Profile Image

Professor Mark Parsons

National Heart Foundation Fellow and Brawn Career Development Fellow

School of Medicine and Public Health

Career Summary

Biography

Professor Mark Parsons is nationally and internationally recognised as an authority and research leader in acute stroke imaging.  Stroke is a disease of global significance both in terms of prevalence, impact and cost.  His original research is now translating into clinical practice and policy in the selection of acute stroke patients for reperfusion therapy and has the potential to change the landscape of acute stroke care and benefit many millions of patients across the world.  His influence and importance in the field of acute stroke imaging is evidenced by his invitations to speak at every international high profile stroke conference over the past five years.  His standing in the international stroke imaging community is evidenced by his membership of the Stroke Imaging Repository Consortium, and his leadership of the NHMRC funded partnership grant for the INternational Stroke Perfusion Imaging Registry (INSPIRE) He is on the executive of the STIR (STroke Imaging Repository) group which is setting the international agenda for stroke imaging research.  He has established Newcastle as a global reference centre and a Strategic Research Partner with Toshiba Medical Corporation and is a consultant to one of Australia’s leading imaging analysis software companies, APOLLO Medical Imaging. 

Due to a strong clinical focus, much of Mark’s imaging work ultimately revolves around improving patient selection for acute stroke therapy (particularly thrombolysis), as well as using imaging to guide stroke recovery rehabilitation approachesHe has conducted pioneering research on the application of advanced brain imaging in identifying potentially salvageable brain tissue following a strokeThese imaging technologies add new and exciting management options to the emergency assessment of stroke patients, improving patient selection for stroke thrombolysis treatment, and especially in safely extending the time window for treatment so a greater number of patients can be treated with better outcomesThis work has led to major publications in New England Journal of Medicine, Annals of Neurology, Neurology and StrokeHe has led two recent advances in acute stroke careThe first of these is the use of advanced brain imaging to identify potentially salvageable brain tissue – the ischaemic penumbraThe second is his recent discovery in a phase 2 trial that the new generation intravenous thrombolytic agent tenecteplase provides substantially better reperfusion and penumbral salvage than the current standard clot-dissolving agent, recombinant tissue plasminogen activator (rtPA, alteplase)This latter trial led to a landmark publication in the New England Journal of Medicine in 2012 and has made Newcastle an international focus of attention in acute stroke research He has now launched the NHMRC-funded phase 3 trial of Tenecteplase, a trial that could change the global landscape of acute stroke therapy Mark will lead this trial across 50 centres internationally. 

Research Expertise
Mark’s research program addresses two highly clinically relevant issues.  The first is the use of advanced brain imaging to identify potentially salvageable brain tissue following a stroke and extend the time window for reperfusion therapies.  The second is the testing of new drug therapies aimed at providing superior reperfusion and clinical outcomes over the current standard thrombolytics. 


Qualifications

  • Doctor of Philosophy, University of Melbourne
  • Bachelor of Medicine, University of Newcastle

Keywords

  • Bedside Teaching
  • • Cerebral blood flow and metabolism
  • • Cerebrovascular disease
  • • Clinical Tutor
  • • Functional brain imaging techniques in stroke
  • • Lecturer
  • • Neurological education
  • • Neurological rehabilitation and brain recovery
  • • Neurology Clinical Tutor

Languages

  • Mandarin (Fluent)

Fields of Research

Code Description Percentage
111799 Public Health and Health Services not elsewhere classified 25
110399 Clinical Sciences not elsewhere classified 30
110999 Neurosciences not elsewhere classified 45

Professional Experience

UON Appointment

Title Organisation / Department
Professor University of Newcastle
School of Medicine and Public Health
Australia

Academic appointment

Dates Title Organisation / Department
1/01/2014 - 31/12/2017 Heart Foundation Future Leader Fellowship National Heart Foundation of Australia
Australia
1/01/2014 - 31/12/2015 Gladys M Brawn Memorial Career Development Fellowship Gladys M Brawn Memorial Fellowship
Australia
22/01/2013 -  Deputy Head of School (Research) University of Newcastle - Faculty of Health and Medicine, School of Medicine and Public Health
Australia
1/03/2010 - 1/02/2014 Fellow ARC

ARC - Discovery - Future Fellowships

University of Newcastle
School of Medicine and Public Health
Australia
22/09/2008 - 31/12/2015 Director, Stroke Research Program The University of Newcastle
Australia
1/01/2006 -  Chairman Hunter and New England Area Human Research Ethics Committee
Australia
22/01/2003 -  Honorary Research Fellow The Florey Institute of Neuroscience and Mental Health
Australia

Professional appointment

Dates Title Organisation / Department
1/01/2016 -  Director, Priority Research Centre for Stroke and Traumatic Brain Injury University of Newcastle
28/09/2013 -  President Stroke Society of Australasia
Australia
1/01/2013 -  Director Acute Stroke Service, John Hunter Hospital
Australia
22/01/2009 -  Senior Staff Specialist John Hunter Hospital, Newcastle
Department of Neurology
Australia
22/01/2003 - 31/12/2008 Staff Specialist John Hunter Hospital, Newcastle
Department of Neurology
Australia
22/01/2003 -  Honorary Neurologist Royal Melbourne Hospital
Australia

Awards

Award

Year Award
2015 Hunter New England Health Quality Awards, Translational Research Category
Hunter New England Local Health District
2014 Director’s Award for Mid-Career Research
Hunter Medical Research Institute (HMRI)
2012 Alumni Medal Winner
The University of Newcastle
2011 Researcher of the Year
Faculty of Health, University of Newcastle
2008 Leonard Cox Award
Australian and New Zealand Association of Neurologists (ANZAN)
2007 CT Publication of the Year
Philips Healthcare
2007 Early Career Researcher of the Year
Hunter Medical Research Institute (HMRI)
2004 Award for Excellence in Brain and Mental Health Research
Hunter Medical Research Institute (HMRI)
2001 Young Investigator Award
Stroke Society of Australasia
2000 Cleveland Young Investigator Award
Royal Melbourne Hospital

Invitations

Keynote Speaker

Year Title / Rationale
2014 Imaging of Pathophysiology in Acute Stroke
2014 Acute Stroke Imaging
2013 Update on acute stroke treatment and imaging
2013 Imaging of collaterals
2013 Teneceteplase versus Alteplase for Stroke Thrombolysis Evaluation (TASTE)
2013 The need for routine advanced imaging in acute stroke patients
2013 How to design and conduct phase III clinical trial
2013 Thrombolysis: present and future
2013 How to design and conduct phase II clinical trial, focusing on the thrombolysis or acute stroke trial
2013 Acute recanalization treatment should be based on imaging, not time
2013 Acute Stroke
2013 Standardization of core and penumbral assessment
2012 Advanced imaging in acute stroke
2012 Imaging in Acute Stroke
2012 Selection of patients for acute therapy with advanced imaging
2012 Tenecteplase trial results
2012 Optimising thrombolytic reperfusion with collaterals
2012 New thrombolytic agents
2012 How to design stroke trials to extend the therapeutic window
2012 The INternational Stroke Perfusion Imaging Registry (INSPIRE)
2012 The Australian Stroke Trials Network China Office
2012 Movement Disorders
2012 Tenecetplase versus Alteplase: An imaging based efficacy study
2012 New Thrombolytic treatments for Acute Stroke
2012 Neuroimaging in Acute Stroke
2012 Pre-Hospital Stroke Assessment
2012 Neuroimaging in acute stroke
2011 Advanced CT imaging in Stroke
2011 Acute Stroke Imaging
2011 Acute management of TIA
2011 Imaging of acute stroke
2011 Neuroimaging case studies
2011 Imaging of Acute Stroke
2011 Secondary prevention of Stroke
2011 Non-contrast CT is not sufficient for the primary assessment of acute stroke
2011 Acute MRI should be performed in all TIA patients
2011 CT perfusion in stroke
2011 Imaging in TIA and Stroke
2011 CT Perfusion Imaging is the modality of choice for future acute stroke trials
2011 Advanced Imaging in Acute Stroke

Panel Participant

Year Title / Rationale
2012 Acute Stroke Trials Session
2011 Perfusion Imaging in Acute Stroke Debate

Participant

Year Title / Rationale
2006 Keynote Speaker on stroke imaging
Organisation: National and International meetings

Speaker

Year Title / Rationale
2013 Advanced imaging does not waste time <4.5 hours after stroke
Edit

Publications

For publications that are currently unpublished or in-press, details are shown in italics.


Chapter (4 outputs)

Year Citation Altmetrics Link
2014 Bivard A, Stanwell P, Parsons M, 'Stroke and Cerebral Ischaemia', Magnetic Resonance Spectroscopy: Tools for Neuroscience Research and Emerging Clinical Applications, Academic Press, London, UK 183-195 (2014) [B2]
Co-authors Peter Stanwell
2006 Parsons MW, Davis SM, 'The Therapeutic Impact of MRI in Acute Stroke', Magnetic Resonance Imaging in Ischemic Stroke, Springer, Berlin 23-40 (2006) [B1]
2002 Parsons MW, 'MRI and Other Neuroimaging for Subcortical Stroke', , Oxford Medical Publications (2002) [B1]
2002 Parsons MW, 'Clinical role of echoplanar MRI in stroke', , Cambridge Press (2002) [B1]
Show 1 more chapter

Journal article (201 outputs)

Year Citation Altmetrics Link
2016 Kawano H, Bivard A, Lin L, Spratt NJ, Miteff F, Parsons MW, Levi CR, 'Relationship Between Collateral Status, Contrast Transit, and Contrast Density in Acute Ischemic Stroke', Stroke, (2016)

© 2016 American Heart Association, Inc. BACKGROUND AND PURPOSE¿: Collateral circulation is recognized to influence the life expectancy of the ischemic penumbra in acute ischemic... [more]

© 2016 American Heart Association, Inc. BACKGROUND AND PURPOSE¿: Collateral circulation is recognized to influence the life expectancy of the ischemic penumbra in acute ischemic stroke. The best method to quantify collateral status on acute imaging is uncertain. We aimed to determine the relationship between visual collateral status, quantitative collateral assessments, baseline computed tomographic perfusion measures, and tissue outcomes on follow-up imaging. METHODS¿: Sixty-six consecutive patients with acute ischemic stroke clinically eligible for recanalization therapy and with M1 or M2 middle cerebral artery occlusion were evaluated. We compared the visual collateral scoring with measures of contrast peak time delay and contrast peak density. We also compared these measures for their ability to predict perfusion lesion and infarct core volumes, final infarct, and infarct growth. RESULTS¿: Shorter contrast peak time delay (P=0.041) and higher contrast peak density (P=0.002) were associated with good collateral status. Shorter contrast peak time delay correlated with higher contrast peak density (ß=-4.413; P=0.037). In logistic regression analysis after adjustment for age, sex, onset¿computed tomographic time, and occlusion site, higher contrast peak density was independently associated with good collateral status (P=0.009). Multiple regression analysis showed that higher contrast peak density was an independent predictor of smaller perfusion lesion volume (P=0.029), smaller ischemic core volume (P=0.044), smaller follow-up infarct volume (P=0.005), and smaller infarct growth volume (P=0.010). CONCLUSIONS¿: Visual collateral status, contrast peak density, and contrast peak time delay were inter-related, and good collateral status was strongly associated with contrast peak density. Contrast peak density in collateral vessel may be an important factor in tissue fate in acute ischemic stroke.

DOI 10.1161/STROKEAHA.115.011320
Co-authors Neil Spratt, Chris Levi
2016 Warach SJ, Luby M, Albers GW, Bammer R, Bivard A, Campbell BC, et al., 'Acute Stroke Imaging Research Roadmap III Imaging Selection and Outcomes in Acute Stroke Reperfusion Clinical Trials: Consensus Recommendations and Further Research Priorities.', Stroke, 47 1389-1398 (2016)
DOI 10.1161/STROKEAHA.115.012364
2016 Yu Y, Han Q, Ding X, Chen Q, Ye K, Zhang S, et al., 'Defining Core and Penumbra in Ischemic Stroke: A Voxel- and Volume-Based Analysis of Whole Brain CT Perfusion.', Sci Rep, 6 20932 (2016)
DOI 10.1038/srep20932
2016 Huang X, MacIsaac R, Thompson JL, Levin B, Buchsbaum R, Haley EC, et al., 'Tenecteplase versus alteplase in stroke thrombolysis: An individual patient data meta-analysis of randomized controlled trials.', Int J Stroke, (2016)
DOI 10.1177/1747493016641112
Co-authors Chris Levi
2016 Bivard A, Cheng X, Lin LT, Levi C, Spratt N, Kleinig T, et al., 'Global White Matter Hypoperfusion on CT Predicts Larger Infarcts and Hemorrhagic Transformation after Acute Ischemia.', CNS Neurosci Ther, 22 238-243 (2016)
DOI 10.1111/cns.12491
Co-authors Chris Levi, Neil Spratt
2016 Jolly TAD, Cooper PS, Wan Ahmadul Badwi SA, Phillips NA, Rennie JL, Levi CR, et al., 'Microstructural white matter changes mediate age-related cognitive decline on the Montreal Cognitive Assessment (MoCA)', Psychophysiology, 53 258-267 (2016)

© 2016 Society for Psychophysiological Research. Although the relationship between aging and cognitive decline is well established, there is substantial individual variability in... [more]

© 2016 Society for Psychophysiological Research. Although the relationship between aging and cognitive decline is well established, there is substantial individual variability in the degree of cognitive decline in older adults. The present study investigates whether variability in cognitive performance in community-dwelling older adults is related to the presence of whole brain or tract-specific changes in white matter microstructure. Specifically, we examine whether age-related decline in performance on the Montreal Cognitive Assessment (MoCA), a cognitive screening tool, is mediated by the white matter microstructural decline. We also examine if this relationship is driven by the presence of cardiovascular risk factors or variability in cerebral arterial pulsatility, an index of cardiovascular risk. Sixty-nine participants (aged 43-87) completed behavioral and MRI testing including T1 structural, T2-weighted FLAIR, and diffusion-weighted imaging (DWI) sequences. Measures of white matter microstructure were calculated using diffusion tensor imaging analyses on the DWI sequence. Multiple linear regression revealed that MoCA scores were predicted by radial diffusivity (RaD) of white matter beyond age or other cerebral measures. While increasing age and arterial pulsatility were associated with increasing RaD, these factors did not mediate the relationship between total white matter RaD and MoCA. Further, the relationship between MoCA and RaD was specific to participants who reported at least one cardiovascular risk factor. These findings highlight the importance of cardiovascular risk factors in the presentation of cognitive decline in old age. Further work is needed to establish whether medical or lifestyle management of these risk factors can prevent or reverse cognitive decline in old age.

DOI 10.1111/psyp.12565
Co-authors Chris Levi, Frini Karayanidis, Pat Michie
2016 Bhaskar S, Stanwell P, Bivard A, Spratt N, Walker R, Kitsos GH, et al., 'The influence of initial stroke severity on the likelihood of unfavourable clinical outcome and death at 90 days following acute ischemic stroke: A tertiary hospital stroke register study', Neurology India, In press (2016)
Co-authors Neil Spratt, John Attia, Chris Levi, Peter Stanwell
2016 Lin L, Bivard A, Krishnamurthy V, Levi CR, Parsons MW, 'Whole-Brain CT Perfusion to Quantify Acute Ischemic Penumbra and Core.', Radiology, 150319 (2016)
DOI 10.1148/radiol.2015150319
Co-authors Chris Levi
2016 Bhaskar S, Bivard A, Parsons M, Nilsson M, Attia JR, Stanwell P, Levi C, 'Delay of late-venous phase cortical vein filling in acute ischemic stroke patients: Associations with collateral status.', J Cereb Blood Flow Metab, (2016)
DOI 10.1177/0271678X16637611
Co-authors John Attia, Peter Stanwell, Chris Levi
2016 Kawano H, Levi C, Inatomi Y, Pagram H, Kerr E, Bivard A, et al., 'International benchmarking for acute thrombolytic therapy implementation in Australia and Japan.', J Clin Neurosci, (2016)
DOI 10.1016/j.jocn.2015.10.043
Co-authors Chris Levi, Neil Spratt
2016 Kernan WN, Viscoli CM, Furie KL, Young LH, Inzucchi SE, Gorman M, et al., 'Pioglitazone after Ischemic Stroke or Transient Ischemic Attack.', N Engl J Med, 374 1321-1331 (2016)
DOI 10.1056/NEJMoa1506930
Citations Scopus - 5
2016 Yassi N, Campbell BCV, Moffat BA, Steward C, Churilov L, Parsons MW, et al., 'Association between baseline peri-infarct magnetic resonance spectroscopy and regional white matter atrophy after stroke', Neuroradiology, 58 3-10 (2016)

© 2015, Springer-Verlag Berlin Heidelberg. Introduction: Cerebral atrophy after stroke is associated with poor functional outcome. The prediction and prevention of post-stroke br... [more]

© 2015, Springer-Verlag Berlin Heidelberg. Introduction: Cerebral atrophy after stroke is associated with poor functional outcome. The prediction and prevention of post-stroke brain atrophy could therefore represent a target for neurorestorative therapies. We investigated the associations between peri-infarct metabolite concentrations measured by quantitative MRS and brain volume change in the infarct hemisphere after stroke. Methods: Twenty patients with ischemic stroke were enrolled. Patients underwent 3T-MRI within 1¿week of onset, and at 1 and 3¿months. At the baseline scan, an MRS voxel was placed manually in the peri-infarct area and another in the corresponding contralateral region. Volumetric analysis of T1 images was performed using two automated processing packages. Changes in gray and white matter volume were assessed as percentage change between 1 and 3¿months. Results: Mean concentrations (institutional units) of N-acetylaspartic acid (NAA) (6.1 vs 7.0, p = 0.039), total creatine (Cr+PCr) (5.4 vs 5.8, p = 0.043), and inositol (4.5 vs 5.0, p = 0.014), were significantly lower in the peri-infarct region compared with the contralateral hemisphere. There was a significant correlation between baseline peri-infarct NAA and white matter volume change in the infarct hemisphere between 1 and 3¿months, with lower NAA being associated with subsequent white matter atrophy (Spearman¿s rho = 0.66, p = 0.010). The baseline concentration of Cr+PCr was also significantly correlated with white matter atrophy in the infarct hemisphere (Spearman¿s rho = 0.59, p = 0.027). Both of these associations were significant after adjustment for the false discovery rate and were validated using the secondary volumetric method. Conclusion: MRS may be useful in the prediction of white matter atrophy post-stroke and in the testing of novel neurorestorative therapies.

DOI 10.1007/s00234-015-1593-6
2016 Karayanidis F, Keuken MC, Wong A, Rennie JL, de Hollander G, Cooper PS, et al., 'The Age-ility Project (Phase 1): Structural and functional imaging and electrophysiological data repository', NeuroImage, 124 1137-1142 (2016)

© 2015 Published by Elsevier Inc. Our understanding of the complex interplay between structural and functional organisation of brain networks is being advanced by the development... [more]

© 2015 Published by Elsevier Inc. Our understanding of the complex interplay between structural and functional organisation of brain networks is being advanced by the development of novel multi-modal analyses approaches. The Age-ility Project (Phase 1) data repository offers open access to structural MRI, diffusion MRI, and resting-state fMRI scans, as well as resting-state EEG recorded from the same community participants (n = 131, 15-35 y, 66 male). Raw imaging and electrophysiological data as well as essential demographics are made available via the NITRC website. All data have been reviewed for artifacts using a rigorous quality control protocol and detailed case notes are provided.

