To demonstrate the utility of an interdisciplinary brain medicine approach to complex cases involving brain disorders impacting affect, behaviour and cognition (ABC) and the effect of these disorders on functional abilities, quality of life, and relationships.

The twentieth century saw increasing division amongst medical disciplines that each lay claim to brain disorders. Psychiatry, neurology, neurosurgery, and geriatric medicine have all developed unique approaches to management of brain disorders, resulting in siloed care for patients (Hogan et al., in preparation). We use a case-based approach to illustrate the importance of a brain medicine lens for providing care to patients with brain disorders that sit at the mind-brain interface. 

Cases were drawn from the inaugural University of Toronto Brain Medicine fellow’s clinical roster. The cases were selected with the following criteria in mind: (1) a complex brain disease involving disordered ABC (2) psychosocial complexity, and (3) requiring a transdisciplinary management approach. 

Three cases, each with its own unique features, demonstrate the benefits of an interdisciplinary brain medicine approach. We present cases of (1) traumatic brain injury-induced catatonia requiring neurosurgery, electroconvulsive therapy, pharmacology, and rehabilitation; (2) refractory temporal lobe epilepsy requiring a lobectomy and ongoing pharmacological management, presenting with new-onset depressive symptoms and suicidality in the context of a recent status epilepticus event; and (3) a significant substance use disorder with associated attention-deficit and hyperactivity disorder and chronic pain presenting with pseudoseizures and suicidal ideation. In each of these cases, transdisciplinary brain medicine objectives were identified and the need for an integrated cross-disciplinary effort is highlighted.

An interdisciplinary brain medicine approach can transcend the barriers separating brain focused specialities. Competence-based training programs, that build on a trainee’s specialty of origin, can foster the translation of this approach into clinical medicine.