Vladimir Hachinski, CM, MD DSc FRCPC FCAHS FAHA FAAN FRSC, Doctor honoris causa4
Scientist, Robarts Research Institute
Department of Clinical Neurological Sciences, Epidemiology and Biostatistics, University of Western Ontario; Distinguished University Professor
Administrative Assistant: Teresa Ford
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 73,300 citations and rising: 2019: 5,376, 2020: 7,609, 2021: projected to be 9,369 (about one citation per hour), his h-index is 118. 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.
He edited "Treatable and Potentially Preventable Dementias", the first comprehensive and authoritative book covering the basis for the joint prevention of stroke and the management, delay, or prevention of some dementias. The book has been “Highly commended” by the British Medical Association.
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.
Developing models of dementia prevention at the population level.
He has developed the concept of the ambibaric brain, ie: of two brain circulations in one: The primitive high pressure one and the homo sapiens low pressure one.
He is seeking collaborators in dynamic brain imaging to advance the concept.
He is only accepting collaborators, post-doctoral students and research fellows.
Joint prevention of stroke, heart disease and dementia. Cerebral circulation. Brain health
Honours and Awards
- 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
Whitehead SN, Bruno A, Burns JM, Carmichael ST, Csiszar A, Edwards JD, Elahi FM, Faraco G, Gould DB, Gustafson DR, Hachinski V, Rosenberg G, Sorond FA, Shih AY, Tse KH, Ungvari Z, Wilcock DM, Zuloaga KL, Barone FC. Expanding the horizon of research into the pathogenesis of the white matter diseases: Proceedings of the 2021 Annual Workshop of the Albert Research Institute for White Matter and Cognition. Geroscience. 2021 Oct 4:1–13. doi: 10.1007/s11357-021-00461-8. Epub ahead of print. PMID: 34606040; PMCID: PMC8488071.
Avan A, 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. Epub ahead of print. PMID: 34569702.
Levit A, Gibson A, Hough O, Jung Y, Agca Y, Agca C, Hachinski V, Allman BL, Whitehead SN. Precocious White Matter Inflammation and Behavioural Inflexibility Precede Learning and Memory Impairment in the TgAPP21 Rat Model of Alzheimer Disease. Mol Neurobiol. 2021 Oct;58(10):5014-5030. doi: 10.1007/s12035-021-02476-w. Epub 2021 Jul 7. PMID: 34232476.
Avan A, Hachinski V. Stroke and dementia, leading causes of neurological disability and death, potential for prevention. Alzheimers Dement. 2021 Jun;17(6):1072-1076. doi: 10.1002/alz.12340. Epub 2021 May 31. PMID: 34057294.
Hachinski V, Østergaard L. The Ambibaric Brain: Pathophysiological and Clinical Implications. Stroke. 2021 Jun;52(6):e259-e262. doi: 10.1161/STROKEAHA.120.033492. Epub 2021 May 4. PMID: 33940956.
Morovatdar N, Avan A, Azarpazhooh MR, Di Napoli M, Stranges S, Kapral MK, Rezayat AA, Shariatzadeh A, Abootalebi S, Mokhber N, Spence JD, Hachinski V. Secular trends of ischaemic heart disease, stroke, and dementia in high-income countries from 1990 to 2017: the Global Burden of Disease Study 2017. Neurol Sci. 2021 May 1. doi: 10.1007/s10072-021-05259-2. Epub ahead of print. PMID: 33934273.
Hachinski V, Avan A, Gilliland J, Oveisgharan S. A new definition of brain health. Lancet Neurol. 2021 May;20(5):335-336. doi: 10.1016/S1474-4422(21)00102-2. PMID: 33894188.
Hachinski V. Brain Health-Curbing Stroke, Heart Disease, and Dementia: The 2020 Wartenberg Lecture. Neurology. 2021 Aug 10;97(6):273-279. doi: 10.1212/WNL.0000000000012103. Epub 2021 Apr 21. PMID: 33883239.