DOI 10.1016/j.neuroimage.2015.04.047
Co-authors Frini Karayanidis, Pat Michie
2016 Bivard A, Yassi N, Krishnamurthy V, Lin L, Levi C, Spratt NJ, et al., 'A comprehensive analysis of metabolic changes in the salvaged penumbra', Neuroradiology, 58 409-415 (2016)

© 2016, Springer-Verlag Berlin Heidelberg. Introduction: We aimed to assess metabolite profiles in peri-infarct tissue with magnetic resonance spectroscopy (MRS) and correlate th... [more]

© 2016, Springer-Verlag Berlin Heidelberg. Introduction: We aimed to assess metabolite profiles in peri-infarct tissue with magnetic resonance spectroscopy (MRS) and correlate these with early and late clinical recovery. Methods: One hundred ten anterior circulation ischemic stroke patients presenting to hospital within 4.5¿h of symptom onset and treated with intravenous thrombolysis were studied. Patients underwent computer tomography perfusion (CTP) scanning and subsequently 3-T magnetic resonance imaging (MRI) 24¿h after stroke onset, including single-voxel, short-echo-time (30¿ms) MRS, and diffusion- and perfusion-weighted imaging (DWI and PWI). MRS voxels were placed in the peri-infarct region in reperfused penumbral tissue. A control voxel was placed in the contralateral homologous area. Results: The concentrations of total creatine (5.39 vs 5.85¿mM, p = 0.044) and N-acetylaspartic acid (NAA, 6.34 vs 7.13¿mM ± 1.57, p < 0.001) were reduced in peri-infarct tissue compared to the matching contralateral region. Baseline National Institutes of Health Stroke Score was correlated with glutamate concentration in the reperfused penumbra at 24¿h (r2 = 0.167, p = 0.017). Higher total creatine was associated with better neurological outcome at 24¿h (r2 = 0.242, p = 0.004). Lower peri-infarct glutamate was a stronger predictor of worse 3-month clinical outcome (area under the curve (AUC) 0.89, p < 0.001) than DWI volume (AUC = 0.79, p < 0.001). Conclusion: Decreased glutamate, creatine, and NAA concentrations are associated with poor neurological outcome at 24¿h and greater disability at 3¿months. The significant metabolic variation in salvaged tissue may potentially explain some of the variability seen in stroke recovery despite apparently successful reperfusion.

DOI 10.1007/s00234-015-1638-x
Co-authors Neil Spratt, Chris Levi
2015 Wang X, Arima H, Yang J, Zhang S, Wu G, Woodward M, et al., 'Mannitol and Outcome in Intracerebral Hemorrhage: Propensity Score and Multivariable Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial 2 Results', Stroke, 46 2762-2767 (2015) [C1]
DOI 10.1161/strokeaha.115.009357
2015 Wintermark M, Luby M, Bornstein NM, Demchuk A, Fiehler J, Kudo K, et al., 'International survey of acute Stroke imaging used to make revascularization treatment decisions', International Journal of Stroke, 10 759-762 (2015) [C1]

© 2015 World Stroke Organization. Background: To assess the differences across continental regions in terms of stroke imaging obtained for making acute revascularization therapy ... [more]

© 2015 World Stroke Organization. Background: To assess the differences across continental regions in terms of stroke imaging obtained for making acute revascularization therapy decisions, and to identify obstacles to participating in randomized trials involving multimodal imaging. Methods: STroke Imaging Repository (STIR) and Virtual International Stroke Trials Archive (VISTA)-Imaging circulated an online survey through its website, through the websites of national professional societies from multiple countries as well as through email distribution lists from STIR and the above mentioned societies. Results: We received responses from 223 centers (2 from Africa, 38 from Asia, 10 from Australia, 101 from Europe, 4 from Middle East, 55 from North America, 13 from South America). In combination, the sites surveyed administered acute revascularization therapy to a total of 25326 acute stroke patients in 2012. Seventy-three percent of these patients received intravenous (IV) tissue plasminogen activator (tPA), and 27%, endovascular therapy. Vascular imaging was routinely obtained in 79% (152/193) of sites for endovascular therapy decisions, and also as part of standard IV tPA treatment decisions at 46% (92/198) of sites. Modality, availability and use of acute vascular and perfusion imaging before revascularization varied substantially between geographical areas. The main obstacles to participate in randomized trials involving multimodal imaging included: mainly insufficient research support and staff (50%, 79/158) and infrequent use of multimodal imaging (27%, 43/158). Conclusion: There were significant variations among sites and geographical areas in terms of stroke imaging work-up used tomake decisions both for intravenous and endovascular revascularization. Clinical trials using advanced imaging as a selection tool for acute revascularization therapy should address the need for additional resources and technical support, and take into consideration the lack of routine use of such techniques in trial planning.

DOI 10.1111/ijs.12491
Citations Scopus - 1
2015 Heeley E, Anderson CS, Woodward M, Arima H, Robinson T, Stapf C, et al., 'Poor utility of grading scales in acute intracerebral hemorrhage: Results from the INTERACT2 trial', International Journal of Stroke, 10 1101-1107 (2015) [C1]
DOI 10.1111/ijs.12518
2015 Campbell BCV, Mitchell PJ, Kleinig TJ, Dewey HM, Churilov L, Yassi N, et al., 'Endovascular therapy for ischemic stroke with perfusion-imaging selection', New England Journal of Medicine, 372 1009-1018 (2015) [C1]

Copyright © 2015 Massachusetts Medical Society. Background: Trials of endovascular therapy for ischemic stroke have produced variable results. We conducted this study to test whe... [more]

Copyright © 2015 Massachusetts Medical Society. Background: Trials of endovascular therapy for ischemic stroke have produced variable results. We conducted this study to test whether more advanced imaging selection, recently developed devices, and earlier intervention improve outcomes. Methods: We randomly assigned patients with ischemic stroke who were receiving 0.9 mg of alteplase per kilogram of body weight less than 4.5 hours after the onset of ischemic stroke either to undergo endovascular thrombectomy with the Solitaire FR (Flow Restoration) stent retriever or to continue receiving alteplase alone. All the patients had occlusion of the internal carotid or middle cerebral artery and evidence of salvageable brain tissue and ischemic core of less than 70 ml on computed tomographic (CT) perfusion imaging. The coprimary outcomes were reperfusion at 24 hours and early neurologic improvement (.8-point reduction on the National Institutes of Health Stroke Scale or a score of 0 or 1 at day 3). Secondary outcomes included the functional score on the modified Rankin scale at 90 days. Results: The trial was stopped early because of efficacy after 70 patients had undergone randomization (35 patients in each group). The percentage of ischemic territory that had undergone reperfusion at 24 hours was greater in the endovascular-therapy group than in the alteplase-only group (median, 100% vs. 37%; P<0.001). Endovascular therapy, initiated at a median of 210 minutes after the onset of stroke, increased early neurologic improvement at 3 days (80% vs. 37%, P = 0.002) and improved the functional outcome at 90 days, with more patients achieving functional independence (score of 0 to 2 on the modified Rankin scale, 71% vs. 40%; P = 0.01). There were no significant differences in rates of death or symptomatic intracerebral hemorrhage. Conclusions: In patients with ischemic stroke with a proximal cerebral arterial occlusion and salvageable tissue on CT perfusion imaging, early thrombectomy with the Solitaire FR stent retriever, as compared with alteplase alone, improved reperfusion, early neurologic recovery, and functional outcome. (Funded by the Australian National Health and Medical Research Council and others; EXTEND-IA ClinicalTrials.gov number, NCT01492725, and Australian New Zealand Clinical Trials Registry number, ACTRN12611000969965.)

DOI 10.1056/NEJMoa1414792
Citations Scopus - 416Web of Science - 143
Co-authors John Attia, Chris Levi
2015 Ang TE, Bivard A, Levi C, Ma H, Hsu CY, Campbell B, et al., 'Multi-modal CT in acute stroke: Wait for a serum creatinine before giving intravenous contrast? No!', International Journal of Stroke, 10 1014-1017 (2015) [C1]

© 2015 World Stroke Organization. Background: Multi-modal CT (MMCT) to guide decision making for reperfusion treatment is increasingly used, but there remains a perceived risk of... [more]

© 2015 World Stroke Organization. Background: Multi-modal CT (MMCT) to guide decision making for reperfusion treatment is increasingly used, but there remains a perceived risk of contrast-induced nephropathy (CIN). At our center, MMCT is used empirically without waiting for serum-creatinine (sCR) or renal profiling. Aims: To determine the incidence of CIN, examine the risk factors predisposing to its development, and investigate its effects on clinical outcome in the acute stroke population. Methods: An institution-wide protocol was implemented for acute stroke presentations to have MMCT (100-150ml nonionic tri-iodinated contrast, perfusion CT and CT angiography) without waiting for serum-creatinine to minimize delays. Intravenous saline is routinely infused (80-125ml/h) for at least 24-h after MMCT. Serial creatinine levels were measured at baseline, risk period, and follow-up. Renal profiles and clinical progress were reviewed up to 90 days. Results: We analyzed 735 consecutive patients who had MMCT for the evaluation of acute ischemic or hemorrhagic stroke during the last five-years. A total of 623 patients met the inclusion criteria for analysis: 16 cases (2·6%) biochemically qualified as CIN; however, the risk period serum-creatinine for 15 of these cases was confounded by dehydration, urinary tract infection, or medications. None of the group had progression to chronic kidney disease or required dialysis. Conclusions: The incidence of CIN is low when MMCT is used routinely to assess acute stroke patients. In this population, CIN was a biochemical phenomenon that did not have clinical manifestations, cause chronic kidney disease, require dialysis, or negatively impact on 90-day mRS outcomes. Renal profiling and waiting for a baseline serum-creatinine are an unnecessary delay to emergency reperfusion treatment. International Journal of Stroke

DOI 10.1111/ijs.12605
Co-authors Chris Levi
2015 Marquez J, van Vliet P, Mcelduff P, Lagopoulos J, Parsons M, 'Transcranial direct current stimulation (tDCS): Does it have merit in stroke rehabilitation? A systematic review', International Journal of Stroke, 10 306-316 (2015) [C1]

© 2013 World Stroke Organization. Transcranial direct current stimulation has been gaining increasing interest as a potential therapeutic treatment in stroke recovery. We perform... [more]

© 2013 World Stroke Organization. Transcranial direct current stimulation has been gaining increasing interest as a potential therapeutic treatment in stroke recovery. We performed a systematic review with meta-analysis of randomized controlled trials to collate the available evidence in adults with residual motor impairments as a result of stroke. The primary outcome was change in motor function or impairment as a result of transcranial direct current stimulation, using any reported electrode montage, with or without adjunct physical therapy. The search yielded 15 relevant studies comprising 315 subjects. Compared with sham, cortical stimulation did not produce statistically significant improvements in motor performance when measured immediately after the intervention (anodal stimulation: facilitation of the affected cortex: standardized mean difference=0·05, P=0·71; cathodal stimulation: inhibition of the nonaffected cortex: standardized mean difference=0·39, P=0·08; bihemispheric stimulation: standardized mean difference=0·24, P=0·39). When the data were analyzed according to stroke characteristics, statistically significant improvements were evident for those with chronic stroke (standardized mean difference=0·45, P=0·01) and subjects with mild-to-moderate stroke impairments (standardized mean difference=0·37, P=0·02). Transcranial direct current stimulation is likely to be effective in enhancing motor performance in the short term when applied selectively to patients with stroke. Given the range of stimulation variables and heterogeneous nature of stroke, this modality is still experimental and further research is required to determine its clinical merit in stroke rehabilitation.

DOI 10.1111/ijs.12169
Citations Scopus - 10Web of Science - 2
Co-authors Patrick Mcelduff, Paulette Vanvliet
2015 Campbell BCV, Yassi N, Ma H, Sharma G, Salinas S, Churilov L, et al., 'Imaging selection in ischemic stroke: Feasibility of automated CT-perfusion analysis', International Journal of Stroke, 10 51-54 (2015) [C1]

© 2014 World Stroke Organization. Background: Advanced imaging may refine patient selection for ischemic stroke treatment but delays to acquire and process the imaging have limit... [more]

© 2014 World Stroke Organization. Background: Advanced imaging may refine patient selection for ischemic stroke treatment but delays to acquire and process the imaging have limited implementation. Aims: We examined the feasibility of imaging selection in clinical practice using fully automated software in the EXTEND trial program. Methods: CTP and perfusion-diffusion MRI data were processed using fully-automated software to generate a yes/no 'mismatch' classification that determined eligibility for trial therapies. The technical failure/mismatch classification error rate and time to image and treat with CT vs. MR-based selection were examined. Results: In a consecutive series of 776 patients from five sites over six-months the technical failure rate of CTP acquisition/processing (uninterpretable maps) was 3·4% (26/776, 95%CI 2·2-4·9%). Mismatch classification was overruled by expert review in an additional 9·0% (70/776, 95%CI 7·1-11·3%) due to artifactual 'perfusion lesion'. In 154 consecutive patients at one site, median additional time to acquire CTP after non-contrast CT was 6·5min. Subsequent RAPID processing time varied from 3-10min across 20 trial centers (median 5min 20s). In the EXTEND trial, door-to-needle times in patients randomized on the basis of CTP (n=47) were median 78min shorter than MRI-selected (n=16) patients (P<0·001). Conclusions: Automated CTP-based mismatch selection is rapid, robust in clinical practice, and associated with faster treatment decisions than MRI. This technological advance has the potential to improve the standardization and reproducibility of interpretation of advanced imaging and extend use to practice settings beyond highly specialized academic centers.

DOI 10.1111/ijs.12381
Citations Scopus - 11Web of Science - 5
2015 Campbell BCV, Parsons MW, 'Repeat brain imaging after thrombolysis is important', International Journal of Stroke, 10 E18-E18 (2015) [C3]
DOI 10.1111/ijs.12412
2015 Cereda CW, Christensen S, Campbell BC, Mishra NK, Mlynash M, Levi C, et al., 'A benchmarking tool to evaluate computer tomography perfusion infarct core predictions against a DWI standard.', J Cereb Blood Flow Metab, (2015)
DOI 10.1177/0271678X15610586
Co-authors Chris Levi
2015 Zhang S, Tang H, Yu YN, Yan SQ, Parsons MW, Lou M, 'Optimal Magnetic Resonance Perfusion Thresholds Identifying Ischemic Penumbra and Infarct Core: A Chinese Population-based Study', CNS Neuroscience and Therapeutics, 21 289-295 (2015) [C1]

© 2014 John Wiley & Sons Ltd. Summary: Aims: To validate whether the optimal magnetic resonance perfusion (MRP) thresholds for ischemic penumbra and infarct core, between voxel a... [more]

© 2014 John Wiley & Sons Ltd. Summary: Aims: To validate whether the optimal magnetic resonance perfusion (MRP) thresholds for ischemic penumbra and infarct core, between voxel and volume-based analysis, are varied greatly among Chinese acute ischemic stroke patients. Materials and methods: Acute ischemic stroke patients receiving intravenous thrombolysis within 6 h of onset that obtained acute and 24-h MRP were reviewed. Patients with either no reperfusion (<30% reperfusion at 24 h) or successful reperfusion (>70% reperfusion at 24 h) were enrolled to investigate the ischemic penumbra and infarct core, respectively. The final infarct was assessed on 24-h diffusion-weighted imaging (DWI), which was retrospectively matched to the baseline perfusion-weighted imaging (PWI) images by volume or voxel-based analysis. The optimal thresholds that determined by each approach were compared. Results: From June 2009 to Jan 2014, of 50 patients enrolled, 19 patients achieved no reperfusion, and 20 patients reperfused at 24 h. In patients with no reperfusion, Tmax > 6 seconds was proved of the best agreement with the final infarct in both volumetric analysis (ratio: 1.05, 95% limits of agreement:-0.23 to 2.33, P < 0.001) and voxel-by-voxel analysis (sensitivity: 72.3%, specificity: 74.3%). In patients with reperfusion, rMTT>225% (ratio:2.4, 95% limits of agreement: -6.5 to 11.4, P < 0.001) was found of the best volumetric agreement with the final infarct, while Tmax > 5.6 seconds (sensitivity: 76.8%, specificity: 70.3%) performed most accurately in voxel-based analysis. Conclusion: Among Chinese acute stroke patients, volume of Tmax >6 seconds may precisely target ischemic penumbra tissue as good as voxel-based analysis performed, albeit no concordant MRP parameter is found to accurately predict infarct core because reperfusion occurred within 24 h after thrombolysis fails to restrain the infarct growth.

DOI 10.1111/cns.12367
2015 Hubbard IJ, Carey LM, Budd TW, Parsons MW, 'Reorganizing therapy: Changing the clinical approach to upper limb recovery post-stroke', Occupational Therapy International, 22 28-35 (2015) [C1]

© 2014 John Wiley & Sons, Ltd. Stroke is the leading cause of adult disability, and as a consequence, most therapists will provide health care to patients with stroke during thei... [more]

© 2014 John Wiley & Sons, Ltd. Stroke is the leading cause of adult disability, and as a consequence, most therapists will provide health care to patients with stroke during their professional careers. An increasing number of studies are investigating the association between upper limb recovery and changes in brain activation patterns following stroke. In this review, we explore the translational implications of this research for health professionals working in stroke recovery. We argue that in light of the most recent evidence, therapists should consider how best to take full advantage of the brain's natural ability to reorganize, when prescribing and applying interventions to those with a stroke-affected upper limb. The authors propose that stroke is a brain-based problem that needs a brain-based solution. This review addresses two topics, anticipating recovery and maximizing recovery. It proposes five practice-ready recommendations that are based on the evidence reviewed. The over-riding aim of this review and discussion is to challenge therapists to reconsider the health care they prescribe and apply to people with a stroke-affected upper limb.

DOI 10.1002/oti.1381
Co-authors Bill Budd, Isobel Hubbard
2015 Sales M, Quain D, Lasserson D, Levi C, Oldmeadow C, Jiwa M, et al., 'Quality of referrals and guideline compliance for time to consultation at an acute neurovascular clinic', Journal of Stroke and Cerebrovascular Diseases, 24 874-880 (2015) [C1]

© 2015 by National Stroke Association. Background: The Age, Blood pressure, Clinical features, Duration of symptoms, Diabetes (ABCD2) score can be used to predict early recurrent... [more]

© 2015 by National Stroke Association. Background: The Age, Blood pressure, Clinical features, Duration of symptoms, Diabetes (ABCD2) score can be used to predict early recurrent stroke risk following Transient ischemic attack (TIA). Given that recurrent stroke risk can be as high as 20% in the first week, international guidelines recommend ''high-risk'' TIAs (ABCD2 .3) be seen by specialist services such as dedicated acute neurovascular clinics within 24 hours. The goal of this study was to examine the associations of both quality of referrals to a specialist acute clinic and of "guideline congruence" of time-to-clinic consultation after TIA/minor stroke. We hypothesized highquality referrals containing key clinical elements would be associated with greater guideline congruence. Methods: A retrospective analysis of referrals to an acute neurovascular clinic within a tertiary care hospital of consecutive patients with TIA/minor stroke. Quality of general practitioner and emergency department referrals was defined on the basis of information content enabling ABCD2-based risk stratification by the clinic triage service. Time-to-clinic consultation was used to define "guideline congruence." Results: Referrals of 148 consecutive eligible patients were reviewed. Sixty-six percent of cases were subsequently neurologist-diagnosed as TIA or minor stroke. Seventy-nine percent were referred by general practitioners. Fifty-three percent of referrals were of high quality, but quality was not associated with guideline congruence. Of the high-risk patients, only 3.6% were seen at the clinic within 24 hours of index event and 31.3% within 24 hours of referral. Conclusions: Current guidelines are pathophysiologically logical and evidence based, but are difficult to implement. Improving quality of primary-secondary communication by improved referral quality is unlikely to improve guideline compliance. Alternative strategies are needed to reduce recurrent stroke risk after TIA/minor stroke.

DOI 10.1016/j.jstrokecerebrovasdis.2014.12.004
Co-authors Chris Levi, Parker Magin, Christopher Oldmeadow
2015 Yassi N, Campbell BCV, Moffat BA, Steward C, Churilov L, Parsons MW, et al., 'Know your tools¿concordance of different methods for measuring brain volume change after ischemic stroke', Neuroradiology, 57 685-695 (2015) [C1]

© 2015, Springer-Verlag Berlin Heidelberg. Introduction: Longitudinal brain volume changes have been investigated in a number of cerebral disorders as a surrogate marker of clini... [more]

© 2015, Springer-Verlag Berlin Heidelberg. Introduction: Longitudinal brain volume changes have been investigated in a number of cerebral disorders as a surrogate marker of clinical outcome. In stroke, unique methodological challenges are posed by dynamic structural changes occurring after onset, particularly those relating to the infarct lesion. We aimed to evaluate agreement between different analysis methods for the measurement of post-stroke brain volume change, and to explore technical challenges inherent to these methods. Methods: Fifteen patients with anterior circulation stroke underwent magnetic resonance imaging within 1¿week of onset and at 1 and 3¿months. Whole-brain as well as grey- and white-matter volume were estimated separately using both an intensity-based and a surface watershed-based algorithm. In the case of the intensity-based algorithm, the analysis was also performed with and without exclusion of the infarct lesion. Due to the effects of peri-infarct edema at the baseline scan, longitudinal volume change was measured as percentage change between the 1 and 3-month scans. Intra-class and concordance correlation coefficients were used to assess agreement between the different analysis methods. Reduced major axis regression was used to inspect the nature of bias between measurements. Results: Overall agreement between methods was modest with strong disagreement between some techniques. Measurements were variably impacted by procedures performed to account for infarct lesions. Conclusions: Improvements in volumetric methods and consensus between methodologies employed in different studies are necessary in order to increase the validity of conclusions derived from post-stroke cerebral volumetric studies. Readers should be aware of the potential impact of different methods on study conclusions.

