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.

Recent Publications

1. Vasquez, B.P., Tomaszczyk, J.C., Sharma, B., Colella, B., Green, R.E.A. (2018). Longitudinal recovery of executive control functions after moderate-severe traumatic brain injury: Examining trajectories of variability and ex-Gaussian parameters. Neurorehabilitation and Neural Repair, 32(3): 191-199. PMID: 29561244

2. Tomaszczyk, J.C., Sharma, B., Chan, A.A., Colella, B., Mok, J.N.Y., Beaton, D., Christensen, B.K., Green, R.E.A. (2018). 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, 50(6): 519-526. PMID: 29806692.

3. Terpstra, A.R., Girard, T.A., Colella, B., Green, R.E.A. (2017). Higher anxiety symptoms predict progressive hippocampal atrophy in the chronic stages of moderate to severe traumatic brain injury. Neurorehabilitation & Neural Repair, 31(12): 1063-1071. PMID: 29153039.

4. Green, R.E.A. (2016). Editorial: Brain Injury as a Neurodegenerative Disorder. Frontiers in Human Neuroscience, 9(615): 1-3. PMID: 26778994.

5. Sharma, B., Tomaszczyk, J., Dawson, D., Turner, G., Colella, B., Green, R.E.A. (2016). Feasibility of online, self-administered cognitive environmental enrichment in moderate-to-severe traumatic brain injury. Journal of Disability and Rehabilitation, 39(14): 1380-1390. PMID: 27414703.

6. Budisin, B., Bradbury, C.L.B., Sharma, B., Hitzig, S.L., Mikulis, D., Craven, C., McGilivray, C., Corbie, J., Green, R.E.A. (2016). Traumatic brain injury in spinal cord injury: Frequency and risk factors. Journal of Head Trauma Rehabilitation, 31(4): E33-42. PMID: 26394288.

7. Tomaszczyk, J., Green, N.L., Frasca, D., Colella, B., Turner, G., Christensen, B., Green, R.E.A. (2014). Negative neuroplasticity in chronic traumatic brain injury and implications for neurorehabilitation. Neuropsychology Review, 24(4): 409-427. PMID: 25421811.

8. Sharma, B., Bradbury, C., Mikulis, D.R., Green, R.E.A. (2014). Missed diagnosis of traumatic brain injury in people with traumatic spinal cord injury. Journal of Rehabilitation Medicine, 46(4): 370-373.

9. Green, R.E.A., Colella, B., Maller, J., Bayley, M., Glazer, J., Mikulis, D.J. (2014). Scale and pattern of atrophy in the chronic stages of moderate-severe traumatic brain injury. Frontiers of Human Neuroscience, Special Issue: Brain Injury as a Neurodegenerative Disorder, 8(67): 1-9. PMID: 24744712.

10. Miller, L., Colella, B., Mikulis, D., Maller, J., Green, R.E.A. (2013). Environmental enrichment may protect against hippocampal atrophy in the chronic stages of traumatic brain injury. Frontiers of Human Neuroscience, Special Issue: Brain Injury as a Neurodegenerative Disorder, 7(506): 1-8. PMID: 24093011.

11. Adnan, A., Crawley, A., Mikulis, D., Moscovitch, M., Colella, B., Green, R.E.A. (2013). Moderate-severe traumatic brain injury causes delayed loss of white matter integrity: Evidence of fornix deterioration in the chronic stage of injury. Brain Injury, 27(12): 1415-22. PMID: 24102365.

Appointments

Honours and Awards

* Nomination, 2018 William Fields Caveness Award, The Brain Injury Association of America. 2018/07. (decision pending)

* Nomination, 2017-2018 Local Impact Award, University Health Network; The TRI Tele-rehabilitation Centre for Acquired Brain Injury Team, [Team Lead]. 2018/07. (decision pending)

* Nomination, To stand for International Neuropsychological Association, Member at Large. 2018/04. (vote pending)

* Canada Research Chair (Tier 2) in Traumatic Brain Injury-Cognitive Rehabilitation Neuroscience, Canadian Institutes of Health Research, Canada. 2009/8 - 2015/7, $500,000.

* Nomination, 2016-17 Education Excellence Award for Contribution to Student and Professional Education at Toronto Rehab (Leader Award), University Health Network. 2015/5 - 2016/5. (Distinction)

* International Public Speaker Grant, Macquarie University, Collaborator: Thompson, W. (PI). 2015/11 - 2015/11

* Canada Research Chair (Tier 2) in Traumatic Brain Injury-Cognitive Rehabilitation Neuroscience, Canadian Institutes of Health Research, Canada. 2015/8 - 2020/7, $500,000.

* Nomination, 2015-16 Faculty of Medicine Graduate Teaching Award for Sustained Excellence in Graduate Teaching and Mentorship, University of Toronto. 2015/5 - 2016/5. (Distinction)

* Education Excellence Award for Contribution to Student and Professional Education at Toronto Rehab (Leader Award), Toronto Rehab. 2014/5. (Distinction)

Grants

2018/8 - 2019/10: 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). $310,500 CAD

2015/8 - 2020/7: PI. Canada Research Chair (Tier 2) Cognitive Rehabilitation Neuroscience, Canadian Institutes of Health Research (CIHR). $500,000 CAD

2018/4 - 2019/4: Co-PI. “Offsetting hippocampal degeneration in moderate-severe traumatic brain injury”. Canadian Traumatic Brain Injury Research Consortium (CTRC), Project Grant. $41,083 CAD

2018/1 - 2020/3: Co-PI. “Development of a remotely delivered learning and memory intervention and province-wide delivery infrastructure”. Ontario Neurotrauma Foundation (ONF). $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

2016/1 - 2017/12: PI. “AGE-WELL: Digital measures of the Trail Making Test in acquired brain injury patients”. Philips Medical Systems, AGE-WELL. $50,000 CAD

2015/1 – 2017/12: Co-I. “Tau ligand for the diagnosis of Chronic Traumatic Encephalopathy in retired CFL athletes”. W. Garfield Weston Foundation, Rapid Response: Neurodegenerative Diseases of Aging. $151,250 CAD

2013/6 - 2015/5: Co-PI. “Time course, clinical correlates and incidence of neurodegeneration in the first year of moderate-severe TBI”. Physicians' Services Incorporated Foundation (PSI). $165,861 CAD

2012/4 - 2014/3: PI. “Improving quality and accessibility of mental health services for older adults: Novel strategies in the delivery of CBT for depression”. Canadian Institutes of Health Research (CIHR). $132,604 CAD