Vladimir Hachinski

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CM, MD, DSc, FRCPC, FCAHS, FAHA, FAAN, FRSC, Doctor honoris causa4

Scientist
Professor of Neurology and Epidemiology,
Department of Clinical Neurological Sciences, Western University;
Distinguished University Professor

Why I Became a Scientist

Dr. Vladimir Hachinski received his MD from the University of Toronto. After completing his residency training at the same university, he undertook a Cerebrovascular Laboratory Fellowship at the National Hospital for Nervous Diseases at Queen Square in London, England and a research fellowship at Bispebjerg Hospital in Copenhagen, Denmark.

He founded, with John W. Norris the world’s first successful acute stroke unit that has become the standard of care and with David Cechetto discovered the key role of the insula of the brain in mediating sudden death. He introduced the concepts of multi-infarct dementia, leukoaraiosis and vascular cognitive impairment and devised the Hachinski ischemic score, (over 4000 citations) that remains the standard for identifying the vascular (treatable) component of cognitive impairment. 

Dr. Hachinski was Editor-in-Chief of the journal Stroke, the leading publication in the field. He introduced 9 international editions and a unique author mentorship program. He has contributed over 1000 scientific papers, book chapters, editorials and other scholarly publications, with over 72,000 citations and rising: 2019: 5,376, 2020: 7,609, 2021: 10,147 (projected) and an h-index of 116. He is the author, co-author or editor or co-editor of 17 books including Stroke: A Comprehensive Guide to Brain Attack, co-authored with his daughter Larissa Hachinski, that was written to increase public awareness of brain attack, a term he coined to drive home the urgency of strokes.

Research Summary

The Dementia Prevention Initiative: Advancing Population Prevention Solutions (APPS)

Dementia is untreatable, but we found that some dementias are being prevented: We aim to find out how and why and help apply the lessons Canada-wide.

We showed that in step with a successful implementation of an Ontario Stroke Strategy aimed at treating, rehabilitating and preventing stroke, that the incidence of stroke declined by 32% and dementia by 7%. Meaning, that in the last year of the study 10,000 Ontarians were spared a stroke and 4,000 were saved from the tragedy of dementia.

Stroke, heart disease and dementia share the same risk and protective factors and probably other undiscovered ones. We plan to map comprehensively, population, environmental, socioeconomic and individual risk and protective in combination with population-based brain imaging and cognitive assessment across Canada identifying areas of high and low incidence of stroke, heart disease, cognitive impairment and dementia.  We will determine the differences and develop customized, cost-effective solutions. The Western Ontario Health Team and the City of London are making an upfront commitment to consider our evidence based, cost-effective, actionable recommendations. 

The initiative involves investigators from 5 faculties at Western University, 5 provinces and 4 countries.  It aims to build bridges among disciplines and foster a new generation of investigators familiar with multidisciplinary approaches and new methodologies.

The upgoing thumb sign

The sudden onset of speech trouble, weakness or numbness of one side of the body or vertigo and unsteadiness all medical emergencies as possible preludes to a stroke. The symptoms might go away but the danger doesn’t.

It is a challenge to determine whether the brain is affected, since up to 1/3 of patients have these symptoms from more benign causes.

Often the examination is normal. However, I noticed that at times, the only sign is an upgoing thumb on the side opposite of the brain involvement, this means a threatened stroke and needs urgent investigation. With Andrew Pruszynski we are exploring the anatomic and pathophysiological bases of the sign with a view of its quantification and widespread use in the clinic.

The Ambibaric Brain

We propose a new evolutionary interpretation of the brain’s circulation that has physiological, pathophysiological, and clinical implications. We conclude that the brain circulation contains complementary low-pressure and high-pressure systems that must be kept in balance for optimal brain health.

Keith St. Lawrence has developed an MRI/PET technique of measuring cerebral blood flow and metabolism simultaneously that can yield physiological and clinical relevant results based on the concept of the ambibaric brain.

