Robin Green

Dr. Robin Green is a Canada Research Chair (II) in traumatic brain injury and a Senior Scientist in the cognitive neurosciences at Toronto Rehab. Dr. Green completed her PhD at Cambridge University, a post-doctoral fellowship at St. Thomas’ and Guys Hospital, London, England, and her clinical training in neuropsychology at the University Health Network in Toronto.

Dr. Green has worked at Toronto Rehab for most of her career. She is currently the head of the Brain Discovery and Recovery Team, and she co-leads the Schroeder Brain Institute with four other scientists.

She recently founded a provincial research centre for people with enduring effects of brain injuries/concussion. The centre provides remotely delivered clinical care to patients across Ontario, including Northern Ontario, through their participation in research. The centre is also collaborating with partners in other provinces to create a broader network, and seeks to establish international links. The interventions that are delivered and tested focus on enhancing cognitive and mood function, and improving brain health, with a particular focus on enhancing neurogenesis in the hippocampi.

Research Synopsis

Dr. Robin Green's program of research addresses brain and behavioural mechanisms of recovery from moderate-severe traumatic brain injury (TBI). Her lab has shown that in addition to beneficial mechanisms that support recovery, there are deleterious mechanisms in the sub-acute and chronic stages of injury giving rise to cognitive, mood and neural deterioration. Her lab has re-conceptualized TBI as a chronic and possibly neurodegenerative disease process; this novel conception is needed in order to identify parallels with other forms of neurodegeneration, which will offer new avenues of treatment. The lab has also focused on identifying modifiable (“post-injury”) factors that contribute to degeneration, focusing on the hippocampi in particular. They have identified that elevated anxiety and reduced cognitive stimulation are both associated with hippocampal volume loss. A converging program of research concerns progressive degeneration and accelerated aging in the later stages of multiple concussions, for example sustained in the context of professional contact sports such as football.

Dr. Green is currently engaged in the development of interventions to mitigate the accelerated aging that is observed in the later stages of TBI by targeting modifiable mechanisms. The treatments are delivered remotely, in order to achieve reach (e.g., into Northern Ontario and across provinces) and to achieve scale. Treatments are both delivered by therapists, in group format online or are self-administered. These treatments are currently being considered for other populations at risk of accelerated aging.

Recently, Dr. Green has started up a centre for remote delivery of clinical care through participation in research. The centre focuses on patients with enduring effects of brain injury, and will expand to other neurological populations in the future.

