Guido J. Falcone, MD, ScD, MPH
Associate Professor of NeurologyCards
About
Titles
Associate Professor of Neurology
Academic Chief, Division of Neurocritical Care, Neurology; Director of Clinical Research in Neurocritical Care, Neurology; Training Director, Yale/AHA Bugher Center for Intracerebral Hemorrhage Research, Neurology; Staff Neurointensivist, Neurology
Biography
I am a Neurologist with subspecialty training in Neurocritical Care and Stroke, and an Epidemiologist with expertise in Population Genetics and Big Data. While on clinical duties, I treat critically ill patients that have sustained a significant neurological injury due to ischemic stroke, subarachnoid hemorrhage, intraparenchymal hemorrhage, traumatic brain injury, seizures, recent neurosurgery, decompensated neuromuscular diseases, and several others.
My research lies at the interphase of clinical neurology, neuroimaging, population genetics and genomic medicine. I am interested in understanding how common and rare genetic variation influences the occurrence, severity, functional outcome and recurrence of stroke, both hemorrhagic and ischemic. Genetic variants influencing these phenotypes can be used for numerous applications, including: (1) identification of novel biological mechanisms involved in causing stroke and determining its severity and outcome, (2) answering non-genetic epidemiological questions using gene mutations as instruments (in the statistical sense of the word), and (3) risk stratification of patients according to their genetic profile. Through the International Stroke Genetics Consortium, I work in close collaboration with numerous investigators interested in stroke genomics from around the world.
Appointments
Neurology
Associate Professor on TermPrimary
Other Departments & Organizations
- Center for Biomedical Data Science
- Center for Brain & Mind Health
- Center for Neuroepidemiology and Clinical Neurological Research
- Neuro Intensive Care & Neurological Emergencies
- Neurology
- Yale Center for Genomic Health
- Yale Medicine
Education & Training
- Board Certification
- United Council for Neurologic Subspecialties, Neurocritical Care (2017)
- Neurocritical Care Fellowship
- Harvard Medical School / Massachusetts General Hospital / Brigham and Women's Hospital (2016)
- SPOTRIAS Fellowship
- Massachusetts General Hospital (2014)
- ScD
- Harvard School of Public Health, Department of Epidemiology (2014)
- MPH
- Harvard School of Public Health, Quantitative Methods (2010)
- Neurology Residency
- F.L.E.N.I. (2008)
- MD
- University of Buenos Aires School of Medicine (2002)
Research
Publications
2024
Cerebral Amyloid Angiopathy and Nontraumatic Subdural Hemorrhage—Reply
Rivier C, Falcone G, Murthy S. Cerebral Amyloid Angiopathy and Nontraumatic Subdural Hemorrhage—Reply. JAMA Neurology 2024, 81: 888-888. PMID: 38856983, DOI: 10.1001/jamaneurol.2024.1598.Peer-Reviewed Original ResearchDeep learning for prediction of post-thrombectomy outcomes based on admission CT angiography in large vessel occlusion stroke
Sommer J, Dierksen F, Zeevi T, Tran A, Avery E, Mak A, Malhotra A, Matouk C, Falcone G, Torres-Lopez V, Aneja S, Duncan J, Sansing L, Sheth K, Payabvash S. Deep learning for prediction of post-thrombectomy outcomes based on admission CT angiography in large vessel occlusion stroke. Frontiers In Artificial Intelligence 2024, 7: 1369702. PMID: 39149161, PMCID: PMC11324606, DOI: 10.3389/frai.2024.1369702.Peer-Reviewed Original ResearchEnd-to-endComputed tomography angiographyLarge vessel occlusionConvolutional neural networkDeep learning pipelineTrain separate modelsLogistic regression modelsResNet-50Deep learningAdmission computed tomography angiographyNeural networkLearning pipelineAdmission CT angiographyPreprocessing stepDiagnosis of large vessel occlusionsLarge vessel occlusion strokeReceiver operating characteristic areaEnsemble modelAutomated modelPre-existing morbidityCT angiographyReperfusion successNeurological examCross-validationOcclusion strokeThe predictive validity of a Brain Care Score for late-life depression and a composite outcome of dementia, stroke, and late-life depression: data from the UK Biobank cohort