DOI 10.1007/s00234-015-1522-8
Citations Scopus - 1
2015 Huang Y, Sharma VK, Robinson T, Lindley RI, Chen X, Kim JS, et al., 'Rationale, design, and progress of the ENhanced Control of Hypertension ANd Thrombolysis strokE stuDy (ENCHANTED) trial: An international multicenter 2×2 quasi-factorial randomized controlled trial of low- vs. standard-dose rt-PA and early intensive vs. guideline-recommended blood pressure lowering in patients with acute ischaemic stroke eligible for thrombolysis treatment', International Journal of Stroke, 10 778-788 (2015) [C3]

© 2015 World Stroke Organization. Rationale: Controversy exists over the optimal dose of intravenous (iv) recombinant tissue plasminogen activator (rt-PA) and degree of blood pre... [more]

© 2015 World Stroke Organization. Rationale: Controversy exists over the optimal dose of intravenous (iv) recombinant tissue plasminogen activator (rt-PA) and degree of blood pressure (BP) control in acute ischaemic stroke (AIS). Asian studies suggest low-dose (0·6mg/kg) is more efficacious than standard-dose (0·9mg/kg) iv rt-PA, and guidelines recommend reducing systolic BP to <185mmHg before and <180mmHg after use of iv rt-PA, despite observational studies indicating better outcomes at much lower (<140mmHg) systolic BP levels in this patient group. Aims: The study aims to assess in thrombolysis-eligible AIS patients whether: (i) low-dose (0·6mg/kg body weight; maximum 60mg) iv rt-PA has non-inferior efficacy and lower risk of symptomatic intracerebral haemorrhage (sICH) compared to standard-dose (0·9mg/kg body weight; maximum 90mg) iv rt-PA; and (ii) early intensive BP lowering (systolic target 130-140mmHg) has superior efficacy and lower risk of any ICH compared to guideline-recommended BP control (systolic target<180mmHg). Design: The ENhanced Control of Hypertension And Thrombolysis strokE stuDy (ENCHANTED) trial is an independent,2×2 quasi-factorial, active-comparison, prospective, randomized, open blinded endpoint (PROBE), clinical trial that is evaluating Arm [A] 'rt-PA dose' and/or Arm [B] 'BP control', using central Internet randomization and data collection in patients fulfilling local criteria for thrombolysis and clinician uncertainty over the study treatments. The treatment arms will be analyzed separately. Study outcomes: The primary study outcome in both trial Arms is death or disability according to the modified Rankin scale (mRS, scores 2-6) assessed at 90 days. Secondary outcomes include sICH, any ICH, a shift ('improvement') in function across mRS scores, separately on death and disability, early neurological deterioration, recurrent major vascular events, health-related quality of life, length of hospital stay, need for permanent residential care, and health care costs. Results: Following launch of the trial in February 2012, the study has recruited more than 2500 patients across a global network of approximately 100 sites in 15 countries. The required sample sizes are 3300 for Arm [A] and 2300 for Arm [B], which will provide >90% power to detect non-inferiority of low-dose iv rt-PA and superiority of intensive BP lowering on the primary clinical outcome, respectively. Conclusions: Low-dose iv rt-PA and early intensive BP lowering could provide more affordable and safer use of thrombolysis treatment for patients with AIS worldwide.

DOI 10.1111/ijs.12486
Citations Scopus - 8Web of Science - 1
Co-authors Chris Levi
2015 Bivard A, Levi C, Krishnamurthy V, McElduff P, Miteff F, Spratt NJ, et al., 'Perfusion computed tomography to assist decision making for stroke thrombolysis', Brain, 138 1919-1931 (2015) [C1]

© 2015 The Author. The use of perfusion imaging to guide selection of patients for stroke thrombolysis remains controversial because of lack of supportive phase three clinical tr... [more]

© 2015 The Author. The use of perfusion imaging to guide selection of patients for stroke thrombolysis remains controversial because of lack of supportive phase three clinical trial evidence. We aimed to measure the outcomes for patients treated with intravenous recombinant tissue plasminogen activator (rtPA) at a comprehensive stroke care facility where perfusion computed tomography was routinely used for thrombolysis eligibility decision assistance. Our overall hypothesis was that patients with 'target' mismatch on perfusion computed tomography would have improved outcomes with rtPA. This was a prospective cohort study of consecutive ischaemic stroke patients who fulfilled standard clinical/non-contrast computed tomography eligibility criteria for treatment with intravenous rtPA, but for whom perfusion computed tomography was used to guide the final treatment decision. The 'real-time' perfusion computed tomography assessments were qualitative; a large perfusion computed tomography ischaemic core, or lack of significant perfusion lesion-core mismatch were considered relative exclusion criteria for thrombolysis. Specific volumetric perfusion computed tomography criteria were not used for the treatment decision. The primary analysis compared 3-month modified Rankin Scale in treated versus untreated patients after 'off-line' (post-treatment) quantitative volumetric perfusion computed tomography eligibility assessment based on presence or absence of 'target' perfusion lesion-core mismatch (mismatch ratio >1.8 and volume >15 ml, core <70 ml). In a second analysis, we compared outcomes of the perfusion computed tomography-selected rtPA-treated patients to an Australian historical cohort of non-contrast computed tomography-selected rtPA-treated patients. Of 635 patients with acute ischaemic stroke eligible for rtPA by standard criteria, thrombolysis was given to 366 patients, with 269 excluded based on visual real-time perfusion computed tomography assessment. After off-line quantitative perfusion computed tomography classification: 253 treated patients and 83 untreated patients had 'target' mismatch, 56 treated and 31 untreated patients had a large ischaemic core, and 57 treated and 155 untreated patients had no target mismatch. In the primary analysis, only in the target mismatch subgroup did rtPA-treated patients have significantly better outcomes (odds ratio for 3-month, modified Rankin Scale 0-2 = 13.8, P < 0.001). With respect to the perfusion computed tomography selected rtPA-treated patients (n = 366) versus the clinical/non-contrast computed tomography selected rtPA-treated patients (n = 396), the perfusion computed tomography selected group had higher adjusted odds of excellent outcome (modified Rankin Scale 0-1 odds ratio 1.59, P = 0.009) and lower mortality (odds ratio 0.56, P = 0.021). Although based on observational data sets, our analyses provide support for the hypothesis that perfusion computed tomography improves the identification of patients likely to respond to thrombolysis, and also those in whom natural history may be difficult to modify with treatment.

DOI 10.1093/brain/awv071
Citations Scopus - 2
Co-authors Chris Levi, Neil Spratt, Patrick Mcelduff
2015 Yassi N, Churilov L, Campbell BCV, Sharma G, Bammer R, Desmond PM, et al., 'The association between lesion location and functional outcome after ischemic stroke', International Journal of Stroke, 10 1270-1276 (2015) [C1]

© 2015 World Stroke Organization. Background: Infarct location has a critical effect on patient outcome after ischemic stroke, but the study of its role independent of overall le... [more]

© 2015 World Stroke Organization. Background: Infarct location has a critical effect on patient outcome after ischemic stroke, but the study of its role independent of overall lesion volume is challenging. We performed a retrospective, hypothesis-generating study of the effect of infarct location on three-month functional outcome in a pooled analysis of the EPITHET and DEFUSE studies.Methods: Posttreatment MRI diffusion lesions were manually segmented and transformed into standard-space. A novel composite brain atlas derived from three standard brain atlases and encompassing 132 cortical and sub-cortical structures was used to segment the transformed lesion into different brain regions, and calculate the percentage of each region infarcted. Classification and Regression Tree (CART) analysis was performed to determine the important regions in each hemisphere associated with nonfavorable outcome at day 90 (modified Rankin score [mRS] > 1).Results: Overall, 152 patients (82 left hemisphere) were included. Median diffusion lesion volume was 37·0 ml, and median baseline National Institutes of Health Stroke Score was 13. In the left hemisphere, the strongest determinants of nonfavorable outcome were infarction of the uncinate fasciculus, followed by precuneus, angular gyrus and total diffusion lesion volume. In the right hemisphere, the strongest determinants of nonfavorable outcome were infarction of the parietal lobe followed by the putamen.Conclusions: Assessment of infarct location using CART demonstrates regional characteristics associated with poor outcome. Prognostically important locations include limbic, default-mode and language areas in the left hemisphere, and visuospatial and motor regions in the right hemisphere.

DOI 10.1111/ijs.12537
Citations Scopus - 1
2015 Aviv RI, Parsons M, Bivard A, Jahromi B, Wintermark M, 'Multiphase CT angiography: A poor man's perfusion CT', Radiology, 277 922-923 (2015) [C3]
DOI 10.1148/radiol.2015150820
2015 Liebeskind DS, Parsons MW, Wintermark M, Selim M, Molina CA, Lev MH, Gonzalez RG, 'Computed Tomography Perfusion in Acute Ischemic Stroke Is It Ready for Prime Time?', STROKE, 46 2364-2367 (2015) [C3]
DOI 10.1161/STROKEAHA.115.009179
2015 Yassi N, Malpas CB, Campbell BCV, Moffat B, Steward C, Parsons MW, et al., 'Contralesional thalamic surface atrophy and functional disconnection 3 months after ischemic stroke', Cerebrovascular Diseases, 39 232-241 (2015) [C1]

© 2015 S. Karger AG, Basel. Background: Remote structural and functional changes have been previously described after stroke and may have an impact on clinical outcome. We aimed ... [more]

© 2015 S. Karger AG, Basel. Background: Remote structural and functional changes have been previously described after stroke and may have an impact on clinical outcome. We aimed to use multimodal MRI to investigate contralesional subcortical structural and functional changes 3 months after anterior circulation ischemic stroke. Methods: Fifteen patients with acute ischemic stroke had multimodal MRI imaging (including high resolution structural T1-MPRAGE and resting state fMRI) within 1 week of onset and at 1 and 3 months. Seven healthy controls of similar age group were also imaged at a single time point. Contralesional subcortical structural volume was assessed using an automated segmentation algorithm in FMRIB's Integrated Registration and Segmentation Tool (FIRST). Functional connectivity changes were assessed using the intrinsic connectivity contrast (ICC), which was calculated using the functional connectivity toolbox for correlated and anticorrelated networks (Conn). Results: Contralesional thalamic volume in the stroke patients was significantly reduced at 3 months compared to baseline (median change -2.1%, interquartile range [IQR] -3.4-0.4, p = 0.047), with the predominant areas demonstrating atrophy geometrically appearing to be the superior and inferior surface. The difference in volume between the contralesional thalamus at baseline (mean 6.41 ml, standard deviation [SD] 0.6 ml) and the mean volume of the 2 thalami in controls (mean 7.22 ml, SD 1.1 ml) was not statistically significant. The degree of longitudinal thalamic atrophy in patients was correlated with baseline stroke severity with more severe strokes being associated with a greater degree of atrophy (Spearman's rho -0.54, p = 0.037). There was no significant difference between baseline contralesional thalamic ICC in patients and control thalamic ICC. However, in patients, there was a significant linear reduction in the mean ICC of the contralesional thalamus over the imaging time points (p = 0.041), indicating reduced connectivity to the remainder of the brain. Conclusions: These findings highlight the importance of remote brain areas, such as the contralesional thalamus, in stroke recovery. Similar methods have the potential to be used in the prediction of stroke outcome or as imaging biomarkers of stroke recovery.

DOI 10.1159/000381105
Citations Scopus - 2
2015 Mcleod DD, Parsons MW, Hood R, Hiles B, Allen J, Mccann SK, et al., 'Perfusion computed tomography thresholds defining ischemic penumbra and infarct core: Studies in a rat stroke model', International Journal of Stroke, 10 553-559 (2015) [C1]

© 2013 World Stroke Organization. Background: Perfusion computed tomography is becoming more widely used as a clinical imaging tool to predict potentially salvageable tissue (isc... [more]

© 2013 World Stroke Organization. Background: Perfusion computed tomography is becoming more widely used as a clinical imaging tool to predict potentially salvageable tissue (ischemic penumbra) after ischemic stroke and guide reperfusion therapies. Aims: The study aims to determine whether there are important changes in perfusion computed tomography thresholds defining ischemic penumbra and infarct core over time following stroke. Methods: Permanent middle cerebral artery occlusion was performed in adult outbred Wistar rats (n=6) and serial perfusion computed tomography scans were taken every 30 mins for 2h. To define infarction thresholds at 1h and 2h post-stroke, separate groups of rats underwent 1h (n=6) and 2h (n=6) of middle cerebral artery occlusion followed by reperfusion. Infarct volumes were defined by histology at 24h. Co-registration with perfusion computed tomography maps (cerebral blood flow, cerebral blood volume, and mean transit time) permitted pixel-based analysis of thresholds defining infarction, using receiver operating characteristic curves. Results: Relative cerebral blood flow was the perfusion computed tomography parameter that most accurately predicted penumbra (area under the curve=0·698) and also infarct core (area under the curve=0·750). A relative cerebral blood flow threshold of <75% of mean contralateral cerebral blood flow most accurately predicted penumbral tissue at 0·5h (area under the curve=0·660), 1h (area under the curve=0·659), 1·5h (area under the curve=0·636), and 2h (area under the curve=0·664) after stroke onset. A relative cerebral blood flow threshold of <55% of mean contralateral most accurately predicted infarct core at 1h (area under the curve=0·765) and at 2h (area under the curve=0·689) after middle cerebral artery occlusion. Conclusions: The data provide perfusion computed tomography defined relative cerebral blood flow thresholds for infarct core and ischemic penumbra within the first two hours after experimental stroke in rats. These thresholds were shown to be stable to define the volume of infarct core and penumbra within this time window.

DOI 10.1111/ijs.12147
Citations Scopus - 4
Co-authors Damian Mcleod, Chris Levi, Neil Spratt, Lucy Murtha
2015 Tu HTH, Campbell BCV, Christensen S, Desmond PM, De Silva DA, Parsons MW, et al., 'Worse stroke outcome in atrial fibrillation is explained by more severe hypoperfusion, infarct growth, and hemorrhagic transformation', International Journal of Stroke, 10 534-540 (2015) [C1]
DOI 10.1111/ijs.12007
Citations Scopus - 3
2015 Marquez J, Conley A, Karayanidis F, Lagopoulos J, Parsons M, 'Anodal direct current stimulation in the healthy aged: Effects determined by the hemisphere stimulated', Restorative Neurology and Neuroscience, 33 509-519 (2015) [C1]

© 2015 - IOS Press and the authors. All rights reserved. Purpose: Research popularity and scope for the application of transcranial direct current stimulation have been steadily ... [more]

© 2015 - IOS Press and the authors. All rights reserved. Purpose: Research popularity and scope for the application of transcranial direct current stimulation have been steadily increasing yet many fundamental questions remain unanswered. We sought to determine if anodal stimulation of either hemisphere leads to improved performance of the contralateral hand and/or altered function of the ipsilateral hand, or affects movement preparation, in older subjects. Method: In this cross-over, double blind, sham controlled study, 34 healthy aged participants (age range 40-86) were randomised to receive 20 minutes of stimulation to either the dominant or non-dominant motor cortex. The primary outcome was functional performance of both upper limbs measured by the Jebsen Taylor Test and hand grip strength. Additionally, we measured motor preparation using electrophysiological (EEG) recordings. Results: Anodal stimulation resulted in statistically significantly improved performance of the non-dominant hand (p < 0.01) but did not produce significant changes in the dominant hand on any measure (p > 0.05). This effect occurred irrespective of the hemisphere stimulated. Stimulation did not produce significant effects on measures of gross function, grip strength, reaction times, or electrophysiological measures on the EEG data. Conclusion: This study demonstrated that the hemispheres respond differently to anodal stimulation and the response appears to be task specific but not mediated by age.

DOI 10.3233/RNN-140490
Citations Scopus - 1
Co-authors Frini Karayanidis
2015 Wardlaw JM, von Kummer R, Carpenter T, Parsons M, Lindley RI, Cohen G, et al., 'Protocol for the perfusion and angiography imaging sub-study of the Third International Stroke Trial (IST-3) of alteplase treatment within six-hours of acute ischemic stroke', International Journal of Stroke, 10 956-968 (2015) [C3]

© 2012 The Authors. Rationale: Intravenous thrombolysis with recombinant tissue Plasminogen Activator improves outcomes in patients treated early after stroke but at the risk of ... [more]

© 2012 The Authors. Rationale: Intravenous thrombolysis with recombinant tissue Plasminogen Activator improves outcomes in patients treated early after stroke but at the risk of causing intracranial hemorrhage. Restricting recombinant tissue Plasminogen Activator use to patients with evidence of still salvageable tissue, or with definite arterial occlusion, might help reduce risk, increase benefit and identify patients for treatment at late time windows. Aims: To determine if perfusion or angiographic imaging with computed tomography or magnetic resonance help identify patients who are more likely to benefit from recombinant tissue Plasminogen Activator in the context of a large multicenter randomized trial of recombinant tissue Plasminogen Activator given within six-hours of onset of acute ischemic stroke, the Third International Stroke Trial. Design: Third International Stroke Trial is a prospective multicenter randomized controlled trial testing recombinant tissue Plasminogen Activator (0·9mg/kg, maximum dose 90mg) started up to six-hours after onset of acute ischemic stroke, in patients with no clear indication for or contraindication to recombinant tissue Plasminogen Activator. Brain imaging (computed tomography or magnetic resonance) was mandatory pre-randomization to exclude hemorrhage. Scans were read centrally, blinded to treatment and clinical information. In centers where perfusion and/or angiography imaging were used routinely in stroke, these images were also collected centrally, processed and assessed using validated visual scores and computational measures. Study outcomes: The primary outcome in Third International Stroke Trial is alive and independent (Oxford Handicap Score 0-2) at 6 months; secondary outcomes are symptomatic and fatal intracranial hemorrhage, early and late death. The perfusion and angiography study additionally will examine interactions between recombinant tissue Plasminogen Activator and clinical outcomes, infarct growth and recanalization in the presence or absence of perfusion lesions and/or arterial occlusion at presentation. The study is registered ISRCTN25765518.

DOI 10.1111/j.1747-4949.2012.00946.x
2015 Carey LM, Crewther S, Salvado O, Lindén T, Connelly A, Wilson W, et al., 'STroke imAging pRevention and treatment (START): A longitudinal stroke cohort study: Clinical trials protocol', International Journal of Stroke, 10 636-644 (2015) [C3]

© 2013 World Stroke Organization. Rationale: Stroke and poststroke depression are common and have a profound and ongoing impact on an individual's quality of life. However, relia... [more]

© 2013 World Stroke Organization. Rationale: Stroke and poststroke depression are common and have a profound and ongoing impact on an individual's quality of life. However, reliable biological correlates of poststroke depression and functional outcome have not been well established in humans. Aims: Our aim is to identify biological factors, molecular and imaging, associated with poststroke depression and recovery that may be used to guide more targeted interventions. Design: In a longitudinal cohort study of 200 stroke survivors, the START - STroke imAging pRevention and Treatment cohort, we will examine the relationship between gene expression, regulator proteins, depression, and functional outcome. Stroke survivors will be investigated at baseline, 24h, three-days, three-months, and 12 months poststroke for blood-based biological associates and at days 3-7, three-months, and 12 months for depression and functional outcomes. A sub-group (n=100), the PrePARE: Prediction and Prevention to Achieve optimal Recovery Endpoints after stroke cohort, will also be investigated for functional and structural changes in putative depression-related brain networks and for additional cognition and activity participation outcomes. Stroke severity, diet, and lifestyle factors that may influence depression will be monitored. The impact of depression on stroke outcomes and participation in previous life activities will be quantified.