Accepting: MSc, PhD, Postdoc

Recent Publications

• Heath, L., Kidwai, M. R., Colella, B., Monette, G., Tselichtchev, P., Tomaszczyk, J., Green, R. Predictors and functional outcomes associated with longitudinal trajectories of anxiety and depression from 2 to 36+ months after moderate to severe traumatic brain injury. Journal of Neurotrauma. 2023 Mar 16; Online ahead of print. PMID: 36927109. Available from: https://doi.org/10.1089/neu.2023.0003.
• Jacob, N., So, I., Sharma, B., Marzolini, S., Tartaglia, C., Oh, P., Green, R. Effects of high-intensity interval training protocols on blood lactate levels and cognition in healthy adults: Systematic review and meta-regression. Sports Medicine. 2023 Mar 14; Online ahead of print. PMID: 36917435. Available from:  https://doi.org/10.1007/s40279-023-01815-2.
• Boulos, M.E., Colella, B., Meusel, L.A., Sharma, B., Dabek, M., Worthington, T., Green, R.E.A. Feasibility of group telerehabilitation for individuals with chronic acquired brain injury: Integrating clinical care and research. Disability and Rehabilitation. 2023 Feb 28; Online ahead of print. PMID: 36855274. Available from: https://doi.org/10.1080/09638288.2023.2177357.
• Jeffay, E., Ponsford, J., Harnett, A., Janzen, S., Patsakos, E., Douglas, J., Kennedy, M., Kua, A., Teasell, B., Welch-West, P., Bayley, M., Green, R. INCOG 2.0 Updated Guidelines for Management of Cognition Following TBI Part III: Executive Function. Journal of Head Trauma Rehabilitation. 2023 Jan-Feb; 38(1):52-64. PMID: 36594859. Available from: doi: 10.1097/HTR.0000000000000834.
• So, I., Meusel, L., Sharma, B., Colella, B., Poublanc, J., Wheeler, A., Rabin, J., Mikulis, D.R., Green, R. Longitudinal patterns of functional connectivity in moderate-severe traumatic brain injury. Journal of Neurotrauma. 2023 Jan 17; Online ahead of print. PMID: 36367163. Available from: https://doi.org/10.1089/neu.2022.0242.
• Gumus, M., Mack, M., Green, R., Khodadadi, M., Wennberg, R., Crawley, A., Colella, B., Tarazi, A., Mikulis, D., Tator, C., Tartaglia, M.C. Brain connectivity changes in Post-Concussion Syndrome as the neural substrate of a heterogeneous syndrome. Brain Connectivity. 2022 Oct; 12(8):711-724. PMID: 35018791. Available from: https://doi.org/10.1089/brain.2021.0127.
• Mazaharally, M., Stojanovski, S., Trossman, R., Szulc-Lerch, K., Chakravarty, M., Colella, B., Glazer, J., Green, R., Wheeler, A. Patterns of change in cortical morphometry following traumatic brain injury in adults. Human Brain Mapping. 2022 Apr; 43(6):1882-1894. PMID: 34953011. Available from: https://doi.org/10.1002/hbm.25761.
• Jacob, N., So, I., Sharma, B., Marzolini, S., Tartaglia, C., Green, R. Effects of high-intensity interval training protocols on blood lactate levels and cognition in healthy adults: protocol for systematic review and network meta-analyses. Systematic Reviews. 2022 Feb 19; 11(1):31. PMID: 35183245. Available from: https://doi.org/10.1186/s13643-021-01874-4.
• Belchev, Z., Gilboa, A., Binns, M., Colella, B., Glazer, J., Mikulis, D.J., Green, R. Progressive neurodegeneration across chronic stages of severe traumatic brain injury. Journal of Head Trauma Rehabilitation. 2021 Jun; 37(3):E144-E156. PMID: 34145157. Available from: https://doi.org/10.1097/htr.0000000000000696.
• Gagliardi, A., Yip, C., Irish, J., Wright, F. C., Rubin, B., Ross, H., Green, R., Abbey, S., McAndrews, M., Stewart, D.E. The psychological burden of waiting for procedures and patient-centred strategies that could support the mental health of wait-listed patients and caregivers during the COVID-19 pandemic: A scoping review. Health Expectations. 2021 Jun; 24(3):978-990. PMID: 33769657. Available from: https://onlinelibrary.wiley.com/doi/10.1111/hex.13241.
• McAndrews, M., Green, R., Ruttan, L., Li, A., Abbey, S., Stewart, D. Psychological distress, resilience and mental health resources in a Canadian hospital during COVID-19: Thoughts in preparing for wave two. General Hospital Psychiatry. 2021 April; 69: 124-125. PMID: 33602535. Available from: https://doi.org/10.1016/j.genhosppsych.2020.11.013. 
• Bray, M., Sharma, B., Cottrelle, J., Peters, M., Bayley, M., Green, R. Hippocampal atrophy is associated with psychotic symptom severity following traumatic brain injury. Brain Communications. 2021 Mar 9; 3(2):fcab026. PMID: 33977261. Available from: https://doi.org/10.1093/braincomms/fcab026.
• Belchev, Z., Boulos, M., Rybkina, J., Johns, K., Jeffay, E., Colella, B., Ozubko, J., Bray, M., Di Genova, N., Levi, A., Changoor, A., Worthington, T., Gilboa, A., Green, R. Remotely delivered environmental enrichment intervention for traumatic brain injury: Study protocol for a randomised controlled trial. BMJ Open. 2021 Feb 11; 11:e039767. PMID: 33574141. Available from: https://bmjopen.bmj.com/content/11/2/e039767.
