Professor NIKOLA SPRIGG's Outputs (171)

Isosorbide Mononitrate and Cilostazol Treatment in Patients With Symptomatic Cerebral Small Vessel Disease: The Lacunar Intervention Trial-2 (LACI-2) Randomized Clinical Trial (2023)
Journal Article
Wardlaw, J. M., Woodhouse, L. J., Mhlanga, I. I., Oatey, K., Heye, A. K., Bamford, J., Cvoro, V., Doubal, F. N., England, T., Hassan, A., Montgomery, A., O’Brien, J. T., Roffe, C., Sprigg, N., Werring, D. J., & Bath, P. M. (2023). Isosorbide Mononitrate and Cilostazol Treatment in Patients With Symptomatic Cerebral Small Vessel Disease: The Lacunar Intervention Trial-2 (LACI-2) Randomized Clinical Trial. JAMA Neurology, 80(7), 682-692. https://doi.org/10.1001/jamaneurol.2023.1526

Importance Cerebral small vessel disease (cSVD) is a common cause of stroke (lacunar stroke), is the most common cause of vascular cognitive impairment, and impairs mobility and mood but has no specific treatment.

Objective To test the feasibili... Read More about Isosorbide Mononitrate and Cilostazol Treatment in Patients With Symptomatic Cerebral Small Vessel Disease: The Lacunar Intervention Trial-2 (LACI-2) Randomized Clinical Trial.

Accuracy of artificial intelligence software for CT angiography in stroke (2023)
Journal Article
Mair, G., White, P., Bath, P. M., Muir, K., Martin, C., Dye, D., Chappell, F., von Kummer, R., Macleod, M., Sprigg, N., Wardlaw, J. M., & for the RITeS Collaboration. (2023). Accuracy of artificial intelligence software for CT angiography in stroke. Annals of Clinical and Translational Neurology, 10(7), 1072-1082. https://doi.org/10.1002/acn3.51790

Objective: Software developed using artificial intelligence may automatically identify arterial occlusion and provide collateral vessel scoring on CT angiography (CTA) performed acutely for ischemic stroke. We aimed to assess the diagnostic accuracy... Read More about Accuracy of artificial intelligence software for CT angiography in stroke.

Evaluation of Endothelial Progenitor Cell Characteristics as Clinical Biomarkers for Elderly Patients with Ischaemic Stroke (2023)
Journal Article
Rakkar, K., Othman, O. A., Sprigg, N., Bath, P. M., & Bayraktutan, U. (2023). Evaluation of Endothelial Progenitor Cell Characteristics as Clinical Biomarkers for Elderly Patients with Ischaemic Stroke. Stem Cell Reviews and Reports, 19(6), 1856-1869. https://doi.org/10.1007/s12015-023-10544-y

Ageing impairs endothelial function and predisposes the person to ischaemic stroke (IS). Endothelial progenitor cells (EPCs) repair endothelial damage and induce post-ischaemic neovascularisation. Given the prevalence of IS in older population, this... Read More about Evaluation of Endothelial Progenitor Cell Characteristics as Clinical Biomarkers for Elderly Patients with Ischaemic Stroke.

Antiplatelet Resistance: A Review of Concepts, Mechanisms, and Implications for Management in Acute Ischemic Stroke and Transient Ischemic Attack (2023)
Journal Article
Krishnan, K., Nguyen, T. N., Appleton, J. P., Law, Z. K., Caulfied, M., Cabrera, C. P., Lenthall, R., Hewson, D., England, T., McConachie, N., Dhillon, P., Malik, L., Podlasek, A., Smith, C. J., Dawson, J., Robinson, T. G., Sprigg, N., James, M. A., White, P., Desborough, M. J., …Bath, P. M. (2023). Antiplatelet Resistance: A Review of Concepts, Mechanisms, and Implications for Management in Acute Ischemic Stroke and Transient Ischemic Attack. Stroke: Vascular and Interventional Neurology, 3(3), Article e000576. https://doi.org/10.1161/svin.122.000576

Acute ischemic stroke is a leading cause of death and major disability worldwide. Approximately 50% of ischemic strokes are caused by atherothrombotic occlusion of the cerebral arteries, and antiplatelets are the mainstay of secondary stroke preventa... Read More about Antiplatelet Resistance: A Review of Concepts, Mechanisms, and Implications for Management in Acute Ischemic Stroke and Transient Ischemic Attack.