Singh S, Rivier C, Papier K, Chemali Z, Gutierrez-Martinez L, Parodi L, Mayerhofer E, Senff J, Clocchiatti-Tuozzo S, Nunley C, Newhouse A, Ouyang A, Westover M, Tanzi R, Lazar R, Pikula A, Ibrahim S, Brouwers H, Howard V, Howard G, Yechoor N, Littlejohns T, Sheth K, Rosand J, Fricchione G, Anderson C, Falcone G. The predictive validity of a Brain Care Score for late-life depression and a composite outcome of dementia, stroke, and late-life depression: data from the UK Biobank cohort. Frontiers In Psychiatry 2024, 15: 1373797. PMID: 39109366, PMCID: PMC11301016, DOI: 10.3389/fpsyt.2024.1373797.Peer-Reviewed Original ResearchIncident late-life depressionLate-life depressionBrain health outcomesCare scoresHealth outcomesHealthy lifestyle choicesOutcome of dementiaUK Biobank cohortRisk factorsComposite outcomeCox proportional hazards modelsCare providersBiobank cohortProportional hazards modelIncident casesMultivariate Cox proportional hazards modelRisk of strokeLifestyle changesClinical careLifestyle choicesDementiaBrain healthFuture depressionBaseline evaluationComplete dataAPOE epsilon variants and composite risk of dementia, disability, and death in the health and retirement study
Clocchiatti‐Tuozzo S, Szejko N, Rivier C, Renedo D, Huo S, Sheth K, Gill T, Falcone G. APOE epsilon variants and composite risk of dementia, disability, and death in the health and retirement study. Journal Of The American Geriatrics Society 2024 PMID: 38946154, DOI: 10.1111/jgs.19043.Peer-Reviewed Original ResearchRisk of dementiaOutcome of dementiaAssociated with lower riskOlder adultsRetirement StudySecondary analysisEffects of tested interventionsHealth and Retirement StudyClinical trials of older adultsApo E4Composite outcomePrimary analysisHigh riskLow riskCox proportional hazards modelsProportional hazards modelMultivariate Cox proportional hazards modelDementiaAPOE genotypeClinical trialsHazards modelDisabilityParticipantsFunctional outcomesHeart diseaseDeep learning survival model predicts outcome after intracerebral hemorrhage from initial CT scan.
Chen Y, Rivier C, Mora S, Torres Lopez V, Payabvash S, Sheth K, Harloff A, Falcone G, Rosand J, Mayerhofer E, Anderson C. Deep learning survival model predicts outcome after intracerebral hemorrhage from initial CT scan. European Stroke Journal 2024, 23969873241260154. PMID: 38880882, DOI: 10.1177/23969873241260154.Peer-Reviewed Original ResearchIntracerebral hemorrhage scoreNon-contrast CT scanIntracerebral hemorrhageCT scanFUNC scoreIntracerebral hemorrhage patientsNon-contrast CTFunctional impairmentSevere disabilityDependent living statusLong-term functional impairmentC-indexPrognostic toolFunctional outcomesTreatment decisionsAcute settingClinical implementationRehabilitation strategiesDependent livingPatientsPredicting functional impairmentLong-term care needsPlanning of patient careDeep learning modelsHemorrhageAutomated detection of early signs of irreversible ischemic change on CTA source images in patients with large vessel occlusion
Mak A, Matouk C, Avery E, Behland J, Haider S, Frey D, Madai V, Vajkoczy P, Griessenauer C, Zand R, Hendrix P, Abedi V, Sanelli P, Falcone G, Petersen N, Sansing L, Sheth K, Payabvash S, Malhotra A. Automated detection of early signs of irreversible ischemic change on CTA source images in patients with large vessel occlusion. PLOS ONE 2024, 19: e0304962. PMID: 38870240, PMCID: PMC11175522, DOI: 10.1371/journal.pone.0304962.Peer-Reviewed Original ResearchConceptsDiffusion-weighted imagingLarge vessel occlusionIrreversible ischemic changesPoor functional outcomeFunctional outcomesIschemic changesInfarct volumeAlberta Stroke Program Early CT ScorePredicting poor functional outcomeVessel occlusionFollow-up diffusion-weighted imagingAnterior circulation LVO strokeCTA source imagesReceiver operating characteristic curveExpert human readersPredicting final infarctionASPECTS regionsAdmission CTANon-inferior performanceBaseline CTACT scoreFinal infarctEndovascular therapyHU attenuationValidation cohortRadiomic Features of Acute Cerebral Hemorrhage on Non-Contrast CT Associated with Patient Survival
