue an alternative path of completing a two-year transfer program at Seneca College before returning to UTSC. At UTSC, Suraiya became involved in research through the Youthdale Child and Adolescent Sleep Centre, a research clinic run by Dr. Colin Shapiro. The work included conducting neuropsychological assessments in paediatric patients and nudged her toward the specialized field of neuropsychology. By the end of her undergraduate studies, this direction became more intentional and led her to the Princess Margaret Cancer Centre where she secured a position as a neurocognitive tester in the brain metastases clinic. Ultimately, she found the volunteer work was limited due to patient-facing restrictions during the COVID-19 pandemic and she wanted to return to the senior population that had initiated her passion for this field. This brought her to Toronto Western Hospital, where she joined as a research coordinator in the neurosurgery department under the supervision of Dr. Andres Lozano, the most cited neurosurgeon in the world. There she worked on clinical trials in neurodegenerative disease including managing concurrent Phase I and II trials: a stem cell study for individuals living with Parkinson’s disease (PD) and a deep brain stimulation (DBS)
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trial for individuals living with AD. Her time in the department allowed her to witness extraordinary moments such as being present in the operating room while surgeons placed electrodes into a conscious patient’s brain. Suraiya recalls one of the most worthwhile experiences was travelling to Nova Scotia to visit a participant in the DBS trial for treatment of AD—an assignment, she says, that research coordinators don’t typically receive. Overall, this was a rewarding experience which allowed her to understand key aspects about the field and clinical pipeline. Suraiya’s fascination with this work led her to continue working with her supervisor as a master’s (MSc) student at IMS. Her thesis examined the effects of subthalamic nucleus (STN) DBS on hippocampal volume in individuals with PD. Specifically, she compared hippocampal volume changes in patients who received STN DBS to two PD cohorts without DBS. Her findings showed that hippocampi atrophied at similar rates across all groups, comparable to normal aging. This provided evidence against the longstanding belief that STN DBS causes significant hippocampal volume loss, a theory that has been used to explain poorer cognition following DBS surgery. Together, these findings challenged a common assumption about STN DBS and helped Suraiya see how clinical research can clarify questions that directly affect patient care. Outside of research, Suraiya served as Editor-in-Chief of the IMS Magazine,
ALUMNI SPOTLIGHT
Following her graduate degree, Suraiya sought to determine potential career options. She had experienced isolation in academic research stemming from being alone on her project and she missed being part of a larger research team. On top of this, a PhD seemed like a distant horizon. However, as a research coordinator, she sometimes watched patients struggle with certain protocol requirements and had no effective channel to bring that feedback to decision-makers. Thus, Suraiya desired to be in the room where those decisions were being made.
Suraiya Mangra, MSc
IMS Alumna and Global Trial Associate at Johnson & Johnson Photo Credit: Suraiya Mangra
working alongside IMS students Kristen Ashworth and Kyla Demkiv. She credits both Dr. Lozano and Dr. Jürgen Germann, Scientist at the Krembil Research Institute, as instrumental to her graduate experience. They significantly guided her writing, as well as encouraged her to aim beyond the completion of her MSc and seek additional opportunities to be involved. Since graduating, she has served as a panelist for IMS MedDash, speaking to high school students about paths within science that are not linear. Suraiya has become a pillar of the community, giving back and providing advice to those exploring potential career avenues. Graphic design by Sarah Kung
These factors led Suraiya to pursue an industry role after completing her MSc. She credits Dr. Pamela Plant and Dr. Michelle Dubinsky’s Medical Science Liaison course as foundational to understanding what industry looks like from the inside. Suraiya is now a Global Trial Associate at Johnson & Johnson— the first and only person in Canada currently in this position. The role is a one-year rotational leadership program focused on three positions in clinical trial operations: clinical trial assistant, site manager, and local trial manager. In these roles, she is learning to become a primary contact for clinical research sites, hold country-level oversight over studies, and foster international collaborations. After completing the program, she will be moving into site management permanently and be able to have a key role in trial oversight. She recognizes that much of her success and personal development over the years is dedicated to her parents, noting that
her move into clinical operations is also a full-circle moment. For years, Suraiya watched her mother, who has worked in clinical research as a site manager, leave for site visits. “Now I’m going to be the one travelling to interesting places and supporting sites the way I was once supported by study sponsors during my coordinator days,” she says in excitement for what is to come. When asked what she would tell IMS students navigating their own obstacles, she stresses: “Don’t let the fear of rejection rule you, you’d be amazed at what you could accomplish.” She emphasizes that there are other ways beyond the traditional route to succeed and it is simply a matter of having the resourcefulness to find opportunities, and more importantly, the bravery to use them. As she wraps up her time in this position and looks towards the future, she reflects on her great-grandmother who arrived in a new country and built something that lasted generations. She states: “I hope I’ve become even a quarter of the woman she was. She had such a challenging life, even before she came here, and she still managed to build something for all of us. She still serves as such an inspiration to me.” Suraiya, who has known rejection and the loneliness of a path that is not conventional, is now the first in the country to hold her current position, blazing the trail for more people to walk. She is indeed like her great-grandmother in more ways than one.