DOI 10.1111/ijs.12190
Citations Scopus - 2Web of Science - 1
2015 Hubbard IJ, Carey LM, Budd TW, Levi C, McElduff P, Hudson S, et al., 'A Randomized Controlled Trial of the Effect of Early Upper-Limb Training on Stroke Recovery and Brain Activation', Neurorehabilitation and Neural Repair, 29 703-713 (2015) [C1]

© 2015 American Society of Neurorehabilitation. Background. Upper-limb (UL) dysfunction is experienced by up to 75% of patients poststroke. The greatest potential for functional ... [more]

© 2015 American Society of Neurorehabilitation. Background. Upper-limb (UL) dysfunction is experienced by up to 75% of patients poststroke. The greatest potential for functional improvement is in the first month. Following reperfusion, evidence indicates that neuroplasticity is the mechanism that supports this recovery. Objective. This preliminary study hypothesized increased activation of putative motor areas in those receiving intensive, task-specific UL training in the first month poststroke compared with those receiving standard care. Methods. This was a single-blinded, longitudinal, randomized controlled trial in adult patients with an acute, first-ever ischemic stroke; 23 participants were randomized to standard care (n = 12) or an additional 30 hours of task-specific UL training in the first month poststroke beginning week 1. Patients were assessed at 1 week, 1 month, and 3 months poststroke. The primary outcome was change in brain activation as measured by functional magnetic resonance imaging. Results. When compared with the standard-care group, the intensive-training group had increased brain activation in the anterior cingulate and ipsilesional supplementary motor areas and a greater reduction in the extent of activation (P =.02) in the contralesional cerebellum. Intensive training was associated with a smaller deviation from mean recovery at 1 month (Pr>F0 = 0.017) and 3 months (Pr>F = 0.006), indicating more consistent and predictable improvement in motor outcomes. Conclusion. Early, more-intensive, UL training was associated with greater changes in activation in putative motor (supplementary motor area and cerebellum) and attention (anterior cingulate) regions, providing support for the role of these regions and functions in early recovery poststroke.

DOI 10.1177/1545968314562647
Citations Scopus - 1Web of Science - 1
Co-authors Isobel Hubbard, Bill Budd, Patrick Mcelduff, Chris Levi
2015 Conley AC, Marquez J, Parsons MW, Fulham WR, Heathcote A, Karayanidis F, 'Anodal tDCS over the motor cortex on prepared and unprepared responses in young adults', PLoS ONE, 10 (2015) [C1]

© 2015 Conley et al. Anodal transcranial direct current stimulation (tDCS) over the primary motor cortex (M1) has been proposed as a possible therapeutic rehabilitation technique... [more]

© 2015 Conley et al. Anodal transcranial direct current stimulation (tDCS) over the primary motor cortex (M1) has been proposed as a possible therapeutic rehabilitation technique for motor impairment. However, despite extensive investigation into the effects of anodal tDCS on motor output, there is little information on how anodal tDCS affects response processes. In this study, we used a cued go/nogo task with both directional and non-directional cues to assess the effects of anodal tDCS over the dominant (left) primary motor cortex on prepared and unprepared motor responses. Three experiments explored whether the effectiveness of tDCS varied with timing between stimulation and test. Healthy, right-handed young adults participated in a double-blind randomised controlled design with crossover of anodal tDCS and sham stimulation. In Experiment 1, twenty-four healthy young adults received anodal tDCS over dominant M1 at least 40 mins before task performance. In Experiment 2, eight participants received anodal tDCS directly before task performance. In Experiment 3, twenty participants received anodal tDCS during task performance. In all three experiments, participants responded faster to directional compared to non-directional cues and with their right hand. However, anodal tDCS had no effect on go/nogo task performance at any stimulation - test interval. Bayesian analysis confirmed that anodal stimulation had no effect on response speed. We conclude that anodal tDCS over M1 does not improve response speed of prepared or unprepared responses of young adults in a go/nogo task.

DOI 10.1371/journal.pone.0124509
Co-authors Andrew Heathcote, Frini Karayanidis
2015 Arima H, Heeley E, Delcourt C, Hirakawa Y, Wang X, Woodward M, et al., 'Optimal achieved blood pressure in acute intracerebral hemorrhage: INTERACT2', Neurology, 84 464-471 (2015) [C1]
DOI 10.1212/WNL.0000000000001205
Citations Scopus - 8Web of Science - 3
2014 Paul CL, Levi CR, D'Este CA, Parsons MW, Bladin CF, Lindley RI, et al., 'Thrombolysis ImPlementation in Stroke (TIPS): Evaluating the effectiveness of a strategy to increase the adoption of best evidence practice - protocol for a cluster randomised controlled trial in acute stroke care', Implementation Science, 9 (2014) [C3]

Background: Stroke is a leading cause of death and disability internationally. One of the three effective interventions in the acute phase of stroke care is thrombolytic therapy w... [more]

Background: Stroke is a leading cause of death and disability internationally. One of the three effective interventions in the acute phase of stroke care is thrombolytic therapy with tissue plasminogen activator (tPA), if given within 4.5 hours of onset to appropriate cases of ischaemic stroke.Objectives: To test the effectiveness of a multi-component multidisciplinary collaborative approach compared to usual care as a strategy for increasing thrombolysis rates for all stroke patients at intervention hospitals, while maintaining accepted benchmarks for low rates of intracranial haemorrhage and high rates of functional outcomes for both groups at three months.Methods and design: A cluster randomised controlled trial of 20 hospitals across 3 Australian states with 2 groups: multi- component multidisciplinary collaborative intervention as the experimental group and usual care as the control group. The intervention is based on behavioural theory and analysis of the steps, roles and barriers relating to rapid assessment for thrombolysis eligibility; it involves a comprehensive range of strategies addressing individual-level and system-level change at each site. The primary outcome is the difference in tPA rates between the two groups post-intervention. The secondary outcome is the proportion of tPA treated patients in both groups with good functional outcomes (modified Rankin Score (mRS <2) and the proportion with intracranial haemorrhage (mRS =2), compared to international benchmarks.Discussion: TIPS will trial a comprehensive, multi-component and multidisciplinary collaborative approach to improving thrombolysis rates at multiple sites. The trial has the potential to identify methods for optimal care which can be implemented for stroke patients during the acute phase. Study findings will include barriers and solutions to effective thrombolysis implementation and trial outcomes will be published whether significant or not.Trial registration: Australian New Zealand Clinical Trials Registry: ACTRN12613000939796. © 2014 Paul et al.; licensee BioMed Central Ltd.

DOI 10.1186/1748-5908-9-38
Citations Scopus - 2Web of Science - 1
Co-authors Chris Levi, Catherine Deste, Frans Henskens, Rob Sanson-Fisher, John Attia, Chris Paul
2014 Hubbard IJ, Evans M, McMullen-Roach S, Marquez J, Parsons MW, 'Five years of acute stroke unit care: Comparing ASU and non-ASU admissions and allied health involvement', Stroke Research and Treatment, (2014) [C1]

Background. Evidence indicates that Stroke Units decrease mortality and morbidity. An Acute Stroke Unit (ASU) provides specialised, hyperacute care and thrombolysis. John Hunter H... [more]

Background. Evidence indicates that Stroke Units decrease mortality and morbidity. An Acute Stroke Unit (ASU) provides specialised, hyperacute care and thrombolysis. John Hunter Hospital, Australia, admits 500 stroke patients each year and has a 4-bed ASU. Aims. This study investigated hospital admissions over a 5-year period of all strokes patients and of all patients admitted to the 4-bed ASU and the involvement of allied health professionals. Methods. The study retrospectively audited 5-year data from all stroke patients admitted to John Hunter Hospital (n=2525) and from nonstroke patients admitted to the ASU (n=826). The study's primary outcomes were admission rates, length of stay (days), and allied health involvement. Results. Over 5 years, 47% of stroke patients were admitted to the ASU. More male stroke patients were admitted to the ASU (chi2=5.81; P=0.016). There was a trend over time towards parity between the number of stroke and nonstroke patients admitted to the ASU. When compared to those admitted elsewhere, ASU stroke patients had a longer length of stay (z=-8.233; P=0.0000) and were more likely to receive allied healthcare. Conclusion. This is the first study to report 5 years of ASU admissions. Acute Stroke Units may benefit from a review of the healthcare provided to all stroke patients. The trends over time with respect to the utilisation of the John Hunter Hospitall's ASU have resulted in a review of the hospitall's Stroke Unit and allied healthcare. © 2014 Isobel J. Hubbard et al.

DOI 10.1155/2014/798258
Co-authors Isobel Hubbard
2014 Meretoja A, Churilov L, Campbell BCV, Aviv RI, Yassi N, Barras C, et al., 'The Spot sign and Tranexamic acid On Preventing ICH growth - AUStralasia Trial (STOP-AUST): Protocol of a phase II randomized, placebo-controlled, double-blind, multicenter trial', International Journal of Stroke, 9 519-524 (2014) [C3]

Rationale: No evidence-based acute therapies exist for intracerebral hemorrhage. Intracerebral hemorrhage growth is an important determinant of patient outcome. Tranexamic acid is... [more]

Rationale: No evidence-based acute therapies exist for intracerebral hemorrhage. Intracerebral hemorrhage growth is an important determinant of patient outcome. Tranexamic acid is known to reduce hemorrhage in other conditions. Aim: The study aims to test the hypothesis that intracerebral hemorrhage patients selected with computed tomography angiography contrast extravasation 'spot sign' will have lower rates of hematoma growth when treated with intravenous tranexamic acid within 4·5-hours of stroke onset compared with placebo. Design: The Spot sign and Tranexamic acid On Preventing ICH growth - AUStralasia Trial is a multicenter, prospective, 1:1 randomized, double-blind, placebo-controlled, investigator-initiated, academic Phase II trial. Intracerebral hemorrhage patients fulfilling clinical criteria (e.g. Glasgow Coma Scale >7, intracerebral hemorrhage volume <70ml, no identified secondary cause of intracerebral hemorrhage, no thrombotic events within the previous 12 months, no planned surgery) and demonstrating contrast extravasation on computed tomography angiography will receive either intravenous tranexamic acid 1g 10-min bolus followed by 1g eight-hour infusion or placebo. A second computed tomography will be performed at 24 ± 3 hours to evaluate intracerebral hemorrhage growth and patients followed up for three-months. Study outcomes: The primary outcome measure is presence of intracerebral hemorrhage growth by 24 ± 3 hours, defined as either >33% or >6ml increase from baseline, and will be adjusted for baseline intracerebral hemorrhage volume. Secondary outcome measures include growth as a continuous measure, thromboembolic events, and the three-month modified Rankin Scale score. Discussion: This is the first trial to evaluate the efficacy of tranexamic acid in intracerebral hemorrhage patients selected based on an imaging biomarker of high likelihood of hematoma growth. The trial is registered as NCT01702636. © 2013 World Stroke Organization.

DOI 10.1111/ijs.12132
Citations Scopus - 7Web of Science - 4
Co-authors Chris Levi, Neil Spratt
2014 Viscoli CM, Brass LM, Carolei A, Conwit R, Ford GA, Furie KL, et al., 'Pioglitazone for secondary prevention after ischemic stroke and transient ischemic attack: Rationale and design of the Insulin Resistance Intervention after Stroke Trial', American Heart Journal, 168 823-829.e6 (2014) [C3]

© 2014 Elsevier Inc. All rights reserved. Background: Recurrent vascular events remain a major source of morbidity and mortality after stroke or transient ischemic attack (TIA). ... [more]

© 2014 Elsevier Inc. All rights reserved. Background: Recurrent vascular events remain a major source of morbidity and mortality after stroke or transient ischemic attack (TIA). The IRIS Trial is evaluating an approach to secondary prevention based on the established association between insulin resistance and increased risk for ischemic vascular events. Specifically, IRIS will test the effectiveness of pioglitazone, an insulin-sensitizing drug of the thiazolidinedione class, for reducing the risk for stroke and myocardial infarction (MI) among insulin resistant, nondiabetic patients with a recent ischemic stroke or TIA. Design: Eligible patients for IRIS must have had insulin resistance defined by a Homeostasis Model Assessment-Insulin Resistance >3.0 without meeting criteria for diabetes. Within 6 months of the index stroke or TIA, patients were randomly assigned to pioglitazone (titrated from 15 to 45 mg/d) or matching placebo and followed for up to 5 years. The primary outcome is time to stroke or MI. Secondary outcomes include time to stroke alone, acute coronary syndrome, diabetes, cognitive decline, and all-cause mortality. Enrollment of 3,876 participants from 179 sites in 7 countries was completed in January 2013. Participant follow-up will continue until July 2015. Summary: The IRIS Trial will determine whether treatment with pioglitazone improves cardiovascular outcomes of nondiabetic, insulin-resistant patients with stroke or TIA. Results are expected in early 2016.

DOI 10.1016/j.ahj.2014.07.016
Citations Scopus - 3
2014 Goyal M, Almekhlafi M, Menon B, Hill M, Fargen K, Parsons M, et al., 'Challenges of Acute Endovascular Stroke Trials', STROKE, 45 3116-3122 (2014) [C3]
DOI 10.1161/STROKEAHA.114.006288
Citations Web of Science - 9
2014 Bivard A, Krishnamurthy V, Stanwell P, Levi C, Spratt NJ, Davis S, Parsons M, 'Arterial Spin Labeling Versus Bolus-Tracking Perfusion in Hyperacute Stroke', Stroke, 45 127-133 (2014) [C1]
DOI 10.1161/STROKEAHA.113.003218
Citations Scopus - 7Web of Science - 5
Co-authors Chris Levi, Peter Stanwell, Neil Spratt
2014 Lin L, Bivard A, Levi CR, Parsons MW, 'Comparison of computed tomographic and magnetic resonance perfusion measurements in acute ischemic stroke: Back-to-back quantitative analysis', Stroke, 45 1727-1732 (2014) [C1]

Background and Purpose: Magnetic resonance perfusion (MRP) and computed tomographic perfusion (CTP) are being increasingly applied in acute stroke trials and clinical practice, ye... [more]

Background and Purpose: Magnetic resonance perfusion (MRP) and computed tomographic perfusion (CTP) are being increasingly applied in acute stroke trials and clinical practice, yet the comparability of their perfusion values is not well validated. The aim of this study was to validate the comparability of CTP and MRP measures. METHODS-: A 3-step approach was used. Step 1 was a derivation step, where we analyzed 45 patients with acute ischemic stroke who had both CTP and MRP performed within 2 hours of each other and within 9 hours of stroke onset. In this step, we derived the optimal perfusion map with the least difference between MRP and CTP. In step 2, the optimal map was validated on whole-brain perfusion data of 15 patients. Step 3 was to apply the optimal perfusion map to define cross-modality reperfusion from acute CTP to 24-hour MRP in 45 patients and, in turn, to assess how accurately this predicted 3-month clinical outcome. RESULTS-: Among 8 different perfusion maps included in this study, time to peak of the residual function (Tmax) was the only one with a nonsignificant difference between CTP and MRP in delineating perfusion defects. This was validated on whole-brain perfusion data, showing high concordance of Tmax between the 2 modalities (concordance correlation coefficient of Lin, >0.91); the best concordance was at 6 s. At T max>6 s threshold, MRP and CTP reached substantial agreement in mismatch classification (¿ >0.61). Cross-modality reperfusion calculated by Tmax>6 s strongly predicted good functional outcome at 3 months (area under the curve, 0.979; P<0.05). CONCLUSIONS-: MRP and CTP can be used interchangeably if one uses Tmax measurement. © 2014 American Heart Association, Inc.

DOI 10.1161/STROKEAHA.114.005419
Citations Scopus - 7Web of Science - 4
Co-authors Chris Levi
2014 Bivard A, Levi C, Krishnamurthy V, Hislop-Jambrich J, Salazar P, Jackson B, et al., 'Defining acute ischemic stroke tissue pathophysiology with whole brain CT perfusion', JOURNAL OF NEURORADIOLOGY, 41 307-315 (2014) [C1]
DOI 10.1016/j.neurad.2013.11.006
Citations Scopus - 7Web of Science - 1
Co-authors Chris Levi
2014 Bivard A, Krishnamurthy V, Stanwell P, Yassi N, Spratt NJ, Nilsson M, et al., 'Spectroscopy of reperfused tissue after stroke reveals heightened metabolism in patients with good clinical outcomes', JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM, 34 1944-1950 (2014) [C1]
DOI 10.1038/jcbfm.2014.166
Citations Scopus - 3
Co-authors Neil Spratt, Peter Stanwell, Chris Levi
2014 Emberson J, Lees KR, Lyden P, Blackwell L, Albers G, Bluhmki E, et al., 'Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic stroke: a meta-analysis of individual patient data from randomised trials', LANCET, 384 1929-1935 (2014) [C1]
DOI 10.1016/S0140-6736(14)60584-5
Citations Scopus - 177Web of Science - 83
2014 Anderson C, Wu G, Yang J, Arima H, Heeley E, Delcourt C, et al., 'Mechanisms of effect of early intensive BP lowering treatment: Pooled analysis of INTERACT CT substudies', INTERNATIONAL JOURNAL OF STROKE, 9 17-18 (2014)
2014 Ang TE, Levi C, Ma HHK, Hsu CY, Campbell B, Parsons M, 'Multi-modal CT in acute stroke: Should we wait for a serum creatinine before giving IV contrast? No!', INTERNATIONAL JOURNAL OF STROKE, 9 24-25 (2014)
Citations Web of Science - 1
Co-authors Chris Levi
2014 Yassi N, Churilov L, Campbell B, Sharma G, Bammer R, Desmond PM, et al., 'Stroke location and lesion volume independently predict functional outcome after Stroke', INTERNATIONAL JOURNAL OF STROKE, 9 25-25 (2014)
2014 Chan E, Anderson C, Wang X, Arima H, Heeley E, Delcourt C, et al., 'Significance of intraventricular haemorrhage in acute intracerebral haemorrhage: INTERACT2 results', INTERNATIONAL JOURNAL OF STROKE, 9 26-26 (2014)
2014 Heeley E, Woodward M, Arima H, Delcourt C, Stapf C, Lavados P, et al., 'Usefulness of clinical grading scales in intracerebral haemorrhage: INTERACT2 experience', INTERNATIONAL JOURNAL OF STROKE, 9 42-42 (2014)
2014 Sewell C, Jordan L-A, Rudd J, Gray J, Wills J, Bulic T, et al., 'Implementation of a tele-thrombolysis service for acute stroke patients of the Manning Rural Referral Hospital: A quasi-experimental study', INTERNATIONAL JOURNAL OF STROKE, 9 44-44 (2014)
Co-authors Chris Levi
2014 Campbell B, Mitchell P, Yan B, Churilov L, Ma H, Parsons M, et al., 'EXtending the time for Thombolysis in Emergency Neurological Deficits - Intra-Arterial: The EXTEND-IA Trial', INTERNATIONAL JOURNAL OF STROKE, 9 46-47 (2014)
2014 Ma H, Campbell B, Parsons M, Christensen S, Connelly A, Churilov L, et al., 'EXtending the time for Thombolysis in Emergency Neurological Deficits - The EXTEND Trial', INTERNATIONAL JOURNAL OF STROKE, 9 47-47 (2014)
2014 Gunathilake R, Krishnamurthy V, Oldmeadow C, Kerr E, Padmakumar C, Attia J, et al., 'Relationships between age, other predictive variables, and the 90-day functional outcome after intravenous thrombolysis for acute ischemic stroke', AUSTRALASIAN JOURNAL ON AGEING, 33 19-19 (2014) [E3]
Co-authors John Attia, Chris Levi, Christopher Oldmeadow
2014 Spurdle AB, Couch FJ, Parsons MT, McGuffog L, Barrowdale D, Bolla MK, et al., 'Refined histopathological predictors of BRCA1 and BRCA2 mutation status: A large-scale analysis of breast cancer characteristics from the BCAC, CIMBA, and ENIGMA consortia', Breast Cancer Research, 16 3419 (2014) [C1]
DOI 10.1186/s13058-014-0474-y
Citations Scopus - 5
Co-authors Rodney Scott
2014 Campbell BCV, Mitchell PJ, Yan B, Parsons MW, Christensen S, Churilov L, et al., 'A multicenter, randomized, controlled study to investigate EXtending the time for Thrombolysis in Emergency Neurological Deficits with Intra-Arterial therapy (EXTEND-IA)', INTERNATIONAL JOURNAL OF STROKE, 9 126-132 (2014) [C3]
DOI 10.1111/ijs.12206
Citations Scopus - 24Web of Science - 12
Co-authors Chris Levi
2014 Picanço MR, Christensen S, Campbell BCV, Churilov L, Parsons MW, Desmond PM, et al., 'Reperfusion after 4·5 hours reduces infarct growth and improves clinical outcomes', International Journal of Stroke, 9 266-269 (2014) [C1]

Background: The currently proven time window for thrombolysis in ischemic stroke is 4·5h. Beyond this, the risks and benefits of thrombolysis are uncertain. Aims: To determine wh... [more]

Background: The currently proven time window for thrombolysis in ischemic stroke is 4·5h. Beyond this, the risks and benefits of thrombolysis are uncertain. Aims: To determine whether thrombolysis and reperfusion were beneficial after 4·5h, we examined clinical and radiological outcomes in patients treated with tissue plasminogen activator or placebo within 4·5-6h, using data from the Echoplanar Imaging Thrombolytic Evaluation Trial. Methods: In the Echoplanar Imaging Thrombolytic Evaluation Trial, ischemic stroke patients presenting three to six-hours after stroke onset were randomized to tissue plasminogen activator or placebo, without knowledge of magnetic resonance imaging results. This analysis was restricted to patients treated between 4·5 and 6h. The effect of tissue plasminogen activator and reperfusion on infarct growth between baseline diffusion-weighted imaging and day 90 T2 imaging was assessed, along with good neurological outcome (=8 point reduction or reaching 0-1 at 90 days on National Institutes of Health Stroke Scale) and functional outcome (modified Rankin scale). The effect of tissue plasminogen activator on reperfusion was also analyzed. Results: Sixty-nine patients were treated 4·5-6h after onset, and infarct growth was assessed in 63. Tissue plasminogen activator was associated with lower relative growth (94% vs. 168%, P=0·03) and a trend to lower absolute growth (-0·17ml versus 9·6ml, P=0·07). Reperfusion was increased in the tissue plasminogen activator group (58% versus 25%, P=0·03) and was associated with increased rates of good neurological (86% versus 28% P<0·001) and functional (modified Rankin scale 0-2 73% versus 34%, P=0·01) outcomes. Reperfusion was strongly associated with lower relative (80% versus 189%, P<0·001) and absolute (-2·5ml versus 40ml, P<0·001) infarct growth. Conclusions: Thrombolysis 4·5-6h after stroke onset reduced infarct growth and increased the rate of reperfusion, which was associated with good neurological and functional outcome. © 2013 World Stroke Organization.

