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Carbon footprint of a sample of clinical trials for people with neurological disorders: cross-sectional analysis (2025)
Journal Article
Cranley, D., Dunn, S., Taylor, J.-P., Desborough, M., Craig, J., Sprigg, N., McComish, R., Foltynie, T., Wardlaw, J. M., Oatey, K., Heye, A., Bath, P., Innes, K., Dinsmore, L., Griffiths, J., Fox, L., Williamson, P. R., & Al-Shahi Salman, R. (2025). Carbon footprint of a sample of clinical trials for people with neurological disorders: cross-sectional analysis. BMJ Open, 15(6), Article e090419. https://doi.org/10.1136/bmjopen-2024-090419

Objective: To quantify the carbon footprint of a sample of clinical trials for neurological disorders.

Design: Cross-sectional study.

Method: Two clinical trial registries were searched on 29 December 2022 for phase 2–4 randomised controlled tr... Read More about Carbon footprint of a sample of clinical trials for people with neurological disorders: cross-sectional analysis.

The carbon footprint of a sample of clinical trials for people with neurological disorders: cross-sectional analysis (2025)
Journal Article
Cranley, D., Dunn, S., Taylor, J.-P., Desborough, M., Craig, J., Sprigg, N., McComish, R., Foltynie, T., Wardlaw, J. M., Oatey, K., Heye, A., Bath, P. M., Innes, K., Dinsmore, L., Griffiths, J., Fox, L., Williamson, P. R., & Al-Shahi Salman, R. (2025). The carbon footprint of a sample of clinical trials for people with neurological disorders: cross-sectional analysis. BMJ Open, 15(6), Article e090419. https://doi.org/10.1136/bmjopen-2024-090419

Objective To quantify the carbon footprint of a sample of clinical trials for neurological disorders.

Design Cross sectional study.

Method Two clinical trial registries were searched for phase 2-4 randomised controlled trials (RCTs) led from a... Read More about The carbon footprint of a sample of clinical trials for people with neurological disorders: cross-sectional analysis.

Safety and Efficacy of Perispinal Etanercept for Chronic Stroke (PESTO). A Randomized Clinical Trial (2025)
Journal Article
Thijs, V., Cloud, G. C., Gilchrist, N., Parsons, B., Tilvawala, F. T., Ho, J. K., Ruthnam, L., Stanislaus, V., Sprigg, N., Walker, M. F., Bath, P. B., Churilov, L., & Bernhardt, J. (in press). Safety and Efficacy of Perispinal Etanercept for Chronic Stroke (PESTO). A Randomized Clinical Trial. Neurology,

Background and objectives
Stroke is a leading cause of long-term disability. Etanercept, a competitive TNF-α inhibitor, has been proposed as a potential treatment for post-stroke impairments when given via a perispinal subcutaneous injection. We aim... Read More about Safety and Efficacy of Perispinal Etanercept for Chronic Stroke (PESTO). A Randomized Clinical Trial.

Polypill and RiskOMeter to Prevent StrOke and CogniTive ImpairmEnt in Primary Health Care (PROMOTE) Randomized Clinical Trial: Rationale and Design (2025)
Journal Article
Martins, S. O., Brainin, M., Anderson, C. S., Bath, P. M., Hankey, G. J., Lopes, R. D., Berwanger, O., Sposato, L. A., Palmeira Pires, A., Secchi, T. L., Teló, B. J., Santos, F. P., Radin, J., Ellwanger, J., Martins, M. O., Pereira, D. A., Quadros, F. W., Silva, L. V., Gonçalves, M. R., Mantovani, G. P., …Rodrigues, M. (in press). Polypill and RiskOMeter to Prevent StrOke and CogniTive ImpairmEnt in Primary Health Care (PROMOTE) Randomized Clinical Trial: Rationale and Design. Neuroepidemiology,

Introduction:
Stroke and dementia have common modifiable risk factors. Current prevention strategies primarily focus on high-risk populations, leaving a gap in addressing the broader population. We report the protocol for a randomized controlled tr... Read More about Polypill and RiskOMeter to Prevent StrOke and CogniTive ImpairmEnt in Primary Health Care (PROMOTE) Randomized Clinical Trial: Rationale and Design.