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FACULTY SPOTLIGHT
The Last Mile: Dr. Sean Rourke on Turning HIV Science into Action
By Rivka Zeng-van Klei & Gisany Ravichandran
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n May 7, 2026, Manitoba officials declared a public health emergency due to a surge of 325 new human immunodeficiency virus (HIV) cases—over 3. 5 times the national average.1 Dr. Sean Rourke, alarmed, immediately reached out to the chief public health officer to advise him on the next steps to mitigate the epidemic. “HIV is a solvable problem in Canada,” said Dr. Rourke. This crisis is not the first time Dr. Rourke has been at the forefront of discussions addressing complex public health challenges through collaboration and advocacy. As a clinical neuropsychologist at St. Michael’s Hospital (SMH) MAP Centre for Urban Health Solutions, professor of psychiatry at the University of Toronto (UofT), and director of REACH Nexus, a national population health research centre funded by the Canadian Institutes of Health Research, Dr. Rourke is passionate about solving the HIV epidemic across Canada. This drive to understand problems and find solutions has been a defining theme in Dr. Rourke’s life. “I always liked how things kind of fit together; I used to take bikes apart and put them together,” said Dr. Rourke reflecting on his childhood. Taking this mindset, Dr. Rourke pursued an undergraduate degree in biology at the University of Windsor to understand more about various biological systems. Early on, he spent his summer breaks working in genetics and physiology labs, quickly developing an interest in how physiology may intersect with psychology through
his exposure to clinical psychology in his childhood home. This curiosity evolved into a lifelong focus on solving problems, guided by a simple question: “When things go wrong, how do you make them better?” Dr. Rourke decided to pursue a career that allowed him to further explore this intersection between the brain and human behaviour. He followed in his father’s footsteps into clinical neuropsychology and attended the University of California San Diego (UCSD). At UCSD, Dr. Rourke was trained as a clinician, but he remained passionate about research, noting, “I love being a part of that space [in academia] where you are always learning from others and teaching others.” His PhD graduate thesis examined how increasing age and other factors impacted brain recovery after periods of substantial alcohol abuse, which helped him better understand disease trajectories and how they can be changed. Through this research, he recognized the importance of translating knowledge into meaningful interventions that improve patients’ lives. After completing his final internship for his PhD at UCSD, Dr. Rourke explored potential career opportunities. There was a job opening at SMH, an epicenter for research on HIV and newly emerging combination therapies that were transforming care at the time in the mid-90s.2 Drawn by the opportunity and missing his life in Canada, Dr. Rourke turned down a job offer from the UCSD Faculty of Medicine, packed his bags, and moved to Toronto to start Canada’s first clinic for HIV-related cognitive concerns.
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At SMH, he connected with UofT through the Department of Psychiatry, and from there, with the Institute of Medical Science (IMS), where he found his academic home. He expresses, “I love IMS because I can have a place in the IMS community.” Through his connections with IMS faculty and students, he found a community that fosters collaboration, learning, and mentorship. From his research on alcohol substance use recovery, Dr. Rourke then applied this knowledge to his new role in HIV care. In his clinical practice, Dr. Rourke saw firsthand the long-standing barriers to accessible healthcare many of his patients living with HIV encountered, including access to testing, housing instability, economic insecurity, and social stigmatization. He realized that clinical care alone could not address many of these factors affecting HIV prevention and treatment. “We have therapeutic cures to stop the HIV epidemic, we just need the resources and efforts,” Dr. Rourke mentioned, highlighting the need for more public health supports. Driven by this idea, Dr. Rourke decided to devote his efforts to developing public health initiatives that directly improve access to HIV care and support. In the early 2000s, Dr. Rourke extended his work beyond hospital settings, engaging directly with the HIV-affected community. In 2004, he was appointed as the first Scientific and Executive Director of the Ontario HIV Treatment Network (OHTN) that is funded by the Ontario Ministry
FACULTY SPOTLIGHT
Dr. Sean B. Rourke, PhD, FCAHS Clinical Neuropsychologist and Scientist at St. Michael’s Hospital, Professor of Psychiatry at the University of Toronto Photo Credit: Dr. Sean B. Rourke
of Health. In this role, he launched the Positive Spaces, Healthy Spaces study that reframed stable housing as a necessity for healthcare rather than just a social issue, driving significant changes to rental housing policies that helped people with HIV overcome housing challenges. “It is the most underserved that have the most disadvantage,” Dr. Rourke explains, “and when you solve those problems, you raise up the levels for everyone else.” Under Dr. Rourke’s leadership, the OHTN became internationally recognized for its community-driven, evidence-based impact on health care policies in HIV. These accomplishments underscore the power of challenging long-standing policies to improve the lives of communities most underserved by the healthcare system. Graphic design by Vicky Lin