DOI 10.1111/ijs.12209
Citations Scopus - 6Web of Science - 2
Co-authors Chris Levi
2014 Gunathilake R, Krishnamurthy V, Oldmeadow C, Kerr E, Padmakumar C, Attia J, et al., 'Relationships between age, other predictive variables, and the 90-day functional outcome after intravenous thrombolysis for acute ischemic stroke', International Journal of Stroke, 9 E36-E37 (2014) [O1]
DOI 10.1111/ijs.12347
Co-authors Chris Levi, Christopher Oldmeadow, John Attia
2014 Meretoja A, Keshtkaran M, Saver JL, Tatlisumak T, Parsons MW, Kaste M, et al., 'Stroke thrombolysis: Save a minute, save a day', Stroke, 45 1053-1058 (2014) [C1]

BACKGROUND AND PURPOSE - : Stroke thrombolysis is highly time-critical, but data on long-term effects of small reductions in treatment delays have not been available. Our objectiv... [more]

BACKGROUND AND PURPOSE - : Stroke thrombolysis is highly time-critical, but data on long-term effects of small reductions in treatment delays have not been available. Our objective was to quantify patient lifetime benefits gained from faster treatment. METHODS - : Observational prospective data of consecutive stroke patients treated with intravenous thrombolysis in Australian and Finnish centers (1998-2011; n=2258) provided distributions of age, sex, stroke severity, onset-to-treatment times, and 3-month modified Rankin Scale in daily clinical practice. Treatment effects derived from a pooled analysis of thrombolysis trials were used to model the shift in 3-month modified Rankin Scale distributions with reducing treatment delays, from which we derived the expected lifetime and level of long-term disability with faster treatment. RESULTS - : Each minute of onset-to-treatment time saved granted on average 1.8 days of extra healthy life (95% prediction interval, 0.9-2.7). Benefit was observed in all groups: each minute provided 0.6 day in old severe (age, 80 years; National Institutes of Health Stroke Scale [NIHSS] score, 20) patients, 0.9 day in old mild (age, 80 years; NIHSS score, 4) patients, 2.7 days in young mild (age, 50 years; NIHSS score, 4) patients, and 3.5 days in young severe (age, 50 years; NIHSS score, 20) patients. Women gained slightly more than men over their longer lifetimes. In the whole cohort, each 15 minute decrease in treatment delay provided an average equivalent of 1 month of additional disability-free life. CONCLUSIONS - : Realistically achievable small reductions in stroke thrombolysis delays would result in significant and robust average health benefits over patients' lifetimes. The awareness of concrete importance of speed could promote practice change. © 2014 American Heart Association, Inc.

DOI 10.1161/STROKEAHA.113.002910
Citations Scopus - 43Web of Science - 27
2014 Clarey J, Lasserson D, Levi C, Parsons M, Dewey H, Barber PA, et al., 'Absolute cardiovascular risk and GP decision making in TIA and minor stroke.', Fam Pract, 31 664-669 (2014) [C1]
DOI 10.1093/fampra/cmu054
Co-authors Patrick Mcelduff, Chris Levi, Parker Magin
2014 Murtha LA, Yang Q, Parsons MW, Levi CR, Beard DJ, Spratt NJ, McLeod DD, 'Cerebrospinal fluid is drained primarily via the spinal canal and olfactory route in young and aged spontaneously hypertensive rats', Fluids and Barriers of the CNS, 11 (2014) [C1]

Background: Many aspects of CSF dynamics are poorly understood due to the difficulties involved in quantification and visualization. In particular, there is debate surrounding the... [more]

Background: Many aspects of CSF dynamics are poorly understood due to the difficulties involved in quantification and visualization. In particular, there is debate surrounding the route of CSF drainage. Our aim was to quantify CSF flow, volume, and drainage route dynamics in vivo in young and aged spontaneously hypertensive rats (SHR) using a novel contrast-enhanced computed tomography (CT) method.Methods: ICP was recorded in young (2-5 months) and aged (16 months) SHR. Contrast was administered into the lateral ventricles bilaterally and sequential CT imaging was used to visualize the entire intracranial CSF system and CSF drainage routes. A customized contrast decay software module was used to quantify CSF flow at multiple locations.Results: ICP was significantly higher in aged rats than in young rats (11.52 ± 2.36 mmHg, versus 7.04 ± 2.89 mmHg, p = 0.03). Contrast was observed throughout the entire intracranial CSF system and was seen to enter the spinal canal and cross the cribriform plate into the olfactory mucosa within 9.1 ± 6.1 and 22.2 ± 7.1 minutes, respectively. No contrast was observed adjacent to the sagittal sinus. There were no significant differences between young and aged rats in either contrast distribution times or CSF flow rates. Mean flow rates (combined young and aged) were 3.0 ± 1.5 µL/min at the cerebral aqueduct; 3.5 ± 1.4 µL/min at the 3rd ventric= and 2.8 ± 0.9 µL/min at the 4th ventricle. Intracranial CSF volumes (and as percentage total brain volume) were 204 ± 97 µL (8.8 ± 4.3%) in the young and 275 ± 35 µL (10.8 ± 1.9%) in the aged animals (NS).Conclusions: We have demonstrated a contrast-enhanced CT technique for measuring and visualising CSF dynamics in vivo. These results indicate substantial drainage of CSF via spinal and olfactory routes, but there was little evidence of drainage via sagittal sinus arachnoid granulations in either young or aged animals. The data suggests that spinal and olfactory routes are the primary routes of CSF drainage and that sagittal sinus arachnoid granulations play a minor role, even in aged rats with higher ICP. © 2014 Murtha et al.; licensee BioMed Central Ltd.

DOI 10.1186/2045-8118-11-12
Citations Scopus - 10
Co-authors Lucy Murtha, Chris Levi, Neil Spratt, Daniel J Beard, Damian Mcleod
2014 Thomas LC, Rivett DA, Parsons M, Levi C, 'Risk factors, radiological features, and infarct topography of craniocervical arterial dissection.', International Journal of Stroke, 9 1073-1082 (2014) [C1]
DOI 10.1111/j.1747-4949.2012.00912.x
Co-authors Lucy Thomas, Chris Levi, Darren Rivett
2013 Bendinelli C, Bivard A, Nebauer S, Parsons MW, Balogh ZJ, 'Brain CT perfusion provides additional useful information in severe traumatic brain injury', INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED, 44 1208-1212 (2013) [C1]
DOI 10.1016/j.injury.2013.03.039
Citations Scopus - 3Web of Science - 1
Co-authors Zsolt Balogh
2013 Campbell BCV, Weir L, Desmond PM, Tu HTH, Hand PJ, Yan B, et al., 'CT perfusion improves diagnostic accuracy and confidence in acute ischaemic stroke', JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 84 613-618 (2013) [C1]
DOI 10.1136/jnnp-2012-303752
Citations Scopus - 18Web of Science - 11
2013 Anderson CS, Heeley E, Huang Y, Wang J, Stapf C, Delcourt C, et al., 'Rapid Blood-Pressure Lowering in Patients with Acute Intracerebral Hemorrhage', NEW ENGLAND JOURNAL OF MEDICINE, 368 2355-2365 (2013) [C1]
DOI 10.1056/NEJMoa1214609
Citations Scopus - 266Web of Science - 163
2013 Bivard A, Levi C, Spratt N, Parsons M, 'Perfusion CT in Acute Stroke: A Comprehensive Analysis of Infarct and Penumbra', RADIOLOGY, 267 543-550 (2013) [C1]
DOI 10.1148/radiol.12120971
Citations Scopus - 47Web of Science - 30
Co-authors Chris Levi, Neil Spratt
2013 Wintermark M, Fiehler J, Kudo K, Liebeskind DS, Luby M, Michel P, et al., 'International Survey of Acute Stroke Imaging Capabilities We Need You!', STROKE, 44 2091-2091 (2013) [C3]
DOI 10.1161/STROKEAHA.113.001441
2013 Parsons MW, Albers GW, 'MR RESCUE: Is the glass half-full or half-empty?', Stroke, 44 2055-2057 (2013) [C2]
DOI 10.1161/STROKEAHA.113.001443
Citations Scopus - 16Web of Science - 11
2013 Wintermark M, Albers GW, Broderick JP, Demchuk AM, Fiebach JB, Fiehler J, et al., 'Acute stroke imaging research roadmap II', Stroke, 44 2628-2639 (2013) [C1]
DOI 10.1161/STROKEAHA.113.002015
Citations Scopus - 48Web of Science - 35
2013 Yassi N, Parsons MW, Christensen S, Sharma G, Bivard A, Donnan GA, et al., 'Prediction of Poststroke Hemorrhagic Transformation Using Computed Tomography Perfusion', Stroke, 44 3039-3043 (2013) [C1]
DOI 10.1161/STROKEAHA.113.002396
Citations Scopus - 7Web of Science - 4
Co-authors Chris Levi
2013 Campbell BCV, Christensen S, Tress BM, Churilov L, Desmond PM, Parsons MW, et al., 'Failure of collateral blood flow is associated with infarct growth in ischemic stroke', JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM, 33 1168-1172 (2013) [C1]
DOI 10.1038/jcbfm.2013.77
Citations Scopus - 40Web of Science - 25
Co-authors Chris Levi
2013 Menon BK, O'Brien B, Bivard A, Spratt NJ, Demchuk AM, Miteff F, et al., 'Assessment of leptomeningeal collaterals using dynamic CT angiography in patients with acute ischemic stroke', Journal of Cerebral Blood Flow and Metabolism, 33 365-371 (2013) [C1]
Citations Scopus - 46Web of Science - 31
Co-authors Neil Spratt, Chris Levi
2013 Campbell BCV, Christensen S, Parsons MW, Churilov L, Desmond PM, Barber PA, et al., 'Advanced imaging improves prediction of hemorrhage after stroke thrombolysis', ANNALS OF NEUROLOGY, 73 510-519 (2013) [C1]
DOI 10.1002/ana.23837
Citations Scopus - 20Web of Science - 14
Co-authors Chris Levi
2013 Bivard A, Stanwell PT, Levi CR, Parsons MW, 'Arterial spin labeling identifies tissue salvage and good clinical recovery after acute ischemic stroke', Journal of Neuroimaging, 23 391-396 (2013) [C1]
Citations Scopus - 10Web of Science - 10
Co-authors Peter Stanwell, Chris Levi
2013 Bivard A, Lin L, Parsons MW, 'Review of Stroke Thrombolytics', JOURNAL OF STROKE, 15 90-98 (2013)
DOI 10.5853/jos.2013.15.2.90
2013 Lin L, Bivard A, Parsons MW, 'Perfusion Patterns of Ischemic Stroke on Computed Tomography Perfusion', JOURNAL OF STROKE, 15 164-173 (2013)
DOI 10.5853/jos.2013.15.3.164
2013 Anderson C, Sharma V, Huang Y, Lavados P, Lindley R, Pandian J, et al., 'The Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED): First Year Experience Regarding Possible Selection Bias', CEREBROVASCULAR DISEASES, 36 20-20 (2013)
Co-authors Chris Levi
2013 Carey LM, Seitz RJ, Parsons M, Levi C, Farquharson S, Tournier JD, et al., 'Beyond the lesion: Neuroimaging foundations for post-stroke recovery', Future Neurology, 8 507-527 (2013)

A shift is emerging in the way in which we view post-stroke recovery. This shift, supported by evidence from neuroimaging studies, encourages us to look beyond the lesion and to i... [more]

A shift is emerging in the way in which we view post-stroke recovery. This shift, supported by evidence from neuroimaging studies, encourages us to look beyond the lesion and to identify viable brain networks with capacity for plasticity. In this article, the authors review current advances in neuroimaging techniques and the new insights that they have contributed. The ability to quantify salvageable tissue, evidence of changes in remote networks, changes of functional and structural connectivity, and alterations in cortical thickness are reviewed in the context of their impact on post-stroke recovery. The value of monitoring spared structural connections and functional connectivity of brain networks within and across hemispheres is highlighted. © 2013 Future Medicine Ltd.

DOI 10.2217/fnl.13.39
Citations Scopus - 6
Co-authors Chris Levi
2013 Donnan GA, Davis SM, Ma H, Campbell BC, Christensen S, Connelly A, et al., 'EXtending the time for Thombolysis in Emergency Neurological Deficits: the EXTEND trial progress', INTERNATIONAL JOURNAL OF STROKE, 8 34-34 (2013)
2013 Campbell BC, Mitchell P, Yan B, Churilov L, Ma H, Parsons M, et al., 'EXtending the time for Thombolysis in Emergency Neurological Deficits - intra-arterial: the EXTEND-IA trial rationale and protocol', INTERNATIONAL JOURNAL OF STROKE, 8 34-34 (2013)
2013 Kitsos GH, Hubbard IJ, Kitsos AR, Parsons MW, 'The Ipsilesional Upper Limb Can Be Affected following Stroke', SCIENTIFIC WORLD JOURNAL, (2013) [C1]
DOI 10.1155/2013/684860
Citations Scopus - 2Web of Science - 3
Co-authors Isobel Hubbard
2013 Jolly TAD, Bateman GA, Levi CR, Parsons MW, Michie PT, Karayanidis F, 'Early detection of microstructural white matter changes associated with arterial pulsatility', FRONTIERS IN HUMAN NEUROSCIENCE, 7 (2013) [C1]
DOI 10.3389/fnhum.2013.00782
Citations Scopus - 5Web of Science - 3
Co-authors Frini Karayanidis, Pat Michie, Chris Levi
2013 Bladin C, Levi C, Parsons M, 'Stroke thrombolysis: Leaving the past, understanding the present and moving forward ...', EMERGENCY MEDICINE AUSTRALASIA, 25 195-196 (2013) [C3]
DOI 10.1111/1742-6723.12025
Citations Scopus - 3Web of Science - 3
Co-authors Chris Levi
2013 Zareie H, Quain DA, Parsons M, Inder KJ, McElduff P, Miteff F, et al., 'The influence of anterior cerebral artery flow diversion measured by transcranial Doppler on acute infarct volume and clinical outcome in anterior circulation stroke', INTERNATIONAL JOURNAL OF STROKE, 8 228-234 (2013) [C1]
DOI 10.1111/j.1747-4949.2012.00801.x
Citations Scopus - 3Web of Science - 2
Co-authors Kerry Inder, Chris Levi, Neil Spratt, Patrick Mcelduff
2013 Anderson C, Heeley E, Heritier S, Arima H, Woodward M, Lindley R, et al., 'Statistical analysis plan for the second INTEnsive blood pressure Reduction in Acute Cerebral hemorrhage Trial (INTERACT2): a large-scale investigation to solve longstanding controversy over the most appropriate management of elevated blood pressure in the hyperacute phase of intracerebral hemorrhage', INTERNATIONAL JOURNAL OF STROKE, 8 327-328 (2013) [C2]
DOI 10.1111/ijs.12004
Citations Scopus - 3Web of Science - 2
2013 Churilov L, Liu D, Ma H, Christensen S, Nagakane Y, Campbell B, et al., 'Multiattribute selection of acute stroke imaging software platform for Extending the Time for Thrombolysis in Emergency Neurological Deficits (EXTEND) clinical trial', International Journal of Stroke, 8 204-210 (2013) [C1]
DOI 10.1111/j.1747-4949.2012.00787.x
Citations Scopus - 6Web of Science - 6
Co-authors Chris Levi
2013 Magin P, Lasserson D, Parsons M, Spratt N, Evans M, Russell M, et al., 'Referral and triage of patients with transient ischemic attacks to an acute access clinic: Risk stratification in an Australian setting', International Journal of Stroke, 8 81-89 (2013) [C1]

Background: Transient ischemic attacks and minor stroke entail considerable risk of completed stroke but this risk is reduced by prompt assessment and treatment. Risk can be strat... [more]

Background: Transient ischemic attacks and minor stroke entail considerable risk of completed stroke but this risk is reduced by prompt assessment and treatment. Risk can be stratified according to the ABCD2 prediction score. Current guidelines suggest specialist assessment and treatment within 24h for high-risk event (ABCD2 score 4-7) and seven-days for low-risk event (ABCD2 score =3). Aims: The study aims to establish paths to care and outcomes for patients referred by general practitioners and emergency departments to an Australian acute access transient ischemic attack service. Methods: This is a prospective audit. Primary outcomes were time from event to referral, from referral to clinic appointment, and from event to appointment. ABCD2 score was calculated for each event. Time from event was modeled using Cox proportional hazards regression. Results: There were 231 clinic attendees (general practitioner: 127; emergency department: 104). Mean time from event to referral was 9·2 days (SD 23·7, median 2), from referral to being seen in the clinic was 13·6 days (SD 19·0, median 7), and from event to being seen in the clinic was 17·2 days (SD 27·1, median 10). Of low-risk patients, 38·5% were seen within seven-days of event. Of high-risk patients, 36·7% were seen within one-day. ABCD2 score was not a significant predictor of any time interval from event to clinic attendance. There were no completed strokes prior to clinic attendance. Conclusions: Times from event to clinic assessment were in excess of current recommendations and risk stratification was suboptimal, though short-term outcomes were good. Improvements in referral mechanisms may enhance risk-stratification and triage. © 2013 World Stroke Organization.

