Bookmark and Share

Charlene E. Hafer-Macko

Charlene E. Hafer-Macko M.D.

Academic Title: Associate Professor
Primary Appointment: Neurology
Secondary Appointments: Medicine, Physical Therapy and Rehabilitation Science
Location: 110 S. Paca Street, 3rd Floor
Phone: (410) 328-3100
Fax: (410) 328-8981

Personal History:

Charlene E. Hafer-Macko, M.D. is an Associate Professor of Neurology with secondary appointments in Geriatrics and Physical Therapy Rehabilitation Science in the University of Maryland, School of Medicine (UMSOM). She is also the Director of the UMSOM Myasthenia Gravis Center and the Baltimore Veterans Administration Medical Center (BVAMC) Neuromuscular Clinic. She is an integral faculty in the Neuromuscular Division and for the Neuromuscular and Electrophysiology Fellowship Program.

She serves as the Director of the Muscle and Molecular Biology Core Laboratory for the VA Rehabilitation Research & Development Maryland Exercise and Robotics Center of Excellence (MERCE, PI: R. Macko) and collaborates with the UMSOM NIA-OIAC Pepper Center (PI: A. Goldberg) and Baltimore VA Geriatrics Research Education and Clinical Center (PI: A. Goldberg) grants. She is a co-leader for the T32 Research Training in Exercise Physiology's Program Core on Muscle and Inflammatory Mechanisms in Aging and Deconditioning.

Research Interests:

Dr. Hafer-Macko's research focuses on skeletal muscle alterations after chronic stroke and the impact of exercise rehabilitation on these skeletal muscles' structural and metabolic abnormalities. The fundamental findings are that pathophysiologic mechanisms associated with aging in skeletal muscle, including increased inflammatory pathway activation, oxidative injury and atrophy, are accelerated following hemiparetic stroke and contribute to disability and impaired insulin and glucose metabolism. She is extending these research interests to clinical research trials of exercise rehabilitation for individuals with other neuromuscular conditions associated with aging, including peripheral neuropathy, diabetic neuropathy, HIV and myasthenia gravis.

Clinical Speciality:

  • Neuromuscular Diseases and Electrodiagnostic Studies
  • Director of the UMSOM Myasthenia Gravis Center
  • Diabetic Neuropathy
  • Immune Mediated Peripheral Neuropathy
  • Hereditary Neuropathy
  • Post-Polio Syndrome
  • Inflammatory Myopathy
  • Amyotrophic Lateral Sclerosis
  • Myopathy
  • Rehabilitation of Neuromuscular Disorders


Lab Techniques and Equipment:

  • Nerve Conduction Studies/Electromyography
  • Needle Muscle Biopsies
  • Skin Punch Biopsies for Small Fiber Neuropathies

Grants & Contracts:

VA Merit Review: Inflammatory changes in hemiparetic skeletal muscle after chronic stroke 10/06 to 11/10 No cost extension

NIA-R01(AG030075-01A1)Co-PIs: Alice Ryan & Charlene Hafer-Macko; Aging, Inflammation and Exercise in Chronic Stroke; 5/08-4/13   
Veterans Affair Rehabilitation Research and Development: Maryland Exercise and Robotics Center of Excellence (MERCE) PI-Richard F Macko, 7/05-6/10, Muscle Biology Laboratory Director

VA MERCE Pilot Grant - Myasthenia gravis exercise program to increase physical activity and fitness and reduce cardiovascular risk. 10/09-9/11


Griffin JW, Li CY, Ho TW, Xue P, Macko C, God U, Yene C, Tian W, Mishu R, Cornblath, DC, Guillain-Barré syndrome in Northern China. The spectrum of neuropathologic changes in clinically defined cases. Brain 118: 577-595, 1995.

McCarthy BG, Hseih ST, Stocks A, Hauer P, Macko C, Cornblath DR, Griffin JW, McArthur, JC, Cutaneous innervation in sensory neuropathies: Evaluation by skin biopsy. Neurology. 45: 1848-1855, 1995.

Hafer-Macko CE, Sheikh KA, Li CY, Ho TW, Cornblath DR, McKhann GM, Asbury AK, Griffin JW. Immune attack on the Schwann cell surface in acute inflammatory demyelinating neuropathy. Ann Neurol 39: 625-635, 1996.

Hafer-Macko CE, Hseih ST, Li CY, Ho TW, Sheikh K, Cornblath DR, McKhann GM, Asbury AK, Griffin JW. Acute motor axonal neuropathy: an antibody-mediated attack on axolemma. Ann Neurol 40: 635-644, 1996.

Griffin JW, Li CY, Macko C, Ho TW, Hsieh ST, Xue P, Wang FA, Cornblath DR, McKhann GM, Asbury AK. Early nodal changes in the acute motor axonal neuropathy pattern of the Guillain -Barré syndrome. J Neurocytology. 25: 33-51, 1996.