When the COVID-19 pandemic emerged, Dr. Rourke decided to shut down his clinic after 25 years of practice. The pandemic had exacerbated barriers to HIV healthcare. Thus, it was important, now more than ever, to focus his efforts on HIV testing accessibility. Dr. Rourke focused more exclusively on his role of director of REACH Nexus, where he has led clinical trials that have secured Health Canada approval for five HIV and syphilis rapid tests in five years, including Canada’s first HIV self-test (2020) and first oral swab HIV self-test (2025). When the COVID19 pandemic disrupted in-person testing services, he launched I’m Ready, Canada’s first national HIV self-testing initiative, which has distributed close to 40,000 HIV self-tests. Additionally, he drove efforts for dual HIV and syphilis testing in response to Canada’s congenital syphilis crisis in 2023. These initiatives saved the lives of thousands of undiagnosed people with HIV and sexually transmitted and blood-borne infections (STBBI) by giving them access to the care they needed, when they needed it. In recognition of his efforts, Dr. Rourke was awarded the 2026 President’s Impact Award by UofT. This award acknowledged his transformative, equity-driven contributions towards advancing accessibility to HIV/ STBBI testing for communities most affected by traditional and structural barriers. HIV testing, however, is just the first step towards solving the HIV epidemic. People living with HIV often experience
a delay between the time of diagnosis and when they receive treatment—a critical period for HIV prevention. In response, Dr. Rourke recently launched Rapid Testing and Linkage to Care (Rapid TLC), a national initiative focused on his next goal: reducing the gap between testing, diagnosis, and HIV and/or other STBBI treatments. By integrating polymerase chain reaction (PCR) testing into communitybased settings, this program will reach communities that have been undiagnosed and historically ignored by the healthcare system. When asked if he encountered resistance when challenging the government to prioritize addressing these issues, Dr. Rourke notes, “None of [the challenges] are insurmountable. It’s really the mindset of not settling for them, and you just find a way.” Dr. Rourke is an exemplary role model who actively works within government spaces to implement solutions and influence health care policies. He continues to redefine Canada’s healthcare system and push beyond human-made barriers. To young researchers aspiring to make an impact in the world, Dr. Rourke encourages them to follow their hearts and not to take “no” for an answer. He emphasizes, “Do [science] for a reason that will improve humanity.” References 1. Province of Manitoba. Province Declares a Public Health Emergency to Combat the Spread of HIV [Internet]. Manitoba: 2026, May [cited 2026 May 28]. Available from: https://news.gov.mb.ca/news/ index.html?item=73717&posted=2026-05-07 2. Shyr ZA, Cheng YS, Lo DC, et al. Drug combination therapy for emerging viral diseases. Drug Discov Today. 2021;26(10):2367–76. doi:10.1016/j.drudis.2021.05.008
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DIVERSITY IN SCIENCE
Dance for Parkinson’s: Bringing Hope Through Dance
By Rebecca Smythe
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or many older adults living with limited mobility or Parkinson’s disease (PD), the idea of participating in exercise classes can be daunting— physically, financially, or emotionally. Despite this, each week the Hamilton City Ballet’s Dance for Parkinson’s classes allow dancers to log into Zoom from their living rooms and kitchens, transforming familiar spaces into places of movement, connection, and possibility. From the comfort of their own homes, dancers warm up with pony trots and rises, then raise their arms in graceful port de bras, using sturdy chairs as a barre to practice balance and movement. These classes transform ballet, which is traditionally considered an elite art form, into something far more accessible: a form of exercise therapy that allows people to join wherever they are; proving that movement, joy, creativity, and community extend beyond the studio. PD is a disorder of the nervous system, characterized by a range of motor symptoms including rigidity, tremors, gait dysfunction, and general slowness of movement.1 Other non-motor symptoms include mood dysfunction, fatigue, sleep disturbances, and gastrointestinal troubles.1 These symptoms are associated with significant burden and impact on quality of life.1 Despite major research efforts towards finding a cure for PD, one still does not exist. Treatment for PD is largely pharmacological in nature, with drugs designed to replace or mimic dopamine.2 While care is primarily coordinated on an outpatient basis, advanced surgical treatments such as deep
brain stimulation, or complications of PD, can cause frequent hospital visits and stays.2 Bringing PD care outside the clinic or the hospital can have a positive impact on both motor and non-motor symptoms, which can support quality of life and neuronal health.2 Exercise therapies, such as ballet, are increasingly recognized as having positive effect on many PD symptoms, allowing people the opportunity to reclaim their body and facilitate social connection and support. The Hamilton City Ballet, located in Dundas, Ontario, has been offering their ‘Dance for Parkinson’s’ classes, for 13 years, and their online classes, for five. Together program director Jody White Van de Klippe and Institute of Medical Science PhD student Sara Corvinelli, who has helped lead and support classes for over nine years, aim to create a safe and welcoming space for Dance for Parkinson’s participants with varying levels of dance experience. Every class begins with a similar question: “What kind of a class are dancers looking for today?” The goals of the class are developed collaboratively to address the dancer’s individual goals. After this, a warmup consisting of pony trots and rises, which can be done seated or standing, is followed by an upper body warmup to prepare for the class ahead. Dancer safety remains at the forefront, ensuring all dancers are warmed up, have a chair next to them in place of a barre, and have plenty of opportunities to ask questions or express concerns. Jody and Sara support the dancers beyond just teaching them the moves.