DOI 10.1111/ijs.12014
Citations Scopus - 2Web of Science - 2
Co-authors Parker Magin, Patrick Mcelduff, Neil Spratt, Chris Levi
2013 McLeod DD, Beard DJ, Parsons MW, Levi CR, Calford MB, Spratt NJ, 'Inadvertent Occlusion of the Anterior Choroidal Artery Explains Infarct Variability in the Middle Cerebral Artery Thread Occlusion Stroke Model', PLOS ONE, 8 (2013) [C1]
DOI 10.1371/journal.pone.0075779
Citations Scopus - 6Web of Science - 3
Co-authors Daniel J Beard, Damian Mcleod, Neil Spratt, Chris Levi
2012 Campbell BCV, Tu HTH, Christensen S, Desmond PM, Levi CR, Bladin CF, et al., 'Assessing response to stroke thrombolysis validation of 24-Hour multimodal magnetic resonance imaging', Archives of Neurology, 69 46-50 (2012) [C1]
Citations Scopus - 27Web of Science - 20
Co-authors Chris Levi
2012 O'Brien B, Parsons MW, Anderson CS, 'Sudden limb weakness', Medical Journal of Australia, 196 572-577 (2012) [C3]
2012 Delcourt C, Huang Y, Arima H, Chalmers J, Davis SM, Heeley EL, et al., 'Hematoma growth and outcomes in intracerebral hemorrhage The INTERACT1 study', NEUROLOGY, 79 314-319 (2012) [C1]
DOI 10.1212/WNL.0b013e318260cbba
Citations Scopus - 41Web of Science - 34
2012 González RG, 'Tenecteplase versus alteplase for acute ischemic stroke', New England Journal of Medicine, 367 275-276 (2012) [C3]
DOI 10.1056/NEJMc1205829
Citations Scopus - 2
2012 Parsons M, Levi C, Davis S, 'The authors reply', New England Journal of Medicine, 367 276 (2012) [C3]
DOI 10.1056/NEJMc1205829
Co-authors Chris Levi
2012 Parsons MW, Spratt NJ, Bivard A, Campbell B, Chung K, Miteff F, et al., 'A randomized trial of tenecteplase versus alteplase for acute ischemic stroke', New England Journal of Medicine, 366 1099-1107 (2012) [C1]
Citations Scopus - 170Web of Science - 131
Co-authors Chris Levi, Neil Spratt, Patrick Mcelduff
2012 Parsons MW, Levi CR, Davis S, 'Tenecteplase versus alteplase for acute ischemic stroke: The authors reply', New England Journal of Medicine, 367 276 (2012) [C1]
Co-authors Chris Levi
2012 Campbell BCV, Christensen S, Levi CR, Desmond PM, Donnan GA, Davis SM, Parsons MW, 'Comparison of computed tomography perfusion and magnetic resonance imaging perfusion-diffusion mismatch in ischemic stroke', Stroke, 43 2648-2653 (2012) [C1]
Citations Scopus - 35Web of Science - 19
Co-authors Chris Levi
2012 Arima H, Huang YN, Wang JG, Heeley E, Delcourt C, Parsons MW, et al., 'Earlier blood pressure-lowering and greater attenuation of hematoma growth in acute intracerebral hemorrhage: INTERACT pilot phase', Stroke, 43 2236-2238 (2012) [C3]
Citations Scopus - 17Web of Science - 14
2012 Nagakane Y, Christensen S, Ogata T, Churilov L, Ma H, Parsons MW, et al., 'Moving beyond a single perfusion threshold to define penumbra: A novel probabilistic mismatch definition', Stroke, 43 1548-1555 (2012) [C1]
Citations Scopus - 13Web of Science - 13
Co-authors Chris Levi
2012 Parsons MW, Levi CR, 'Reperfusion trials for acute ischaemic stroke', The Lancet, 380 706-708 (2012) [C3]
Citations Scopus - 1
Co-authors Chris Levi
2012 Campbell BCV, Purushotham A, Christensen S, Desmond PM, Nagakane Y, Parsons MW, et al., 'The infarct core is well represented by the acute diffusion lesion: sustained reversal is infrequent', Journal of Cerebral Blood Flow and Metabolism, 32 50-56 (2012) [C1]
Citations Scopus - 57Web of Science - 48
2012 Holliday EG, Maguire JM, Evans T-J, Koblar SA, Jannes J, Sturm J, et al., 'Common variants at 6p21.1 are associated with large artery atherosclerotic stroke', Nature Genetics, 44 1147-1153 (2012) [C1]
Citations Scopus - 63Web of Science - 54
Co-authors Chris Levi, Wayne Smith, Jane Maguire, Liz Holliday, Christopher Oldmeadow, Mark Mcevoy, Roseanne Peel, John Attia, Pablo Moscato, Lisa Lincz, Rodney Scott
2012 Ma H, Parsons MW, Christensen S, Campbell BCV, Churilov L, Connelly A, et al., 'A multicentre, randomized, double-blinded, placebo-controlled phase III study to investigate EXtending the time for Thrombolysis in Emergency Neurological Deficits (EXTEND)', International Journal of Stroke, 7 74-80 (2012) [C1]
Citations Scopus - 85Web of Science - 63
2012 Bivard A, Parsons M, 'ASPECTaSaurus (a dinosaur)?', Int J Stroke, 7 564-564 (2012) [C1]
DOI 10.1111/j.1747-4949.2012.00854.x
Citations Scopus - 6Web of Science - 5
2012 Davis S, Campbell B, Christensen S, Ma H, Desmond P, Parsons MW, et al., 'Perfusion/diffusion mismatch is valid and should be used for selecting delayed interventions', Translational Stroke Research, 3 188-197 (2012) [C1]
Citations Scopus - 7Web of Science - 5
Co-authors Chris Levi
2012 Levi CR, Zareie H, Parsons MW, 'Transcranial Doppler in acute stroke management - A 'real-time' bed-side guide to reperfusion and collateral flow', Perspectives in Medicine, 1 185-193 (2012) [C1]
Co-authors Chris Levi
2011 Bivard A, Spratt NJ, Levi CR, Parsons MW, 'Acute stroke thrombolysis: Time to dispense with the clock and move to tissue-based decision making?', Expert Review of Cardiovascular Therapy, 9 451-461 (2011) [C1]
Citations Scopus - 7
Co-authors Neil Spratt, Chris Levi
2011 McLeod DD, Parsons MW, Levi CR, Beautement S, Buxton D, Roworth B, Spratt NJ, 'Establishing a rodent stroke perfusion computed tomography model', International Journal of Stroke, 6 284-289 (2011) [C1]
DOI 10.1111/j.1747-4949.2010.00564.x
Citations Scopus - 12Web of Science - 9
Co-authors Neil Spratt, Damian Mcleod, Chris Levi
2011 Donnan GA, Davis SM, Parsons MW, Ma H, Dewey HM, Howells DW, 'How to make better use of thrombolytic therapy in acute ischemic stroke', Nature Reviews Neurology, 7 400-409 (2011) [C1]
Citations Scopus - 55Web of Science - 44
2011 Bivard A, Spratt NJ, Levi CR, Parsons MW, 'Perfusion computer tomography: Imaging and clinical validation in acute ischaemic stroke', Brain, 134 3408-3416 (2011) [C1]
Citations Scopus - 47Web of Science - 40
Co-authors Chris Levi, Neil Spratt
2011 Simpson MA, Dewey HM, Parsons MW, 'In reply', Medical Journal of Australia, 194 212-213 (2011) [C3]
2011 Simpson MA, Dewey HM, Parsons MW, 'Thrombolysis for acute stroke in Australia', Medical Journal of Australia, 194 212-213 (2011) [C3]
2011 Hunter AJ, Snodgrass SN, Quain D, Parsons MW, Levi CR, 'HOBOE (head-of-bed optimization of elevation) study: Association of higher angle with reduced cerebral blood flow velocity in acute ischemic stroke', Physical Therapy, 91 1503-1512 (2011) [C1]
DOI 10.2522/ptj.20100271
Citations Scopus - 12Web of Science - 5
Co-authors Suzanne Snodgrass, Chris Levi
2011 Nagakane Y, Christensen S, Brekenfeld C, Ma H, Churilov L, Parsons MW, et al., 'EPITHET positive result after reanalysis using baseline diffusion-weighted imaging/perfusion-weighted imaging co-registration', Stroke, 42 59-64 (2011) [C1]
DOI 10.1161/strokeaha.110.580464
Citations Scopus - 55Web of Science - 42
Co-authors Chris Levi
2011 Parsons MW, 'Advanced brain imaging studies should be performed in patients with suspected stroke presenting within 4.5 hours of symptom onset', Stroke, 42 2666-2667 (2011) [C3]
DOI 10.1161/STROKEAHA.111.621771
Citations Scopus - 6Web of Science - 5
2011 Campbell BCV, Christensen S, Levi CR, Desmond PM, Donnan GA, Davis SM, Parsons MW, 'Cerebral blood flow is the optimal CT perfusion parameter for assessing infarct core', Stroke, 42 3435-3440 (2011) [C1]
DOI 10.1161/strokeaha.111.618355
Citations Scopus - 84Web of Science - 62
Co-authors Chris Levi
2011 Parsons MW, 'Treating as early as Possible with Thrombolysis Is Crucial, but Can We Do Better in the Sub-4.5-Hour Time Window?', Cerebrovascular Diseases, 31 229 (2011) [C3]
DOI 10.1159/000322555
Citations Scopus - 1Web of Science - 1
2011 Parsons MW, Bivard A, McElduff P, Spratt NJ, Levi CR, 'Defining the extent of irreversible brain ischemia using perfusion computed tomography', Cerebrovascular Diseases, 31 238-245 (2011) [C1]
DOI 10.1159/000321897
Citations Scopus - 50Web of Science - 43
Co-authors Neil Spratt, Chris Levi, Patrick Mcelduff
2011 Campbell BCV, Costello C, Christensen S, Ebinger M, Parsons MW, Desmond PM, et al., 'Fluid-attenuated inversion recovery hyperintensity in acute ischemic stroke may not predict hemorrhagic transformation', Cerebrovascular Diseases, 32 401-405 (2011) [C1]
Citations Scopus - 10Web of Science - 8
Co-authors Chris Levi
2011 Thomas L, Rivett DA, Attia JR, Parsons MW, Levi CR, 'Risk factors and clinical features of craniocervical arterial dissection', Manual Therapy, 16 351-356 (2011) [C1]
DOI 10.1016/j.math.2010.12.008
Citations Scopus - 23Web of Science - 18
Co-authors John Attia, Chris Levi, Lucy Thomas, Darren Rivett
2010 Ahmed N, Wahlgren N, Grond M, Hennerici M, Lees KR, Mikulik R, et al., 'Implementation and outcome of thrombolysis with alteplase 3-4.5 h after an acute stroke: An updated analysis from SITS-ISTR', The Lancet Neurology, 9 866-874 (2010) [C1]
DOI 10.1016/S1474-4422(10)70165-4
Citations Scopus - 145Web of Science - 117
2010 Lees KR, Bluhmki E, Von Kummer R, Brott TG, Toni D, Grotta JC, et al., 'Time to treatment with intravenous alteplase and outcome in stroke: an updated pooled analysis of ECASS, ATLANTIS, NINDS, and EPITHET trials', The Lancet, 375 1695-1703 (2010) [C1]
DOI 10.1016/S0140-6736(10)60491-6
Citations Scopus - 875Web of Science - 688
Co-authors John Attia, Chris Levi
2010 Delcourt C, Huang Y, Wang J, Heeley E, Lindley R, Stapf C, et al., 'The second (main) phase of an open, randomised, multicentre study to investigate the effectiveness of an intensive blood pressure reduction in acute cerebral haemorrhage trial (INTERACT2)', International Journal of Stroke, 5 110-116 (2010) [C1]
DOI 10.1111/j.1747-4949.2010.00415.x
Citations Scopus - 70Web of Science - 59
2010 Garnett AR, Marsden DL, Parsons MW, Quain DA, Spratt NJ, Loudfoot AR, et al., 'The rural Prehospital Acute Stroke Triage (PAST) trial protocol: A controlled trial for rapid facilitated transport of rural acute stroke patients to a regional stroke centre', International Journal of Stroke, 5 506-513 (2010) [C1]
DOI 10.1111/j.1747-4949.2010.00522.x
Citations Scopus - 10Web of Science - 8
Co-authors Chris Levi, Neil Spratt
2010 Parsons MW, 'Portable computed tomography scanners in community hospitals: are they necessary?', International Journal of Stroke, 5 67 (2010) [C3]
DOI 10.1111/j.1747-4949.2010.00407.x
2010 Simpson MA, Dewey HM, Churilov L, Ahmed N, Bladin CF, Schultz D, et al., 'Thrombolysis for acute stroke in Australia: Outcomes from the Safe Implementation of Thrombolysis in Stroke registry (2002-2008)', Medical Journal of Australia, 193 439-443 (2010) [C1]
Citations Scopus - 19Web of Science - 14
Co-authors Chris Levi
2010 Chemmanam T, Campbell BCV, Christensen S, Nagakane Y, Desmond PM, Bladin CF, et al., 'Ischemic diffusion lesion reversal is uncommon and rarely alters perfusion-diffusion mismatch', Neurology, 75 1040-1047 (2010) [C1]
DOI 10.1212/WNL.0b013e3181f39ab6
Citations Scopus - 59Web of Science - 47
Co-authors Chris Levi
2010 Anderson CS, Huang YN, Arima H, Heeley E, Skulina C, Parsons MW, et al., 'Effects of early intensive blood pressure-lowering treatment on the growth of hematoma and perihematomal edema in acute intracerebral hemorrhage: The Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial (INTERACT)', Stroke, 41 307-312 (2010) [C1]
DOI 10.1161/STROKEAHA.109.561795
Citations Scopus - 116Web of Science - 80
2010 Campbell BCV, Christensen S, Butcher KS, Gordon I, Parsons MW, Desmond PM, et al., 'Regional very low cerebral blood volume predicts hemorrhagic transformation better than diffusion-weighted imaging volume and thresholded apparent diffusion coefficient in acute ischemic stroke', Stroke, 41 82-88 (2010) [C1]
DOI 10.1161/STROKEAHA.109.562116
Citations Scopus - 58Web of Science - 49
Co-authors Chris Levi
2010 Butcher K, Christensen S, Parsons MW, De Silva DA, Ebinger M, Levi CR, et al., 'Postthrombolysis blood pressure elevation is associated with hemorrhagic transformation', Stroke, 41 72-77 (2010) [C1]
DOI 10.1161/STROKEAHA.109.563767
Citations Scopus - 35Web of Science - 27
Co-authors Chris Levi
2010 De Silva DA, Brekenfeld C, Ebinger M, Christensen S, Barber PA, Butcher KS, et al., 'The benefits of intravenous thrombolysis relate to the site of baseline arterial occlusion in the echoplanar imaging thrombolytic evaluation trial (EPITHET)', Stroke, 41 295-299 (2010) [C1]
DOI 10.1161/STROKEAHA.109.562827
Citations Scopus - 52Web of Science - 44
Co-authors Chris Levi
2010 Pickering RL, Hubbard IJ, Baker KG, Parsons MW, 'Assessment of the upper limb in acute stroke: The validity of hierarchal scoring for the Motor Assessment Scale', Australian Occupational Therapy Journal, 57 174-182 (2010) [C1]
DOI 10.1111/j.1440-1630.2009.00810.x
Citations Scopus - 6Web of Science - 4
Co-authors Isobel Hubbard
2010 Arima H, Anderson CS, Wang JG, Huang Y, Heeley E, Neal B, et al., 'Lower treatment blood pressure is associated with greatest reduction in hematoma growth after acute intracerebral hemorrhage', Hypertension, 56 852-858 (2010) [C1]
DOI 10.1161/HYPERTENSIONAHA.110.154328
Citations Scopus - 35Web of Science - 27
2010 Parsons MW, Christensen S, McElduff P, Levi CR, Butcher KS, De Silva DA, et al., 'Pretreatment diffusion- and perfusion-MR lesion volumes have a crucial influence on clinical response to stroke thrombolysis', Journal of Cerebral Blood Flow and Metabolism, 30 1214-1225 (2010) [C1]
DOI 10.1038/jcbfm.2010.3
Citations Scopus - 95Web of Science - 83
Co-authors Patrick Mcelduff, Chris Levi
2010 Johnston KC, Parsons MW, 'Aggressive glucose control in acute stroke: Is the answer in the imaging?', Annals of Neurology, 67 557-558 (2010) [C3]
DOI 10.1002/ana.22046
Citations Scopus - 1Web of Science - 1
2010 Parsons MW, 'Commentary: Echocardiography in the detection of cardioembolism in a stroke population', Journal of Clinical Neuroscience, 17 566-566 (2010) [C3]
DOI 10.1016/j.jocn.2010.01.001
2010 Campbell BCV, Christensen S, Foster SJ, Desmond PM, Parsons MW, Butcher KS, et al., 'Visual assessment of perfusion-diffusion mismatch is inadequate to select patients for thrombolysis', Cerebrovascular Diseases, 29 592-596 (2010) [C1]
DOI 10.1159/000311080
Citations Scopus - 37Web of Science - 35
Co-authors Chris Levi
2010 Tu HTH, Campbell BCV, Christensen S, Collins M, De Silva DA, Butcher KS, et al., 'Pathophysiological determinants of worse stroke outcome in atrial fibrillation', Cerebrovascular Diseases, 30 389-395 (2010) [C1]
DOI 10.1159/000316886
Citations Scopus - 40Web of Science - 26
Co-authors Chris Levi
