I am a physician–scientist and board-certified neuropathologist whose work focuses on unraveling the mechanisms that drive dementia and related neurodegenerative diseases. My research bridges diagnostic neuropathology, brain banking, and cutting-edge digital pathology. I direct a high-complexity CLIA-certified plasma and CSF biomarker laboratory, lead the Nun Study of Aging and Alzheimer’s Disease, and co-lead multiple national and international collaborations. Much of my work explores how mixed pathologies—such as TDP-43, tau, and vascular brain lesions—interact to shape clinical outcomes. To push beyond traditional histology, I leverage spatial transcriptomics to map gene expression directly onto neuropathological lesions, uncovering cell-specific vulnerabilities within their microenvironment. By integrating these high-resolution molecular datasets with deeply phenotyped longitudinal cohorts such as the Nun Study and the Honolulu-Asia Aging Study (HAAS), we can link decades of clinical, cognitive, and lifestyle data to molecular signatures in brain tissue.
Francesca leads a dedicated line of research on women’s brain health with a particular focus on modifiable factors that influence risk for Alzheimer’s disease and related dementias. Her work emphasises the importance of early detection, with a goal of identifying both risk and resilience factors that emerge during key life transitions, such as menopause. She also co-leads the Next Generation Brain Health project, which investigates factors affecting brain health in young adulthood.