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During class, dancers gain insights into functional anatomy to support a higher quality of movement through imagery and understanding. Classes are inspired by full length ballets including Giselle, Swan Lake, The Nutcracker, and many others. “We can actually imagine ourselves being ballerinas,” one dancer shared with a smile. Ballet differs from other forms of exercise, as it is not simply movement to music, but designed so that dancers are able to feel gracefulness and musicality throughout. In addition to weekly ballet, relaxation classes are offered that utilize the Franklin Method, or Dynamic Neuro-Cognitive Imagery. This is a systematic, imagery-based therapy that retrains posture, movement, and cognition by helping the brain form more accurate physical representations of the body.3 These classes are 20-minute sessions supported by calming instrumental music. “My restless leg syndrome is a part of my Parkinson’s that gets worse at night,” says one dancer. “The relaxation classes and ballet help stretch and relax my muscles.” Classes occur later in the evening, and dancers have shared that it has been tremendously helpful to attend these classes before going to bed at night. Many dancers expressed that they engage in a variety of exercise therapies but emphasized that ballet classes are unique because they highlight specific body movements. As one dancer described, “ballet is all about movements that you wouldn’t do in a traditional exercise or aerobics class. We float, or at least it feels like I do.” Jody works to emphasize the
DIVERSITY IN SCIENCE
artistry of the motions, in addition to teaching the movements and alleviating tremors via muscle activation. As one dancer further explained, “Parkinson’s wants to tighten up our muscles and shrink us, but ballet gives us the opportunity to stretch those muscles again—we get to counteract the physical restrictions that Parkinson’s wants to give us.” Through gentle stretches, posture work, and controlled movement, participants describe the class as a way of reclaiming space within their bodies and resisting the physical limitations that PD can impose.
program has also made a global impact. They have participated in World Parkinson’s Day and the National Ballet Congress by preparing performance videos, sharing their love for dance and performance with people worldwide. A group of dancers even authored a book titled Diagnosed with Parkinson’s Now What?, available upon request, where they share their stories. You can find videos, resources, information, and more on the Dance for Parkinson’s Instagram page @hopethrudance.
Beyond the physical benefits of ballet, the camaraderie and social aspect of classes is also impactful. The 15-minute social time before each class allows dancers to connect and talk about whatever is on their mind. This can range from sharing recipes with one another to talking about symptom flare-ups of PD. “I’ve never met anyone in person, but they are my best friends,” said one dancer. These friendships create a supportive community, working to complement the physical benefits of dance, and extend positive effects beyond classes.
In many ways, the virtual ballet classes hosted by Hamilton City Ballet are about far more than just dance. They are about preserving independence, fostering connection, and creating moments of joy. Dancers can strengthen their muscles and practice balance from the comfort of their own homes, at no cost, while challenging assumptions about aging and disability. As the music fades and screens begin to log off at the end of class, one thing remains clear. Even through Zoom, ballet has become a powerful form of exercise therapy proving that movement and community can continue to bring hope through dance.
Although these classes are primarily held via Zoom, class outings and social excursions are also offered. An annual local boat cruise on the Stratford River allows the Dance for Parkinson’s community to come together and celebrate all that they have accomplished. Occasionally, they also visit local ballet stores to equip dancers with slipper fittings and other gear to support their dancing. The Dance for Parkinson’s
1. Podlewska AM, Batzu L, Soukup T, et al. The PD-ballet study: Study protocol for a randomised controlled single-blind hybrid type 2 clinical trial evaluating the effects of ballet dancing on motor and non-motor symptoms in Parkinson’s disease. BMC Complement Med Ther. 2024;24(1):41. doi: 10.1186/s12906-023-04296-y 2. Jankovic J, Aguilar LG. Current approaches to the treatment of Parkinson’s disease. Neuropsychiatr Dis Treat. 2008;4(4):743-57. doi: 10.2147/ndt.s2006 3. Abraham A, Hart A, Andrade I, et al. Dynamic neuro-cognitive imagery improves mental imagery ability, disease severity, and motor and cognitive functions in people with Parkinson’s disease. Neural Plast. 2018. doi: 10.1155/2018/6168507
Graphic design by Vicky Lin
References
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PAST EVENTS
Finding Community in Graduate School: IMSSA Running Club By Carmen K. Chan
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clear blue sky, afternoon sun, and 19 °C weather on May 4th, 2026 marked the start of the Institute of Medical Science Student Association (IMSSA) Running Club, hosted by the IMSSA Wellness and Sporting subcommittees. After a frigid winter, a group of students in the Institute of Medical Science (IMS), both familiar and new faces, met outside the University of Toronto Medical Sciences Building for a casual run to welcome the start of the summer semester. From novice runners to experienced athletes, all skill levels were welcome. This inclusivity is reflected in the run club’s motto: Your direction matters more than your speed. The group set off at a breezy, conversational pace that kept everyone together. As with many graduate student events, conversations about programs, research projects, and professional