The Relationship Between Neutrophil Count and 90-Day Outcomes and Effect of Dual Antiplatelet Therapy in Patients with Acute Ischemic Stroke or Transient Ischemic Attack: A Post Hoc Analysis of the INSPIRES Trial (2025)
Journal Article
Wang, Y., Pan, Y., Wang, X., Gao, Y., Chen, W., Claiborne Johnston, S., Bath, P. M., Amarenco, P., Gao, C., Wang, Y., Liao, X., & Wang, Y. (in press). The Relationship Between Neutrophil Count and 90-Day Outcomes and Effect of Dual Antiplatelet Therapy in Patients with Acute Ischemic Stroke or Transient Ischemic Attack: A Post Hoc Analysis of the INSPIRES Trial. Journal of the American Heart Association,

Background: Inflammation is an important mechanism in ischemic stroke and high-risk transient ischemic attack (TIA), but clinical inflammatory markers on antiplatelet therapy remains to be studied. To compare the neutrophil count (NC) on the efficacy... Read More about The Relationship Between Neutrophil Count and 90-Day Outcomes and Effect of Dual Antiplatelet Therapy in Patients with Acute Ischemic Stroke or Transient Ischemic Attack: A Post Hoc Analysis of the INSPIRES Trial.

Lessons from the PROTECT-CH COVID-19 platform trial in care homes (2025)
Journal Article
Bath, P. M., Ball, J., Boyd, M., Gage, H., Glover, M., Godfrey, M., Guthrie, B., Hewitt, J., Howard, R., Jaki, T., Juszczak, E., Lasserson, D., Leighton, P., Leyland, V., Shen Lim, W., Logan, P., Meakin, G., Montgomery, A., Ogollah, R., Passmore, P., …Gordon, A. L. (2025). Lessons from the PROTECT-CH COVID-19 platform trial in care homes. Health Technology Assessment, https://doi.org/10.3310/MTRS8833

Background
Coronavirus disease-2019 was associated with significant mortality and morbidity in care homes in 2020–1. Repurposed antiviral drugs might reduce morbidity and mortality through reducing viral transmission, infection, replication and infl... Read More about Lessons from the PROTECT-CH COVID-19 platform trial in care homes.

Clinical predictors of outcome after pharyngeal electrical stimulation (PES) in non-stroke related neurogenic dysphagia after mechanical ventilation and tracheotomy: results from subgroup analysis of PHADER study (2025)
Journal Article
Cheng, I., Bath, P. M., Hamdy, S., Muhle, P., Mistry, S., Dziewas, R., & Suntrup-Krüger, S. (2025). Clinical predictors of outcome after pharyngeal electrical stimulation (PES) in non-stroke related neurogenic dysphagia after mechanical ventilation and tracheotomy: results from subgroup analysis of PHADER study. Neurological Research and Practice, 7(1), Article 23. https://doi.org/10.1186/s42466-025-00380-5

Background
Pharyngeal electrical stimulation (PES) is a neurostimulation intervention that can improve swallowing and facilitate decannulation in tracheotomised stroke patients with dysphagia. The PHAryngeal electrical stimulation for treatment of n... Read More about Clinical predictors of outcome after pharyngeal electrical stimulation (PES) in non-stroke related neurogenic dysphagia after mechanical ventilation and tracheotomy: results from subgroup analysis of PHADER study.