Zaman S, Dierksen F, Knapp A, Haider S, Karam G, Qureshi A, Falcone G, Sheth K, Payabvash S. Radiomic Features of Acute Cerebral Hemorrhage on Non-Contrast CT Associated with Patient Survival. Diagnostics 2024, 14: 944. PMID: 38732358, PMCID: PMC11083693, DOI: 10.3390/diagnostics14090944.Peer-Reviewed Original ResearchInternational Normalized RatioArea under the curveNational Institutes of Health Stroke ScaleIntracerebral hemorrhageRadiomic featuresAntihypertensive Treatment of Acute Cerebral Hemorrhage IINon-contrast head CT scanBaseline International Normalized RatioAssociated with worse survival outcomesAcute intracerebral hemorrhageSupratentorial intracerebral hemorrhageWorse survival outcomesKaplan-Meier analysisHead CT scanCox proportional hazards modelsPredictors of mortalityAcute cerebral hemorrhageReceiver Operating Characteristic (ROC) analysisFirst-order energyHigher mortality riskProportional hazards modelHealth Stroke ScaleCT radiomicsHematoma expansionPost-ICHSecondary Prevention in Patients With Stroke Versus Myocardial Infarction: Analysis of 2 National Cohorts
Rivier C, Acosta J, Leasure A, Forman R, Sharma R, de Havenon A, Spatz E, Inzucchi S, Kernan W, Falcone G, Sheth K. Secondary Prevention in Patients With Stroke Versus Myocardial Infarction: Analysis of 2 National Cohorts. Journal Of The American Heart Association 2024, 13: e033322. PMID: 38639369, PMCID: PMC11179946, DOI: 10.1161/jaha.123.033322.Peer-Reviewed Original ResearchMeSH KeywordsAgedAntihypertensive AgentsBlood PressureCross-Sectional StudiesFemaleHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMiddle AgedMyocardial InfarctionPlatelet Aggregation InhibitorsPractice Guidelines as TopicRisk AssessmentRisk FactorsSecondary PreventionStrokeUnited KingdomUnited StatesConceptsMyocardial infarctionPrevention scoreSecondary preventionImplementation of preventive therapyNational cohortUK BiobankAntiplatelet therapy useGuideline-directed therapyPrevention profilesBlood pressure controlAdherence to guideline-directed therapyLow-density lipoprotein controlNeighborhood deprivation levelHistory of strokeVascular risk profileStatin useAntiplatelet useTherapy usePreventive therapyComparison to participantsPrevention criteriaCross-sectional analysisBlood pressurePatientsPressure controlImpact of sleep quality and physical activity on blood pressure variability
de Havenon A, Falcone G, Rivier C, Littig L, Petersen N, de Villele P, Prabhakaran S, Kimberly W, Mistry E, Sheth K. Impact of sleep quality and physical activity on blood pressure variability. PLOS ONE 2024, 19: e0301631. PMID: 38625967, PMCID: PMC11020843, DOI: 10.1371/journal.pone.0301631.Peer-Reviewed Original ResearchConceptsSleep qualityPhysical activityOdds ratioCohort of community-dwelling adultsCommunity-dwelling adultsExcess relative riskBlood pressure variabilityExamined sleep qualityPoor sleep qualitySystolic blood pressure standard deviationSleep interruptionBody mass indexPhysical inactivityPrimary study outcomeStep countsImpact of sleep qualityLowest tertileRelative riskHigh blood pressure variabilityHome measurement devicesActivity levelsExposure statusPoor sleepMass indexStudy outcomesChronic Kidney Disease and Risk of Intracerebral Hemorrhage: The Role of Hypertension as a Mediator (S34.004)
Vanent K, Rivier C, Matouk C, Levitt M, Leslie-Mazwi T, Gill T, Sheth K, Falcone G. Chronic Kidney Disease and Risk of Intracerebral Hemorrhage: The Role of Hypertension as a Mediator (S34.004). Neurology 2024, 102 DOI: 10.1212/wnl.0000000000205783.Peer-Reviewed Original Research
