Rebecca Folkerth, MD

I am a diagnostic neuropathologist, responsible for the diagnosis of central and peripheral nervous system abnormalities in human adults and children. I have been integrally involved in the study of disorders involving the nervous system for over 35 years, including 26 years of hospital-based practice at Harvard-affiliated hospitals in Boston.

My primary research interests in neuropathology have been conducted directly in the human postmortem brain:  1) traumatic brain injury (TBI);  and 2) inherent and acquired abnormalities of the developing brain;  3) rabies encephalitis;  and 4)  ischemic stroke in the adult.

My work in TBI has focused on the tissue substrates for post-traumatic neurodegeneration, including chronic traumatic encephalopathy (CTE), and in disorders of consciousness.  Since 2011, I have been an ongoing collaborator with Prof. Kristen Dams-O’Connor of the Brain Injury Research Center, along with other national and international experts, in the analysis of postmortem brains for both short- and long-term sequelae of TBI among members of the community (i.e., not centered on contact athletes or soldiers). Drawing from my 2015 and 2019 experience in the NIH-convened Consensus Group for determination of the neuropathologic criteria for CTE, most recently Prof. Dams-O’Connor and our team showed a surprising lack of CTE among victims of intimate partner violence, shifting attention from tau proteinopathy to microvascular brain injury as a potential mechanism for neurobehavioral dysfunction in this vulnerable cohort (PMID: 37897548). I was brought on board by her in the fall of 2023 to oversee directly the neuropathologic analyses of her Late Effects of TBI cohort.

Regarding TBI-related disorders of consciousness, I have been working with Dr. Brian Edlow, a neurointensivist in Boston, since 2010 when he was a neurology resident rotating on my service.  Together with his team, we have mapped the normative human ascending arousal system and the traumatic disruption of its connectivity, essential to understanding and utilizing imaging predictors of recovery among living patients (PMID: 38691619;  PMID: 23656993). 

My second main research focus is the anatomy and pathology of the developing human brain.  I have contributed to knowledge of the cellular bases of both normal and abnormal process across the entire fetal and infant period.  As part of my clinical responsibility for diagnostic analyses of perinatal brains over my 28-year affiliation with Harvard Medical School, I was invited into a Program Project under Professors Joseph J. Volpe (Emeritus) and Hannah C. Kinney (Emerita) investigating the relationship of preterm birth to brain changes underlying cerebral palsy (PMID: 16417840; PMID: 17912538).  In addition, I was a key member of a multi-institutional consortium in the first prospective study of sudden infant death syndrome (SIDS) and stillbirth focused on the impact of maternal health, including drinking and smoking, among disadvantaged populations in the US and South Africa (PMID: 34424306;  PMID: 32140668).  Currently, our group is analyzing the connectivity of the fetal and infant ascending arousal network to explore the concept of SIDS as a disorder of arousal. 

Over the last few years, I have served as a Consultant to the Sudha Gopalakrishnan Brain Centre at the Indian Institute of Technology Madras, assisting in research efforts in normal human brain development, malformations and acquired brain abnormalities of infants, rabies encephalitis, and cerebral ischemia in adults.  The latter study is focused on delineating the cellular and molecular signatures of the ischemic penumbra.  All studies at the Centre use a novel multi-modal whole-brain imaging platform allowing 3-dimentional spatial delineation in unprecedented detail (PMID: 39905665; PMID: 38591638).