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Rapid intervention with glyceryl trinitrate in hypertensive stroke trial-2(right-2): safety and efficacy of transdermal glyceryl trinitrate, a nitric oxide donor (2016)
Journal Article
Dixon, M., Appleton, J., Scutt, P., England, T., Havard, D., Howard, H., …Bath, P. (2016). Rapid intervention with glyceryl trinitrate in hypertensive stroke trial-2(right-2): safety and efficacy of transdermal glyceryl trinitrate, a nitric oxide donor. Emergency Medicine Journal, 33(9), e13-e14. https://doi.org/10.1136/emermed-2016-206139.42

Rationale High blood pressure (BP) is common in acute stroke and is associated with poor outcome. Previous hospital-based trials testing the effects of BP lowering on functional outcome have been inconclusive. The PIL-FAST and RIGHT pilot trials conf... Read More about Rapid intervention with glyceryl trinitrate in hypertensive stroke trial-2(right-2): safety and efficacy of transdermal glyceryl trinitrate, a nitric oxide donor.

Granulocyte Colony Stimulating Factor and Physiotherapy after Stroke: Results of a Feasibility Randomised Controlled Trial: Stem Cell Trial of Recovery EnhanceMent after Stroke-3 (STEMS-3 ISRCTN16714730) (2016)
Journal Article
Sprigg, N., O’Connor, R., Woodhouse, L. J., Krishnan, K., England, T. J., Connell, L. A., …Bath, P. M. (2016). Granulocyte Colony Stimulating Factor and Physiotherapy after Stroke: Results of a Feasibility Randomised Controlled Trial: Stem Cell Trial of Recovery EnhanceMent after Stroke-3 (STEMS-3 ISRCTN16714730). PLoS ONE, 11(9), Article e0161359. https://doi.org/10.1371/journal.pone.0161359

Background Granulocyte-colony stimulating factor (G-CSF) mobilises endogenous haematopoietic stem cells and enhances recovery in experimental stroke. Recovery may also be dependent on an enriched environment and physical activity. G-CSF may have the... Read More about Granulocyte Colony Stimulating Factor and Physiotherapy after Stroke: Results of a Feasibility Randomised Controlled Trial: Stem Cell Trial of Recovery EnhanceMent after Stroke-3 (STEMS-3 ISRCTN16714730).

Human neural stem cells in patients with chronic ischaemic stroke (PISCES): a phase 1, first-in-man study (2016)
Journal Article
Kalladka, D., Sinden, J., Pollock, K., Haig, C., McLean, J., Smith, W., …Muir, K. W. (2016). Human neural stem cells in patients with chronic ischaemic stroke (PISCES): a phase 1, first-in-man study. Lancet, 388(10046), 787-796. https://doi.org/10.1016/S0140-6736%2816%2930513-X

Background: CTX0E03 is an immortalised human neural stem-cell line from which a drug product (CTX-DP) was developed for allogeneic therapy. Dose-dependent improvement in sensorimotor function in rats implanted with CTX-DP 4 weeks after middle cerebra... Read More about Human neural stem cells in patients with chronic ischaemic stroke (PISCES): a phase 1, first-in-man study.

The Insulin Resistance Intervention after Stroke trial: a perspective on future practice and research (2016)
Journal Article
Bath, P. M., Appleton, J. P., & Sprigg, N. (in press). The Insulin Resistance Intervention after Stroke trial: a perspective on future practice and research. International Journal of Stroke, https://doi.org/10.1177/1747493016660099

The prevention of recurrent events after ischaemic stroke and transient ischaemic attack is well established and based on lifestyle changes, antithrombotics, statins, antihypertensives and carotid surgery. The international IRIS trial assessed whethe... Read More about The Insulin Resistance Intervention after Stroke trial: a perspective on future practice and research.

Pharyngeal electrical stimulation for treatment of dysphagia in subacute stroke (2016)
Journal Article
Bath, P. M., Scutt, P., Love, J., Clavé, P., Cohen, D., Dziewas, R., …Hamdy, S. (in press). Pharyngeal electrical stimulation for treatment of dysphagia in subacute stroke. Stroke, 47(6), https://doi.org/10.1161/STROKEAHA.115.012455

Background and Purpose: Dysphagia is common after stroke, associated with increased death and dependency, and treatment options are limited. Pharyngeal electric stimulation (PES) is a novel treatment for poststroke dysphagia that has shown promise in... Read More about Pharyngeal electrical stimulation for treatment of dysphagia in subacute stroke.