Measures of intracranial compartments in acute intracerebral haemorrhage: data from the Rapid Intervention with Glyceryl Trinitrate in Hypertensive Stroke-2 Trial (RIGHT-2) (2022)
Journal Article
Krishnan, K., Law, Z. K., Woodhouse, L. J., Dineen, R. A., Sprigg, N., Wardlaw, J. M., & Bath, P. M. (2023). Measures of intracranial compartments in acute intracerebral haemorrhage: data from the Rapid Intervention with Glyceryl Trinitrate in Hypertensive Stroke-2 Trial (RIGHT-2). Stroke and Vascular Neurology, 8(2), 151-160. https://doi.org/10.1136/svn-2021-001375

Background and purpose: Intracerebral haemorrhage volume (ICHV) is prognostically important but does not account for intracranial volume (ICV) and cerebral parenchymal volume (CPV). We assessed measures of intracranial compartments in acute ICH using... Read More about Measures of intracranial compartments in acute intracerebral haemorrhage: data from the Rapid Intervention with Glyceryl Trinitrate in Hypertensive Stroke-2 Trial (RIGHT-2).

Semantic Segmentation of Spontaneous Intracerebral Hemorrhage, Intraventricular Hemorrhage, and Associated Edema on CT Images Using Deep Learning (2022)
Journal Article
Kok, Y. E., Pszczolkowski, S., Law, Z. K., Ali, A., Krishnan, K., Bath, P., Sprigg, N., Dineen, R. A., & French, A. P. (2022). Semantic Segmentation of Spontaneous Intracerebral Hemorrhage, Intraventricular Hemorrhage, and Associated Edema on CT Images Using Deep Learning. Radiology: Artificial Intelligence, 4(6), https://doi.org/10.1148/ryai.220096

This study evaluated deep learning algorithms for semantic segmentation and quantification of intracerebral hemorrhage (ICH), perihematomal edema (PHE), and intraventricular hemorrhage (IVH) on noncontrast CT scans of patients with spontaneous ICH. M... Read More about Semantic Segmentation of Spontaneous Intracerebral Hemorrhage, Intraventricular Hemorrhage, and Associated Edema on CT Images Using Deep Learning.

External validation of e-ASPECTS software for interpreting brain CT in stroke (2022)
Journal Article
Mair, G., White, P., Bath, P. M., Muir, K. W., Salman, R. A.-S., Martin, C., Dye, D., Chappell, F. M., Vacek, A., Von Kummer, R., Macleod, M., Sprigg, N., & Wardlaw, J. M. (2022). External validation of e-ASPECTS software for interpreting brain CT in stroke. Annals of Neurology, 92(6), 943-957. https://doi.org/10.1002/ana.26495

Objective
To test e-ASPECTS software in patients with stroke. Marketed as a decision-support tool, e-ASPECTS may detect features of ischemia or hemorrhage on computed tomography (CT) imaging and quantify ischemic extent using ASPECTS (Alberta Strok... Read More about External validation of e-ASPECTS software for interpreting brain CT in stroke.

Outgrowth Endothelial Cell Conditioned Medium Negates TNF-α-Evoked Cerebral Barrier Damage: A Reverse Translational Research to Explore Mechanisms (2022)
Journal Article
Kadir, R. R. A., Alwjwaj, M., Rakkar, K., Othman, O. A., Sprigg, N., Bath, P. M., & Bayraktutan, U. (2022). Outgrowth Endothelial Cell Conditioned Medium Negates TNF-α-Evoked Cerebral Barrier Damage: A Reverse Translational Research to Explore Mechanisms. Stem Cell Reviews and Reports, https://doi.org/10.1007/s12015-022-10439-4

Improved understanding of the key mechanisms underlying cerebral ischemic injury is essential for the discovery of efficacious novel therapeutics for stroke. Through detailed analysis of plasma samples obtained from a large number of healthy voluntee... Read More about Outgrowth Endothelial Cell Conditioned Medium Negates TNF-α-Evoked Cerebral Barrier Damage: A Reverse Translational Research to Explore Mechanisms.