Clinical Trials
Current Trials
Biomarker and Edema Attenuation in IntraCerebral Hemorrhage (BEACH)
HIC ID2000031665RoleSub InvestigatorPrimary Completion Date12/01/2025Recruiting ParticipantsGenderBothAge18+ yearsRegulating Blood Pressure During Recovery from Intracerebral Hemorrhage and Ischemic Stroke (REDUCE)
HIC ID2000029811RoleSub InvestigatorPrimary Completion Date01/31/2025Recruiting ParticipantsGenderBothAge18+ yearsBrain Oxygen Optimization in Severe TBI, Phase 3 (BOOST3)
HIC ID2000024956RoleSub InvestigatorPrimary Completion Date07/01/2023Recruiting ParticipantsGenderBothAge14+ yearsAnticoagulation for Stroke Prevention and Recovery After ICH (ASPIRE)
HIC ID2000026409RolePrincipal InvestigatorPrimary Completion Date04/30/2024Recruiting ParticipantsGenderBothAge18+ yearsTransforming Acute Stroke Detection through Real Time Neurological Monitoring
HIC ID1605017863RoleSub InvestigatorPrimary Completion Date07/01/2017Recruiting ParticipantsGenderBothAge18+ years
Academic Achievements and Community Involvement
Clinical Care
Overview
Guido Falcone, MD, ScD, MPH, is a critical care neurologist who treats patients with severe brain injuries from trauma, strokes, hemorrhages, and seizures, among other conditions. “I usually meet patients with these injuries immediately after they come to the hospital,” Dr. Falcone says. He also sees patients suffering from symptoms caused by neuromuscular diseases or complications from brain surgery.
“One important characteristic of our specialty is that many important decisions need to be made in those initial few minutes to hours,” Dr. Falcone says. “We also need to factor in the patient’s wishes, but often they are unconscious and cannot communicate.”
In those cases, Dr. Falcone relies on the patient’s family for guidance. “This can cause a tremendous amount of stress as they carry the huge responsibility of representing their loved ones,” he says.
Dr. Falcone keeps this additional stress in mind when he’s talking with the patient’s family about a diagnosis and what to expect next. “It’s very important for us to be honest and explain to them what we know and don’t know so that this uncertainty can be taken into consideration when we’re making a clinical decision,” he says. Dr. Falcone says he and his colleagues in the Neuroscience Intensive Care Unit (Neuro ICU) frequently update families on the status of a patient’s condition and progress.
“Something I came to realize after a few years in the field is that we help patients and families all the time. Sometimes, we help them get better,” Dr. Falcone says. “But another important part of our job is to give the very best end-of-life care, with the same approach we use when curing a disease or saving lives, if that is necessary.”
In his research, Dr. Falcone specializes in population genetics and genomic medicine, two related fields that involve analyzing large amounts of data and searching for different variants of genes that might influence human disease. He works with a team that uses information from across disciplines, such as neuroimaging data, for example, to conduct studies. “We want to use data to understand not just what causes disease, but also who is at high risk of developing it,” Dr. Falcone says. “Genes are such a powerful tool in patient care because our genetic information is constant from birth.”
Clinical Specialties
Links & Media
News
- July 05, 2023
Cyprien Rivier, MD, MSc Wins ESOC Young Research Investigator Award in Stroke
- February 08, 2023
Santiago Clocchiatti-Tuozzo, MD Honored with Bernard J. Tyson Career Development Award and Stroke Underrepresented Racial and Ethnic Groups Travel Grant
- February 07, 2023
Daniela Renedo, MD Wins American Heart Association Stroke Basic Science Award
- January 31, 2023
Yale Study Links Genetics and Blood Pressure Control in Stroke Survivors