Griffin JW, Li CY, Ho TW, Tian M, Gao CY, Xue P, Mishu, Cornblath DR, Macko CE, McKhann GM, Asbury, AK. Pathology of Acute Motor-Sensory Axonal Guillain Barré Syndrome. Ann Neurol. 39: 17-28, 1996.

Hafer-Macko C, Pang M, Seilhamer JJ, Baum LG. Galectin-1 is expressed by thymic epithelial cells in myasthenia gravis. Glycoconjugate J. 13: 591-7, 1996.

Hafer-Macko CE, Dyck PJ, Koski CL. Complement activation in acquired and hereditary amyloid neuropathy. J Peripheral Nervous System 5: 131-139, 2000.

Hafer-Macko CE, Ivey F, Guyre K, Sorkin J, Macko RF. Reduced thrombomodulin in human peripheral nerve. Muscle and Nerve 26: 218-224, 2002.

Hafer-Macko CE, Ivey F, Gurye K, Sorkin J, Macko RF. Diminished microvascular thrombomodulin in human diabetic neuropathy: A neuropathologic study. Diabetes 51: 1957-1963, 2002.

De Deyne PG, Hafer-Macko CE, Ivey FM, Ryan AS, Macko RF. Muscle molecular phenotype after stroke is associated with gait deficit severity. Muscle and Nerve 30: 209-215, 2004.

Ivey FM, Macko RF, Ryan AS, Hafer-Macko CE. Cardiovascular health and fitness after stroke. Topics in Stroke Rehabilitation. Winter; 12:1-16, 2005.

Hafer-Macko CE, Yu S, Ryan A, Ivey F, Macko R. Elevated levels of tumor necrosis factor in skeletal muscle after hemiparetic stroke. Stroke 36: 2021-2023, 2005.

Ivey FM, Hafer-Macko CE, Macko RF. Exercise rehabilitation after stroke. NeuroRx. 3: 439-450, 2006.

Ivey FM, Ryan AS, Hafer-Macko CE, Garrity BM, Sorkin JD, Goldberg AP, Macko RF. High prevalence of abnormal glucose metabolism and poor sensitivity of fasting plasma glucose in the chronic phase of stroke. Cerebrovasc Dis. 22(5-6): 368-371, 2006.

Hafer-Macko CE, Ivey FM, Sorkin J, Macko RF. Microvascular tissue plasminogen activator is reduced in diabetic neuropathy.  Neurology 69: 268-274, 2007.

Ivey FM, Ryan AS, Hafer-Macko CE, Goldberg AP, Macko RF. Treadmill aerobic training improves glucose tolerance and indices of insulin sensitivity in disabled stroke survivors: a preliminary report. Stroke 38: 2752-2758, 2007.

Ivey, FM, Hafer-Macko, CE, Macko, RF. Exercise training for cardiometabolic adaptation after stroke. Review. J Cardiopulm Rehabil Prev. 2008 Jan-Feb;28(1):2-11.

Ivey FM, Hafer-Macko CE, Macko RF. Task-oriented treadmill aerobic exercise in chronic stroke. J Rehab Res Dev 2008 45: 249-260, 2008.

Hafer-Macko CE, Ryan AS, Ivey FM, Macko RF.  Skeletal muscle changes after hemiparetic stroke and potential beneficial effects of exercise intervention strategies. J Rehab Res Dev 45: 261-272, 2008.

McKenzie, M, Yu S, McLenithan J, Macko R, Hafer-Macko CE. Human genome comparison of paretic and non-paretic vastus lateralis muscle in hemiparetic stroke patients: profile of metabolic abnormalities. J Rehab Res Dev 45:273-280, 2008.

Rabek JP, Hafer-Macko CE, Amaning JK, Madsen MA, Macko RF, and Papaconstantinou J. A proteomics analysis of the effects of chronic hemiparetic stroke on troponin T expression in human vastus lateralis. J Gerontol A Biol Sci Med Sci. 2009 Aug;64(8):839-849.

Ryan AS, Macko RF, Peters MN, Ivey FM, Prior SJ, Joseph LJ, Hafer-Macko CE. Plasma adiponectin levels are associated with insulin sensitivity in stroke survivors. J. Stroke Cerebrovascular Dis. 2009 May-Jun;18(3):214-220.

Prior SJ, McKenzie MJ, Joseph LJ, Ivey FM, Macko RF, Hafer-Macko CE, Ryan AS. Reduced skeletal muscle capillarization and glucose intolerance. Microcirculation. 2009 Apr;16(3):203-212.

Luft AR, Hafer-Macko CE, Schallert T. Physiological basis of rehabilitation therapeutics in stroke. In: Stein J, Harvey RL, Macko R, Winstein CJ, Zorowitz, eds. Stroke Recovery and Rehabilitation. 1st ed. New York, NY: Demos Medical; 2008:145-152.

McKenzie MJ, Yu S, Prior SJ, Macko RF, Hafer-Macko CE. Hemiparetic stroke alters vastus lateralis myosin heavy chain profiles between the paretic and nonparetic muscles. Res Sports Med. 2009 Jan-Mar;17(1):17-27.