Smith EE, Barber P, Field TS, Ganesh A, Hachinski V, Hogan DB, Lanctôt KL, Lindsay MP, Sharma M, Swartz RH, Ismail Z, Gauthier S, Black SE. Canadian Consensus Conference on Diagnosis and Treatment of Dementia (CCCDTD)5: Guidelines for management of vascular cognitive impairment. Alzheimers Dement (N Y). 2020 Nov 11;6(1):e12056. doi: 10.1002/trc2.12056. PMID: 33209971; PMCID: PMC7657196.
Ganesh A, Barber P, Black SE, Corbett D, Field TS, Frayne R, Hachinski V, Ismail Z, Mai LM, McCreary CR, Sahlas D, Sharma M, Swartz RH, Smith EE. Trial of remote ischaemic preconditioning in vascular cognitive impairment (TRIC-VCI): protocol. BMJ Open. 2020 Oct 14;10(10):e040466. doi: 10.1136/bmjopen-2020-040466. PMID: 33055122; PMCID: PMC7559076.
Oveisgharan S, Hachinski V. No difference in dementia prediction between apolipoprotein E4 and the ischemic score. Alzheimers Dement. 2020 Nov;16(11):1596-1599. doi: 10.1002/alz.12139. Epub 2020 Jul 30. PMID: 32729966.
Hachinski V, Bornstein NM, Markus HS. In Memoriam: John W Norris (1933-2020). Int J Stroke. 2020 Jun 29:1747493020925315. doi: 10.1177/1747493020925315. Epub ahead of print. PMID: 32597703.
Montero-Odasso M, Speechley M, Muir-Hunter SW, Pieruccini-Faria F, Sarquis-Adamson Y, Hachinski V, Bherer L, Borrie M, Wells J, Garg AX, Tian Q, Ferrucci L, Bray NW, Cullen S, Mahon J, Titus J, Camicioli R; Canadian Gait and Cognition Network. Dual decline in gait speed and cognition is associated with future dementia: evidence for a phenotype. Age Ageing. 2020 Oct 23;49(6):995-1002. doi: 10.1093/ageing/afaa106. PMID: 32559288; PMCID: PMC7583522.
Brainin M, Feigin VL, Norrving B, Martins SCO, Hankey GJ, Hachinski V; World Stroke Organization Board of Directors. Global prevention of stroke and dementia: the WSO Declaration. Lancet Neurol. 2020 Jun;19(6):487-488. doi: 10.1016/S1474-4422(20)30141-1. Epub 2020 May 26. PMID: 32470419.
Hachinski V, Bornstein NM, Markus HS. John W. Norris: 1933-2020. Stroke. 2020 Jul;51(7):1913-1915. doi: 10.1161/STROKEAHA.120.030168. Epub 2020 May 22. PMID: 32441207.
Levit A, Cheng S, Hough O, Liu Q, Agca Y, Agca C, Hachinski V, Whitehead SN. Hypertension and Pathogenic hAPP Independently Induce White Matter Astrocytosis and Cognitive Impairment in the Rat. Front Aging Neurosci. 2020 Apr 15;12:82. doi: 10.3389/fnagi.2020.00082. PMID: 32351378; PMCID: PMC7174625.
Roseborough A, Hachinski V, Whitehead S. White Matter Degeneration-A Treatable Target? JAMA Neurol. 2020 Jul 1;77(7):793-794. doi: 10.1001/jamaneurol.2020.0814. PMID: 32338713.
Hachinski V. Stroke: The Essential Journal: 2000 to 2010. Stroke. 2020 Mar;51(3):1027-1031. doi: 10.1161/STROKEAHA.120.028421. Epub 2020 Feb 19. Erratum in: Stroke. 2020 May;51(5):e101. PMID: 32073366.
Levit A, Hachinski V, Whitehead SN. Neurovascular unit dysregulation, white matter disease, and executive dysfunction: the shared triad of vascular cognitive impairment and Alzheimer disease. Geroscience. 2020 Apr;42(2):445-465. doi: 10.1007/s11357-020-00164-6. Epub 2020 Jan 30. PMID: 32002785; PMCID: PMC7205943.