• Sharma, B., Changoor, A., Monteiro, L., Colella, B., Green, R.E.A. Prognostic-factors for neurodegeneration in chronic moderate-to-severe traumatic brain injury: A systematic review protocol. Systematic Reviews. 2020 Feb 3; 9(23): 1-6. PMID: 32014038. Available from: https://doi.org/10.1186/s13643-020-1281-4.
• Sharma, B., Changoor, A., Monteiro, L., Colella, B., Green, R.E.A. The scale of neurodegeneration in moderate-to-severe traumatic brain injury: A systematic review protocol. Systematic Reviews. 2019 Dec 18; 8(332): 1-5. PMID: 31852523. Available from: https://doi.org/10.1186/s13643-019-1208-0.
• Bethell, J., Babineau, J., Iaboni, A., Green, R., McGilton, K. Social integration and loneliness among long-term care home residents: Protocol for a scoping review. BMJ Open. 2019 Dec 9; 9:e033240. PMID: 31822544. Available from: http://dx.doi.org/10.1136/bmjopen-2019-033240.
• Terpstra, A.R., Vasquez, B., Colella, B., Tartaglia, M.C., Tator, C.H., Mikulis, D., Davis, K.D., Wennberg, R., Green, R.E.A. Comprehensive neuropsychiatric and cognitive characterization of former professional football players: Implications for neurorehabilitation. Frontiers in Neurology: Neurorehabilitation; Special Issue - Concussion Rehabilitation. 2019 Aug 7; 10(712): 1-12. PMID: 31447753. Available from: https://www.frontiersin.org/articles/10.3389/fneur.2019.00712/abstract.
• Stukas, S., Higgins, V., Frndova, H., Gill, J., Hubara, E., Guerguerian, A.-M., Boutis, K., Beauchamp, M., Farrell, C., Babl, F. E., Delzoppo, C., Greenham, M., Wilkinson, A. A., Crichton, A., Anderson, V., Adeli, K., Hutchison, J., Wellington, C.; Serum Biomarkers and Quality of Life in Children with Traumatic Brain Injury investigators; National Biobank and Database for Patients with Traumatic Brain Injury investigators; Canadian Critical Care Translation Biology Group; Canadian Traumatic Brain Injury Research Consortium. Characterisation of serum total tau following paediatric traumatic brain injury: A case-control study. The Lancet. Child & Adolescent Health. 2019 Jun 21; 3(8): 558-567. PMID: 31231066. Available from: https://doi.org/10.1016/S2352-4642(19)30194-4.
• Engel, L., Beaton, D., Green, R.E.A., Dawson, D. Financial management activity process: Qualitative inquiry of adults with acquired brain injury. Canadian Journal of Occupational Therapy. 2019 May 19; 86(3): 196-208. PMID: 31106591. Available from: https://doi.org/10.1177%2F0008417419833839.
• Habib Perez, O., Green, R.E.A., Mochizuki, G. Spectral analysis of centre of pressure identifies altered balance control in individuals with moderate-severe traumatic brain injury. Disability and Rehabilitation. 2018 Oct 16; 42(4):519-527. PMID: 30325695. Available from: https://doi.org/10.1080/09638288.2018.1501101.
• Habib Perez, O., Green, R.E.A., Mochizuki, G. Characterization of balance control after moderate severe traumatic brain injury: A longitudinal recovery study. Physical Therapy. 2018 Sep 1; 98(9): 786-795. PMID: 29878265. Available from: https://doi.org/10.1093/ptj/pzy065.
• Engel, L., Chui, A., Beaton, D., Green, R.E.A., Dawson, D. Systematic review of measurement property evidence for eight financial management instruments in populations with acquired cognitive impairment. Archives of Physical Medicine and Rehabilitation. 2018 Sep; 99(9): 1848-1875. PMID: 29524397. Available from: https://doi.org/10.1016/j.apmr.2018.02.004.
• Tomaszczyk, J.C., Sharma, B., Colella, B., Mok, J.N.Y., Beaton, D., Christensen, B.K., Green, R.E.A. Measuring cognitive assessment and intervention burden in patients with acquired brain injury: Development of the 'How Much is Too Much?' questionnaire. Journal of Rehabilitation Medicine. 2018 Jun 15; 50(6): 519-526. PMID: 29806692. Available from: https://www.medicaljournals.se/jrm/content/abstract/10.2340/16501977-2344.
• Vasquez, B.P., Tomaszczyk, J.C., Sharma, B., Colella, B., Green, R.E.A. Longitudinal recovery of executive control functions after moderate-severe traumatic brain injury: Examining trajectories of variability and ex-Gaussian parameters. Neurorehabilitation and Neural Repair. 2018 Mar; 32(3): 191-199. PMID: 29561244. Available from: https://doi.org/10.1177/1545968318760727.
• Terpstra, A.R., Girard, T.A., Colella, B., Green, R.E.A. Higher anxiety symptoms predict progressive hippocampal atrophy in the chronic stages of moderate to severe traumatic brain injury. Neurorehabilitation & Neural Repair. 2017 Dec; 31(12): 1063-1071. PMID: 29153039. Available from: https://doi.org/10.1177/1545968317736817.

