Dr. Tiffany Chow, MD

Clinician-Scientist Rotman Research Institute, Baycrest

Assistant Professor of Neurology Department of Medicine, Neurology Division, University of Toronto

Assistant Professor of Psychiatry Department of Medicine, Geriatric Psychiatry Division, University of Toronto

Research Focus

My clinical research is dedicated to finding meaningful interventions for patients with behavioural disturbances due to dementia. These interventions range from pharmacologic ways of compensating for neurotransmitter imbalances caused by the dementia to non-pharmacologic means, such as specialized Day Programs or dance. Against a backdrop of No Known Cure, clinical research in dementia is a deep frontier for neuroscientists. The most Frequently Asked Question in my Frontotemporal Dementia Clinic is, “Dr., how long will this dementia go on? What do we expect to happen over time?” My research goals have arisen from my best response thus far, that there are four phases to this behaviourally-disturbed type of dementia, beginning with a questionably symptomatic phase, a definitely abnormal behavioural and personality change that intensifies and almost always requires pharmacotherapy, then a third stage, during which the patients symptoms subside and become withdrawn, amotivated, and intermittently agitated. The fourth stage for this dementia resembles the final stages of all neurodegenerative dementias.

My research is an attempt to identify what causes that crucial shift from stage 2 to stage 3. Thus far, I cannot link that shift to a critical degree of structural atrophy.

My efforts have utilized in vivo radioligand PET imaging and functional MRI methods, as opposed to post-mortem tissue staining that is difficult to connect to the shift in behavioural disturbances we observe over the course of the illness. The long-range goal is to identify a clear target to inform pharmacotherapy.

Currently, I am most intrigued by an apparent subclinical response of cerebral cortex in FTD to memantine, which is hypothesized to have neuroprotective properties. The placebo-controlled crossover study to follow-up on results from the initial open-label FDG-PET study will launch later this year.

The nature of behavioural disturbances in dementia belies brain-behaviour correlations taught from lesion studies: by the time patients are diagnosed, the ravages of FTD and Alzheimer's disease have struck in several places, not just within one frontosubcortical circuit. Patients paradoxically manifest both apathy and hyperactive disinhibition during the first half of the illness.

As one of the investigators in the multidisciplinary Frontotemporal Dementia Workgroup, I am dedicated to advancing innovative and meaningful research in FTD by optimizing collaboration among investigators, facilitating patient and family participation in research, and providing a collegial, educational forum for investigators, clinicians and their trainees.

Education

• 1992: M.D., Alternative Curriculum , Rush Medical College Chicago, Illinois, USA
• 1988: M.Sc., Marine Biology, Stanford University Stanford, California, USA
• 1987: B.A., B.Sc., German Studies, Biological Sciences, Stanford University Stanford, California, USA
• 1983: Undeclared Major, High School Scholar , UCLA Los Angeles, California, USA

Academic Appointments

• 2003–Present: Clinician-Scientist, Rotman Research Institute, Baycrest, Toronto, Ontario, Canada
• 2003–Present: Assistant Professor of Neurology , Department of Medicine, Neurology Division, University of Toronto, Toronto, Ontario, Canada
• 2006–Present: Assistant Professor of Psychiatry, Department of Medicine, Geriatric Psychiatry Division, University of Toronto, Toronto, Ontario, Canada
• 2000–2003: Director , Frontotemporal Dementia Clinic, University of Southern California, California, USA
• 2000–2003: Director Translational Core of Rancho Los Amigos, Alzheimer's Disease Center, University of Southern California, California, USA
• 2000–2003: Assistant Professor, Neurology , University of Southern California, California, USA

Professional Affiliations

• 2007–Present: Board of Directors, Alzheimer Society of Toronto
• 2002–Present: Education Committee Chair, Medical Advisory Board, Association for Frontotemporal Dementias, Philadelphia, PA
• 2008–Present: Board of Directors, Dancing with Parkinson's, Inc

Distinctions and Awards

• 2009: First Women of Baycrest-Supported Scientist
• 2005: Dean's Fund for New Faculty, University of Toronto
• 2000: Alzheimer's Disease Research Scholar, Deane Johnson Foundation
• 1999: Turken Award for Junior Investigator in Alzheimer's Disease Research, Alzheimer's Association, 10,000
• 1997: Selection for the NIA-supported Summer Research Institute, NIA
• 1996: Kaiser Permanente Housestaff Teaching Award, UCSD, voted by UCSD third and fourth year medical students
• 1996: Golden Neuron Award for Teaching Medical Students, UCSD Neurology Department
• 1996: Annual Meeting Scholarship for Residents, American Academy of Neurology
• 1995: Chief Resident, Neurology, UCSD
• 1995: Golden Diaper Award, UCSD Pediatric Neurology Department, For performance on pediatric neurology rotation
• 1994: Kaiser Permanente Housestaff Teaching Award, UCSD
• 1994: Golden Neuron Award for Teaching Medical Students, UCSD Neurology Department
• 1991: Joseph Collins Foundation Scholarship, Joseph Collins Foundation
• 1991: Theresa M. Knorr Memorial Award, American Medical Women's Association
• 1987: Award for Exceptional Achievement in Teaching, Stanford University

Research Projects

External

• 2007–2010: Open-Label Study of Memantine on FDG-PET in Frontotemporal Dementia
  Institutions: Baycrest, CAMH

  Sponsors: Lundbeck Research Grant

• 2002–2005: PET Serotonin Studies in Frontotemporal Dementia
  Collaborators: Tiffany Chow MD; Sandra Black, MD, FRCPC; Paul Verhoeff, MD,PhD, FRCPC; Jeff Meyer, MD, PhD, FRCPC;Morris Freedman
  Institutions: University of Toronto