Egorova N, Liem F, Hachinski V, Brodtmann A. Predicted Brain Age After Stroke. Front Aging Neurosci. 2019 Dec 10;11:348. doi: 10.3389/fnagi.2019.00348. PMID: 31920628; PMCID: PMC6914736.
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 Rev. 2020 Mar;58:101002. doi: 10.1016/j.arr.2019.101002. Epub 2019 Dec 30. PMID: 31899366.
Azarpazhooh MR, Hachinski V. Vascular cognitive impairment: A preventable component of dementia. Handb Clin Neurol. 2019;167:377-391. doi: 10.1016/B978-0-12-804766-8.00020-0. PMID: 31753144.
Vargas-González JC, Hachinski V. Insidious Cerebrovascular Disease-The Uncool Iceberg. JAMA Neurol. 2020 Feb 1;77(2):155-156. doi: 10.1001/jamaneurol.2019.3933. PMID: 31738373.
Hachinski V, Einhäupl K, Ganten D, Alladi S, Brayne C, Stephan BCM, Sweeney MD, Zlokovic B, Iturria-Medina Y, Iadecola C, Nishimura N, Schaffer CB, Whitehead SN, Black SE, Østergaard L, Wardlaw J, Greenberg S, Friberg L, Norrving B, Rowe B, Joanette Y, Hacke W, Kuller L, Dichgans M, Endres M, Khachaturian ZS. Special topic section: linkages among cerebrovascular, cardiovascular, and cognitive disorders: Preventing dementia by preventing stroke: The Berlin Manifesto. Int J Stroke. 2019 Sep 22:1747493019871915. doi: 10.1177/1747493019871915. Epub ahead of print. PMID: 31543058.
Hachinski V, Einhäupl K, Ganten D, Alladi S, Brayne C, Stephan BCM, Sweeney MD, Zlokovic B, Iturria-Medina Y, Iadecola C, Nishimura N, Schaffer CB, Whitehead SN, Black SE, Østergaard L, Wardlaw J, Greenberg S, Friberg L, Norrving B, Rowe B, Joanette Y, Hacke W, Kuller L, Dichgans M, Endres M, Khachaturian ZS. Preventing dementia by preventing stroke: The Berlin Manifesto. Alzheimers Dement. 2019 Jul;15(7):961-984. doi: 10.1016/j.jalz.2019.06.001. PMID: 31327392; PMCID: PMC7001744.
Iadecola C, Duering M, Hachinski V, Joutel A, Pendlebury ST, Schneider JA, Dichgans M. Vascular Cognitive Impairment and Dementia: JACC Scientific Expert Panel. J Am Coll Cardiol. 2019 Jul 2;73(25):3326-3344. doi: 10.1016/j.jacc.2019.04.034. PMID: 31248555; PMCID: PMC6719789.
Saposnik G, Hachinski V. The pathway towards an effective reduction of stroke burden worldwide: teamwork. Lancet Neurol. 2019 Jul;18(7):622-623. doi: 10.1016/S1474-4422(19)30198-X. PMID: 31202465.
Alber J, Alladi S, Bae HJ, Barton DA, Beckett LA, Bell JM, Berman SE, Biessels GJ, Black SE, Bos I, Bowman GL, Brai E, Brickman AM, Callahan BL, Corriveau RA, Fossati S, Gottesman RF, Gustafson DR, Hachinski V, Hayden KM, Helman AM, Hughes TM, Isaacs JD, Jefferson AL, Johnson SC, Kapasi A, Kern S, Kwon JC, Kukolja J, Lee A, Lockhart SN, Murray A, Osborn KE, Power MC, Price BR, Rhodius-Meester HFM, Rondeau JA, Rosen AC, Rosene DL, Schneider JA, Scholtzova H, Shaaban CE, Silva NCBS, Snyder HM, Swardfager W, Troen AM, van Veluw SJ, Vemuri P, Wallin A, Wellington C, Wilcock DM, Xie SX, Hainsworth AH. White matter hyperintensities in vascular contributions to cognitive impairment and dementia (VCID): Knowledge gaps and opportunities. Alzheimers Dement (N Y). 2019 Apr 9;5:107-117. doi: 10.1016/j.trci.2019.02.001. PMID: 31011621; PMCID: PMC6461571.
