By Leslie Shepherd

St. Michael’s Hospital has announced plans to build the world’s leading treatment and research centre for multiple sclerosis.

The centre will occupy the entire top two floors—about 25,000 square feet–of the hospital’s new 17-story Peter Gilgan Patient Care Tower under construction in the heart of downtown Toronto.

St. Michael’s already has the largest MS clinic in North America, with about 7,000 patients, and is home to some of the world’s leading MS clinicians and researchers.

MS is known as “Canada’s disease” because the country has the highest prevalence of the neurological disease in the world. One in every 340 Canadians lives with MS.  It affects three times as many women as men and strikes people in the prime of their lives, as the average age of onset is 31.

“Our ultimate goal in creating the world’s premier multiple sclerosis centre is to find the cause of this disease and then a cure,” said Dr. Xavier Montalban, the world-renowned Spanish clinician and researcher who was recruited to St. Michael’s this summer to lead the centre.

“While we are working on that, we will give our patients the best possible care from the moment they are diagnosed in our new world-best centre of excellence.  Every day, three more Canadians are diagnosed with MS. Early diagnosis means we can start people on promising new treatments and give them hope they can live fulfilling and productive lives.”

The clinic, which will be custom-designed for the care and needs of MS patients, is expected to open in 2020.

Dr. Montalban said the clinic will offer “one-stop care” for patients who will be diagnosed, treated and offered the opportunity to participate in research, all in the same location. They will see not only their neurologists and nursing team in the same place, but also a broad interprofessional support team of social workers, physiotherapists, occupational therapists, speech therapists and other medical professionals.

He said that because of the growing awareness of the impact MS has on a patient’s mental health, cognition and relationships, the clinic is already recruiting a neuropsychologist—a psychologist that deals with how the brain and the rest of the nervous system influence a person’s cognition and behavior.

St. Michael’s is also conducting an international search for a basic scientist to study the disease at a cellular and molecular level in the hopes of finding out what causes MS and then how to stop or delay the onset of symptoms.  Growing evidence suggests that Vitamin D levels play a part, which would explain the high prevalence of the disease in Canada.  Smoking, exposure to certain viruses, obesity and genetics may also contribute.

The clinic will also have:

• an “independent living laboratory,” an apartment/living space where people with mobility and/or cognitive difficulties can learn how to adapt their movements to their surroundings
• A dedicated infusion centre, where MS patients can receive drugs intravenously when they need them and with their expert health-care team nearby.
• Expanded use of telemedicine so patients don’t have to always come to Toronto

Dr. Tom Parker, the physician-in-chief of St. Michael’s, described Dr. Montalban’s arrival from the renowned MS Centre of Catalonia in Barcelona, Spain, as a “game-changer” for multiple sclerosis treatment and research in Canada.

“World-class physicians attract other researchers and graduate students who wish to collaborate on new and groundbreaking work, which leads to better research, greater collaboration and life-changing results,” Dr. Parker said. “That’s another reason why these new facilities are essential.”

Dr. Parker noted that St. Michael’s already has one of the most promising young MS researchers on staff, Dr. Jiwon Oh, a neurologist and MS expert who joined the hospital in May 2014 after completing her PhD in clinical investigations at Johns Hopkins School of Medicine. Dr. Oh is one of the only researchers in the world using multiple advanced imaging techniques to look at the impact of MS on spinal cord tissue in the hopes of finding biomarkers that will help clinicians monitor and more accurately predict how MS will progress in individual patients.

Leslie Shepherd works in communications at St. Micheal’s Hospital.