Advancing Functional Neurological Disorder Research: GSEF Merit Scholar Dr. Carl Leochico

Dr. Carl Froilan D. Leochico is a physiatrist currently completing his Master’s of Health Sciences in Translational Research (TRP) in the Department of Laboratory Medicine and Pathobiology and using it to explore his research interest in Functional Neurological Disorders (FND). Coming from the Philippines, his academic excellence has recently been recognized by the GSEF Merit Scholarship for International Students, awarded by the Office of Research and Health Science Education, Temerty Faculty of Medicine.

Dr. Leochico finished his residency training in Physical Medicine & Rehabilitation at the Philippine General Hospital in 2016. Shortly after graduation, he became a research affiliate at the Institute on Aging in the National Institutes of Health at the University of the Philippines. He was sent as an exchange program research scholar to Italy and Poland in 2017, where he collaborated with experts in the field of Computer Science and Engineering on research related to Gerontechnology (or technologies for older adults).

When he returned to Manila, he became a Clinical Associate Professor in the College of Medicine at the University of the Philippines where he spent the next five years practicing Physical Medicine & Rehabilitation as a clinician, teacher, and researcher.

Seeking further training, he was accepted to the Azrieli Brain Medicine clinical fellowship mainly based at Sunnybrook Health Sciences Centre and recently finished his two-year program. During his fellowship he gained particular interest in FNDs, which he is further exploring in a fellowship in Brain Rehabilitation at Toronto Rehabilitation Institute. 
Whilst in his fellowships at U of T, he was encouraged by his program directors to join the TRP, which he did “to incorporate a more translational component to my ongoing and future research works and further improve patient care.”

Leochico has conducted extensive contextual inquiries to understand the current state of FND care locally and is currently finalising his research question for his TRP capstone project on FND with the guidance of experts in the field and in collaboration with his project partner and classmate, Daniyal Kashif. FND is a problem with the functioning of the nervous system and how the brain and body send and receive signals. The variety of physical, sensory, and/or cognitive symptoms of FND cannot currently be explained by structural changes in the brain.

As FND as a disease has been only recently recognized, its exact prevalence is unknown. “FND is the second most common diagnosis (next to headaches) in neurology clinics, but the diagnostic and treatment capacities of our current healthcare system are extremely limited in this context,” explains Leochico. 

Patients with FND can present with a constellation of symptoms, such as, but not limited to, motor changes (e.g., tremors, weakness, incoordination, gait changes), sensory disturbances (e.g., chronic pain, numbness, balance issues), seizures, fatigue, and cognitive dysfunction. The symptoms often result in significant physical disability and psychosocial distress, especially as patients go on undiagnosed and untreated for a long time (with a mean diagnostic delay of 6-8 years).

Leochico adds, “we hope to explore specifically how local rehabilitation providers - physiatrists like me and therapists from various disciplines - could contribute meaningfully to the care of this underserved population.” 

Joining the TRP was a way for him to learn how to better integrate patients and other stakeholders into his research. “Previously, I thought we could simply formulate research questions from gaps in the literature, but the TRP has taught me to think differently. The program has shown me how important it is to always consider the inputs of stakeholders by properly conducting contextual inquiries that could better inform us of the current state, for example actual needs, gaps in practice, firsthand information on top issues encountered by patients and care providers. Knowing the current state can help us understand what the future or desired state looks like from the viewpoints of people who need it to be realized.” 

On receiving a prestigious award that recognises his academic excellence, Leochico commented, “Being appreciated in this way is both heart-warming and humbling, and I would like to share this recognition with my loved ones and mentors, supervisors, colleagues and patients in the Philippines and Canada. Indeed, I am shaped by all the experiences that mold me to be the clinician-researcher I have always aspired to be.” 

Find out more about our professional masters: The Translational Research Program (TRP)

This story showcases the following pillars of the LMP strategic plan: Dynamic Collaboration (pillar 2), Impactful Research (pillar 3) and Agile Education (Pillar 5).