Vladimir Hachinski, CM, MD, DSc, FRCPC, FCAHS, FAHA, FAAN, FRSC, Doctor honoris causa x4

Research

Integral Brain Health Implementation Strategy (IBHIS)

Stroke and dementia account for the majority of disability adjusted life years (DALYS), which is increasing with the global ‘aging population’. The current brain health plans, globally, do not address this issue comprehensively in a low-cost, accessible, effective and long-term way. The Integral Brain Health Implementation Strategy (IBHIS) is both a combined research study and implementation program designed to address this challenge. The study is focused initially on individuals undergoing change (e.g. new employees, expectant parents, employees and their partners)  2 years within retirement, in the St. Joseph’s Health Centre and the London Health Sciences Hospitals.  as they are more likely to adopt change. The prevention stroke and dementia through integral brain health (cerebral, mental and social) have been simplified to 5 simple BASIC-S actions, Blood pressure control, Activity, Sleep, Interacting, Consumption - Synergy (BASIC-S), as they are low cost, effective, accessible and long-term. The impacts of these changes will be measured in the participants an integral Brain Health Index an Integral Brain Health Implementation Index and identification and control of high blood pressure, being the most prevalent, powerful and preventable risk factor for stroke, heart disease and dementia. This simple intervention will be taught to and applied through health professionals and trained lay persons which saves money, training and implementation time, and skips the mobilization of knowledge step.  Proving early success within these populations will help expand IBHIS to more organizations and family practices, the community and disadvantaged populations, and at selected Canadian and international countries: three in Canada, two in Europe, one in Africa, India and one each in Singapore and Hong Kong.

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.

Kevin Shoemaker is leading a team based on this concept to develop methods to determine “What is the best blood pressure for my brain”. In acute stroke and in prevention of stroke, heart disease and dementia.

Medical Interests

Joint prevention of stroke, heart disease and dementia. Cerebral circulation. Brain health

Honours and Awards

• 2024, The Ryman Prize for “The world’s best discovery, development, advance or achievement that enhances quality of life for older people.”
• 2022, The Potamkin Prize for Research in Pick's, Alzheimer's, and Related Dise
• 2021, The World Federation of Neurology Medal for Services to World Neurology
• 2020, The American Academy of Neurology Wartenberg Lecture & Award
• 2020, The 41st T.S. Srinivasan Oration and gold medal and scroll
• 2020, FNG Starr Medal of the Canadian Medical Association, "Highest award available to one of its memebers"
• 2018, Killam Prize, Canadian Council for the Arts
• 2017, Canadian Medical Hall of Fame
• 2016, McLaughlin Medal, Royal Society of Canada
• 2015, Lawson Career Scientist Award, Lawson Research Institute
• 2013, Officer of the Order of Ontario
• 2013, Queen Elizabeth II Diamond Jubilee Medal
• 2013, Chancellor's Award Lecture in Neuroscience and Neurology
• 2011, International BIAL Merit Award in Medical Sciences, BILAL
• 2010, Biomedical Science Ambassador Award, Canadian national charity Partners In Research
• 2008, Honorary Member, Mexican Academy of Neurology
• 2008, Mihara International Award
• 2008, World Stroke Organization Leadership in Stroke Medicine Award
• 2008, Premier's Discovery Award in the Life Sciences and Medicine
• 2008, Officer of the Order of Canada
• 2008, Mihara International Award
• 2006, Distinguished Professor, Western University