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Cerebral edema in intracerebral hemorrhage: pathogenesis, natural history, and potential treatments from translation to clinical trials (2023)
Journal Article
Krishnan, K., Campos, P. B., Nguyen, T. N., Tan, C. W., Chan, S. L., Appleton, J. P., …Bath, P. M. (2023). Cerebral edema in intracerebral hemorrhage: pathogenesis, natural history, and potential treatments from translation to clinical trials. Frontiers in Stroke, 2, Article 1256664. https://doi.org/10.3389/fstro.2023.1256664

Acute intracerebral hemorrhage is the most devastating stroke subtype and is associated with significant morbidity and mortality. Poor prognosis is associated with primary brain injury from the presenting hematoma, and despite advances in clinical tr... Read More about Cerebral edema in intracerebral hemorrhage: pathogenesis, natural history, and potential treatments from translation to clinical trials.

Bleeding with intensive versus guideline antiplatelet therapy in acute cerebral ischaemia (2023)
Journal Article
Woodhouse, L. J., Appleton, J. P., Christensen, H., Dineen, R. A., England, T. J., James, M., …Bath, P. M. (2023). Bleeding with intensive versus guideline antiplatelet therapy in acute cerebral ischaemia. Scientific Reports, 13, Article 11717. https://doi.org/10.1038/s41598-023-38474-2

Intensive antiplatelet therapy did not reduce recurrent stroke/transient ischaemic attack (TIA) events as compared with guideline treatment in the Triple Antiplatelets for Reducing Dependency after Ischaemic Stroke (TARDIS) trial, but did increase th... Read More about Bleeding with intensive versus guideline antiplatelet therapy in acute cerebral ischaemia.

Remote ischemic conditioning for stroke: A critical systematic review (2023)
Journal Article
Keevil, H., Phillips, B. E., & England, T. J. (in press). Remote ischemic conditioning for stroke: A critical systematic review. International Journal of Stroke, 19(3), 271-279. https://doi.org/10.1177/17474930231191082

Remote ischemic conditioning (RIC) is the application of brief periods of ischemia to an organ or tissue with the aim of inducing protection from ischemia in a distant organ. It was first developed as a cardioprotective strategy but has been increasi... Read More about Remote ischemic conditioning for stroke: A critical systematic review.

Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): effects on outcomes at day 365 in a randomised, sham-controlled, blinded, phase III, superiority ambulance-based trial (2023)
Journal Article
Woodhouse, L. J., Appleton, J. P., Ankolekar, S., England, T. J., Mair, G., Muir, K., …Bath, P. M. (2023). Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): effects on outcomes at day 365 in a randomised, sham-controlled, blinded, phase III, superiority ambulance-based trial. BMJ Neurology Open, 5(1), Article e000424. https://doi.org/10.1136/bmjno-2023-000424

Background The Rapid Intervention with Glyceryl Trinitrate in Hypertensive Stroke Trial-2 (RIGHT-2) reported no overall treatment difference between glyceryl trinitrate (GTN) and sham at day 90. Here we assess participants' outcomes 1 year after rand... Read More about Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): effects on outcomes at day 365 in a randomised, sham-controlled, blinded, phase III, superiority ambulance-based trial.

Effects of blood pressure and tranexamic acid in spontaneous intracerebral haemorrhage: A secondary analysis of a large randomised controlled trial (2023)
Journal Article
Appleton, J. P., Kang, Z., Woodhouse, L. J., Al-Shahi Salman, R., Beridze, M., Christensen, H., …Sprigg, N. (2023). Effects of blood pressure and tranexamic acid in spontaneous intracerebral haemorrhage: A secondary analysis of a large randomised controlled trial. BMJ Neurology Open, 5(1), Article e000423. https://doi.org/10.1136/bmjno-2023-000423

Background Tranexamic acid reduced haematoma expansion and early death, but did not improve functional outcome in the tranexamic acid for hyperacute spontaneous intracerebral haemorrhage-2 (TICH-2) trial. In a predefined subgroup, there was a statist... Read More about Effects of blood pressure and tranexamic acid in spontaneous intracerebral haemorrhage: A secondary analysis of a large randomised controlled trial.

Prehospital transdermal glyceryl trinitrate for ultra-acute ischaemic stroke: data from the RIGHT-2 randomised sham-controlled ambulance trial (2023)
Journal Article
Appleton, J. P., Woodhouse, L. J., Anderson, C. S., Ankolekar, S., Cala, L., Dixon, M., …Bath, P. M. (2023). Prehospital transdermal glyceryl trinitrate for ultra-acute ischaemic stroke: data from the RIGHT-2 randomised sham-controlled ambulance trial. Stroke and Vascular Neurology, 9(1), https://doi.org/10.1136/svn-2022-001634

Background The effect of transdermal glyceryl trinitrate (GTN, a nitrovasodilator) on clinical outcome when administered before hospital admission in suspected stroke patients is unclear. Here, we assess the safety and efficacy of GTN in the prespeci... Read More about Prehospital transdermal glyceryl trinitrate for ultra-acute ischaemic stroke: data from the RIGHT-2 randomised sham-controlled ambulance trial.

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., …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.

Endovascular Thrombectomy Versus Best Medical Management Beyond 24 Hours From Last Known Well in Acute Ischemic Stroke Due to Large Vessel Occlusion (2023)
Journal Article
Dhillon, P. S., Butt, W., Jovin, T. G., Podlasek, A., McConachie, N., Lenthall, R., …England, T. J. (2023). Endovascular Thrombectomy Versus Best Medical Management Beyond 24 Hours From Last Known Well in Acute Ischemic Stroke Due to Large Vessel Occlusion. Stroke: Vascular and Interventional Neurology, 3(5), Article e000790. https://doi.org/10.1161/svin.122.000790

BACKGROUND The safety and efficacy of endovascular thrombectomy (EVT) in patients with acute ischemic stroke due to large vessel occlusion presenting beyond 24 hours from last known well (LKW) remains undetermined. METHODS In this single center... Read More about Endovascular Thrombectomy Versus Best Medical Management Beyond 24 Hours From Last Known Well in Acute Ischemic Stroke Due to Large Vessel Occlusion.