Appointments

Canada Research Chair (tier 2) traumatic brain injury, cognitive neurorehabilitation sciences

Honours and Awards

• 2022/05                        Interprofessional Education Team Award, Team ECHO-UHN-Toronto Rehab, Toronto Rehabilitation Institute, University Health Network
• 2020/05                        2020 Dr. Dina Brooks Continuing/Sustained Excellence in Graduate Student Supervision & Mentorship award, University of Toronto
• 2020/01 - 2024/12   Saunderson Chair in Acquired Brain Injury Research, Saunderson Family, Toronto Rehabilitation Institute, Canada
• 2020/04                        Nomination, 2020-21 Rehabilitation Sciences Institute Graduate Teaching Award for Sustained Excellence in Graduate Student Supervision and Mentorship, University of Toronto
• 2019/04                        Nomination, Henry Durost Award for Excellence in Creative Professional Activity, Department of Psychiatry, University of Toronto
• 2019/04                        Nomination, 2019-20 Rehabilitation Sciences Institute Graduate Teaching Award for Sustained Excellence in Graduate Student Supervision and Mentorship, University of Toronto
• 2019/01 - 2022/12   Member-at-Large, Board of Governors, International Neuropsychological Association
• 2018/10                        2018 Dr. Jane Gillett Research Award, Brain Injury Canada
• 2018/07                        Nomination, 2018 William Fields Caveness Award, The Brain Injury Association of America
• 2009/08 - 2020/07   Canada Research Chair (Tier 2) in Traumatic Brain Injury-Cognitive Rehabilitation Neuroscience, Canadian Institutes of Health Research, Canada

Grants

 2021/07 - 2022/06                   Co-PI: “An intervention to teach self-management skills for persisting symptoms of COVID-19: Minimizing impact of symptoms on everyday functioning and on healthcare usage/utilization - A randomized controlled trial”. Canadian Institutes of Health Research (CIHR), Operating Grant: Emerging COVID-19 Research Gaps and Priorities Funding Opportunity. $330,562 CAD

·       2021/07 - 2022/06                   Co-PI: “Developing a low-cost, remotely deliverable education intervention to mitigate the impact of long-COVID symptoms”. Cass Family Grants for Catalyzing Access and Change. $5,000 CAD.

·       2021/01 - 2024/12                   Co-Chief Investigator and Canadian Lead. “Physical musicality: Optimising lived experience among older adults”. Australian Research Council (ARC), Discovery Projects. $416,369 AUD. PI: William F. Thompson.

·       2020/09 – present                  Co-PI: “ECHO Concussion - UHN”. Ministry of Health and Long-Term Care (MOHLTC). $111,264 CAD, annual.

·       2020/06 - 2020/11                   Co-PI: “Approaches to support mental health of diverse patients on wait lists for procedures delayed by COVID-19”. CIHR Knowledge Synthesis: COVID-19 in Mental Health and Substance Use. $49,980 CAD.

·       2020/01 - 2024/12                   Co-I: “Canadian Concussion Network”. Canadian Institutes of Health Research (CIHR), Catalyst Grant. $1,500,000 CAD. PI: Keith Yeates.

·       2020/01 - 2024/12                   PI: “Saunderson Family Chair in Acquired Brain Injury Research”. Saunderson Family. $375,000 CAD.

·       2019/06 - 2021/02                   Co-PI: “Spatial navigation intervention for individuals living with Multiple Sclerosis”. Branch Out Neurological Foundation, Multiple Sclerosis NeuroCAM Seed Grant. $48,270 CAD. * (N.b., only one award is allocated per competition) 

·       2018/08 - 2020/03                 Co-PI: “Scalable training and web-based application package for offsetting hippocampal neurodegeneration using Google Streetview”. Centre for Aging & Brain Health Innovation (CABHI), Researcher-Clinician Partnership Program (RCP2). $372,000 CAD.

·       2018/04 - 2019/04                   Co-PI: “Offsetting hippocampal degeneration in moderate-severe traumatic brain injury”. Canadian Traumatic Brain Injury Research Consortium (CTRC), Project Grant. $41,083 CAD.

·       2018/01 - 2021/01                   Co-PI: “Development of a remotely delivered learning and memory intervention and province-wide delivery infrastructure”. Ontario Neurotrauma Foundation. $197,755 CAD.

·       2017/4 - 2022/3                        PI: “Understanding and improving hippocampal neuroplasticity through allocentric spatial navigation training”. Natural Sciences and Engineering Research Council of Canada (NSERC), Discovery grant. $125,000 CAD