Hachinski V. Dementia: Paradigm shifting into high gear. Alzheimers Dement. 2019 Jul;15(7):985-994. doi: 10.1016/j.jalz.2019.01.006. Epub 2019 Apr 9. PMID: 30979540.
Azarpazhooh MR, Mandzia JL, Thrift AG, Sposato LA, Morovatdar N, Amiri A, Kapral MK, Yassi N, Bahit C, Kaul S, Alladi S, Nilanont Y, Coppola M, Nucera A, Silver B, Werring D, Simister R, Swartz RH, Owolabi MO, Ovbiagele B, Hachinski V; ASSESS investigators. Age, sex, and setting in the etiology of stroke study (ASSESS): Study design and protocol. J Neurol Sci. 2019 Apr 15;399:209-213. doi: 10.1016/j.jns.2019.02.024. Epub 2019 Feb 14. PMID: 30851659.
Azarpazhooh MR, Avan A, Cipriano LE, Munoz DG, Sposato LA, Hachinski V. Concomitant vascular and neurodegenerative pathologies double the risk of dementia. Alzheimers Dement. 2017 Sep 30. pii: S1552-5260(17)33686-5. doi: 10.1016/j.jalz.2017.07.755. [Epub ahead of print] PubMed PMID: 28974416.
Levit A, Regis AM, Garabon JR, Oh SH, Desai SJ, Rajakumar N, Hachinski V, Agca Y, Agca C, Whitehead SN, Allman BL. Behavioural inflexibility in a comorbid rat model of striatal ischemic injury and mutant hAPP overexpression. Behav Brain Res. 2017 Aug 30;333:267-275. doi: 10.1016/j.bbr.2017.07.006. Epub 2017 Jul 8. PubMed PMID: 28693862.
Nucera A, Azarpazhooh MR, Alsubaie R, Riccio P, Hachinski V. Time is brain: Balancing risk in the treatment of presumed cardioembolic stroke. J Neurol Sci. 2017 Jul 21. pii: S0022-510X(17)30458-6. doi: 10.1016/j.jns.2017.07.022. [Epub ahead of print] PubMed PMID: 28778583.
Prior PL, Hachinski V, Chan R, Unsworth K, Mytka S, Harnadek M, OʼCallaghan C, Suskin N. Comprehensive Cardiac Rehabilitation for Secondary Prevention After Transient Ischemic Attack or Mild Stroke: PSYCHOLOGICAL PROFILE AND OUTCOMES. J Cardiopulm Rehabil Prev. 2017 Jul 19. doi: 10.1097/HCR.0000000000000274. [Epub ahead of print] PubMed PMID: 28727668.
Levit A, Regis AM, Garabon JR, Oh SH, Desai S, Rajakumar N, Hachinski V, Agca Y, Agca C, Whitehead SN, Allman BL. Behavioural inflexibility in a comorbid rat model of striatal ischemic injury and mutant hAPP overexpression. Behav Brain Res. 2017 Jul 7. pii: S0166-4328(17)30488-6. doi: 10.1016/j.bbr.2017.07.006. [Epub ahead of print] PubMed PMID: 28693862.