Comparison Between In‐Hospital and Community‐Onset Stroke Treated With Endovascular Thrombectomy: A Propensity Score–Matched Cohort Study (2023)
Journal Article
Dhillon, P. S., Soo, E., Butt, W., Nguyen, T. N., Barrett, E., Podlasek, A., …England, T. J. (2023). Comparison Between In‐Hospital and Community‐Onset Stroke Treated With Endovascular Thrombectomy: A Propensity Score–Matched Cohort Study. Stroke: Vascular and Interventional Neurology, 3(4), Article e000816. https://doi.org/10.1161/svin.122.000816

Effect of proximal blood flow arrest during endovascular thrombectomy (ProFATE): Study protocol for a multicentre randomised controlled trial (2023)
Journal Article
Dhillon, P. S., Butt, W., Podlasek, A., Bhogal, P., McConachie, N., Lenthall, R., …England, T. J. (2023). Effect of proximal blood flow arrest during endovascular thrombectomy (ProFATE): Study protocol for a multicentre randomised controlled trial. European Stroke Journal, 8(2), 581-590. https://doi.org/10.1177/23969873231166194

Background: Observational studies have demonstrated improved outcomes with the adjunctive use of balloon guide catheters (BGC) during endovascular thrombectomy (EVT) for anterior circulation acute ischaemic stroke (AIS). However, the lack of high-lev... Read More about Effect of proximal blood flow arrest during endovascular thrombectomy (ProFATE): Study protocol for a multicentre randomised controlled trial.

Incidence and predictors of poor functional outcome despite complete recanalisation following endovascular thrombectomy for acute ischaemic stroke (2023)
Journal Article
Dhillon, P. S., Butt, W., Marei, O., Podlasek, A., McConachie, N., Lenthall, R., …England, T. J. (2023). Incidence and predictors of poor functional outcome despite complete recanalisation following endovascular thrombectomy for acute ischaemic stroke. Journal of Stroke and Cerebrovascular Diseases, 32(5), Article 107083. https://doi.org/10.1016/j.jstrokecerebrovasdis.2023.107083

Background: Numerous ischaemic stroke patients experience poor functional outcome despite successful recanalisation following endovascular thrombectomy (EVT). We aimed to identify the incidence and predictors of futile complete recanalisation (FCR) i... Read More about Incidence and predictors of poor functional outcome despite complete recanalisation following endovascular thrombectomy for acute 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., …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.

Endovascular Thrombectomy vs Best Medical Therapy for Late Presentation Acute Ischaemic Stroke with Proximal Large Vessel Occlusion Selected Based on Non-Contrast CT: A Retrospective Analysis of Two Prospectively Defined Cohorts (2022)
Journal Article
Singh Dhillon, P., Butt, W., Jovin, T. G., Podlasek, A., McConachie, N., Lenthall, R., …England, T. J. (2023). Endovascular Thrombectomy vs Best Medical Therapy for Late Presentation Acute Ischaemic Stroke with Proximal Large Vessel Occlusion Selected Based on Non-Contrast CT: A Retrospective Analysis of Two Prospectively Defined Cohorts. Stroke: Vascular and Interventional Neurology, 3(2), Article e000686. https://doi.org/10.1161/SVIN.122.000686

Background: The efficacy and safety of endovascular thrombectomy (EVT) beyond 6 hours from acute ischaemic stroke (AIS) onset for patients selected without CT perfusion or MR imaging is undetermined in routine clinical practice. Methods: In this... Read More about Endovascular Thrombectomy vs Best Medical Therapy for Late Presentation Acute Ischaemic Stroke with Proximal Large Vessel Occlusion Selected Based on Non-Contrast CT: A Retrospective Analysis of Two Prospectively Defined Cohorts.

Dietary nitrate supplementation for preventing and reducing the severity of winter infections, including COVID-19, in care homes (BEET-Winter)-a randomised placebo-controlled feasibility trial (2022)
Journal Article
Bath, P. M., Skinner, C. J. C., Bath, C. S., Woodhouse, L. J., Areti, A., Korovesi, K., …Gordon, A. L. (2022). Dietary nitrate supplementation for preventing and reducing the severity of winter infections, including COVID-19, in care homes (BEET-Winter)-a randomised placebo-controlled feasibility trial. European Geriatric Medicine, 13, 1343-1355. https://doi.org/10.1007/s41999-022-00714-5

Purpose Infections cause considerable care home morbidity and mortality. Nitric oxide (NO) has broad-spectrum anti-viral, bacterial and yeast activity in vitro. We assessed the feasibility of supplementing dietary nitrate (NO substrate) intake in ca... Read More about Dietary nitrate supplementation for preventing and reducing the severity of winter infections, including COVID-19, in care homes (BEET-Winter)-a randomised placebo-controlled feasibility trial.

Remote ischaemic conditioning: defining critical criteria for success—report from the 11th Hatter Cardiovascular Workshop (2022)
Journal Article
Bell, R. M., Basalay, M., Bøtker, H. E., Beikoghli Kalkhoran, S., Carr, R. D., Cunningham, J., …Yellon, D. M. (2022). Remote ischaemic conditioning: defining critical criteria for success—report from the 11th Hatter Cardiovascular Workshop. Basic Research in Cardiology, 117, Article 39. https://doi.org/10.1007/s00395-022-00947-2

The Hatter Cardiovascular Institute biennial workshop, originally scheduled for April 2020 but postponed for 2years due to the Covid pandemic, was organised to debate and discuss the future of Remote Ischaemic Conditioning (RIC). This evolved from th... Read More about Remote ischaemic conditioning: defining critical criteria for success—report from the 11th Hatter Cardiovascular Workshop.

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., …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.

Association between anesthesia modality and clinical outcomes following endovascular stroke treatment in the extended time window (2022)
Journal Article
Dhillon, P. S., Butt, W., Podlasek, A., McConachie, N., Lenthall, R., Nair, S., …England, T. J. (2023). Association between anesthesia modality and clinical outcomes following endovascular stroke treatment in the extended time window. Journal of NeuroInterventional Surgery, 15(5), 478-482. https://doi.org/10.1136/neurintsurg-2022-018846

Background: There is a paucity of data on anesthesia-related outcomes for endovascular treatment (EVT) in the extended window (>6 hours from ischemic stroke onset). We compared functional and safety outcomes between local anesthesia (LA) without seda... Read More about Association between anesthesia modality and clinical outcomes following endovascular stroke treatment in the extended time window.