Does the Burden of CSVD Modify the Efficacy of Dual Antiplatelet Therapy? A Post Hoc Analysis of the INSPIRES Trial (2025)
Journal Article
Li, H., Cheng, M., Gao, Y., Yan, H., Wang, Y., Johnston, S. C., Bath, P. M., Amarenco, P., Yang, Y., Chen, W., Wang, Y., Pan, Y., & Wang, Y. (2025). Does the Burden of CSVD Modify the Efficacy of Dual Antiplatelet Therapy? A Post Hoc Analysis of the INSPIRES Trial. Stroke, 56(6), 1376-1387. https://doi.org/10.1161/STROKEAHA.124.049826

BACKGROUND:
The prevalence of cerebral small vessel disease (CSVD) imaging markers is high, yet their influence on stroke prognosis remains unclear. This study aimed to estimate the effects of CSVD on the efficacy and safety of clopidogrel+aspirin v... Read More about Does the Burden of CSVD Modify the Efficacy of Dual Antiplatelet Therapy? A Post Hoc Analysis of the INSPIRES Trial.

Feasibility of Cerebellar Stimulation for the Treatment of Post-Stroke Dysphagia (2025)
Journal Article
Wilkinson, G., Sasegbon, A., Smith, C. J., Bath, P. M., & Hamdy, S. (2025). Feasibility of Cerebellar Stimulation for the Treatment of Post-Stroke Dysphagia. Cerebellum, 24(3), Article 74. https://doi.org/10.1007/s12311-025-01823-0

Post-stroke dysphagia (PSD) is common and associated with poor outcomes. We aimed to explore the feasibility, safety, and proof of concept of cerebellar rTMS in patients with sub-acute PSD. We intended to recruit 48 participants with PSD. Randomised... Read More about Feasibility of Cerebellar Stimulation for the Treatment of Post-Stroke Dysphagia.

The hazards of chasing subgroups in neutral stroke trials (2025)
Journal Article
Bath, P. M., Howard, G., & Hacke, W. (2025). The hazards of chasing subgroups in neutral stroke trials. Neurological Research and Practice, 7, Article 17. https://doi.org/10.1186/s42466-025-00369-0

Background
The majority of randomised controlled trials in acute stroke and many for prevention are neutral, i.e. they failed to reach statistical significance. However, many of these will find apparent benefit in a component of a subgroup, finding... Read More about The hazards of chasing subgroups in neutral stroke trials.

Impact of central adjudication of the score on the modified Rankin Scale in an international, randomized, acute stroke trial (2025)
Journal Article
Sluis, W. M., de Jonge, J. C., Reinink, H., Wilson, A., Woodhouse, L. J., Dawson, J., Lees, K. R., Bath, P. M., & van der Worp, H. B. (2025). Impact of central adjudication of the score on the modified Rankin Scale in an international, randomized, acute stroke trial. European Stroke Journal, https://doi.org/10.1177/23969873251320207

Introduction:
The modified Rankin Scale (mRS) is the most frequently used primary outcome measure in acute stroke research despite significant interobserver variability in assigning grades. We assessed the use of central blinded adjudication of the... Read More about Impact of central adjudication of the score on the modified Rankin Scale in an international, randomized, acute stroke trial.

Non-inferiority trials in stroke research: what are they, and how should we interpret them? (2025)
Journal Article
Li, L., Lioutas, V.-A., Akyea, R. K., Gerner, S., Lau, K. K., Ramage, E., Katsanos, A. H., Howard, G., & Bath, P. M. (2025). Non-inferiority trials in stroke research: what are they, and how should we interpret them?. Journal of Stroke, 27(1), 41-51. https://doi.org/10.5853/jos.2024.03923

Randomized clinical trials are important in both clinical and academic stroke communities with increasing numbers of new design concepts emerging. One of the “less traditional” designs that have gained increasing interest in the last decade is non-in... Read More about Non-inferiority trials in stroke research: what are they, and how should we interpret them?.