goals quickly emerged. Along the route, discussions about upcoming deadlines and medical school applications naturally shifted to stories about pets, hobbies, and life outside of academia. A sense of community and camaraderie formed along the route. When someone needed a walk break, others walked with them while encouraging them to keep going. Rather than focusing on setting new distance or pace records, these runs create a space to connect in-person with fellow graduate students outside of the lab and classroom. These kinds of environments are referred to as “third places,” a term coined by sociologist Dr. Ray Oldenburg. In contrast to home (a “first place”) and work (a “second place”), third places are neutral grounds where people gather to build informal communities, such as cafés, gyms, libraries, parks, and theatres.1 Considering this, third places are important for connecting with people both similar to and different from us.2 However, social distancing during the COVID-19 pandemic resulted in years of remote work and learning, merging first and second places while significantly limiting access to third places. The absence of third places is particularly noticeable in graduate school. Busy schedules make it difficult to meet people on a different floor of the same building, let alone at different research sites. It becomes easy to develop tunnel vision for our programs, projects, and
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deadlines, leaving little room for our identities outside of academia. Third places like the IMSSA Running Club create opportunities to connect through shared experiences with peers who may be navigating many of the same challenges and experiences. While we are all scientists and students, beyond research and coursework, conversations along the route also centred around newly adopted pets and hobbies like Pilates. In this way, the IMSSA Running Club offers both the benefits of exercise and a small oasis from experiments, paperwork, and deadlines. Gentle breeze, cherry blossoms in bloom, and the city coming back to life after a long, gloomy winter captured the first run led by the IMSSA Running Club. Each step forward was a reminder that graduate school does not have to be a solitary journey. Join the IMSSA Running Club every Monday at 6PM in front of the Medical Sciences Building! References 1. Oldenburg R. The Great Good Place: Cafes, coffee shops, bookstores, bars, hair salons, and other hangouts at the heart of a community. Great Barrington, MA: Berkshire Publishing Group LLC; 2023. 2. Roberts-Ganim M. Third places: What are they and why are they important to American culture? [Internet]. University of Chicago; [cited 2026 May 15]. Available from: https://esl.uchicago. edu/2023/11/01/third-places-what-are-they-and-why-are-they-important-to-american-culture/
Graphic design by Qingyue Guo
TRAVEL BITES
From Sand Dunes to Andean Peaks Three Weeks in Peru and Bolivia By Stephanie Rizza
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Well then… what are we going to do for the month of March?” I asked my supervisor after learning that our lab would be closed for maintenance. While there is always work to be done as a graduate student, I couldn’t help but see the lab closure as a rare opportunity to escape the cold after a long, busy winter. “I’m planning to take some vacation during the closure,” my supervisor said, “you should too!” That was all the encouragement I needed to start browsing flights. I had never been to South America before and had heard great things from friends who had visited Peru and Bolivia. With flights to Lima being relatively inexpensive at the time, the choice was easy. My partner and I set off on a three-week adventure. We landed in Lima, Peru’s sprawling capital, where we explored the historic city centre, the coastal neighbourhood of Miraflores, and the artsy streets of Barranco. We then headed south to Huacachina, a desert oasis surrounded by towering sand dunes. There, I crossed an experience off my bucket list: sand skiing! The friction made it feel different from skiing on snow, but the steep dunes were just as thrilling. We continued to Arequipa, the most beautiful city of the trip, with historic buildings lining the streets, framed by views of three large volcanoes in the distance. We tried delicious Peruvian cuisine, including ceviche, lomo saltado, and queso helado, a traditional Arequipan dessert. Beyond the Graphic design by Jinny Moon
food, we enjoyed learning about the city’s rich Spanish-colonial history and culture.
We headed back into Peru for our final destination, Cusco. After exploring the city’s Incan ruins, we embarked on what would become the highlight of our trip: the four-day Salkantay Trek. Over roughly 70 km, we crossed everything from rainforests to rugged alpine terrain. After passing the stunning Humantay Lake, reaching the Salkantay Pass at 4 600 metres above sea level, sleeping under the stars in geodomes, and roasting our own handpicked coffee beans, we finally reached the iconic Incan city of Machu Picchu. It was the perfect ending to our trip.
Sand dunes towering over Huacachina. Photo Credit: Stephanie Rizza
Next, we crossed the border into Bolivia and headed to Copacabana, a small town on the shores of Lake Titicaca, the world’s highest navigable lake. It was the perfect place to acclimatize to the high altitude, while relaxing lakeside and watching alpacas wander past. Soon after, we found ourselves in the bustling city of La Paz. We explored the famous Witches’ Market and rode the city’s extensive cable car system, which offered us great views of the city and surrounding mountains. While there, we completed a day hike to Laguna Charquini, a blue lagoon nestled high in the Andes mountains at over 5 000 metres above sea level. The altitude made the short hike surprisingly difficult, but the beautiful scenery made it well worth the effort.
Humantay Lake on the Salkantay Trek. Photo Credit: Stephanie Rizza
What began as an unexpected lab closure turned into an unforgettable trip to a new destination. It was a reminder that sometimes the best adventures can begin with a change in plans.