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., …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., …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.

Endovascular thrombectomy beyond 24 hours from ischemic stroke onset: A propensity score matched cohort study (2022)
Journal Article
Singh Dhillon, P., Butt, W., Podlasek, A., Barrett, E., McConachie, N., Lenthall, R., …England, T. J. (2023). Endovascular thrombectomy beyond 24 hours from ischemic stroke onset: A propensity score matched cohort study. Journal of NeuroInterventional Surgery, 15(3), 233-237. https://doi.org/10.1136/neurintsurg-2021-018591

Background: The safety and functional outcome of endovascular thrombectomy (EVT) in the very late (VL; >24 hours) time window from ischemic stroke onset remains undetermined. Methods: Using data from a national stroke registry, we used propensity sco... Read More about Endovascular thrombectomy beyond 24 hours from ischemic stroke onset: A propensity score matched cohort study.

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., …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., …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.

Diagnostic accuracy of the Dysphagia Trained Nurse Assessment tool in acute stroke (2021)
Journal Article
Benfield, J. K., Wilkinson, G., Everton, L. F., Bath, P. M., & England, T. J. (2021). Diagnostic accuracy of the Dysphagia Trained Nurse Assessment tool in acute stroke. European Journal of Neurology, 28(8), 2766-2774. https://doi.org/10.1111/ene.14900

Background and purpose Comprehensive swallow screening assessments to identify dysphagia and make early eating and drinking recommendations can be used by trained nurses. This study aimed to validate the Dysphagia Trained Nurse Assessment (DTNAx) to... Read More about Diagnostic accuracy of the Dysphagia Trained Nurse Assessment tool in acute stroke.

Direct mechanical thrombectomy without intravenous thrombolysis versus bridging therapy for acute ischemic stroke: A meta-analysis of randomized controlled trials (2021)
Journal Article
Podlasek, A., Dhillon, P. S., Butt, W., Grunwald, I. O., & England, T. J. (2021). Direct mechanical thrombectomy without intravenous thrombolysis versus bridging therapy for acute ischemic stroke: A meta-analysis of randomized controlled trials. International Journal of Stroke, 16(6), 621-631. https://doi.org/10.1177/17474930211021353

Background: Direct mechanical thrombectomy may result in similar outcomes compared to a bridging approach with intravenous thrombolysis (IVT + MT) in acute ischemic stroke. Recent randomized controlled trials have varied in their design and noninferi... Read More about Direct mechanical thrombectomy without intravenous thrombolysis versus bridging therapy for acute ischemic stroke: A meta-analysis of randomized controlled trials.

A pilot of the feasibility and usefulness of an aged obese model for use in stroke research (2021)
Journal Article
Learoyd, A. E., Calmus, R., Cunningham, C. N., England, T. J., Farr, T. D., Fone, K. C., …Trueman, R. C. (2021). A pilot of the feasibility and usefulness of an aged obese model for use in stroke research. Wellcome Open Research, 6, Article 104. https://doi.org/10.12688/wellcomeopenres.16592.1

Background: Animal models of stroke have been criticised as having poor predictive validity, lacking risk factors prevalent in an aging population. This pilot study examined the development of comorbidities in a combined aged and high-fat diet model,... Read More about A pilot of the feasibility and usefulness of an aged obese model for use in stroke research.

Local anaesthesia as a distinct comparator versus conscious sedation and 1 general anaesthesia in endovascular stroke treatment: a systematic review and meta-analysis (2021)
Journal Article
Butt, W., Dhillon, P. S., Podlasek, A., Malik, L., Nair, S., Hewson, D., …Mcconachie, N. (2022). Local anaesthesia as a distinct comparator versus conscious sedation and 1 general anaesthesia in endovascular stroke treatment: a systematic review and meta-analysis. Journal of NeuroInterventional Surgery, 14(3), 221-226. https://doi.org/10.1136/neurintsurg-2021-017360

Background: The optimal anesthetic modality for endovascular treatment (EVT) in acute ischemic stroke (AIS) is undetermined. Comparisons of general anesthesia (GA) with composite non-GA cohorts of conscious sedation (CS) and local anesthesia (LA) wit... Read More about Local anaesthesia as a distinct comparator versus conscious sedation and 1 general anaesthesia in endovascular stroke treatment: a systematic review and meta-analysis.

Protective Effects of Cannabidivarin and Cannabigerol on Cells of the Blood-Brain Barrier Under Ischemic Conditions (2021)
Journal Article
Stone, N. L., England, T. J., & O' Sullivan, S. E. (2021). Protective Effects of Cannabidivarin and Cannabigerol on Cells of the Blood-Brain Barrier Under Ischemic Conditions. Cannabis and Cannabinoid Research, 6(4), 315-326. https://doi.org/10.1089/can.2020.0159

Background and Objectives: Preclinical studies have shown cannabidiol is protective in models of ischemic stroke. Based on results from our recent systematic review, we investigated the effects of two promising neuro-protective phytocannabinoids, can... Read More about Protective Effects of Cannabidivarin and Cannabigerol on Cells of the Blood-Brain Barrier Under Ischemic Conditions.

Outcomes in Antiplatelet?Associated Intracerebral Hemorrhage in the TICH?2 Randomized Controlled Trial (2021)
Journal Article
Law, Z. K., Desborough, M., Roberts, I., Al‐Shahi Salman, R., England, T. J., Werring, D. J., …Sprigg, N. (2021). Outcomes in Antiplatelet‐Associated Intracerebral Hemorrhage in the TICH‐2 Randomized Controlled Trial. Journal of the American Heart Association, 10(5), Article e019130. https://doi.org/10.1161/jaha.120.019130

Background Antiplatelet therapy increases the risk of hematoma expansion in intracerebral hemorrhage (ICH) while the effect on functional outcome is uncertain. Methods and Results This is an exploratory analysis of the TICH‐2 (Tranexamic Acid in... Read More about Outcomes in Antiplatelet?Associated Intracerebral Hemorrhage in the TICH?2 Randomized Controlled Trial.