Montero-Odasso MM, Sarquis-Adamson Y, Speechley M, Borrie MJ, Hachinski VC, Wells J, Riccio PM, Schapira M, Sejdic E, Camicioli RM, Bartha R, McIlroy WE, Muir-Hunter S. Association of Dual-Task Gait With Incident Dementia in Mild Cognitive Impairment: Results From the Gait and Brain Study. JAMA Neurol. 2017 Jul 1;74(7):857-865. doi: 10.1001/jamaneurol.2017.0643. PMID: 28505243
Hachinski V, Alsubaie R, Azarpazhooh MR. Upgoing thumb sign: A sensitive indicator of brain involvement? Neurology. 2017 Jun 28. pii: 10.1212/WNL.0000000000004157. doi: 10.1212/WNL.0000000000004157. [Epub ahead of print] PubMed PMID: 28659430.
Azarpazhooh MR, Hachinski V. Optimisation of stroke research. Lancet Neurol. 2017 May;16(5):340-341. doi: 10.1016/S1474-4422(17)30081-9. No abstract available. PMID: 28414643
Hachinski V. Stoop to conquer: preventing stroke and dementia together. Lancet. 2017 Apr 15;389(10078):1518. doi: 10.1016/S0140-6736(17)30954-6. No abstract available. PMID: 28422027
Gregory MA, Boa Sorte Silva NC, Gill DP, McGowan CL, Liu-Ambrose T, Shoemaker JK, Hachinski V, Holmes J, Petrella RJ. Combined Dual-Task Gait Training and Aerobic Exercise to Improve Cognition, Mobility, and Vascular Health in Community-Dwelling Older Adults at Risk for Future Cognitive Decline1. J Alzheimers Dis. 2017;57(3):747-763. doi: 10.3233/JAD-161240. PMID: 28304305
Patel SK, Restrepo C, Werden E, Churilov L, Ekinci EI, Srivastava PM, Ramchand J, Wai B, Chambers B, O'Callaghan CJ, Darby D, Hachinski V, Cumming T, Donnan G, Burrell LM, Brodtmann A. Does left ventricular hypertrophy affect cognition and brain structural integrity in type 2 diabetes? Study design and rationale of the Diabetes and Dementia (D2) study. BMC Endocr Disord. 2017 Apr 7;17(1):24. doi: 10.1186/s12902-017-0173-7. PMID: 2838889
Cerasuolo JO, Cipriano LE, Sposato LA, Kapral MK, Fang J, Gill SS, Hackam DG, Hachinski V. Population-based stroke and dementia incidence trends: Age and sex variations. Alzheimers Dement. 2017 Mar 28. pii: S1552-5260(17)30095-X. doi: 10.1016/j.jalz.2017.02.010. [Epub ahead of print] PMID: 28363085
Lee SA, Sposato LA, Hachinski V, Cipriano LE. Cost-effectiveness of cerebrospinal biomarkers for the diagnosis of Alzheimer's disease. Alzheimers Res Ther. 2017 Mar 16;9(1):18. doi: 10.1186/s13195-017-0243-0. PMID: 28302164
Sposato LA, Wardlaw JM, Hachinski V. Response by Sposato et al to Letter Regarding Article, "Effect of Right Insular Involvement on Death and Functional Outcome After Acute Ischemic Stroke in the IST-3 Trial (Third International Stroke Trial)". Stroke. 2017 Mar;48(3):e92. doi: 10.1161/STROKEAHA.116.016387. Epub 2017 Feb 7. No abstract available. PMID: 28174325
Hachinski V. Henry J.M. Barnett, MD (1922-2016). Neurology. 2017 Feb 28;88(9):824-825. doi: 10.1212/WNL.0000000000003668. No abstract available. PMID:28242847
Oveisgharan S, Hachinski V. Atherosclerosis and vascular cognitive impairment neuropathological guideline. Brain. 2017 Feb;140(Pt 2):e12. doi: 10.1093/brain/aww304. Epub 2016 Dec 21. No abstract available. PMID: 28007992
Sposato LA, Hachinski V. Right insular cortex involvement is consistently associated with death after ischaemic stroke. Eur J Neurol. 2017 Jan;24(1):1-2. doi: 10.1111/ene.13174. Epub 2016 Oct 31. No abstract available. PMID: 27797138
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