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BOOK REVIEW
Spark
The Revolutionary New Science of Exercise and the Brain
By Melina Alborzi
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vividly remember one Tuesday when I spent two hours staring at the same paragraph of my thesis proposal. My mind was all over the place, the literature was a haze, and the harder I tried to write, the less sense it made. So, out of frustration, I shut my laptop, put on my running shoes, and went for a run. When I came back 40 minutes later, everything suddenly clicked. It felt like my brain had just been waiting for me to move. Turns out, according to Harvard psychiatrist John J. Ratey, that wasn’t magic; it was just my brain getting the neurochemicals it needed. In his book Spark: The Revolutionary New Science of Exercise and the Brain,1 Ratey argues that exercise is not just good for our bodies, but it is actually the strongest tool we have to improve how our brains work. Drawing from his clinical experience and neuroscience research at Harvard, he describes physical activity as a “neurochemical intervention” that healthcare and education systems often overlook. Central to this neurochemical intervention is a protein called brainderived neurotrophic factor (BDNF), which Ratey refers to as the “Miracle-Gro for the brain.” BDNF helps new brain cells grow, strengthens their connections, and keeps them healthy. He says that aerobic exercise is one of the best ways to increase BDNF levels, along with neurotransmitters such as dopamine, serotonin, and norepinephrine. The combined effect is better focus, a
more stable mood, faster learning, and increased resilience to stress.1 Exercise affects not just brain chemistry but brain activity itself. Vigorous exercise activates 60 to 65% of the brain, primarily within the prefrontal cortex, where higherlevel thinking happens.1 Ratey calls this cognitive boost a “sidecar benefit” of moving the body, which he connects to evolution. “Thinking is the internalization of movement,” a cognitive skill that we developed because our hunter-gatherer ancestors had to adapt, communicate, and remember how to survive. With this foundation in place, Ratey goes on to show just how far-reaching exercise’s effects on the brain can be. Ratey covers a lot in this book: learning, stress, depression, ADHD, addiction, and even aging. He shares stories and research that bring the science to life. One story that stuck with me was about a school in Naperville, Illinois, where kids started their day with exercise. Students at this school ended up ranking first in the world in science and math. Beyond the stories, what I appreciate about Spark is that Ratey doesn’t oversimplify the science. He discusses the underlying neuroscience in depth including the molecular pathways, stress hormones, and growth factors that explain why exercise works, which is great if you like to see the scientific evidence for yourself. That being said, there are moments where the book makes exercise sound like a miracle
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cure, which may be both dismissive and misleading. Not everyone is able to just head out for a run; there are real barriers like time, safety, and access to outdoor space or facilities. Research has progressed significantly since Spark was published back in 2008, however, the core science in the book still holds up, and new studies continue to support Ratey’s main ideas. As a graduate student, reading Spark felt very personal. So much of our work involves long hours of reading and critical thinking. These processes depend entirely on the brain, which Ratey shows is particularly affected by how we move. For those of us in the medical sciences who will design interventions, advise patients, and shape policy, Spark invites us to consider exercise as both a clinical and cognitive tool, starting with ourselves. After reading Spark, I know that the next time I get stuck on a paragraph, the smartest thing I can do is get up and move. I encourage you to give it a read—perhaps you’ll be tempted to do the same!
References 1. 1. Ratey JJ, Hagerman E. Spark: The Revolutionary New Science of Exercise and the Brain. New York: Little, Brown; 2008.
Graphic design by Raymond Zhang
CHATGPD
ChatGPD
A Graduate Professional Development Podcast One-Year Anniversary: Reflections and What’s Next
By Ilakkiah Chandran, Sarah Topa, and Pam Plant
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raduate students are often asked to plan their next career steps, but many feel limited by what they believe is possible. Dr. Pamela Plant, Director of Graduate Professional Development (GPD) at the Institute of Medical Science (IMS), works closely with graduate students to support their post-graduation plans, and she often hears the same refrain: “I’m not sure what my options really are.” Many students view medical school or staying in academia as tenure or teaching-stream faculty as the most viable pathway. Through conversations with biomedical science alumni from IMS and beyond, Dr. Plant was struck by their deep satisfaction with vibrant careers outside the traditional ones, including interesting and meaningful roles in public health, entrepreneurship, industry and even law. Dr. Plant began to consider: What if alumni could share their professional journeys directly with all IMS students? And what if those stories could be preserved as an everlasting resource for generations of graduate students to come? From this idea, ChatGPD: A Graduate Professional Development Podcast was born. Dr. Plant began to assemble her team: she onboarded Emily Yeung and Ilakkiah Chandran to bring a student perspective, while Sarah Topa contributed a staff and institutional lens as the vision took shape. Within a few months, they were preparing to record their first episode featuring Dr. Michelle Dubinsky, an IMS PhD alumna and now Medical Science Liaison. The group wondered if students would engage with Graphic design by Ravneet Jaura
the podcast, would the technical aspects work and if there would be momentum to continue beyond the first few episodes. Now, one year later, ChatGPD has released 14 episodes, surpassed 3000 views on YouTube, and proudly holds a 5-star rating on Spotify. The podcast has highlighted a wide range of careers, including Regulatory Affairs, Scientific Visualization, Entrepreneurship, Public Health, Intellectual Property, Venture Capital, and Senior Administrative Leadership. The team has also expanded to include graduate student Christopher Zhang and IMS alumna Shaghayegh Foroozan. The podcast provides structured, interview-style conversations focused on transitioning from graduate training to diverse careers both within but especially outside of academia. Each guest shares practical insights, real-world experiences, and clear guidance to listeners. Conversations emphasize transferable skills, decision-making strategies, and actionable advice. Guests walk listeners through their day-to-day roles, the skills required for success, and resources to support career development. ChatGPD aims to expand awareness of career options, while strengthening students’ confidence in their future and building connections between trainees and alumni. Reflecting on this first year, the team has seen clear growth in both production quality and audience engagement. Viewership has increased within IMS and across the broader University of Toronto and graduate professional development community. “I learn something new with each podcast guest yet, overarching themes emerge:
(1) that extra-curricular experiences or core competencies developed in grad school are the commodities most leveraged and (2) the vitality of a graduate degree in positioning students for life outside of schooling,” says Dr. Plant. The creators’ goal of having ChatGPD act as a bridge between academic training and the professional workforce seems to be coming to fruition. A survey of student listeners showed they find the podcast to be a valuable resource for exploring diverse career paths, providing clear insight into different and unique roles, and supporting more informed decision-making. Hearing directly from professionals also helped them identify and build the skills needed to be competitive applicants. The ChatGPD team is excited about what’s ahead. They look forward to continuing to produce engaging episodes that reflect the full range of what’s possible in students’ professional lives after graduate school. They want to keep expanding how students see their options, and to make those paths feel clearer, desirable and achievable. If you are exploring your next steps or just curious about different careers, they invite you to listen to the stories shared. You’ll likely hear a word of wisdom to support your professional growth, or even discover a career path you had never considered! Mail Chimp for ChatGPD
To be the first to hear about new episodes, join the ChatGPD mailing list:
IMS MAGAZINE SUMMER 2026 EXERCISE AND SPORTS MEDICINE | 47
RAW TALK
Trip or Treatment? What Psychedelics Can Do for the Mind
By Tiffany Chien, Avni Bhargava, and Nicole Chu
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nce dismissed as relics of counterculture, psychedelics are now being studied in some of the world’s leading research institutes. While headlines often celebrate these substances as “miracle cures,” the clinical reality is far more nuanced.1 Emerging clinical trials across Canada are gradually changing the longstanding reputation psychedelics had as illicit drugs, as researchers increasingly explore their potential as promising candidates for the treatment of mental illness. Psychedelics refer to a class of drugs that alter feelings, perceptions, and self-awareness.2 Classical psychedelic drugs are serotonin 2A receptor agonists such as lysergide D-tartrate (LSD), mescaline, psilocybin, as well as more potent and fast-acting compounds like Dimethyltryptamine (DMT) and 5-MeO-DMT. These drugs have gained significant traction for their potential therapeutic effects at low doses.2 In contrast to macrodosing, where individuals take enough of the drug to experience a “trip”, microdosing involves taking small amounts regularly, without experiencing hallucinations.3 Psychedelic research gained early momentum in the 1960s but came to an abrupt halt amid political and public concerns about recreational drug use. By the early 1970s, psychedelics were classified as Schedule I under United States federal law–a category reserved for drugs
considered to have no accepted medical use and a high potential for abuse.4 Research stalled and psychedelics became symbols of rebellion rather than subjects of rigorous medical study. In the early 2000s, improved ethical frameworks and renewed interest in novel mental health treatments sparked interest in resuming psychedelic research. Substances once pushed to the margins of medicine are now at the centre of cuttingedge conversations about mental health, trauma, pain management, and end of life care. This resurgence of interest is largely driven by limitations of existing treatment options and the need for novel therapeutic approaches to improve patient outcomes. Current treatments for neuropsychiatric disorders, including mood and anxiety disorders, primarily involve the use of selective serotonin reuptake inhibitors (SSRIs) and serotonin-noradrenaline reuptake inhibitors (SNRIs). While effective, approximately 30% to 50% of patients experience only partial relief, and 10% to 30% of patients are treatment-resistant.5 The gap in treatment efficacy has led to renewed interest in exploring psychedelic-assisted therapy, which has shown promising results, including sustained antidepressant effects among patients with major depressive disorder, treatment-resistant depression, and cancer patients dealing with psychological distress.5 Across North America, several clinical trials are on the brink of discovering psychedelic treatments to target common
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neuropsychiatric disorders such as Major depression, treatment resistant depression (TRD), post-traumatic stress disorder (PTSD), anxiety disorders, and substance abuse.6 Depression, PTSD, and addiction have high comorbidity and common pathophysiology that involve changes in the same brain areas, particularly the shrinkage and loss of neurons in the prefrontal cortex.7 Studies have shown that the antidepressant and anxiolytic effects of psychedelics are attributable to their ability to promote rapid structural and functional neuronal growth.7 While psilocybin, the active ingredient found in “magic mushrooms,” remains illegal in many parts of the world, the trend of decriminalization across the United States is slowly expanding in Canada through the Health Canada Special Access Program.8,9 It is expected that the FDA will approve these hallucinogenic drugs for treating psychiatric disorders in the upcoming year. Compass Pathways, a UK biotechnology company, has developed a drug candidate called COMP360, a psilocybin for the treatment of TRD.10 Additionally, Definium Therapeutics (formerly MindMed), a New York-based biotechnology company, is currently in its second phase 3 clinical trial evaluating the safety and efficacy of DT120 (formerly MM120), an LSD treatment for generalized anxiety disorder, is underway.11,12 Since psychedelics can produce intense alterations in perception, cognition, and
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emotion, especially when used outside of controlled settings, the therapeutic benefits observed in trials may not be the same as effects of recreational psychedelic use, which may carry risks such as psychological distress, adverse reactions, and unpredictable outcomes. As such, increasing evidence suggests that sustained benefits may arise not from the psychedelic compound alone, but from its integration within a structured psychotherapeutic framework.13 Several studies have demonstrated the therapeutic potential of psychedelics in combination with psychotherapy to reduce distress and improve quality of life.14 Patients suffering from lifethreatening illnesses often experience distress, depression, and anxiety. The Psychedelic Psychotherapy Research Group at the University Health Network (UHN) have developed ongoing studies, specifically the Psilocybin-assisted Existential, Attachment and Relational (PEARL) study, for helping patients with advanced cancer and their caregivers ease end-of-life existential distress, mortalityrelated anxiety, and depression.15 On episode 138 of Raw Talk Podcast, a graduate student-run initiative at the University of Toronto, we spoke with Dr. Emma Hapke, Co-Founder and Associate Director at the UHN Psychedelic Psychotherapy Research Group emphasized the importance of providing support to both patients and their caregivers because end-of-life distress Graphic design by Raymond Zhang
in patients with advanced cancer, chronic and life-threatening illnesses “affect the whole family […] and [caregivers are] often overlooked in the system that’s really focused on the patient,” says Dr. Hapke. In recent years, private clinics, biotechnology companies, and investors have increasingly entered the psychedelic space, hoping to translate promising research into new treatments. While this momentum has accelerated innovation, it has also raised important questions about regulation, equitable access, and whether commercial enthusiasm may outpace scientific evidence. As scientific interest in psychedelics continues to grow, we also enter a period termed “the psychedelic gold rush,” where private clinics and biotech startups want to capitalize on public fascination.16 Ultimately, as the field matures, it must contend with the reality that these interventions are not one size fits all and require regulations that prioritize patient safety over market velocity.