  Sponsors: NIA, 162,000 (USD)

• 2004–2009: Frontal Aging Study
  Collaborators: Donald Stuss PhD, C Psych; Tiffany Chow MD

  Sponsors: CIHR

• 2003–2005: Supporting Caregivers of Patients with Frontotemporal Dementia
  Collaborators: Lynn McCleary RN, PhD, Elsa Marziali PhD; Tiffany Chow MD
• 2001–2003: Assessing Barriers to Dementia Care among Asian Communities in Southern California: Primary Care Provider Survey

  Sponsors: Pfizer Research Grant

• 2001–2003: Frontotemporal Dementia Consortium: Multi-Center Alzheimer's Research Centre of California Study
  Collaborators: Bruce Miller, Kirk WIlhelmsen, Mario Mendez
  Institutions: UC:LA, UCSF

  Sponsors: Alzheimer's Research Centers of California

• 2001–2003: Depression in Alzheimer's Disease: Multi-Center ARCC Study
  Collaborators: Bruce Miller, Jeffrey Cummings
  Institutions: UC Davis, UCLA, UCSF, USC, UC Irvine

  Sponsors: Alzheimer's Research Centers of California

• 2001–2003: Assessing Barriers to Dementia Care among Asian Communities in Southern California: Community Focus Groups
  Collaborators: Tiffany Chow MD
  Institutions: USC, Rancho Los Amigos

  Sponsors: Pfizer, Inc., 68000 (USD)

• 1969:
• 1998–2003: Investigating the Neural Substrates of Reasoning: Studies with Dementia Patients
  Collaborators: Barbara Knowlton PhD at UCLA Dept of Psych
  Institutions: UCLA, USC
• 2002: Language Processing in Semantic Dementia and Functional MRI
  Collaborators: Tiffany Chow MD
  Institutions: USC, Rancho Los Amigos National Rehabilitation Center
• 2000–2002: Open Label Trial of Guanfacine for Symptomatic Treatment of Frontotemporal Dementia
  Institutions: USC, Rancho Los Amigos
• 2002: Open Label Use of Amantadine for Symptomatic Treatment of Non-Fluent Primary Progressive Aphasia
  Institutions: USC, Rancho Los Amigos

Internal

• 2010–2012: RELATION OF CHOLINERGIC RECEPTOR CHANGES TO DEVELOPMENT OF ALZHEIMER’S DISEASE
  Collaborators: Peter Bloomfield, Sylvain Houle, Zahinoor Ismail, Benoit Mulsant, Bruce Pollock, Pablo Rusjan, Neil Vasdev, Alan Wilson
  Institutions: Baycrest, CAMH

  Sponsors: CAMH Geriatric Mental Health Program

• 2009–2012: Resting State Functional Connectivity in Frontotemporal Dementia
  Collaborators: Cheryl Grady, Steve Strother

  Sponsors: Moir Family Fund

• 2010–2012: A Randomized, Placebo-Controlled Crossover Study of the Effects of Acute Memantine Administration on FDG-PET in Frontotemporal Dementia
  Collaborators: Morris Freedman, Ariel Graff-Guerrero, Bruce Pollock
• 2010–2012: RELATION OF BETA-AMYLOID DEPOSITION TO PSYCHIATRIC DISTURBANCE IN DEMENTIA
  Collaborators: Sylvain Houle, Zahinoor Ismail, Benoit Mulsant, Bruce Pollock, Alan Wilson
  Institutions: Baycrest, CAMH

  Sponsors: CAMH Geriatric Mental Health Program

• 2007–2010: SPECT and Apathy in Frontotemporal Dementia
  Collaborators: Sandra Black
  Institutions: Baycrest, Sunnybrook Health Sciences Centre

  Sponsors: Sunnybrook Campbell Neurology Division

Media Coverage

Women of Baycrest

"Forgetful, not Forgotten," TVO Panel Discussion, aired live across Canada and through webcast January 11, 2009
"The Rising Tide of Alzheimer's Disease," CBC World News, across Canada January 5, 2009

"Ginkgo no help for preventing Alzheimer's: Study, The National, CBC, across Canada. November 18, 2008

"Rethinking Alzheimer's," The Agenda with Steve Paikin, TVO, Toronto. April 21, 2008

"Neuroimaging Advances and New Ethical Dilemmas in Alzheimer's Disease Detection," The Rutherford Show, CHQR AM 770, "Alberta's #1 talk show," Calgary March 27, 2008

Early Onset Dementias, Discovery Canada Health Channel and Toronto One, Health on Line with Avery Haines, 2003;

Medication Precautions for Alzheimer's Disease Patients, ABC, Local ABC News Segment, 2002;

Warning Signs of Alzheimer's Disease, CBS, Local CBS News Segment, 2000;

Beta-Secretase and the Mouse Vaccine: Implications for Alzheimer's Disease Patients, CNN, CNN Saturday, 1999;

Identification of Beta-Secretase by Amgen, NBC , NBC News Health Update , 1999;

Identification of Beta-Secretase by Amgen, Fox, Fox 11 News Health Segment, 1999;

Fox 11 News Health Segment on Alzheimer's Disease Research and the Alzheimer's Association Memory Walk, Fox, 1999;

Public Service Announcement for National Alzheimer's Association Memory Walk Kick-Off, 1999;

Neurological Consultant for episodes on a physician (Alan Alda) impaired by Alzheimer's disease, E.R. television show, aired Oct.-Nov. 1999, 1999;

Curriculum Vitae

Download Curriculum Vitae here

Contact

The Rotman Research Institute
Baycrest
3560 Bathurst Street, 954
Toronto, Ontario
Canada M6A 2E1 Phone: 416-785-2500 x3459 Email: tchowrotman-baycrest.on.ca Fax: 416-785-2862