Continuing versus Stopping Prestroke Antihypertensive Therapy in Acute Intracerebral Hemorrhage: A Subgroup Analysis of the Efficacy of Nitric Oxide in Stroke Trial (2016)
Journal Article
Krishnan, K., Scutt, P., Woodhouse, L., Bath, P. M., Adami, A., Becker, J. L., …Bath, P. M. (2016). Continuing versus Stopping Prestroke Antihypertensive Therapy in Acute Intracerebral Hemorrhage: A Subgroup Analysis of the Efficacy of Nitric Oxide in Stroke Trial. Journal of Stroke and Cerebrovascular Diseases, 25(5), 1017-1026. https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.01.010

Background and purpose: More than 50% of patients with acute intracerebral haemorrhage (ICH) are taking antihypertensive drugs before ictus. Although antihypertensive therapy should be given long term for secondary prevention, whether to continue or... Read More about Continuing versus Stopping Prestroke Antihypertensive Therapy in Acute Intracerebral Hemorrhage: A Subgroup Analysis of the Efficacy of Nitric Oxide in Stroke Trial.

Effect of treatment delay, stroke type, and thrombolysis on the effect of glyceryl trinitrate, a nitric oxide donor, on outcome after acute stroke: a systematic review and meta-analysis of individual patient from randomised trials (2016)
Journal Article
Bath, P. M., Woodhouse, L. J., Krishnan, K., Anderson, C., Berge, E., Ford, G. A., …Wardlaw, J. M. (2016). Effect of treatment delay, stroke type, and thrombolysis on the effect of glyceryl trinitrate, a nitric oxide donor, on outcome after acute stroke: a systematic review and meta-analysis of individual patient from randomised trials. Stroke Research and Treatment, 2016, https://doi.org/10.1155/2016/9706720

Background. Nitric oxide (NO) donors are a candidate treatment for acute stroke and two trials have suggested that they might improve outcome if administered within 4–6 hours of stroke onset. We assessed the safety and efficacy of NO donors using ind... Read More about Effect of treatment delay, stroke type, and thrombolysis on the effect of glyceryl trinitrate, a nitric oxide donor, on outcome after acute stroke: a systematic review and meta-analysis of individual patient from randomised trials.

Glyceryl Trinitrate for Acute Intracerebral Hemorrhage: Results From the Efficacy of Nitric Oxide in Stroke (ENOS) Trial, a Subgroup Analysis (2015)
Journal Article
Krishnan, K., Scutt, P., Woodhouse, L. J., Adami, A., Becker, J. L., Berge, E., …Bath, P. M. (in press). Glyceryl Trinitrate for Acute Intracerebral Hemorrhage: Results From the Efficacy of Nitric Oxide in Stroke (ENOS) Trial, a Subgroup Analysis. Stroke, 47(1), 44-52. https://doi.org/10.1161/strokeaha.115.010368

Background and purpose: The Efficacy of Nitric oxide in Stroke (ENOS) trial found that transdermal glyceryl trinitrate (GTN, a nitric oxide donor) lowered blood pressure but did not improve functional outcome in patients with acute stroke. However, G... Read More about Glyceryl Trinitrate for Acute Intracerebral Hemorrhage: Results From the Efficacy of Nitric Oxide in Stroke (ENOS) Trial, a Subgroup Analysis.

Baseline characteristics, analysis plan and report on feasibility for the Prevention Of Decline in Cognition After Stroke Trial (PODCAST) (2015)
Journal Article
Scutt, P., Blackburn, D., Krishnan, K., Ballard, C., Burns, A., Ford, G. A., …Bath, P. M. (2015). Baseline characteristics, analysis plan and report on feasibility for the Prevention Of Decline in Cognition After Stroke Trial (PODCAST). Trials, 16(1), Article 509. https://doi.org/10.1186/s13063-015-1033-2

Background A common complication after stroke is development of cognitive impairment and dementia. However, effective strategies for reducing the risk of developing these problems remain undefined. Potential strategies include intensive lowering o... Read More about Baseline characteristics, analysis plan and report on feasibility for the Prevention Of Decline in Cognition After Stroke Trial (PODCAST).