Blood markers in remote ischaemic conditioning for acute ischaemic stroke: data from the REmote ischaemic Conditioning After Stroke Trial (2020)
Journal Article
Appleton, J. P., O'Sullivan, S. E., Hedstrom, A., May, J. A., Donnelly, R., Sprigg, N., …England, T. J. (2021). Blood markers in remote ischaemic conditioning for acute ischaemic stroke: data from the REmote ischaemic Conditioning After Stroke Trial. European Journal of Neurology, 28(4), 1225-1233. https://doi.org/10.1111/ene.14650

Background and purpose: Remote ischaemic per-conditioning (RIC) is neuroprotective in experimental ischaemic stroke. Several neurohumoral, vascular and inflammatory mediators are implicated. The effect of RIC on plasma biomarkers was assessed using c... Read More about Blood markers in remote ischaemic conditioning for acute ischaemic stroke: data from the REmote ischaemic Conditioning After Stroke Trial.

Predictors and outcomes of neurological deterioration in intracerebral hemorrhage: results from the TICH-2 randomised controlled trial (2020)
Journal Article
Kang Law, Z., Dineen, R., England, T. J., Cala, L., Mistri, A. K., Appleton, J. P., …TICH-2 investigators. (2021). Predictors and outcomes of neurological deterioration in intracerebral hemorrhage: results from the TICH-2 randomised controlled trial. Translational Stroke Research, 12, 275-283. https://doi.org/10.1007/s12975-020-00845-6

Neurological deterioration is common after intracerebral hemorrhage (ICH). We aimed to identify the predictors and effects of neurological deterioration and whether tranexamic acid reduced the risk of neurological deterioration. Data from the Tranexa... Read More about Predictors and outcomes of neurological deterioration in intracerebral hemorrhage: results from the TICH-2 randomised controlled trial.

A Systematic Review of Minor Phytocannabinoids with Promising Neuroprotective Potential (2020)
Journal Article
Stone, N. L., Murphy, A. J., England, T. J., & O’Sullivan, S. E. (2020). A Systematic Review of Minor Phytocannabinoids with Promising Neuroprotective Potential. British Journal of Pharmacology, https://doi.org/10.1111/bph.15185

Embase and Pubmed were systematically searched for articles addressing the neuroprotective properties of phytocannabinoids, aside from cannabidiol and Δ9‐tetrahydrocannabinol, including Δ9‐tetrahydrocannabinolic acid (Δ9‐THCA), Δ9‐tetrahydrocannabiva... Read More about A Systematic Review of Minor Phytocannabinoids with Promising Neuroprotective Potential.

A meta-analysis of remote ischaemic conditioning in experimental stroke (2020)
Journal Article
Weir, P., Maguire, R., O’Sullivan, S. E., & England, T. J. (2021). A meta-analysis of remote ischaemic conditioning in experimental stroke. Journal of Cerebral Blood Flow and Metabolism, 41(1), 3-13. https://doi.org/10.1177/0271678x20924077

Remote ischaemic conditioning (RIC) is achieved by repeated transient ischaemia of a distant organ/limb and is neuroprotective in experimental ischaemic stroke. However, the optimal time and methods of administration are unclear. Systematic review id... Read More about A meta-analysis of remote ischaemic conditioning in experimental stroke.

The Landscape of Videofluoroscopy in the UK: A Web-Based Survey (2020)
Journal Article
Benfield, J. K., Michou, E., Everton, L. F., Mills, C., Hamdy, S., Bath, P. M., & England, T. J. (2020). The Landscape of Videofluoroscopy in the UK: A Web-Based Survey. Dysphagia, https://doi.org/10.1007/s00455-020-10130-1

Videofluoroscopy (VFS) is considered one of the gold-standard assessments of swallowing. Whilst guidelines for the application and conduct of VFS exist, their translation into clinical practice remain challenging. To build a greater understanding on... Read More about The Landscape of Videofluoroscopy in the UK: A Web-Based Survey.

Psychometric assessment and validation of the dysphagia severity rating scale in stroke patients (2020)
Journal Article
Everton, L. F., Benfield, J. K., Hedstrom, A., Wilkinson, G., Michou, E., England, T. J., …Hamdy, S. (2020). Psychometric assessment and validation of the dysphagia severity rating scale in stroke patients. Scientific Reports, 10, Article 7268. https://doi.org/10.1038/s41598-020-64208-9

Post stroke dysphagia (PSD) is common and associated with poor outcome. The Dysphagia Severity Rating Scale (DSRS), which grades how severe dysphagia is based on fluid and diet modification and supervision requirements for feeding, is used for clinic... Read More about Psychometric assessment and validation of the dysphagia severity rating scale in stroke patients.

Protocol: The Lacunar Intervention Trial 2 (LACI-2). A trial of two repurposed licenced drugs to prevent progression of cerebral small vessel disease (2020)
Journal Article
Wardlaw, J., Bath, P. M., Doubal, F., Heye, A., Sprigg, N., Woodhouse, L. J., …The LACI-2 Trial Investigators. (2020). Protocol: The Lacunar Intervention Trial 2 (LACI-2). A trial of two repurposed licenced drugs to prevent progression of cerebral small vessel disease. European Stroke Journal, 5(3), 297-308. https://doi.org/10.1177/2396987320920110

Background Small vessel disease causes a quarter of ischaemic strokes (lacunar subtype), up to 45% of dementia either as vascular or mixed types, cognitive impairment and physical frailty. However, there is no specific treatment to prevent progressi... Read More about Protocol: The Lacunar Intervention Trial 2 (LACI-2). A trial of two repurposed licenced drugs to prevent progression of cerebral small vessel disease.

The effects of acute and sustained cannabidiol dosing for seven days on the haemodynamics in healthy men: A randomised controlled trial (2020)
Journal Article
O'Sullivan, S. E., England, T. J., & Sultan, S. R. (2020). The effects of acute and sustained cannabidiol dosing for seven days on the haemodynamics in healthy men: A randomised controlled trial. British Journal of Clinical Pharmacology, https://doi.org/10.1111/bcp.14225

© 2020 The British Pharmacological Society Background: In vivo studies show that cannabidiol (CBD) acutely reduces blood pressure (BP) in men. The aim of this study was to assess the effects of repeated CBD dosing on haemodynamics. Methods: Twenty-si... Read More about The effects of acute and sustained cannabidiol dosing for seven days on the haemodynamics in healthy men: A randomised controlled trial.

