David Spence MD, FRCPC, FAHA, FCAHS
Professor of Neurology and Clinical Pharmacology, Western University
Director, Stroke Prevention and Atherosclerosis Research Centre, Robarts Research Institute
My research is based on uses of ultrasound in stroke prevention. We use transcranial Doppler for risk stratification in asymptomatic carotid stenosis and for detection of right-to-left shunts in patients with suspected paradoxical embolism, and measurement of carotid plaque burden for risk stratification, management of patients and genetic research. In CAIN I am chair of Project 2, which is validating preoperative imaging of vulnerable plaque by 3D ultrasound, MRI, CT angio, contrast studies of plaque vascularity and PET/CT imaging of plaque inflammation, with 3D histology of carotid endarterectomy specimens.
I have been greatly influenced by Dr. Henry Barnett, with whom I trained in Neurology. He was the first to show that aspirin reduced the risk of stroke, was PI of the North American Carotid Endarterectomy Study, and a giant in stroke prevention. My greatest personal achievement has been the prevention of approximately 7000 strokes among the 30,000 patients referred to me; my greatest academic achievement has been the pioneering of measurement of carotid plaque burden for risk stratification, management of patients and genetic research.