The Role of Processed Electroencephalography in the Detection and Management of Acute Cerebral Ischemia: A Scoping Review (2025)
Journal Article
Hewson, D. W., Mankoo, A., Bath, P. M., Barley, M., Dhillon, P., Malik, L., & Krishnan, K. (2025). The Role of Processed Electroencephalography in the Detection and Management of Acute Cerebral Ischemia: A Scoping Review. Journal of Neurosurgical Anesthesiology, https://doi.org/10.1097/ANA.0000000000001018

Processed electroencephalography (pEEG) is increasingly used to titrate the depth of anesthesia. Whether such intra-procedural pEEG monitoring can offer additional information on cerebral perfusion or acute focal or global cerebral ischemia is unknow... Read More about The Role of Processed Electroencephalography in the Detection and Management of Acute Cerebral Ischemia: A Scoping Review.

Recombinant Human Tissue Kallikrein-1 for Treating Acute Ischemic Stroke and Preventing Recurrence (2025)
Journal Article
Kasner, S. E., Bath, P. M., Hill, M. D., Volpi, J. J., Giuffre, M., Masuoka, L., Wambeke, D., & Madeddu, P. R. (2025). Recombinant Human Tissue Kallikrein-1 for Treating Acute Ischemic Stroke and Preventing Recurrence. Stroke, 56(3), 745-753. https://doi.org/10.1161/STROKEAHA.124.048858

Novel strategies are needed for the treatment of acute ischemic stroke when revascularization therapies are not clinically appropriate or are unsuccessful. Recombinant human tissue kallikrein-1 (rKLK1), a bradykinin-producing enzyme, offers a promis... Read More about Recombinant Human Tissue Kallikrein-1 for Treating Acute Ischemic Stroke and Preventing Recurrence.

Developing treatments for cerebral small vessel disease: a scoping review of licensed interventions for potential repurposing (2024)
Journal Article
M Bath, P., P Phan, E., Clay, G., Dawson, J., Malhotra, P., Howard, R., Pal, S., M Wardlaw, J., Quinn, T., & Macleod, M. (2024). Developing treatments for cerebral small vessel disease: a scoping review of licensed interventions for potential repurposing. F1000Research, 13, Article 1546. https://doi.org/10.12688/f1000research.157890.1

Background
Cerebral small vessel disease (cSVD) is a progressive neurovascular-degenerative condition without specific treatment that causes lacunar stroke, most intracerebral haemorrhage, vascular cognitive impairment (VCI) and several neuropsychia... Read More about Developing treatments for cerebral small vessel disease: a scoping review of licensed interventions for potential repurposing.

Dual Antiplatelet Treatment up to 72 Hours After Ischemic Stroke Stratified by Risk Profile: A Post Hoc Analysis (2024)
Journal Article
Zhang, Y., Wang, X., Gao, Y., Chen, W., Johnston, S. C., Amarenco, P., Bath, P. M., Yan, H., Wang, T., Yang, Y., Zhou, Q., Wang, M., Jing, J., Wang, C., Wang, Y., Wang, Y., & Pan, Y. (2025). Dual Antiplatelet Treatment up to 72 Hours After Ischemic Stroke Stratified by Risk Profile: A Post Hoc Analysis. Stroke, 56(1), 46-55. https://doi.org/10.1161/strokeaha.124.049246

BACKGROUND: Risk profile of recurrence may influence the effect of antiplatelet therapy. This study aimed to evaluate the efficacy and safety of clopidogrel-aspirin initiated within 72 hours after symptom onset for acute mild stroke or high-risk tran... Read More about Dual Antiplatelet Treatment up to 72 Hours After Ischemic Stroke Stratified by Risk Profile: A Post Hoc Analysis.