Cerebral Amyloid Angiopathy and the Risk of Hematoma Expansion (2022)
Journal Article
Seiffge, D. J., Polymeris, A. A., Law, Z. K., Krishnan, K., Zietz, A., Thilemann, S., Werring, D., Al-Shahi Salman, R., Dineen, R. A., Engelter, S. T., Bath, P. M., Sprigg, N., Lyrer, P., & Peters, N. (2022). Cerebral Amyloid Angiopathy and the Risk of Hematoma Expansion. Annals of Neurology, 92(6), 921-930. https://doi.org/10.1002/ana.26481

Objective: We assessed whether hematoma expansion (HE) and favorable outcome differ according to type of intracerebral hemorrhage (ICH). Methods: Among participants with ICH enrolled in the TICH-2 (Tranexamic Acid for Hyperacute Primary Intracerebral... Read More about Cerebral Amyloid Angiopathy and the Risk of Hematoma Expansion.

Perfusion Imaging for Endovascular Thrombectomy in Acute Ischemic Stroke Is Associated With Improved Functional Outcomes in the Early and Late Time Windows (2022)
Journal Article
Dhillon, P. S., Butt, W., Podlasek, A., McConachie, N., Lenthall, R., Nair, S., Malik, L., Booth, T. C., Bhogal, P., Makalanda, H. L. D., Spooner, O., Mortimer, A., Lamin, S., Chavda, S., Chew, H. S., Nader, K., Al-Ali, S., Butler, B., Rajapakse, D., Appleton, J. P., …England, T. J. (2022). Perfusion Imaging for Endovascular Thrombectomy in Acute Ischemic Stroke Is Associated With Improved Functional Outcomes in the Early and Late Time Windows. Stroke, 53(9), 2770–2778. https://doi.org/10.1161/STROKEAHA.121.038010

Background: The impact on clinical outcomes of patient selection using perfusion imaging for endovascular thrombectomy (EVT) in patients with acute ischemic stroke presenting beyond 6 hours from onset remains undetermined in routine clinical practice... Read More about Perfusion Imaging for Endovascular Thrombectomy in Acute Ischemic Stroke Is Associated With Improved Functional Outcomes in the Early and Late Time Windows.

UK clinical approaches to address post-stroke fatigue: findings from The Nottingham Fatigue after Stroke study (2022)
Journal Article
Ablewhite, J., Condon, L., das Nair, R., Jones, A., Jones, F., Nouri, F., Sprigg, N., Thomas, S., & Drummond, A. (2022). UK clinical approaches to address post-stroke fatigue: findings from The Nottingham Fatigue after Stroke study. International Journal of Therapy and Rehabilitation, 29(5), 1-12. https://doi.org/10.12968/ijtr.2021.0163

Background/aims Although post-stroke is common and debilitating, there is little published research on how it is managed by clinicians. The aim of this study was to document UK management of post-stroke fatigue and ascertain whether there are any dif... Read More about UK clinical approaches to address post-stroke fatigue: findings from The Nottingham Fatigue after Stroke study.

Inhibition of oxidative stress delays senescence and augments functional capacity of endothelial progenitor cells (2022)
Journal Article
Reskiawan A. Kadir, R., Alwjwaj, M., Ahmad Othman, O., Rakkar, K., Sprigg, N., Bath, P. M., & Bayraktutan, U. (2022). Inhibition of oxidative stress delays senescence and augments functional capacity of endothelial progenitor cells. Brain Research, 1787, Article 147925. https://doi.org/10.1016/j.brainres.2022.147925

Ageing is characterised by a progressive loss of vascular endothelial function and integrity. Endothelial progenitor cells (EPCs) play an integral role in endothelial regeneration but are prone to age-dependent changes which may accelerate their sene... Read More about Inhibition of oxidative stress delays senescence and augments functional capacity of endothelial progenitor cells.

