#research and #fundraising platform combining Dynamic Review & #PrecisionFunding to make #med research efficient, inclusive & impactful. #BetterMedicineTogether
Calgary, AB
Joined January 2022
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🚨 TRIC-VCI - our pilot phase 2b trial of RIC in vascular cognitive impairment - is now out @alzdemjournals. Both twice & once daily RIC were safe & well tolerated. TNF-alpha and IL-1b levels declined over treatment, representing treatment-related markers doi.org/10.1002/trc2.70335
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Interesting results in @JAMA_current from CREST2 and CREST-H studies indicating that revascularization of asymptomatic carotid stenosis does not improve cognitive outcomes. Here is our accompanying editorial @VCI_EricSmith: jamanetwork.com/journals/jam… @DCNSNeuro @HotchkissBrain
🧵 In patients with severe asymptomatic #carotid artery stenosis, carotid revascularization with carotid artery stenting or carotid endarterectomy plus intensive medical management did not improve cognition vs intensive medical management alone over up to 4 years.
These findings indicate that cognitive benefit should not be presented as an expected outcome when discussing treatment options for this population.
ja.ma/4xwkzH9
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🚨 To improve the clinical relevance and completion of cognitive outcomes in studies of stroke, aging and cardiovascular diseases, we propose a new multidimensional and inclusive framework, Major Adverse Cognitive Events (MACE-Cog)! @DrRickSwartz ahajournals.org/doi/10.1161/… @CircAHA
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Futility trials seem feasible in Alzheimer disease-associated dementia, offering a faster, cost-effective alternative to traditional phase 2 randomized-controlled trials: hubs.la/Q04mSDFq0
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🚨Brain frailty is associated with worse outcomes after EVT for stroke. Here, we examine sex differences in the assoc of brain frailty with stroke outcomes in the ESCAPE-NA1 trial: sciencedirect.com/science/ar… @joachimfladt @mihill68 @mayank_G0 @DCNSNeuro @HotchkissBrain @OBrien_IPH
ALT Forest plots showing the association of brain frailty markers and sex with mRS 0–2 at 90 days. mRS, modified Rankin Scale; OR, odds ratio; CI, confidence interval; CC/IT, intercaudate distance to inner table width.
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🚨In this intl mixed-methods study led by postdoc Bogna Drozdowska, we found physicians encounter multifaceted uncertainty in determining Goals of Care for ppl with disability or dementia, which may contribute to adverse variability in stroke care @WilliamBetzner @RamkumarRaksha
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In a mixed method study, the investigators found that physicians encounter profound, multifaceted uncertainty in determining goals of care for patients with disability or dementia after #stroke. ahajrnls.org/4oIqUfE
ALT Graphic abstract in Drozdowska et al.
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🚨Cerebrovascular fibromuscular dysplasia (cFMD) is sometimes seen in patients with stroke/TIA - implications for future risk are unclear. In this cohort study, we found that cFMD was rare but assoc with substantial rates of recurrent stroke & mortality: strokejournal.org/article/S1…
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🚨The cost & complexity of phase 2 RCTs hinder development of promising AD treatments. We show that futility trials seem feasible in AD dementia, offering a faster cost-effective alternative to traditional ph2 RCTs. CDR-SB may be an optimal primary outcome neurology.org/doi/10.1212/WN…
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🚨In this detailed analysis of imaging features of small vessel disease (CSVD) in the national COMPASS-ND cohort, we show how CSVD burden contributes to poorer cognition across neurodegenerative conditions and cognitive profiles alz-journals.onlinelibrary.w… @alzdemjournals @ccna_ccnv
ALT Violin-box and stacked bar plots of cognitive outcomes as a function of CSVD scores showing worsening outcomes with higher CSVD burden. Raw unadjusted data are shown. Corresponding p values are shown in top right of plot and were extracted from linear or median quantile regression, as appropriate, adjusted for age, sex, and years of education. Better cognitive function is indicated by higher MoCA scores, lower CDR-SB scores, and higher neuropsychological composite z-scores. MoCA, Montreal Cognitive Assessment; CDR-SB, Clinical Dementia Rating-Sum of Boxes; CSVD, cerebral small vessel disease.