Tranexamic Acid Within 4.5 Hours of Intracerebral Hemorrhage With the CTA Spot Sign: Systematic Review and Individual Patient Meta-analysis (2024)
Journal Article
Yassi, N., Yogendrakumar, V., Churilov, L., Meretoja, A., Wu, T., Campbell, B. C., Strbian, D., Jeng, J.-S., Woodhouse, L. J., Ovesen, C., Law, Z. K., Gu, H.-Q., Nie, X., Liu, J., Ma, H. H., Zhao, H., Bath, P. M., Liu, L., Sprigg, N., Donnan, G. A., & Davis, S. M. (2024). Tranexamic Acid Within 4.5 Hours of Intracerebral Hemorrhage With the CTA Spot Sign: Systematic Review and Individual Patient Meta-analysis. Neurology, 103(12), https://doi.org/10.1212/wnl.0000000000210104

Background and Objectives The antifibrinolytic agent tranexamic acid has been tested in intracerebral hemorrhage trials with overall neutral results. Ongoing contrast extravasation on CT angiography (spot sign) can identify individuals with ongoing b... Read More about Tranexamic Acid Within 4.5 Hours of Intracerebral Hemorrhage With the CTA Spot Sign: Systematic Review and Individual Patient Meta-analysis.

Pre‐hospital transdermal glyceryl trinitrate for transient ischaemic attack: Data from the RIGHT‐2 trial (2024)
Journal Article
Appleton, J. P., Dixon, M., Woodhouse, L. J., Anderson, C. S., Ankolekar, S., Cala, L., England, T. J., Godolphin, P. J., Krishnan, K., Mair, G., Muir, K. W., Potter, J., Price, C. I., Randall, M., Robinson, T. G., Roffe, C., Rothwell, P. M., Sandset, E. C., Saver, J. L., Siriwardena, A. N., …Bath, P. M. (2024). Pre‐hospital transdermal glyceryl trinitrate for transient ischaemic attack: Data from the RIGHT‐2 trial. European Journal of Neurology, 31(12), Article e16502. https://doi.org/10.1111/ene.16502

Background and purpose
Ambulance trials assessing interventions in suspected stroke patients will recruit patients with currently active symptoms that will resolve into transient ischaemic attack (TIA). The safety and efficacy of glyceryl trinitrate... Read More about Pre‐hospital transdermal glyceryl trinitrate for transient ischaemic attack: Data from the RIGHT‐2 trial.

Perception and acquaintance of stroke specialists on non-inferiority trials: An international survey (2024)
Journal Article
Katsanos, A. H., Lioutas, V. A., Yperzeele, L., Ullberg, T., Li, L., Ramage, E. R., Koltsov, I. A., Shapranova, J., Howard, G., Bath, P. M., & Khan, M. (2025). Perception and acquaintance of stroke specialists on non-inferiority trials: An international survey. Journal of Stroke and Cerebrovascular Diseases, 34(1), Article 108132. https://doi.org/10.1016/j.jstrokecerebrovasdis.2024.108132

Introduction: The adoption of non-inferiority trial designs for assessing new interventions in stroke treatment is on the rise. We designed a survey to assess stroke specialists' understanding and familiarity with non-inferiority trials and margins.... Read More about Perception and acquaintance of stroke specialists on non-inferiority trials: An international survey.

Duration of Benefit and Risk of Dual Antiplatelet Therapy up to 72 Hours After Mild Ischemic Stroke and Transient Ischemic Attack (2024)
Journal Article
Guan, L., Han, S., Johnston, S. C., Bath, P. M., Amarenco, P., Yang, Y., Wang, T., Jing, J., Wang, C., Gao, Y., Chen, W., Yan, H., Wang, X., Wang, Y., Wang, Y., & Pan, Y. (2024). Duration of Benefit and Risk of Dual Antiplatelet Therapy up to 72 Hours After Mild Ischemic Stroke and Transient Ischemic Attack. Neurology, 103(7), https://doi.org/10.1212/wnl.0000000000209845

Background and ObjectivesClopidogrel-aspirin initiated within 72 hours of symptom onset is effective in patients with mild ischemic stroke or transient ischemic attack (TIA) in the Intensive Statin and Antiplatelet Therapy for Acute High-risk Intracr... Read More about Duration of Benefit and Risk of Dual Antiplatelet Therapy up to 72 Hours After Mild Ischemic Stroke and Transient Ischemic Attack.