Inhibition of TNF-? protects in vitro brain barrier from ischaemic damage (2015)
Journal Article
Abdullah, Z., Rakkar, K., Bath, P. M., & Bayraktutan, U. (2015). Inhibition of TNF-? protects in vitro brain barrier from ischaemic damage. Molecular and Cellular Neuroscience, 69, https://doi.org/10.1016/j.mcn.2015.11.003

Cerebral ischaemia, associated with neuroinflammation and oxidative stress, is known to perturb blood–brain barrier (BBB) integrity and promote brain oedema formation. Using an in vitro model of human BBB composed of brain microvascular endothelial c... Read More about Inhibition of TNF-? protects in vitro brain barrier from ischaemic damage.

Safety and efficacy of intensive vs. guideline antiplatelet therapy in high-risk patients with recent ischemic stroke or transient ischemic attack: rationale and design of the Triple Antiplatelets for Reducing Dependency after Ischaemic Stroke (TARDIS) trial (ISRCTN47823388) (2015)
Journal Article
Beridze, M., Christensen, H., Dineen, R. A., Duley, L., Heptinstall, S., James, M., …Bath, P. M. (2015). Safety and efficacy of intensive vs. guideline antiplatelet therapy in high-risk patients with recent ischemic stroke or transient ischemic attack: rationale and design of the Triple Antiplatelets for Reducing Dependency after Ischaemic Stroke (TARDIS) trial (ISRCTN47823388). International Journal of Stroke, 10(7), https://doi.org/10.1111/ijs.12538

RATIONALE: The risk of recurrence following a stroke or transient ischemic attack is high, especially immediately after the event. HYPOTHESIS: Because two antiplatelet agents are superior to one in patients with non-cardioembolic events, more... Read More about Safety and efficacy of intensive vs. guideline antiplatelet therapy in high-risk patients with recent ischemic stroke or transient ischemic attack: rationale and design of the Triple Antiplatelets for Reducing Dependency after Ischaemic Stroke (TARDIS) trial (ISRCTN47823388).

Pharmacological treatment and prevention of cerebral small vessel disease: a review of potential interventions (2015)
Journal Article
Bath, P. M., & Wardlaw, J. M. (2015). Pharmacological treatment and prevention of cerebral small vessel disease: a review of potential interventions. International Journal of Stroke, 10(4), https://doi.org/10.1111/ijs.12466

Small vessel disease encompasses lacunar stroke, white matter hyperintensities, lacunes and microbleeds. It causes a quarter of all ischemic strokes, is the commonest cause of vascular dementia, and the cause is incompletely understood. Vascular prop... Read More about Pharmacological treatment and prevention of cerebral small vessel disease: a review of potential interventions.

Performance characteristics of methods for quantifying spontaneous intracerebral haemorrhage: data from the Efficacy of Nitric Oxide in Stroke (ENOS) trial (2015)
Journal Article
Krishnan, K., Mukhtar, S. F., Dineen, R., Lingard, J., Houlton, A., Walker, E., …Wardlaw, J. M. (2015). Performance characteristics of methods for quantifying spontaneous intracerebral haemorrhage: data from the Efficacy of Nitric Oxide in Stroke (ENOS) trial. Journal of Neurology, Neurosurgery and Psychiatry, 86(11), 1258-1266. https://doi.org/10.1136/jnnp-2014-309845

Background: Poor prognosis after intracerebral haemorrhage (ICH) is related to haemorrhage characteristics. Along with developing therapeutic interventions, we sought to understand the performance of haemorrhage descriptors in large clinical trials.... Read More about Performance characteristics of methods for quantifying spontaneous intracerebral haemorrhage: data from the Efficacy of Nitric Oxide in Stroke (ENOS) trial.