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🚨In the current landscape of mixed results from MeVO RCTs, we discuss how consideration of occlusion location, vessel size, and stroke severity can inform MeVO treatment decision-making in practice: ahajournals.org/doi/full/10.… @mayank_G0 @rondalun1 @johanna_ospel @SVINJournal
ALT A Graphic Abstract showing the importance of individualized, anatomy- and severity-based decision-making in MeVO stroke.
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Kudos to grad students @kadenlam8 @rahulnair320 and Anjana Menon @HotchkissBrain for representing our lab at the 2026 @VAST_training conference with their work on small vessel disease and vascular contributions to dementia!
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🚨In this study of nonstenotic carotid disease in Manitoba, we show the role of plaque thickness+ ulceration in⏫risk of recurrent stroke. Kudos to @nishita_singh3 for building this team from the ground up & to med student Kamran on the paper! @NimaKashani jvsvi.org/article/S2949-9127…
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Proud to share our latest in @JournalCJNS 🧠
Secondary analysis of the large phase 3 AcT Trial shows:
➡️Patients treated at PSCs achieve outcomes comparable to CSCs
➡️Despite longer DNTs times,
➡️Tenecteplase may facilitate faster transfer workflows in EVT candidate
OA link👇
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ICYMI: Check out the April episode of the #StrokeAlert Podcast. In this episode, host @NAsdaghi addresses these three questions.
ahajournals.org/do/10.1161/p…
@draravindganesh @dyavagal @NKrementzMD @CT_LP_MRI @LovepreetKalra @ShahabMarzoughi @IAlhabli @FouziBala @WilliamBetzner
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Faster Thrombolysis, Sharper Minds: Early Alteplase or Tenecteplase Linked to Better Poststroke Cognition
In this #BloggingStroke post, Anel Karisik discusses #Stroke article by Sujanthan et al. ahajournals.org/do/10.1161/b…
ALT Graphic abstract in Sujanthan et al.
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#ICYMI: Long-Term Risk of Stroke After TIA or Minor Stroke @FaizanK91 @HotchkissBrain @UCalgaryMed
@mihill68 @VYogendrakumar
@draravindganesh @SimonFaHo
@shanfernands @khanevski @rondalun1
#Systematic Review and Meta-analysis quantifies the relative contribution of prognostic factors to long-term stroke risk in patients with TIA or mini stroke, emphasizing the need for comprehensive assessment and individualized management. ahajrnls.org/3PjczsI
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Redefining the Cerebral Ischemic Core-Penumbra-Oligemia Continuum @StrokeAHA_ASA @johanna_ospel @draravindganesh @nishita_singh3 @AlmekhlafiMa @BroocksGabriel @Libero131087 @DGutierrez__V @NguyenThanhMD @VYogendrakumar @ZiniAndrea @KimBJstroke ahajournals.org/doi/10.1161/…
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🚨Our meta-analysis on trials of remote ischemic conditioning for mitigation of postoperative cognitive dysfunction and delirium, led by @kadenlam8, is now officially out in press in @journal_aps! @DCNSNeuro @HotchkissBrain
🧠Can RIC really protect the brain? New meta-analysis just dropped!
📊15 RCTs, ~3000 patients:
❌No reduction in POD
❌No reduction in POCD
⚠️Slight improvement in global cognition (MMSE/MoCA ↑)
🤔 Neuroprotection ≠ clinical benefit?
link.springer.com/article/10…
#POCD #Delirium
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"Time is clot" in #stroke? not in our post hoc analysis of AcT! Kudos to @Katha_MD! @FouziBala @brianhb @lucianacatanese @AlmekhlafiMa @draravindganesh @nishita_singh3 @DCNSNeuro strokejournal.org/article/S1…
