Early in neurology residency, Dr. Adam de Havenon became interested in stroke and brain imaging with MRI, but it was during his vascular neurology fellowship that he realized his core interest would be developing and testing advanced neuroimaging that can improve stroke diagnosis, treatment, and prevention.
“Similar to many of the vascular neurologists and neuroradiologists I consider role models, my passion for clinical research stems from intellectual curiosity and a commitment to discovering superior diagnostic and treatment options for my patients,” says de Havenon.
Intracranial atherosclerosis is the buildup of plaque in the arteries that supply the brain with blood and is the most common cause of stroke in the world, yet it is understudied in the United States because it disproportionately affects racial and ethnic minorities. The average annual rate of recurrence for all causes of stroke is 5%, but for intracranial atherosclerosis patients, that rate of recurrence jumps to 12-20%.
Dr. de Havenon’s central hypothesis is that ischemic stroke in intracranial atherosclerosis is due to immune cells called macrophages. Macrophages are large, specialized cells that form in response to an infection in the body and serve as a first line of defense against different microbes and invaders. They migrate to stroke lesions as part of the immune response after a stroke, but they seem to increase the risk of stroke recurrence.
Dr. de Havenon just received a prestigious K23 award from the National Institute of Neurological Diseases and Stroke to test his hypothesis. Using an advanced imaging technique called vessel wall MRI and a specific labeling technique for macrophages, he will be able to visualize macrophage-specific effects on vessels at risk for recurrent stroke. He predicts that vessels with more macrophage activity will be more likely to have a second stroke. If this research is successful, it will provide clinicians with a new tool to assess the risk of recurrent stroke, and potentially new macrophage-targeted treatments.