2010 Marsden DL, Spratt NJ, Walker R, Barker DJ, Attia JR, Pollack MR, et al., 'Trends in stroke attack rates and case fatality in the Hunter Region, Australia 1996-2008', Cerebrovascular Diseases, 30 500-507 (2010) [C1]
DOI 10.1159/000319022
Citations Scopus - 17Web of Science - 16
Co-authors Chris Levi, Neil Spratt, John Attia
2010 De Silva DA, Ebinger M, Christensen S, Parsons MW, Levi CR, Butcher K, et al., 'Baseline diabetic status and admission blood glucose were poor prognostic factors in the EPITHET trial', Cerebrovascular Diseases, 29 14-21 (2010) [C1]
DOI 10.1159/000255969
Citations Scopus - 30Web of Science - 27
Co-authors Chris Levi
2009 Levi CR, Bateman GA, Spratt NJ, McElduff P, Parsons MW, Miteff F, 'The independent predictive utility of computed tomography angiographic collateral status in acute ischaemic stroke', Brain, 132 2231-2238 (2009) [C1]
DOI 10.1093/brain/awp155
Citations Scopus - 144Web of Science - 113
Co-authors Chris Levi, Patrick Mcelduff, Neil Spratt
2009 Parsons MW, Miteff F, Bateman GA, Spratt NJ, Loiselle A, Attia JR, Levi CR, 'Acute ischemic stroke imaging-guided tenecteplase treatment in an extended time window', Neurology, 72 915-921 (2009) [C1]
DOI 10.1212/01.wnl.0000344168.05315.9d
Citations Scopus - 71Web of Science - 49
Co-authors Chris Levi, Neil Spratt, John Attia
2009 Arima H, Wang JG, Huang Y, Heeley E, Skulina C, Parsons MW, et al., 'Significance of perihematomal edema in acute intracerebral hemorrhage: The INTERACT trial', Neurology, 73 1963-1968 (2009) [C1]
DOI 10.1212/wnl.0b013e3181c55ed3
Citations Scopus - 73Web of Science - 61
2009 Ebinger M, Christensen S, De Silva DA, Parsons MW, Levi CR, Butcher KS, et al., 'Expediting MRI-based proof-of-concept stroke trials using an earlier imaging end point', Stroke, 40 1353-1358 (2009) [C1]
DOI 10.1161/strokeaha.108.532622
Citations Scopus - 23Web of Science - 21
Co-authors Chris Levi
2009 Ebinger M, Iwanaga T, Prosser JF, De Silva DA, Christensen S, Collins M, et al., 'Clinical-diffusion mismatch and benefit from thrombolysis 3 to 6 hours after acute stroke', Stroke, 40 2572-2574 (2009) [C1]
DOI 10.1161/strokeaha.109.548073
Citations Scopus - 23Web of Science - 23
Co-authors Chris Levi
2009 De Silva DA, Fink JN, Christensen S, Ebinger M, Bladin C, Levi CR, et al., 'Assessing reperfusion and recanalization as markers of clinical outcomes after intravenous thrombolysis in the echoplanar imaging thrombolytic evaluation trial (EPITHET)', Stroke, 40 2872-2874 (2009) [C1]
DOI 10.1161/strokeaha.108.543595
Citations Scopus - 56Web of Science - 43
Co-authors Chris Levi
2009 Hubbard IJ, Vyslysel G, Parsons MW, 'Interprofessional, practice-driven research: Reflections of one 'community of inquiry' based in acute stroke', Journal of Allied Health, 38 E69-E74 (2009) [C1]
Co-authors Isobel Hubbard
2009 Hubbard IJ, Parsons MW, Neilson C, Carey LM, 'Task-specific training: Evidence for and translation to clinical practice', Occupational Therapy International, 16 175-189 (2009) [C1]
DOI 10.1002/oti.275
Citations Scopus - 80Web of Science - 54
Co-authors Isobel Hubbard
2009 Ebinger M, De Silva DA, Christensen S, Parsons MW, Markus R, Donnan GA, Davis SM, 'Imaging the penumbra: Strategies to detect tissue at risk after ischemic stroke', Journal of Clinical Neuroscience, 16 178-187 (2009) [C1]
DOI 10.1016/j.jocn.2008.04.002
Citations Scopus - 30Web of Science - 21
2009 Levi CR, Lindley R, Smith B, Bladin C, Parsons MW, Read S, et al., 'The implementation of intravenous tissue plasminogen activator in acute ischaemic stroke: A scientific position statement from the National Stroke Foundation and the Stroke Society of Australasia', Internal Medicine Journal, 39 317-324 (2009) [C1]
DOI 10.1111/j.1445-5994.2009.01938.x
Citations Scopus - 12Web of Science - 6
Co-authors Chris Levi
2008 Anderson CS, Huang Y, Wang JG, Arima H, Neal B, Peng B, et al., 'Intensive blood pressure reduction in acute cerebral haemorrhage trial (INTERACT): a randomised pilot trial', The Lancet Neurology, 7 391-399 (2008) [C1]
DOI 10.1016/s1474-4422(08)70069-3
Citations Scopus - 380Web of Science - 282
2008 Davis SM, Donnan GA, Parsons MW, Levi CR, Butcher KS, Peeters A, et al., 'Effects of alteplase beyond 3 h after stroke in the Echoplanar Imaging Thrombolytic Evaluation Trial (EPITHET): A placebo-controlled randomised trial', The Lancet Neurology, 7 299-309 (2008) [C1]
DOI 10.1016/s1474-4422(08)70044-9
Citations Scopus - 581Web of Science - 492
Co-authors Chris Levi, John Attia
2008 Davis SM, Donnan GA, Parsons MW, Levi CR, Butcher KS, Barber PA, et al., 'EPITHET: Where next? Authors' reply', The Lancet Neurology, 7 571-572 (2008) [C3]
DOI 10.1016/s1474-4422(08)70124-8
Citations Web of Science - 1
Co-authors Chris Levi
2008 Parsons MW, 'Perfusion CT: Is it clinically useful?', International Journal of Stroke, 3 41-50 (2008) [C1]
DOI 10.1111/j.1747-4949.2008.00175.x
Citations Scopus - 39Web of Science - 34
2008 Quain DA, Parsons MW, Loudfoot AR, Spratt NJ, Evans MK, Russell ML, et al., 'Improving access to acute stroke therapies: A controlled trial of organised pre-hospital and emergency care', Medical Journal of Australia, 189 429-433 (2008) [C1]
Citations Scopus - 67Web of Science - 51
Co-authors John Attia, Patrick Mcelduff, Neil Spratt, Chris Levi
2008 Maguire JM, Thakkinstian A, Sturm J, Levi CR, Lincz L, Parsons MW, et al., 'Polymorphisms in platelet glycoprotein 1b [alpha] and factor VII and risk of ischemic stroke', Stroke, 39 1710-1716 (2008) [C1]
DOI 10.1161/strokeaha.107.507228
Citations Scopus - 24Web of Science - 23
Co-authors Lisa Lincz, Jane Maguire, John Attia, Chris Levi
2008 Butcher K, Parsons MW, Allport L, Lee SB, Barber PA, Tress B, et al., 'Rapid assessment of perfusion-diffusion mismatch', Stroke, 39 75-81 (2008) [C1]
DOI 10.1161/strokeaha.107.490524
Citations Scopus - 46Web of Science - 46
2007 Attia JR, Thakkinstian A, Wang Y, Lincz L, Parsons MW, Sturm J, et al., 'The PAI-1 4G/5G gene polymorphism and ischemic stroke: An association study and meta-analysis', Journal of Stroke and Cerebrovascular Diseases, 16 173-179 (2007) [C1]
DOI 10.1016/j.jstrokecerebrovasdis.2007.03.002
Citations Scopus - 31
Co-authors John Attia, Rodney Scott, Chris Levi, Lisa Lincz
2007 Hubbard IJ, Parsons MW, 'The conventional care of therapists as acute stroke specialists: A case study', International Journal of Therapy and Rehabilitation, 14 357-362 (2007) [C1]
Citations Scopus - 5
Co-authors Isobel Hubbard
2007 Parsons MW, Pepper EM, Bateman GA, Wang Y, Levi CR, 'Identification of the penumbra and infarct core on hyperacute noncontrast and perfusion CT', Neurology, 68 730-736 (2007) [C1]
DOI 10.1212/01.wnl.0000256366.86353.ff
Citations Scopus - 86Web of Science - 66
Co-authors Chris Levi
2007 Butcher KS, Lee SB, Parsons MW, Allport L, Fink J, Tress B, et al., 'Differential prognosis of isolated cortical swelling and hypoattenuation on CT in acute stroke', Stroke, 38 941-947 (2007) [C1]
DOI 10.1161/01.str.0000258099.69995.b6
Citations Scopus - 37Web of Science - 28
2006 Parsons MW, Barber Alan P, Davis SM, Donnan G, Phan TG, Reutens DC, et al., 'Proof of Principle Phase II MRI studies in Stroke: Sample size estimates from Dichotomous and Continuous Data', Stroke, 37 2521-2525 (2006) [C1]
DOI 10.1161/01.STR.0000239696.61545.4b
2006 Parsons MW, Pepper EM, Chan V, Siddique S, Rajaratnam S, Rajarabram S, et al., 'Toxic brainstem encephalopathy after artemisinin treatment for breast cancer - Reply', Annals of Neurology, 59 726-726 (2006) [C3]
Citations Scopus - 1Web of Science - 2
Co-authors Chris Levi
2006 Parsons MW, Pepper EM, Chan VWC, Siddique S, Rajaratnam S, Rajarabram S, et al., 'Reply [4] Perfusion computed tomography: prediction of final infarct extent and stroke outcome', Annals of Neurology, 59 726 (2006) [C3]
Co-authors Chris Levi
2006 Butcher K, Parsons MW, Allport L, Prosser J, Tress B, Donnan G, Davis S, 'Refining and testing the PWI-DWI mismatch hypothesis', International Congress Series, 1290 56-66 (2006) [C1]
DOI 10.1016/j.ics.2005.11.107
Citations Scopus - 1
2006 Pepper EM, Parsons MW, Bateman GA, Levi CR, 'CT perfusion source images improve identification of early ischaemic change in hyperacute stroke', Journal of Clinical Neuroscience, 13 199-205 (2006) [C1]
DOI 10.1016/j.jocn.2005.03.030
Citations Scopus - 19Web of Science - 15
Co-authors Chris Levi
2005 Yan B, Parsons MW, McKay S, Campbell D, Infeld B, Czajko R, Davis SM, 'When to measure lipid profile after stroke: A prospective serial study', Cerebrovascular Diseases, 19 234-238 (2005) [C1]
DOI 10.1159/000084086
2005 Davis SM, Donnan GA, Butcher KS, Parsons MW, 'Selection of thrombolytic therapy beyond 3 h using magnetic resonance imaging', Current Opinion in Neurology, 18 47-52 (2005) [C1]
DOI 10.1097/00019052-200502000-00010
Citations Scopus - 83Web of Science - 73
2005 Poh-Sien L, Butcher KS, Parsons MW, Macgregor LR, Desmond P, Tess B, Davis S, 'Apparent Diffusion Coefficient Thresholds do not predict the response to Acute Stroke Thrombolysis', Stroke, 36 2626-2631 (2005) [C1]
DOI 10.1161/01.STR.0000189688.95557.2b
Citations Scopus - 37Web of Science - 33
2005 Parsons MW, Pepper EM, Chan V, Siddique S, Rajaratnam S, Bateman GA, Levi CR, 'Perfusion computed tomography: Prediction of final infarct extent and stroke outcome', Annals of Neurology, 58 672-679 (2005) [C1]
DOI 10.1002/ana.20638
Citations Scopus - 131Web of Science - 103
Co-authors Chris Levi
2005 Allport LE, Parsons MW, Butcher KS, Macgregor L, Desmond PM, Tress BM, Davis SM, 'Elevated hematocrit is associated with reduced reperfusion and tissue survival in acute stroke', Neurology, 65 1382-1387 (2005) [C1]
DOI 10.1212/01.wnl.0000183057.96792.a8
2005 Butcher K, Parsons MW, Macgregor LR, Barber PA, Chalk J, Bladin CF, et al., 'Refining the Perfusion-Diffusion Mismatch Hypothesis', Stroke, 36 1153-1159 (2005) [C1]
DOI 10.1161/01.STR.0000166181.86928.8b
Citations Scopus - 170Web of Science - 149
Co-authors Chris Levi
2005 Prosser J, Butcher K, Allport L, Parsons MW, Macgregor L, Desmond P, et al., 'Clinical-diffusion mismatch predicts the putative penumbra with high specificity', Stroke, 36 1700-1704 (2005) [C1]
DOI 10.1161/01.str.0000173407.40773.17
2004 Levi CR, 'Tissue plasminogen activator (tPA) in acute ischaemic stroke: time for collegiate and consensus', Medical Journal of Australia, 180 634-636 (2004) [C3]
Citations Scopus - 3Web of Science - 6
Co-authors Chris Levi
2004 Lovelock C, Parsons MW, 'Hypokalaemic paralysis revealing Sjogrens syndrome', J Clin Neurosci, 11 319-321 (2004) [C2]
Citations Scopus - 6Web of Science - 6
2004 Barber PA, Parsons MW, Desmond PM, Bennett DA, Donnan GA, Tress BM, Davis SM, 'Use of PWI and DWI Measures in the Design of Proof of Concept Stroke Trials', Journal of Neuroimaging, (2004) [C1]
DOI 10.1177/1051228403259879
2003 Smith BJ, Donnan GA, Davis SM, Levi CR, Johnson KR, Bailey PM, et al., 'Thrombolysis for acute ischaemic stroke: Revisiting the evidence (multiple letters)', Medical Journal of Australia, 179 386-389 (2003)
Citations Scopus - 5
Co-authors Chris Levi
2003 Szoeke CEI, Parsons MW, Butcher KS, Baird TA, Mitchell PJ, Fox SE, Davis SM, 'Acute stroke thrombolysis with intravenous tissue plasminogen activator in an Australian tertiary hospital', Medical Journal of Australia, 178 324-328 (2003) [C1]
2003 Baird TA, Parsons MW, Phanh T, Butcher KS, Desmond PM, Tress BM, et al., 'Persistent poststroke hyperglycemia in independently associated with infarct expansion and worse clinical outcome', Department Neurology Royal Melbourne Hospital, 34 2208-2214 (2003) [C1]
DOI 10.1161/01.STR.0000085087.41330.FF
2003 Butcher K, Parsons MW, Baird T, Barber A, Donnan G, Desmond P, et al., 'Perfusion thresholds in acute stroke thrombolysis', Stroke, 34 2159-2164 (2003) [C1]
DOI 10.1161/01.STR.0000086529.83878.A2
2003 Butcher KS, Parsons MW, Davis S, Donnan G, 'PWI/DWI mismatch: Better definition required', Stroke, 34 E215-E216 (2003) [C3]
DOI 10.1161/01.str.0000099066.23627.24
2003 Lovelock C, Mitchel P, Brown J, Campbell D, Field P, Parsons MW, Sm D, 'Is doppler ultrasound sufficient as the sole investigation before carotid endarterectomy', Journal of Clinical Neurscience, 10 420-424 (2003) [C1]
DOI 10.1016/S0967-5868(03)00081-X
2002 Parsons MW, Barber PA, Davis SM, 'Relationship between severity of MR perfusion deficit and DWI lesion evolution', Neurology 2002, 58 (2002) [C3]
2002 Parsons MW, Barber PA, Chalk J, Darby DG, Rose S, Desmond PM, et al., 'Diffusion and Perfusion-weighted MR imaging response to thrombolysis', Annals of Neurology, (2002) [C1]
2002 Parsons MW, Barber PA, Desmond PM, Baird TA, Tress BM, Davis SM, 'Acute hyperglycaemia adversely affects stroke outcome: an MR imaging and spectroscopy study', Annals of Neurology, (2002) [C1]
2002 Baird TA, Parsons MW, Butcher K, Davis SM, Colman P, Jerums G, et al., 'The influence of diabetes mellitus and hyperglycaemia on stroke incidence and outcome', J Clin Neurosci, (2002) [C1]
2002 Gerraty RP, Parsons MW, Barber PA, Darby DG, Desmond PM, Tress BM, Davis SM, 'Examining the lacunar hypothesis with diffusion and perfusion MRI', Stroke, (2002) [C1]
2002 Butcher KS, Parsons MW, 'Cardiac enzyme elevations after stroke: the importance of specificity', Stroke, 33 1944-1945 (2002) [C3]
2002 Butcher K, Baird TA, Parsons MW, Davis SM, 'Medical management of intracerebral haemorrhage', Neurosurgery Quarterly, (2002) [C1]
2001 Barter P, Best J, Boyden A, Cooper C, Gillam I, Mansfield P, et al., 'Lipid Management Guidelines 2001', Med J Aust, 175 57-88 (2001) [C2]
2001 Baird AE, Dambroisa J, Janket S, Eichbaum Q, Chaves C, Silver B, et al., 'A three-item scale for the early prediction of stroke recovery', Lancet, (2001) [C1]
2001 Desmond PM, Lovell AC, Rawlinson AA, Parsons MW, Barber PA, Yang Q, et al., 'The value of apparent diffusion coefficient maps in early cerebral ischemia', AJNR, (2001) [C1]
2001 Parsons MW, Yang Q, Barber PA, Darby DG, Desmond PM, Gerraty RP, et al., 'Perfusion MRI maps in hyperacute stroke: relative cerebral blood flow most accurately identifies tissue destined to infarct', Stroke, (2001) [C1]
2001 Gerraty RP, Parsons MW, Barber PA, Darby DG, Davis SM, 'The volume of lacunes', Stroke, 32 1937-1938 (2001) [C3]
1997 Parsons M, Buckley NA, 'Overdose of antipsychotic drugs - Practical management guidelines', CNS DRUGS, 7 427-441 (1997)
DOI 10.2165/00023210-199707060-00002
Citations Scopus - 10Web of Science - 5
1996 Buckley NA, Dobbins TA, Parsons M, Dawson AH, 'A drug-free Olympics - A goal for spectators as well as athletes', MEDICAL JOURNAL OF AUSTRALIA, 165 682-683 (1996)
Citations Scopus - 1Web of Science - 1
Show 198 more journal articles