Incidence and predictors of early seizures in intracerebral haemorrhage and the effect of tranexamic acid (2020)
Journal Article
Law, Z. K., England, T. J., Mistri, A. K., Woodhouse, L. J., Cala, L., Dineen, R., …TICH-2 investigators. (2020). Incidence and predictors of early seizures in intracerebral haemorrhage and the effect of tranexamic acid. European Stroke Journal, 5(2), 123-129. https://doi.org/10.1177/2396987320901391

Introduction: Seizures are common after intracerebral haemorrhage. Tranexamic acid increases the risk of seizures in non-intracerebral haemorrhage population but its effect on post-intracerebral haemorrhage seizures is unknown. We explored the risk f... Read More about Incidence and predictors of early seizures in intracerebral haemorrhage and the effect of tranexamic acid.

Accuracy and clinical utility of comprehensive dysphagia screening assessments in acute stroke: A systematic review and meta?analysis (2020)
Journal Article
Benfield, J. K., Everton, L. F., Bath, P. M., & England, T. J. (2020). Accuracy and clinical utility of comprehensive dysphagia screening assessments in acute stroke: A systematic review and meta?analysis. Journal of Clinical Nursing, 29(9-10), 1527-1538. https://doi.org/10.1111/jocn.15192

Introduction Nurses and other nonspecialists in dysphagia are often trained to screen swallowing poststroke. There are many basic tools that test water only, they are usually conservative, and patients that fail the test remain nil by mouth until... Read More about Accuracy and clinical utility of comprehensive dysphagia screening assessments in acute stroke: A systematic review and meta?analysis.

The Hazard of Negative (Not Neutral) Trials on Treatment of Acute Stroke: A Review (2019)
Journal Article
Bath, P. M., Appleton, J. P., & England, T. (2020). The Hazard of Negative (Not Neutral) Trials on Treatment of Acute Stroke: A Review. JAMA Neurology, 77(1), 114-124. https://doi.org/10.1001/jamaneurol.2019.4107

Importance: While there are a limited number of beneficial treatments for acute stroke (eg, stroke units, reperfusion, aspirin, hemicraniectomy), there are more negative (as opposed to neutral) interventions spanning multiple different mechanisms of... Read More about The Hazard of Negative (Not Neutral) Trials on Treatment of Acute Stroke: A Review.

Noncontrast Computed Tomography Signs as Predictors of Hematoma Expansion, Clinical Outcome and Response to Tranexamic Acid in Acute Intracerebral Hemorrhage (2019)
Journal Article
Law, Z. K., Ali, A., Krishnan, K., Bischoff, A., Appleton, J., Scutt, P., …Sprigg, N. (2020). Noncontrast Computed Tomography Signs as Predictors of Hematoma Expansion, Clinical Outcome and Response to Tranexamic Acid in Acute Intracerebral Hemorrhage. Stroke, 51(1), 121–128. https://doi.org/10.1161/STROKEAHA.119.026128

Background and purpose Blend, black hole and island signs and hypodensities are reported to predict hematoma expansion in acute intracerebral hemorrhage (ICH). We explored the value of these noncontrast CT (NCCT) signs in predicting hematoma expan... Read More about Noncontrast Computed Tomography Signs as Predictors of Hematoma Expansion, Clinical Outcome and Response to Tranexamic Acid in Acute Intracerebral Hemorrhage.

Prehospital Transdermal Glyceryl Trinitrate for Ultra-Acute Intracerebral Hemorrhage (2019)
Journal Article
Bath, P. M., Woodhouse, L. J., Krishnan, K., Appleton, J. P., Anderson, C. S., Berge, E., …Sprigg, N. (2019). Prehospital Transdermal Glyceryl Trinitrate for Ultra-Acute Intracerebral Hemorrhage. Stroke, 50(11), 3064-3071. https://doi.org/10.1161/STROKEAHA.119.026389

Background and Purpose— Pilot trials suggest that glyceryl trinitrate (GTN; nitroglycerin) may improve outcome when administered early after stroke onset. Methods— We undertook a multicentre, paramedic-delivered, ambulance-based, prospective ran... Read More about Prehospital Transdermal Glyceryl Trinitrate for Ultra-Acute Intracerebral Hemorrhage.

Behavioural activation therapy for post-stroke depression: the BEADS feasibility RCT (2019)
Journal Article
Coates, E., Thomas, S. A., Drummond, A. E., Lincoln, N. B., Palmer, R. L., Sutherland, K. E., …Topcu, G. (2019). Behavioural activation therapy for post-stroke depression: the BEADS feasibility RCT. Health Technology Assessment, 23(47), 1-176. https://doi.org/10.3310/hta23470

Background: There is currently insufficient evidence for the clinical effectiveness and cost-effectiveness of psychological therapies for post-stroke depression. Objective: To evaluate the feasibility of undertaking a definitive trial to evaluate the... Read More about Behavioural activation therapy for post-stroke depression: the BEADS feasibility RCT.

A systematic review of cannabidiol dosing in clinical populations (2019)
Journal Article
Millar, S. A., Stone, N., Bellman, Z., Yates, A., England, T., & O'Sullivan, S. (2019). A systematic review of cannabidiol dosing in clinical populations. British Journal of Clinical Pharmacology, 85(9), 1888-1900. https://doi.org/10.1111/bcp.14038

Aims: Cannabidiol is a cannabis-derived medicinal product with potential application in a wide-variety of contexts, however its effective dose in different disease states remains unclear. This review aimed to investigate what doses have been applied... Read More about A systematic review of cannabidiol dosing in clinical populations.

Tranexamic acid to improve functional status in adults with spontaneous intracerebral haemorrhage: the TICH-2 RCT (2019)
Journal Article
Sprigg, N., Flaherty, K., Appleton, J. P., Al-Shahi Salman, R., Bereczki, D., Beridze, M., …Bath, P. M. (2019). Tranexamic acid to improve functional status in adults with spontaneous intracerebral haemorrhage: the TICH-2 RCT. Health Technology Assessment, 23(35), 1-48. https://doi.org/10.3310/hta23350

BACKGROUND: Tranexamic acid reduces death due to bleeding after trauma and postpartum haemorrhage. OBJECTIVE: The aim of the study was to assess if tranexamic acid is safe, reduces haematoma expansion and improves outcomes in adults with spontaneous... Read More about Tranexamic acid to improve functional status in adults with spontaneous intracerebral haemorrhage: the TICH-2 RCT.

