Stéphanie Debette

Spécialiste des maladies vasculaires cérébrales, elle vient d’entrer à l’Académie des sciences, quelques mois après avoir reçu le Grand Prix Inserm 2024. Médecin, chercheuse et universitaire, elle s’est illustrée par ses travaux sur l’AVC et la démence à la tête du laboratoire Inserm Bordeaux Population Health puis de l’institut hospitalo-universitaire VBHI. Un nouveau chapitre s’ouvre pour celle qui n’a de cesse de faire progresser la recherche sur le cerveau.

You have had a rich and diverse career, spanning medicine, research, and teaching. What was the catalyst that led you to specialize in genetic epidemiology and cerebrovascular diseases?

Early in my career, I encountered strokes in young patients with no obvious risk factors. This experience prompted me to look for explanations beyond the usual causes. In addition, I have always been interested in the highly rational and quantitative, almost “mathematical” nature of genetics and statistical approaches. While completing my residency in neurology, I therefore undertook a master's degree in genetic statistics in Paris, followed by a PhD in epidemiology in Lille. In addition to this PhD, which focused on the risk factors for carotid atheroma, I had the opportunity to set up and coordinate a genetic association study on cervical artery dissections, a relatively rare disease that is nevertheless one of the leading causes of stroke in young people. This project, initiated in Lille, was extended to six French centers and then to numerous European and international centers, brought together within the CADISP consortium. It was a very long-term project requiring a great deal of perseverance, as we were starting from scratch and, by the time we had managed to collect DNA from more than 1,400 patients, genome-wide association studies had only just begun.

You have led or participated in several international consortia. How have these global collaborations changed the approach to research on cerebrovascular diseases?

After my initial experience with CADISP, which launched me into international collaborations, I discovered international research consortia in Boston during my postdoctoral studies. These consortia emerged with the advent of high-throughput genotyping technologies, enabling sufficient statistical power to be achieved by combining genetic and phenotypic data from several large cohorts or studies. This has profoundly transformed the scientific approach by providing access to data on a scale never before seen. These consortia rely on large cohorts of individuals, which gives the research the statistical power it needs. For example, the Gigastroke study, published in Nature in 2022, included more than 200,000 stroke patients and more than 2.5 million controls. This exceptional power has become essential for genetic and molecular epidemiology work.

You were recently appointed head of the Brain Institute in Paris. What are your priority objectives for this institute in the coming years?

With the teams in place, we are currently developing a new strategic plan for the Institute. One of the expected objectives is to better leverage the considerable wealth of data collected over the past 15 years by the Institute's researchers by launching an ambitious data science program reinforced by the development of innovative artificial intelligence approaches. Another key focus is to increase the impact of our research by facilitating the translation of fundamental discoveries into new diagnostic and, above all, innovative therapeutic approaches, collectively removing the barriers that hinder these transitions. At the same time, we continue to support ambitious fundamental research programs guided by curiosity, while trying to break down the silos between the Institute's “traditional” research areas and stimulating interdisciplinarity.

How do you plan to strengthen cross-disciplinary collaboration, for example between neuroscience, public health, and social sciences, to better understand and treat cerebrovascular diseases through more comprehensive and integrative approaches?

To increase innovation and the impact of our research, it is crucial to break down silos and build bridges between disciplines. Various disciplines are already represented within the Brain Institute (physics, mathematics, computer science, psychology, philosophy, etc.), and I plan to strengthen this by interacting with other research units within Sorbonne University and collaborating with our national and international partners. We will also continue and strengthen initiatives around the link between neuroscience and society, for example by creating an artist-in-residence program. For research on cerebral vascular diseases, we will collaborate closely with the Institute for Cerebral Vascular Health (IHU VBHI) in Bordeaux and focus particularly on the impact of these vascular diseases on neurodegenerative diseases, such as Alzheimer's disease. Thanks to a France 2030 Chair of Excellence in Biology and Health, we will be able to study the molecular mechanisms underlying the impact of cerebral vascular diseases on neurodegenerative processes at the single-cell level, using samples from the neuroCEB brain bank (Pitié-Salpêtrière).