Pharyngeal electrical stimulation for treatment of poststroke dysphagia: individual patient data meta-analysis of randomised controlled trials (2015)
Journal Article
Scutt, P., Lee, H. S., Hamdy, S., & Bath, P. M. (2015). Pharyngeal electrical stimulation for treatment of poststroke dysphagia: individual patient data meta-analysis of randomised controlled trials. Stroke Research and Treatment, 2015, Article 429053. https://doi.org/10.1155/2015/429053

Background. Dysphagia after stroke is common, associated independently with poor outcome, and has limited treatment options. Pharyngeal electrical stimulation (PES) is a novel treatment being evaluated for treatment of poststroke dysphagia. Methods.... Read More about Pharyngeal electrical stimulation for treatment of poststroke dysphagia: individual patient data meta-analysis of randomised controlled trials.

Statistical analysis plan for the ‘Triple Antiplatelets for Reducing Dependency after Ischaemic Stroke’ (TARDIS) trial (2014)
Journal Article
Bath, P. M., Robson, K., Woodhouse, L. J., Sprigg, N., Dineen, R. A., & Pocock, S. J. (2015). Statistical analysis plan for the ‘Triple Antiplatelets for Reducing Dependency after Ischaemic Stroke’ (TARDIS) trial. International Journal of Stroke, 10(3), https://doi.org/10.1111/ijs.12445

Rationale: Antiplatelet agents such as aspirin, clopidogrel and dipyridamole are effective in reducing the risk of recurrence after a stroke. Importantly, the risk of recurrence is highest immediately after the index event while antiplatelets cause b... Read More about Statistical analysis plan for the ‘Triple Antiplatelets for Reducing Dependency after Ischaemic Stroke’ (TARDIS) trial.

Interventions for deliberately altering blood pressure in acute stroke (2014)
Journal Article
Bath, P. M., & Krishnan, K. (2014). Interventions for deliberately altering blood pressure in acute stroke. Cochrane Database of Systematic Reviews, 2014(10), Article CD000039. https://doi.org/10.1002/14651858.CD000039.pub3

Background: It is unclear whether blood pressure should be altered actively during the acute phase of stroke. This is an update of a Cochrane review first published in 1997, and previously updated in 2001 and 2008. Objectives: To assess the clinical... Read More about Interventions for deliberately altering blood pressure in acute stroke.

Efficacy of nitric oxide, with or without continuing antihypertensive treatment, for management of high blood pressure in acute stroke (ENOS): a partial-factorial randomised controlled trial (2014)
Journal Article
Bath, P. M. (2015). Efficacy of nitric oxide, with or without continuing antihypertensive treatment, for management of high blood pressure in acute stroke (ENOS): a partial-factorial randomised controlled trial. Lancet, 385(9968), https://doi.org/10.1016/S0140-6736%2814%2961121-1

Background High blood pressure is associated with poor outcome after stroke. Whether blood pressure should be lowered early after stroke, and whether to continue or temporarily withdraw existing antihypertensive drugs, is not known. We assessed ou... Read More about Efficacy of nitric oxide, with or without continuing antihypertensive treatment, for management of high blood pressure in acute stroke (ENOS): a partial-factorial randomised controlled trial.

Testing devices for the prevention and treatment of stroke and its complications (2014)
Journal Article
Bath, P. M., Brainin, M., Brown, C., Campbell, B., Davis, S. M., Donnan, G. A., …Truelsen, T. (in press). Testing devices for the prevention and treatment of stroke and its complications. International Journal of Stroke, 9(6), https://doi.org/10.1111/ijs.12302

We are entering a challenging but exciting period when many new interventions may appear for stroke based on the use of devices. Hopefully these will lead to improved outcomes at a cost that can be afforded in most parts of the world. Nevertheless, i... Read More about Testing devices for the prevention and treatment of stroke and its complications.

Relationship between Poststroke Cognition, Baseline Factors, and Functional Outcome: Data from “Efficacy of Nitric Oxide in Stroke” Trial (2014)
Journal Article
Ankolekar, S., Renton, C., Sare, G., Ellender, S., Sprigg, N., Wardlaw, J. M., & Bath, P. M. (2014). Relationship between Poststroke Cognition, Baseline Factors, and Functional Outcome: Data from “Efficacy of Nitric Oxide in Stroke” Trial. Journal of Stroke and Cerebrovascular Diseases, 23(7), 1821-1829. https://doi.org/10.1016/j.jstrokecerebrovasdis.2014.04.022