A novel transwell blood brain barrier model using primary human cells (2019)
Journal Article
Stone, N. L., England, T. J., & O’Sullivan, S. E. (2019). A novel transwell blood brain barrier model using primary human cells. Frontiers in Cellular Neuroscience, 13, Article 230. https://doi.org/10.3389/fncel.2019.00230

© 2019 Stone, England and O’Sullivan. Structural alterations and breakdown of the blood brain barrier (BBB) is often a primary or secondary consequence of disease, resulting in brain oedema and the transport of unwanted substances into the brain. It... Read More about A novel transwell blood brain barrier model using primary human cells.

Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): an ambulance-based, randomised, sham-controlled, blinded, phase 3 trial (2019)
Journal Article
Bath, P. M., Scutt, P., Anderson, C. S., Appleton, J. P., Berge, E., Cala, L., …Mir, R. (2019). Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): an ambulance-based, randomised, sham-controlled, blinded, phase 3 trial. Lancet, 393(10175), 1009-1020. https://doi.org/10.1016/S0140-6736%2819%2930194-1

© 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Background: High blood pressure is common in acute stroke and is a predictor of poor outcome; however, large trials of lowering blood pressure... Read More about Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): an ambulance-based, randomised, sham-controlled, blinded, phase 3 trial.

Triple versus guideline antiplatelet therapy to prevent recurrence after acute ischaemic stroke or transient ischaemic attack: The TARDIS RCT (2018)
Journal Article
Bath, P. M., Woodhouse, L. J., Appleton, J. P., Beridze, M., Christensen, H., Dineen, R. A., …Sprigg, N. (2018). Triple versus guideline antiplatelet therapy to prevent recurrence after acute ischaemic stroke or transient ischaemic attack: The TARDIS RCT. Health Technology Assessment, 22(48), 1-75. https://doi.org/10.3310/hta22480

© Queen’s Printer and Controller of HMSO 2018. Background: Two antiplatelet agents are better than one for preventing recurrent stroke after acute ischaemic stroke or transient ischaemic attack (TIA). Therefore, intensive treatment with three agents... Read More about Triple versus guideline antiplatelet therapy to prevent recurrence after acute ischaemic stroke or transient ischaemic attack: The TARDIS RCT.

Does therapy with biofeedback improve swallowing in adults with dysphagia?: a systematic review and meta-analysis (2018)
Journal Article
Benfield, J. K., Everton, L. F., Bath, P. M., & England, T. J. (in press). Does therapy with biofeedback improve swallowing in adults with dysphagia?: a systematic review and meta-analysis. Archives of Physical Medicine and Rehabilitation, https://doi.org/10.1016/j.apmr.2018.04.031

Objective To describe and systematically review the current evidence on the effects of swallow therapy augmented by biofeedback in adults with dysphagia (PROSPERO 2016:CRD42016052942). Data sources Two independent reviewers conducted searches whic... Read More about Does therapy with biofeedback improve swallowing in adults with dysphagia?: a systematic review and meta-analysis.

Serum amyloid protein is associated with outcome following acute ischaemic stroke: data from the REmote ischaemic Conditioning After Stroke Trial (RECAST) (2018)
Conference Proceeding
Appleton, J. P., Hedstrom, A., O'Sullivan, S., May, J., Sprigg, N., Bath, P. M., & England, T. J. (2018). Serum amyloid protein is associated with outcome following acute ischaemic stroke: data from the REmote ischaemic Conditioning After Stroke Trial (RECAST).

Background: Remote ischaemic per-conditioning (RIC) in experimental ischaemic stroke is neuroprotective. Several neurohumoral, vascular and inflammatory mediators are implicated. Methods: The REmote ischaemic Conditioning After Stroke Trial (RECAS... Read More about Serum amyloid protein is associated with outcome following acute ischaemic stroke: data from the REmote ischaemic Conditioning After Stroke Trial (RECAST).

Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2 (RIGHT-2): safety and efficacy of transdermal glyceryl trinitrate, a nitric oxide donor, and of the feasibility of a multicentre ambulance-based stroke trial (2018)
Conference Proceeding
Dixon, M., Appleton, J. P., Scutt, P., England, T., Havard, D., Howard, H., …Bath, P. M. (2018). Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2 (RIGHT-2): safety and efficacy of transdermal glyceryl trinitrate, a nitric oxide donor, and of the feasibility of a multicentre ambulance-based stroke trial.

Tranexamic acid for hyperacute primary IntraCerebral Haemorrhage (TICH-2): an international randomised, placebo-controlled, phase 3 superiority trial (2018)
Journal Article
Sprigg, N., Flaherty, K., Appleton, J. P., Al-Shahi Salman, R., Bereczki, D., Beridze, M., …Bath, P. M. (2018). Tranexamic acid for hyperacute primary IntraCerebral Haemorrhage (TICH-2): an international randomised, placebo-controlled, phase 3 superiority trial. Lancet, 391(10135), 2107-2115. https://doi.org/10.1016/S0140-6736%2818%2931033-X

Background Tranexamic acid (TXA) reduces death due to bleeding after trauma and post-partum haemorrhage. The aim was to assess if tranexamic acid reduces haematoma expansion and improves outcome in adults with stroke due to intracerebral 6 haemorrha... Read More about Tranexamic acid for hyperacute primary IntraCerebral Haemorrhage (TICH-2): an international randomised, placebo-controlled, phase 3 superiority trial.

Does tranexamic acid lead to changes in MRI-measures of brain tissue health in patients with spontaneous intracerebral haemorrhage? An MRI sub-study nested within the double-blind randomised controlled TICH-2 trial (2018)
Journal Article
Dineen, R. A., Pszczolkowski, S., Flaherty, K., Law, Z. K., Morgan, P. S., Roberts, I., …Sprigg, N. (in press). Does tranexamic acid lead to changes in MRI-measures of brain tissue health in patients with spontaneous intracerebral haemorrhage? An MRI sub-study nested within the double-blind randomised controlled TICH-2 trial. BMJ Open, 8(2), Article e019930. https://doi.org/10.1136/bmjopen-2017-019930

Objectives: To test whether administration of the antifibrinolytic drug tranexamic acid (TXA) in patients with spontaneous intracerebral haemorrhage (SICH) leads to increased prevalence of diffusion-weighted MRI defined hyperintense ischaemic lesions... Read More about Does tranexamic acid lead to changes in MRI-measures of brain tissue health in patients with spontaneous intracerebral haemorrhage? An MRI sub-study nested within the double-blind randomised controlled TICH-2 trial.