Effect of Tranexamic Acid Administration on Remote Cerebral Ischemic Lesions in Acute Spontaneous Intracerebral Hemorrhage: A Substudy of a Randomized Clinical Trial (2022)
Journal Article
Pszczolkowski, S., Sprigg, N., Woodhouse, L. J., Gallagher, R., Swienton, D., Law, Z. K., Casado, A. M., Roberts, I., Werring, D. J., Al-Shahi Salman, R., England, T. J., Morgan, P. S., Bath, P. M., & Dineen, R. A. (2022). Effect of Tranexamic Acid Administration on Remote Cerebral Ischemic Lesions in Acute Spontaneous Intracerebral Hemorrhage: A Substudy of a Randomized Clinical Trial. JAMA Neurology, 79(5), 468-477. https://doi.org/10.1001/jamaneurol.2022.0217

Importance: Hyperintense foci on diffusion-weighted imaging (DWI) that are spatially remote from the acute hematoma occur in 20% of people with acute spontaneous intracerebral hemorrhage (ICH). Tranexamic acid, a hemostatic agent that is under invest... Read More about Effect of Tranexamic Acid Administration on Remote Cerebral Ischemic Lesions in Acute Spontaneous Intracerebral Hemorrhage: A Substudy of a Randomized Clinical Trial.

Association between time to treatment and clinical outcomes in endovascular thrombectomy beyond 6 hours without advanced imaging selection (2022)
Journal Article
Dhillon, P. S., Butt, W., Podlasek, A., McConachie, N., Lenthall, R., Nair, S., Malik, L., Bhogal, P., Makalanda, H. L. D., Spooner, O., Krishnan, K., Sprigg, N., Mortimer, A., Booth, T. C., Lobotesis, K., White, P., James, M. A., Bath, P., Dineen, R. A., & England, T. J. (2023). Association between time to treatment and clinical outcomes in endovascular thrombectomy beyond 6 hours without advanced imaging selection. Journal of NeuroInterventional Surgery, 15(4), 336-342. https://doi.org/10.1136/neurintsurg-2021-018564

Background: The effectiveness and safety of endovascular thrombectomy (EVT) in the late window (6-24 hours) for acute ischemic stroke (AIS) patients selected without advanced imaging is undetermined. We aimed to assess clinical outcomes and the relat... Read More about Association between time to treatment and clinical outcomes in endovascular thrombectomy beyond 6 hours without advanced imaging selection.

Effect of continuing versus stopping pre-stroke antihypertensive agents within 12h on outcome after stroke: A subgroup analysis of the efficacy of nitric oxide in stroke (ENOS) trial (2022)
Journal Article
Woodhouse, L. J., Appleton, J. P., Scutt, P., Everton, L., Wilkinson, G., Caso, V., Czlonkowska, A., Gommans, J., Krishnan, K., Laska, A. C., Ntaios, G., Ozturk, S., Phillips, S., Pocock, S., Prasad, K., Szatmari, S., Wardlaw, J. M., Sprigg, N., & Bath, P. M. (2022). Effect of continuing versus stopping pre-stroke antihypertensive agents within 12h on outcome after stroke: A subgroup analysis of the efficacy of nitric oxide in stroke (ENOS) trial. eClinicalMedicine, 44, Article 101274. https://doi.org/10.1016/j.eclinm.2022.101274

Background: It is not known whether to continue or temporarily stop existing antihypertensive drugs in patients with acute stroke. Methods: We performed a prospective subgroup analysis of patients enrolled into the Efficacy of Nitric Oxide in Stroke... Read More about Effect of continuing versus stopping pre-stroke antihypertensive agents within 12h on outcome after stroke: A subgroup analysis of the efficacy of nitric oxide in stroke (ENOS) trial.

Automated Detection of Candidate Subjects With Cerebral Microbleeds Using Machine Learning (2022)
Journal Article
Sundaresan, V., Arthofer, C., Zamboni, G., Dineen, R. A., Rothwell, P. M., Sotiropoulos, S. N., Auer, D. P., Tozer, D. J., Markus, H. S., Miller, K. L., Dragonu, I., Sprigg, N., Alfaro-Almagro, F., Jenkinson, M., & Griffanti, L. (2022). Automated Detection of Candidate Subjects With Cerebral Microbleeds Using Machine Learning. Frontiers in Neuroinformatics, 15, Article 777828. https://doi.org/10.3389/fninf.2021.777828

Cerebral microbleeds (CMBs) appear as small, circular, well defined hypointense lesions of a few mm in size on T2*-weighted gradient recalled echo (T2*-GRE) images and appear enhanced on susceptibility weighted images (SWI). Due to their small size,... Read More about Automated Detection of Candidate Subjects With Cerebral Microbleeds Using Machine Learning.