Acknowledgements To learn more about psychedelics and psychedelic assisted therapies, we invite readers to check out episode #137 and 138 of Raw Talk Podcast. We would like to acknowledge the efforts, creativity, and dedication of the episode team: Avni Bhargava and Swapna Mylabathula served as Show Hosts, Bellinda Yin was our content creator, Victoria Li was our audio engineer, and Nicole Chu was our Executive Producer.
References 1. Mitchell A. Psychedelic drugs ‘overhyped as miracle cures.’ The Times [Internet]. 2024 Jun 9 [cited 2026 Feb 21]. Available from: https://www.thetimes.com/uk/healthcare/article/psychedelic-drugs-overhyped-as-miracle-cures-0zdzm6v2g 2. Mosurinjohn S, Roseman L, Girn M. Psychedelic-induced mystical experiences: An interdisciplinary discussion and critique. Frontiers in Psychiatry. 2023 Apr 5;14. doi:10.3389/fpsyt.2023.1077311 3. Kuypers KP, Ng L, Erritzoe D, et al. Microdosing psychedelics: More questions than answers? an overview and suggestions for future research. Journal of Psychopharmacology. 2019 Jul 14;33(9):1039–57. doi:10.1177/0269881119857204 4. Geyer MA. A brief historical overview of psychedelic research. Biol Psychiatry Cogn Neurosci Neuroimaging. 2024 May; 9(5): 464-471. doi:10.1016/j.bpsc.2023.11.003. PMID:38000715. 5. Davis AK, Barrett FS, May DG, et al. Effects of psilocybin-assisted therapy on major depressive disorder. JAMA Psychiatry. 2021 May 1;78(5):481. doi:10.1001/jamapsychiatry.2020.3285 6. Healing Maps Editorial Staff. The countdown to approval: The psychedelic clinical trials that could reshape mental healthcare. 2025 Nov. Medium [Internet]. 2025 Nov 4 [cited 2026 Feb 21]. Available from: https://medium.com/@HealingMaps/the-countdown-to-approval-the-psychedelic-clinical-trials-that-could-reshape-mentalhealthcare-84b93c9716b6 7. Ly C, Greb AC, Cameron LP, et al. Psychedelics promote structural and functional neural plasticity. Cell Reports. 2018 Jun 23(11):3170–82. doi:10.1016/j.celrep.2018.05.022 8. Chesak J. What psychedelics legalisation and decriminalisation looks like around the world [Internet]. BBC; 2024 [cited 2026 Feb 21]. Available from: https://www.bbc.com/future/article/20240320-legal-status-of-psychedelics-around-the-world 9. Canada H. Government of Canada [Internet]. / Gouvernement du Canada; 2025 [cited 2026 Feb 21]. Available from: https://www. canada.ca/en/health-canada/services/substance-use/controlled-illegal-drugs/magic-mushrooms.html 10. Biotechnology company [Internet]. [cited 2026 Feb 21]. Available from: https://compasspathways.com/ 11. Robison R, Barrow R, Conant C, et al. Single treatment with MM120 (lysergide) in generalized anxiety disorder. JAMA. 2025 Oct 21;334(15):1358. doi:10.1001/jama.2025.13481 12. Definium Therapeutics. Clinical trials [Internet]. New York (NY): Definium Therapeutics; [cited 2026 Jun 1]. Available from: https:// definiumtx.com/clinical-trials/ 13. Boehnke KF, Cox K, Weston C, et al. Slouching towards engagement: interactions between people using psychedelics naturalistically and their healthcare providers. Front Psychiatry. 2023;14:1224551. doi:10.3389/fpsyt.2023.1224551. 14. Rosenbaum D, Boyle AB, Rosenblum AM, et al. Psychedelics for psychological and existential distress in palliative and cancer care. Current Oncology. 2019 Aug 1;26(4):225–6. doi:10.3747/co.26.5009 15. Psychedelic Psychotherapy Research [Internet]. [cited 2026 Feb 21]. Available from: https://www.uhn.ca/MentalHealth/Research/Psychedelic-Psychotherapy-Research/Pages/Research.aspx 16. Wright W. The psychedelic gold rush: marketing the future of mental healthcare to the masses. The Drum [Internet]. 2022 May 2 [cited 2026 Feb 21]. Available from https://www.thedrum.com/ news/the-psychedelic-gold-rush-marketing-the-future-mentalhealthcare-the-masses
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