A systematic review and meta-analysis of the in vivo haemodynamic effects of ?9-Tetrahydrocannabinol (2018)
Journal Article
Sultan, S. R., Millar, S. A., O’Sullivan, S. E., & England, T. J. (2018). A systematic review and meta-analysis of the in vivo haemodynamic effects of Δ9-Tetrahydrocannabinol. Pharmaceuticals, 11(1), Article 13. https://doi.org/10.3390/ph11010013

?9-Tetrahydrocannabinol (THC) has complex effects on the cardiovascular system. We aimed to systematically review studies of THC and haemodynamic alterations. PubMed, Medline, and EMBASE were searched for relevant studies. Changes in blood pressure (... Read More about A systematic review and meta-analysis of the in vivo haemodynamic effects of ?9-Tetrahydrocannabinol.

Antiplatelet therapy with aspirin, clopidogrel, and dipyridamole versus clopidogrel alone or aspirin and dipyridamole in patients with acute cerebral ischaemia (TARDIS): a randomised, open-label, phase 3 superiority trial (2017)
Journal Article
Bath, P. M., Christensen, L. M., Woodhouse, L. J., Bentsen, L., Appleton, J. P., Krarup Hansen, C., …Farren, P. (2018). Antiplatelet therapy with aspirin, clopidogrel, and dipyridamole versus clopidogrel alone or aspirin and dipyridamole in patients with acute cerebral ischaemia (TARDIS): a randomised, open-label, phase 3 superiority trial. Lancet, 391(10123), 850-859. https://doi.org/10.1016/S0140-6736%2817%2932849-0

Background: Intensive antiplatelet therapy with three agents might be more effective than guideline treatment for preventing recurrent events in patients with acute cerebral ischaemia. We aimed to compare the safety and efficacy of intensive antiplat... Read More about Antiplatelet therapy with aspirin, clopidogrel, and dipyridamole versus clopidogrel alone or aspirin and dipyridamole in patients with acute cerebral ischaemia (TARDIS): a randomised, open-label, phase 3 superiority trial.

Osteocalcin, vascular calcification, and atherosclerosis: a systematic review and meta-analysis (2017)
Journal Article
Millar, S. A., Patel, H., Anderson, S. I., England, T. J., & O'Sullivan, S. (2017). Osteocalcin, vascular calcification, and atherosclerosis: a systematic review and meta-analysis. Frontiers in Endocrinology, 8, Article 183. https://doi.org/10.3389/fendo.2017.00183

Background: Osteocalcin (OC) is an intriguing hormone, concomitantly being the most abundant non-collagenous peptide found in the mineralized matrix of bone, and expanding the endocrine function of the skeleton with far reaching extra-osseous effects... Read More about Osteocalcin, vascular calcification, and atherosclerosis: a systematic review and meta-analysis.

Remote assessment of platelet function in patients with acute stroke or transient ischaemic attack (2017)
Journal Article
Bath, P. M., May, J., Flaherty, K., Woodhouse, L. J., Dovlatova, N., Fox, S. C., …TARDIS Investigators. (2017). Remote assessment of platelet function in patients with acute stroke or transient ischaemic attack. Stroke Research and Treatment, 2017, Article 7365684. https://doi.org/10.1155/2017/7365684

Background: Antiplatelets reduce recurrence after cerebral ischaemia. The international TARDIS trial assessed the safety and efficacy of intensive (combined aspirin, dipyridamole and clopidogrel) versus guideline (aspirin and dipyridamole, or clopido... Read More about Remote assessment of platelet function in patients with acute stroke or transient ischaemic attack.

Remote Ischaemic Conditioning after Stroke Trial (RECAST): a pilot randomised placebo controlled phase II trial in acute ischaemic stroke (ISRCTN 86672015) (2017)
Journal Article
England, T. J., Hedstrom, A., O'Sullivan, S., Donnelly, R., Barrett, D. A., Sarmad, S., …Bath, P. M. (2017). Remote Ischaemic Conditioning after Stroke Trial (RECAST): a pilot randomised placebo controlled phase II trial in acute ischaemic stroke (ISRCTN 86672015). Stroke, 48(5), https://doi.org/10.1161/STROKEAHA.116.016429

Background: Repeated episodes of limb ischaemia and reperfusion (remote ischaemic conditioning, RIC) may improve outcome after acute stroke. Methods: We performed a pilot blinded placebo-controlled trial in patients with acute ischaemic stroke, ra... Read More about Remote Ischaemic Conditioning after Stroke Trial (RECAST): a pilot randomised placebo controlled phase II trial in acute ischaemic stroke (ISRCTN 86672015).

A systematic review and meta-analysis of the haemodynamic effects of cannabidiol (2017)
Journal Article
Sultan, S. R., Millar, S. A., England, T. J., & O'Sullivan, S. (2017). A systematic review and meta-analysis of the haemodynamic effects of cannabidiol. Frontiers in Pharmacology, 8, Article 81. https://doi.org/10.3389/fphar.2017.00081

Despite cannabidiol (CBD) having numerous cardiovascular effects in vitro, its haemodynamic effects in vivo are unclear. Nonetheless, the clinical use of CBD (Epidiolex) is becoming more widespread. The aim of this systematic review was to establish... Read More about A systematic review and meta-analysis of the haemodynamic effects of cannabidiol.

Granulocyte-colony stimulating factor (G-CSF) for stroke: an individual patient data meta-analysis (2016)
Journal Article
England, T. J., Sprigg, N., Alasheev, A. M., Belkin, A. A., Kumar, A., Prasad, K., & Bath, P. M. (in press). Granulocyte-colony stimulating factor (G-CSF) for stroke: an individual patient data meta-analysis. Scientific Reports, 6, Article 36567. https://doi.org/10.1038/srep36567

Granulocyte colony stimulating factor (G-CSF) may enhance recovery from stroke through neuroprotective mechanisms if administered early, or neurorepair if given later. Several small trials suggest administration is safe but effects on efficacy are un... Read More about Granulocyte-colony stimulating factor (G-CSF) for stroke: an individual patient data meta-analysis.

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).