Pre-hospital transdermal glyceryl trinitrate in patients with stroke mimics: data from the RIGHT-2 randomised-controlled ambulance trial (2022)
Journal Article
Tunnage, B., Woodhouse, L. J., Dixon, M., Anderson, C. S., Ankolekar, S., Appleton, J. P., England, T., Cala, L., Krishnan, K., Havard, D., Mair, G., Muir, K., Phillips, S. J., Potter, J., Price, C. I., Randall, M., Robinson, T. G., Roffe, C., Sandset, E. C., Siriwardena, N., …Bath, P. M. (2022). Pre-hospital transdermal glyceryl trinitrate in patients with stroke mimics: data from the RIGHT-2 randomised-controlled ambulance trial. BMC Emergency Medicine, 22(1), Article 2. https://doi.org/10.1186/s12873-021-00560-x

Background: Prehospital stroke trials will inevitably recruit patients with non-stroke conditions, so called stroke mimics. We undertook a pre-specified analysis to determine outcomes in patients with mimics in the second Rapid Intervention with Glyc... Read More about Pre-hospital transdermal glyceryl trinitrate in patients with stroke mimics: data from the RIGHT-2 randomised-controlled ambulance trial.

Brief Consent Methods Enable Rapid Enrollment in Acute Stroke Trial: Results From the TICH-2 Randomized Controlled Trial (2021)
Journal Article
the TICH-2 Investigators, Law, Z. K., Appleton, J. P., Scutt, P., Roberts, I., Al-Shahi Salman, R., England, T. J., Werring, D. J., Robinson, T., Krishnan, K., Dineen, R. A., Laska, A. C., Lyrer, P. A., Egea-Guerrero, J. J., Karlinski, M., Christensen, H., Roffe, C., Bereczki, D., Ozturk, S., Thanabalan, J., …Sprigg, N. (2021). Brief Consent Methods Enable Rapid Enrollment in Acute Stroke Trial: Results From the TICH-2 Randomized Controlled Trial. Stroke, 53(4), 1141-1148. https://doi.org/10.1161/STROKEAHA.121.035191

Background: Seeking consent rapidly in acute stroke trials is crucial as interventions are time sensitive. We explored the association between consent pathways and time to enrollment in the TICH-2 (Tranexamic Acid in Intracerebral Haemorrhage-2) rand... Read More about Brief Consent Methods Enable Rapid Enrollment in Acute Stroke Trial: Results From the TICH-2 Randomized Controlled Trial.

Statistical reanalysis of vascular event outcomes in primary and secondary vascular prevention trials (2021)
Journal Article
Woodhouse, L. J., Montgomery, A. A., Mant, J., Davis, B. R., Algra, A., Mas, J.-L., Staessen, J. A., Thijs, L., Tonkin, A., Kirby, A., Pocock, S. J., Chalmers, J., Hankey, G. J., Spence, J. D., Sandercock, P., Diener, H.-C., Uchiyama, S., Sprigg, N., & Bath, P. M. (2021). Statistical reanalysis of vascular event outcomes in primary and secondary vascular prevention trials. BMC Medical Research Methodology, 21, Article 218. https://doi.org/10.1186/s12874-021-01388-6

Background: Vascular prevention trials typically use dichotomous event outcomes although this may be inefficient statistically and gives no indication of event severity. We assessed whether ordinal outcomes would be more efficient and how to best ana... Read More about Statistical reanalysis of vascular event outcomes in primary and secondary vascular prevention trials.

Managing post-stroke fatigue: A qualitative study to explore multifaceted clinical perspectives (2021)
Journal Article
Drummond, A., Nouri, F., Ablewhite, J., Condon, L., Das Nair, R., Jones, A., Jones, F., Sprigg, N., & Thomas, S. (2022). Managing post-stroke fatigue: A qualitative study to explore multifaceted clinical perspectives. British Journal of Occupational Therapy, 85(7), 505-512. https://doi.org/10.1177/03080226211042269

Introduction: Post-stroke fatigue (PSF) is common and debilitating. However, while its effective management is a priority for clinicians and stroke survivors, there remains little evidence to provide guidance or underpin practice. Our aim, therefore,... Read More about Managing post-stroke fatigue: A qualitative study to explore multifaceted clinical perspectives.