Awards and Honours

2020 - FNG Starr Medal of the Canadian Medical Association, “Highest award available to one of its members”

2018 - Killam Prize in Health Sciences, Canadian Council for the Arts

2017 - Canadian Medical Hall of Fame 

2017 - International Prince Mahidol Award Laureate in the Field of Public Health

2016 -  McLaughlin Medal, Royal Society of Canada

2013 - Queen Elizabeth II Diamond Jubilee Medal

2011 - International BIAL Merit Award in Medical Sciences

2008 - Mihara International Award

2008 - Member of the Order of Canada

2008 - Premier's Discovery Award in the Life Sciences and Medicine

Publications

View all PubMed publications

  1. Sposato LA, Kapral MK, Wu J, Gill SS, Hackam DG, Cipriano LE, Hachinski V. Declining incidence of stroke and dementia: Coincidence or prevention opportunity? JAMA Neurol. 2015:72;1529-1531
  2. Vargas ER, Soros P, Shoemaker JK, Hachinski V. Human cerebral circuitry related to cardiac control: A neuroimaging meta-analysis . Annals of Neurol. 2016;79:709-716
  3. Sposato LA, Geoffrey C, Wardlaw JM….Hachinski V et al. Effect of right insular involvement on death and functional outcome after acute ischemic stroke in the IST-3 Trial (Third International Stroke Trial). Group        Author(s):  IST-3 Expert Reading Panel; IST-3 Collaborative Grp. STROKE. 2016;47:2959-2965
  4. Hachinski V, Alsubaie R, Azarpazhooh MR. Upgoing thumb sign: A sensitive indicator of brain involvement? Neurology. 2017;89;370-375
  5. Abootalebi S, Azarpazhooh MR, Sposato L, Hachinski V. The upgoing thumb sign. An interobserver/intraobserver reliability study. Neurology – Clin Pract. 2017;7:483-487
  6. Azarpazhooh MR, Avan A, Cipriano LE, Munoz DG, Sposato LA, Hachinski V. Concomitant vascular and neurodegenerative pathologies double the risk of dementia. Alz & Dem. 2018;14:148-156
  7. Alladi S, Hachinski V. World dementia: One approach does not fit all. Neurol. 2018;91:264-270
  8. Hachinski V. K Einhaupl, Ganten D, et al. Preventing dementia by preventing stroke: The Berlin Manifesto. Alz & Dement. 2019;15:962-984 / Int J of Stroke. Sept 2019
  9. Azarpazhooh MR, Avan A, Cipriano LE, Munoz DG, Erfanian M; Amiri A, Stranges S, Hachinski V. A third of community-dwelling elderly with intermediate and high level of Alzheimer's neuropathologic changes are not demented: A meta-analysis.  Ageing Res Reviews 2019;58:101002 (Epub 2019 Dec 30)
  10. Oveisgharan S, Hachinski V. No difference in dementia prediction between apolipoprotein E4 and the ischemic score.  Alzheimer's & Dement 2020;49:995-1002
  11. Hachinski V, Østergaard L. The Ambibaric Brain: Pathophysiological and Clinical Implications. Stroke. 2021 Jun;52(6):e259-e262. Epub 2021 May 4.
  12. Avan A and Hachinski V. Stroke and dementia, leading causes of neurological disability and death, potential for prevention. Alzheimer & Dementia. 2021 Jun;17(6):1072-1076
  13. 13. Avan A and Hachinski V, Brain Health Learn and Act Group. Brain health: Key to health, productivity, and well-being. Alzheimers Dement. 2021 Sep 27. doi: 10.1002/alz.12478. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/34569702/

 

G-7 Policy Publications

  1. Hachinski V. Bolstering brain health makes perfect sense. The G8 2012 Camp David Summit: The Road to Recovery. 2012:32/34. http://www.g7g20.utoronto.ca/books/campdavid/g8campdavid2012-07.pdf
  2. Hachinski V. Dementia: A new perspective. Global Health Governance. G7 Germany: The Schloss Elmau Summit. June 2015: 116-117. http://www.g7g20.utoronto.ca/books/g7elmau2015.pdf
  3. Hachinski V. Brain Health: Key to health, wealth and wellbeing. Global Health Governance. G7 UK: The 2021 Cornwall Summit. 2021:42-43. https://www.globalgovernanceproject.org/brain-health-key-to-health-wealth-and-well-being/

Contact Info

Email: vladimir.hachinski@lhsc.on.ca
Administrative Assistant: Teresa Ford
Email:  tford25@uwo.ca