Behavioural Activation Therapy for Depression after Stroke (BEADS): a study protocol for a feasibility randomised controlled pilot trial of a psychological intervention for post-stroke depression (2016)
Journal Article
Thomas, S. A., Coates, E., das Nair, R., Lincoln, N. B., Cooper, C., Palmer, R., …Drummond, A. E. R. (2016). Behavioural Activation Therapy for Depression after Stroke (BEADS): a study protocol for a feasibility randomised controlled pilot trial of a psychological intervention for post-stroke depression. Pilot and Feasibility Studies, 2(1), 1-12. https://doi.org/10.1186/s40814-016-0072-0

Background There is currently insufficient evidence for the clinical and cost-effectiveness of psychological therapies for treating post-stroke depression. Methods/Design BEADS is a parallel group feasibility multicentre randomised controlled... Read More about Behavioural Activation Therapy for Depression after Stroke (BEADS): a study protocol for a feasibility randomised controlled pilot trial of a psychological intervention for post-stroke depression.

Cannabidiol protects an in vitro model of the blood brain barrier (BBB) from oxygen-glucose deprivation via PPAR? and 5-HT1A (2015)
Journal Article
Hind, W. H., England, T. J., & O'Sullivan, S. E. (2016). Cannabidiol protects an in vitro model of the blood brain barrier (BBB) from oxygen-glucose deprivation via PPAR? and 5-HT1A. British Journal of Pharmacology, 173(5), 815-825. doi:10.1111/bph.13368

Background and Purpose: In vivo and in vitro studies have demonstrated a protective effect of cannabidiol (CBD) in reducing infarct size in stroke models and against epithelial barrier damage in numerous disease models. We aimed to investigate whethe... Read More about Cannabidiol protects an in vitro model of the blood brain barrier (BBB) from oxygen-glucose deprivation via PPAR? and 5-HT1A.

Endocannabinoids modulate human blood-brain barrier permeability in vitro (2015)
Journal Article
Hind, W. H., Tufarelli, C., Neophytou, M., Anderson, S. I., England, T. J., & O'Sullivan, S. (2015). Endocannabinoids modulate human blood-brain barrier permeability in vitro. British Journal of Pharmacology, 172(12), 3015-3027. https://doi.org/10.1111/bph.13106

Background and Purpose Endocannabinoids alter permeability at various epithelial barriers, and cannabinoid receptors and endocannabinoid levels are elevated by stroke, with potential neuroprotective effects. We therefore explored the role of endoc... Read More about Endocannabinoids modulate human blood-brain barrier permeability in vitro.

Cannabinoids in experimental stroke: a systematic review and meta-analysis (2014)
Journal Article
England, T. J., Hind, W. H., Rasid, N. A., & O'Sullivan, S. (2015). Cannabinoids in experimental stroke: a systematic review and meta-analysis. Journal of Cerebral Blood Flow and Metabolism, 35(3), https://doi.org/10.1038/jcbfm.2014.218

Cannabinoids (CBs) show promise as neuroprotectants with some agents already licensed in humans for other conditions. We systematically reviewed CBs in preclinical stroke to guide further experimental protocols. We selected controlled studies assessi... Read More about Cannabinoids in experimental stroke: a systematic review and meta-analysis.

Granulocyte-colony stimulating factor in experimental stroke and its effects on infarct size and functional outcome: a systematic review (2009)
Journal Article
England, T. J., Gibson, C. L., & Bath, P. M. (2009). Granulocyte-colony stimulating factor in experimental stroke and its effects on infarct size and functional outcome: a systematic review. Brain Research, 62(1), 71-82. https://doi.org/10.1016/j.brainresrev.2009.09.002

Background: Granulocyte-colony stimulating factor (G-CSF) shows promise as a treatment for stroke. This systematic review assesses G-CSF in experimental ischaemic stroke. Methods: Relevant studies were identified with searches of Medline, Embase and... Read More about Granulocyte-colony stimulating factor in experimental stroke and its effects on infarct size and functional outcome: a systematic review.

Stem cells for enhancing recovery after stroke: a review (2009)
Journal Article
England, T. J., Martin, P., & Bath, P. M. (2009). Stem cells for enhancing recovery after stroke: a review. International Journal of Stroke, 4(2),

The potential application for stem cell therapy is vast, and development for use in ischaemic stroke is still in its infancy. Access to stem cells for research is contentious; however, stem cells are obtainable from both animal and human. Despite a... Read More about Stem cells for enhancing recovery after stroke: a review.

The relationship between baseline blood pressure and computed tomography findings in acute stroke: data from the Tinzaparin in Acute Ischaemic Stroke Trial (TAIST) (2009)
Journal Article
Sare, G. M., Bath, P. M., Gray, L. J., Moulin, T., Woimant, F., England, T., …Ringelstein, B. (2009). The relationship between baseline blood pressure and computed tomography findings in acute stroke: data from the Tinzaparin in Acute Ischaemic Stroke Trial (TAIST). Stroke, 40(1), https://doi.org/10.1161/STROKEAHA.108.526665

Background and Purpose—High blood pressure (BP) is present in 80% of patients with acute ischemic stroke and is independently associated with poor outcome. There are few data examining the relationship between admission BP and acute CT findings. M... Read More about The relationship between baseline blood pressure and computed tomography findings in acute stroke: data from the Tinzaparin in Acute Ischaemic Stroke Trial (TAIST).

A randomised controlled trial of triple antiplatelet therapy (Aspirin, Clopidogrel and Dipyridamole) in the secondary prevention of stroke: safety, tolerability and feasibility (2008)
Journal Article
Sprigg, N., Gray, L. J., England, T. J., Wilmot, M. R., Zhao, L., Sare, G. M., & Bath, P. M. (2008). A randomised controlled trial of triple antiplatelet therapy (Aspirin, Clopidogrel and Dipyridamole) in the secondary prevention of stroke: safety, tolerability and feasibility. PLoS ONE, 3(8),

Background: Aspirin, dipyridamole and clopidogrel are effective in secondary vascular prevention. Combination therapy with three antiplatelet agents might maximise the benefit of antiplatelet treatment in the secondary prevention of ischaemic stroke.... Read More about A randomised controlled trial of triple antiplatelet therapy (Aspirin, Clopidogrel and Dipyridamole) in the secondary prevention of stroke: safety, tolerability and feasibility.