Conference (168 outputs)

Year Citation Altmetrics Link
2015 Zareie H, Selmes C, Kawano H, Parsons M, Spratt N, Miteff F, et al., 'Feasibility and Accuracy of Fusion TCCD in Monitoring Acute Stroke Treatment', CEREBROVASCULAR DISEASES (2015) [E3]
Co-authors Chris Levi, Neil Spratt
2015 Campbell BCV, Mitchell PJ, Kleinig TJ, Dewey HM, Churilov L, Parsons MW, et al., 'CT perfusion 'target mismatch' patients have poor outcome in the absence of reperfusion', INTERNATIONAL JOURNAL OF STROKE (2015)
2015 Campbell BCV, Mitchell PJ, Kleinig TJ, Dewey HM, Churilov L, Parsons MW, et al., 'Endovascular thrombectomy reduces length of stay and treatment costs within 3 months of stroke', INTERNATIONAL JOURNAL OF STROKE (2015) [E3]
2015 Campbell BCV, Mitchell PJ, Kleinig TJ, Dewey HM, Churilov L, Parsons MW, et al., 'Severe hypoperfusion in the absence of a large ischemic core should not exclude patients from reperfusion therapies', INTERNATIONAL JOURNAL OF STROKE (2015) [E3]
2015 Campbell B, Mitchell P, Kleinig T, Dewey H, Churilov L, Yassi N, et al., 'Reperfusion and clinical outcome in the EXTEND-IA randomized trial', INTERNATIONAL JOURNAL OF STROKE (2015) [E3]
Co-authors Chris Levi
2015 Campbell B, Mitchell P, Kleinig T, Dewey H, Churilov L, Yassi N, et al., 'Endovascular stent-thrombectomy reduces length of stay and treatment costs within 3 months of stroke', INTERNATIONAL JOURNAL OF STROKE (2015) [E3]
Co-authors Chris Levi
2015 Campbell BCV, Mitchell PJ, Kleinig TJ, Dewey HM, Churilov L, Yassi N, et al., 'Severe hypoperfusion in the absence of a large ischemic core should not exclude patients from reperfusion therapies', INTERNATIONAL JOURNAL OF STROKE (2015) [E3]
Co-authors Chris Levi
2015 Cereda CW, Christensen S, Campbell BCV, Mishra NK, Mlynash M, Levi C, et al., 'Optimizing computer tomography perfusion with a benchmarking tool to standardize acute stroke imaging research', INTERNATIONAL JOURNAL OF STROKE (2015) [E3]
Co-authors Chris Levi
2015 Levi C, Davey A, Lasserson D, Parsons M, Barber AP, Dewey H, et al., 'Presentation patterns of patients with transient ischemic attack (TIA) and minor stroke, compared with those of stroke/TIA mimics', INTERNATIONAL JOURNAL OF STROKE (2015) [E3]
Co-authors Chris Levi, Parker Magin
2015 Delcourt C, Magin P, Parsons M, Jordan L-A, Young A, Quain D, Levi C, 'TRANSIENT, Tele-Response for Acute traNSIent neurological symptoms and evENTs. Project update', INTERNATIONAL JOURNAL OF STROKE (2015) [E3]
Co-authors Chris Levi, Parker Magin
2015 Bhaskar S, Bivard A, Parsons M, Nilsson M, Attia J, Stanwell P, Levi C, 'Delay of late-venous phase cortical vein filling in acute ischemic stroke patients' (2015) [E3]
Co-authors John Attia, Peter Stanwell, Chris Levi
2015 Huang X, Fulton R, Parsons M, Levi C, Campbell B, Bladin C, et al., 'Tenecteplase versus alteplase in acute ischemic stroke thrombolysis: A meta-analysis of individual patient data from randomized studies', INTERNATIONAL JOURNAL OF STROKE (2015) [E3]
Co-authors Chris Levi
2015 Saxena A, Anderson CS, Wang X, Chan E, Arima H, Heeley E, et al., 'Hyperglycemia and hematoma parameters in intracerebral hemorrhage: INTERACT 2 results', INTERNATIONAL JOURNAL OF STROKE (2015) [E3]
2015 Delcourt C, Sato S, Heeley E, Arima H, Salman RA-S, Stapf C, et al., 'Haematoma volume measurement techniques and their influence on outcome: INTERACT2', INTERNATIONAL JOURNAL OF STROKE (2015) [E3]
2015 Bladin C, Levi C, Parsons M, Campbell B, Panagos P, Derdyn C, Creighton F, 'Can we augment stroke thrombolysis? The use of magnetically-Enhanced Diffusion (MED (TM)) of intravenous tPA in Acute Ischemic Stroke', INTERNATIONAL JOURNAL OF STROKE (2015) [E3]
Co-authors Chris Levi
2015 Lin L, Levi C, Parsons M, 'How consistent is reperfusion in predicting good clinical outcome of stroke?', INTERNATIONAL JOURNAL OF STROKE (2015) [E3]
Co-authors Chris Levi
2015 Parsons M, Bivard A, Campbell B, McElduff P, Hsu C, Butcher K, et al., 'Tenecteplase versus Alteplase for Stroke Thrombolysis Evaluation (TASTE) Trial', CEREBROVASCULAR DISEASES (2015) [E3]
Co-authors Patrick Mcelduff, Chris Levi
2015 Bivard A, Huang X, Muir K, Levi C, Kalladka D, Moreton F, et al., 'Pooled analysis of Scottish and Australian randomized trials of tenecteplase versus alteplase in stroke', INTERNATIONAL JOURNAL OF STROKE (2015) [E3]
Co-authors Chris Levi, Neil Spratt
2015 Yassi N, Malpas CB, Campbell BCV, Moffat B, Steward C, Parsons MW, et al., 'Contralesional thalamic atrophy and functional disconnection after stroke: A multimodal mri study', INTERNATIONAL JOURNAL OF STROKE (2015) [E3]
2015 Magin P, Najib N, Tapley A, Lasserson D, Quain D, Dewey H, et al., 'A comparison of rural and urban health-seeking behaviour and processes of care in patients with transient ischemic attack and minor stroke', INTERNATIONAL JOURNAL OF STROKE (2015) [E3]
Co-authors Chris Levi, Parker Magin
2015 Parsons M, Bivard A, Campbell B, McElduff P, Hsu C, Butcher K, et al., 'Tenecteplase versus alteplase for stroke thrombolysis evaluation trial', INTERNATIONAL JOURNAL OF STROKE (2015) [E3]
Co-authors Chris Levi, Patrick Mcelduff
2015 Kawano H, Levi C, Inatomi Y, Pagram H, Kerr E, Bivard A, et al., 'International bench marking for acute stroke codes: Thrombolytic therapy access in Australia and Japan', INTERNATIONAL JOURNAL OF STROKE (2015) [E3]
Co-authors Chris Levi, Neil Spratt
2015 Levi CR, Campbell BCV, Lindley RI, Nandurkar H, Parsons MW, Hankey G, 'Apixaban and patient management following stroke/TIA: A consensus guide', INTERNATIONAL JOURNAL OF STROKE (2015) [E3]
Co-authors Chris Levi
2014 Ang T, Levi C, Ma H, Hsu C, Campbell B, Donnan G, et al., 'Multi-Modal CT in Acute Stroke: Wait for a Serum Creatinine Before Giving Intravenous Contrast? No!', CEREBROVASCULAR DISEASES (2014) [E3]
Co-authors Chris Levi
2014 Kitsos GH, Hubbard I, Kitsos AR, Parsons M, '2Up: A longitudinal study of upper limb recovery', INTERNATIONAL JOURNAL OF STROKE (2014) [E3]
Co-authors Isobel Hubbard
2014 Campbell B, Mitchell P, Yan B, Churilov L, Ma H, Parsons M, et al., 'Extending the Time for Thrombolysis in Emergency Neurological Deficits - Intra-Arterial: The EXTEND-IA Trial', CEREBROVASCULAR DISEASES (2014) [E3]
2014 Lin L, Bivard A, Krishnamurthy V, Levi C, Parsons M, 'Comparison of Whole-Brain CTP and Limited-Coverage CTP', CEREBROVASCULAR DISEASES (2014) [E3]
Co-authors Chris Levi
2014 Lin L, Bivard A, Levi C, Parsons M, 'How to Measure Cross-Modality Reperfusion with Acute CTP and 24-Hour MRP', CEREBROVASCULAR DISEASES (2014) [E3]
Co-authors Chris Levi
2014 Bivard A, Krishnamurthy V, Levi C, Mcelduff P, Miteff F, Spratt N, et al., 'Stroke Thrombolysis: Tissue Is More Important Than Time', CEREBROVASCULAR DISEASES (2014) [E3]
Co-authors Patrick Mcelduff, Neil Spratt, Chris Levi
2014 Bivard A, Krishnamurthy V, Levi C, Mcelduff P, Miteff F, Spratt N, et al., 'Does the Presence of CTP Mismatch Predict Better Outcomes in Thrombolysis-Treated Patients?', CEREBROVASCULAR DISEASES (2014) [E3]
Co-authors Patrick Mcelduff, Chris Levi, Neil Spratt
2014 Bivard A, Krishnamurthy V, Levi C, Mcelduff P, Miteff F, Spratt N, et al., 'Better Stroke Outcomes Despite Worse Baseline Stroke Severity with Combined Clinical and CTP Assessment', CEREBROVASCULAR DISEASES (2014) [E3]
Co-authors Patrick Mcelduff, Chris Levi, Neil Spratt
2014 Ang T, Levi C, Henry M, Hsu C, Campbell B, Donnan G, et al., 'Multi-modal CT in acute stroke: Wait for a serum creatinine before giving intravenous contrast? No?', INTERNATIONAL JOURNAL OF STROKE (2014)
DOI 10.1111/ijs.12374_3
Co-authors Chris Levi
2014 Sewell C, Garnett A, Marsden D, McElduff P, Parsons M, Levi C, 'Validation of the 'Hunter 8' abbreviated National Institutes of Health Scale score for pre-hospital thrombolysis eligible stroke recognition', INTERNATIONAL JOURNAL OF STROKE (2014) [E3]
Citations Web of Science - 1
Co-authors Chris Levi, Patrick Mcelduff
2014 Bhaskar S, Evans M, Kitsos G, Russel M, Stanwell P, Walker R, et al., 'The influence of initial stroke severity on the likelihood of death at 90 days following acute stroke: A tertiary hospital stroke register study', INTERNATIONAL JOURNAL OF STROKE (2014) [E3]
Co-authors Neil Spratt, Peter Stanwell, Chris Levi
2014 Bivard A, Krishnamurthy V, Levi C, McElduff P, Miteff F, Spratt N, et al., 'Stroke thrombolysis: Tissue is more important than time', INTERNATIONAL JOURNAL OF STROKE (2014) [E3]
Co-authors Patrick Mcelduff, Neil Spratt, Chris Levi
2014 Bivard A, Krishnamurthy V, Levi C, McElduff P, Miteff F, Spratt N, et al., 'Does the presence of CTP mismatch predict better outcomes in thrombolysis-treated patients?', INTERNATIONAL JOURNAL OF STROKE (2014) [E3]
Co-authors Patrick Mcelduff, Chris Levi, Neil Spratt
2014 Zareie H, Selmes C, Kawano H, Parsons M, Spratt N, Miteff F, et al., 'Feasibility and accuracy of fusion TCCD in monitoring acute stroke treatment', INTERNATIONAL JOURNAL OF STROKE (2014) [E3]
Co-authors Neil Spratt, Chris Levi
2014 Lin L, Bivard A, Krishnamurthy V, Levi C, Parsons M, 'Whole-brain CT perfusion measures the acute ischaemic lesion accurately and precisely', INTERNATIONAL JOURNAL OF STROKE (2014) [E3]
Co-authors Chris Levi
2014 Bivard A, Krishnamurthy V, Levi C, McElduff P, Miteff F, Spratt N, et al., 'Better stroke outcomes despite worse baseline stroke severity - The value of a combined clinical and advanced CT selection approach to thrombolysis', INTERNATIONAL JOURNAL OF STROKE (2014) [E3]
Co-authors Patrick Mcelduff, Neil Spratt, Chris Levi
2014 Gunathilake R, Krishnamurthy V, Oldmedow C, Kerr E, Padmakumar C, Attia J, et al., 'Relationships between age, other predictive variables and the 90-day functional outcome after intravenous thrombolysis for acute ischemic stroke', INTERNATIONAL JOURNAL OF STROKE (2014) [E3]
Co-authors John Attia, Christopher Oldmeadow, Chris Levi
2014 Yassi N, Campbell B, Desmond PM, Parsons M, Davis SM, Bivard A, 'Baseline peri-infarct n-acetylaspartic acid correlates with regional white matter atrophy after ischaemic stroke', INTERNATIONAL JOURNAL OF STROKE (2014) [E3]
2014 Kerr E, Sanson-Fisher RW, Paul CL, DEste C, Parsons M, Bladin C, et al., 'Thrombolysis ImPlementation in Stroke (TIPS): Evaluating the effectiveness of a strategy to increase the adoption of best evidence practice: An overview of data collected during the baseline period', INTERNATIONAL JOURNAL OF STROKE (2014) [E3]
Co-authors John Attia, Rob Sanson-Fisher, Frans Henskens, Chris Levi, Chris Paul, Catherine Deste
2014 Zareie H, Selmes C, Kawano H, Parsons M, Spratt N, Miteff F, et al., 'Feasibility and accuracy of fusion TCCD in acute stroke treatment', INTERNATIONAL JOURNAL OF STROKE (2014) [E3]
Co-authors Chris Levi, Neil Spratt
2014 Kitsos, Evans MK, Kerr E, Russell M, Royan A, Kaauwai L, et al., 'Target stroke: Improving door to needle time; A quality improvement workshop', International Journal of Stroke (2014) [E3]
2013 Rennie JL, Jolly TA, Bateman GA, Michie PT, Levi CR, Parsons MW, Karayanidis F, 'Age-related decline in white matter organisation: Relationship to global cognitive changes in a longitudinal study', Frontiers in Human Neuroscience (2013) [E3]
DOI 10.3389/conf.fnhum.2013.212.00085
Co-authors Chris Levi, Pat Michie, Frini Karayanidis
2013 Bivard A, Parsons M, 'Defining Acute Ischemic Stroke Tissue Pathophysiology Using Whole Brain 320 Slice Ct Perfusion', STROKE (2013)
2013 Bladin C, Levi C, Parsons M, 'Magnetically Enhanced Diffusion (MED) for Improved Efficacy of Thrombolytic Therapy in Acute Ischemic Stroke_A Prospective First in Man Clinical Study', STROKE (2013) [E3]
Co-authors Chris Levi
2013 Yassi N, Campbell BC, Christensen S, Sharma G, Bivard A, Lin L, et al., 'Reduced Cerebral Blood Flow on Acute Whole Brain CT Perfusion Best Predicts Hemorrhagic Transformation', STROKE (2013) [E3]
Co-authors Chris Levi
2013 Campbell BC, Christensen S, Yassi N, Sharma G, Bivard A, Lin L, et al., 'Comparison of Automated Whole Brain CT Perfusion Analysis with Perfusion-Diffusion MRI in Ischemic Stroke', STROKE (2013) [E3]
Co-authors Chris Levi
2013 Bivard A, Parsons M, 'Defining Acute Ischemic Stroke Tissue Pathophysiology Using Whole Brain 320 Slice Ct Perfusion', STROKE (2013) [E3]
2013 Bivard A, Parsons M, 'Whole Brain Perfusion In Tia', STROKE (2013) [E3]
2013 Karayanidis F, Jolly T, Michie P, Parsons M, Levi C, Heathcote A, 'AGE-RELATED CHANGES IN WHITE MATTER IN FRONTO-PARIETAL AND FRONTO-STRIATAL TRACTS ARE ASSOCIATED WITH DISTINCT MEASURES OF COGNITIVE FLEXIBILITY', PSYCHOPHYSIOLOGY (2013) [E3]
Co-authors Frini Karayanidis, Pat Michie, Andrew Heathcote, Chris Levi
2013 Karayanidis F, Jolly T, Michie P, Levi C, Parsons M, Heathcote A, 'AGE-RELATED CHANGES IN WHITE MATTER IN FRONTO-PARIETAL AND FRONTO-STRIATAL TRACTS ARE ASSOCIATED WITH DISTINCT MEASURES OF COGNITIVE FLEXIBILITY', JOURNAL OF COGNITIVE NEUROSCIENCE (2013) [E3]
Co-authors Chris Levi, Andrew Heathcote, Frini Karayanidis, Pat Michie
2013 Yassi N, Parsons MW, Donnan GA, Christensen S, Levi CR, Desmond PM, et al., 'Infarct core volume on whole brain perfusion CT is predictive of haemorrhagic transformation after stroke', CEREBROVASCULAR DISEASES (2013) [E3]
Co-authors Chris Levi
2013 Bivard A, Krishnamurthy V, Stanwell P, Levi C, Davis S, Parsons M, '3T MR Spectroscopy assessment of metabolic changes in the recently salvaged human ischemic penumbra', CEREBROVASCULAR DISEASES (2013) [E3]
Co-authors Peter Stanwell, Chris Levi
2013 Meretoja A, Keshtkaran M, Tatlisumak T, Parsons MW, Davis SM, Donnan GA, Churilov L, 'Stroke thrombolysis: Save a minute - save a day', CEREBROVASCULAR DISEASES (2013) [E3]
2013 Bivard A, Stanwell P, Spratt N, Levi C, Krishnamurthy V, Davis S, Parsons M, 'Arterial spin labelling versus bolus-tracking CT and MR in hyper-acute ischemic stroke', CEREBROVASCULAR DISEASES (2013) [E3]
Co-authors Neil Spratt, Peter Stanwell, Chris Levi
2013 Marquez J, Van Vliet P, McElduff P, Lagopoulos J, Parsons M, 'Transcranial Direct Current Stimulation (tDCS): is it effective as a stroke therapy?: a systematic review', INTERNATIONAL JOURNAL OF STROKE (2013) [E3]
Co-authors Paulette Vanvliet, Patrick Mcelduff
2013 Bivard A, Stanwell P, Krishnamurthy V, Levi CR, Davis SM, Parsons M, 'Automated mismatch assessment of arterial spin labeling compared to conventional bolus tracking perfusion mismatch', INTERNATIONAL JOURNAL OF STROKE (2013) [E3]
Co-authors Peter Stanwell, Chris Levi
2013 Bivard A, Yassi N, Stanwell P, Krishnamurthy V, Levi CR, Davis SM, Parsons M, 'Spectroscopy of hyperperfused and mildly hypoperfused tissue following ischemic stroke', INTERNATIONAL JOURNAL OF STROKE (2013) [E3]
Co-authors Peter Stanwell, Chris Levi
2013 Lillicrap T, Tahtali M, Neely A, Wang X, Levi CR, Parsons M, et al., 'Validation of a finite element model of heat transfer in the stroke-affected brain against data from humans and non-human primates', INTERNATIONAL JOURNAL OF STROKE (2013) [E3]
Co-authors Chris Levi
2013 Lillicrap T, Stanwell P, Neeman T, Parsons M, Spratt N, Levi CR, Lueck C, 'Variation in regional brain temperature as measured by MR thermography in healthy volunteers', INTERNATIONAL JOURNAL OF STROKE (2013) [E3]
Co-authors Neil Spratt, Peter Stanwell, Chris Levi
2013 Fuentes S, Sharma V, Huang Y, Lavados P, Lindley R, Pandian J, et al., 'The Enhanced Control of Hypertension ANd Thrombolysis strokE StuDy (ENCHANTED): first year experience regarding possible selection bias', INTERNATIONAL JOURNAL OF STROKE (2013) [E3]
Co-authors Chris Levi
2013 Miller J, Marquez J, Van Vliet P, Lagopoulos J, Parsons M, 'Transcranial Direct Current Stimulation: A randomised controlled trial to investigate the effects on upper limb function in chronic stroke', INTERNATIONAL JOURNAL OF STROKE (2013) [E3]
Co-authors Paulette Vanvliet
2013 Kitsos G, Hubbard IJ, Kitsos A, Parsons MW, 'Non-affected or less affected: What is the ipsilesional upper limb following stroke? A systematic literature review', INTERNATIONAL JOURNAL OF STROKE (2013) [E3]
Co-authors Isobel Hubbard
2013 Bivard A, Stanwell P, Krishnamurthy V, Levi C, Davis S, Parsons M, 'Automated mismatch assessment of arterial spin labeling compared to conventional bolus tracking perfusion mismatch', International Journal of Stroke (2013) [E3]
DOI 10.1111/ijs.12214
Co-authors Chris Levi, Peter Stanwell
2012 Marsden DL, Garnett AR, Parsons MW, Spratt NJ, Watson T, Loudfoot A, et al., 'No thrombolysis service? No worries. A controlled trial of facilitated access for rural stroke patients to a regional thrombolysis centre - The Hunter Rural PAST Protocol', Abstract E-book. 2012 European Stroke Conference (2012) [E3]
Co-authors Chris Levi, Neil Spratt, Patrick Mcelduff
2012 Hubbard IJ, Carey LM, Budd TW, Parsons MW, 'An RCT of differing intensities of early upper limb training post stroke: Evidence of neuroplastic changes in the ipsilesional SMA', Congress Handbook. 7th World Congress for Neurorehabilitation (2012) [E3]
Co-authors Bill Budd, Isobel Hubbard
2012 Jolly TAD, Bateman GA, Levi CR, Parsons MW, Karayanidis F, 'The relationship between arterial and venous pulsatility and microstructural white matter changes', Front. Hum. Neurosci. Conference Abstract: ACNS-2012 Australasian Cognitive Neuroscience Conference (2012) [E3]
Co-authors Frini Karayanidis, Chris Levi
2012 Rennie JL, Jolly TAD, Michie PT, Levi CR, Parsons MW, Lenroot R, Karayanidis F, 'Measures of white matter decline and global cognitive ability in older adults', Front. Hum. Neurosci. Conference Abstract: ACNS-2012 Australasian Cognitive Neuroscience Conference (2012) [E3]
Co-authors Frini Karayanidis, Pat Michie, Chris Levi
2012 Conley A, Marquez JL, Parsons MW, Fulham WR, Lagopoulos J, Karayanidis F, 'Sustained effects of anodal tDCS over the dominant motor cortex on response preparation processes', Front. Hum. Neurosci. Conference Abstract: ACNS-2012 Australasian Cognitive Neuroscience Conference (2012) [E3]
Co-authors Frini Karayanidis
2012 Karayanidis F, Jolly TAD, Cooper PS, Levi CR, Parsons MW, Michie PT, 'Disruption to frontal white matter pathways on performance in the task-switching paradigm', Front. Hum. Neurosci. Conference Abstract: ACNS-2012 Australasian Cognitive Neuroscience Conference (2012) [E3]
Co-authors Chris Levi, Frini Karayanidis, Pat Michie
2012 Jolly TAD, Fulham WR, Michie PT, Levi CR, Parsons MW, Karayanidis F, 'Disruption to frontal white matter pathways related to performance on the stop-signal task', Front. Hum. Neurosci. Conference Abstract: ACNS-2012 Australasian Cognitive Neuroscience Conference (2012) [E3]
Co-authors Frini Karayanidis, Pat Michie, Chris Levi
2012 Conley A, Marquez JL, Parsons MW, Lagopoulos J, Karayanidis F, 'Effects of anodal tDCS over the primary motor cortex on response preparation and execution', Combined Abstracts of 2012 Australian Psychology Conferences (2012) [E3]
Co-authors Frini Karayanidis
2012 Cooper P, Jolly TAD, Michie PT, Parsons MW, Levi CR, Fulham WR, Karayanidis F, 'The role of white matter tract disruption on age-related decline in cognitive flexibility', Combined Abstracts of 2012 Australian Psychology Conferences (2012) [E3]
Co-authors Pat Michie, Frini Karayanidis, Chris Levi
2012 Hata J, Arima H, Delcourt C, Heeley E, Huang Y, Stapf C, et al., 'DETERMINANTS OF HYPERTENSIVE RESPONSE IN ACUTE INTRACEREBRAL HAEMORRHAGE: DATA FROM 1000 INTERACT SUBJECTS', HYPERTENSION (2012)
2012 Bivard A, Parsons MW, 'A new measure of acute perfusion imaging in ischemic stroke- Severity', International Journal of Stroke (2012) [E3]
2012 Campbell BCV, Christensen S, Tress BM, Desmond PM, Parsons MW, Barber PA, et al., 'Insights into the relationship of perfusion-diffusion mismatch and leptomeningeal collateral quality - Simultaneous assessment through novel visualization of perfusion imaging', International Journal of Stroke (2012) [E3]
Citations Web of Science - 1
Co-authors Chris Levi
2012 Thomas LH, Rivett DA, Parsons MW, Levi CR, 'Radiological features of craniocervical arterial dissection and topography of the resultant infarct: Relation with risk factors', International Journal of Stroke (2012) [E3]
Co-authors Chris Levi, Darren Rivett, Lucy Thomas
2012 Bivard A, Parsons MW, 'Defining acute ischemic stroke tissue pathophysiology using 320 slice CT perfusion', International Journal of Stroke (2012) [E3]
Co-authors Chris Levi
2012 Karayanidis F, Jolly TAD, Bateman GA, Michie PT, Parsons MW, Levi CR, 'Structural brain changes associated with pulse-wave encephalopathy', International Journal of Stroke (2012) [E3]
Co-authors Chris Levi, Frini Karayanidis, Pat Michie
2012 Karayanidis F, Cooper P, Jolly TAD, Michie PT, Parsons MW, Levi CR, Fulham WR, 'The influence of white matter changes with ageing and mild ischemic attacks on cognitive flexibility', International Journal of Stroke (2012) [E3]
Co-authors Frini Karayanidis, Pat Michie, Chris Levi
2012 Hubbard IJ, Carey L, Budd TW, Parsons MW, 'Brain activation and upper limb recovery post stroke: A systematic literature review', International Journal of Stroke (2012) [E3]
Citations Web of Science - 2
Co-authors Bill Budd, Isobel Hubbard
2012 Campbell B, Donnan G, Davis S, Ma H, Christensen S, Connelly A, et al., 'EXtending the time for Thombolysis in Emergency Neurological Deficits - Intra-Arterial: The EXTEND Trial progress', International Journal of Stroke (2012) [E3]
2012 Campbell B, Mitchell P, Yan B, Churilov L, Ma H, Parsons MW, et al., 'EXtending the time for Thombolysis in Emergency Neurological Deficits - Intra-Arterial: the EXTEND-IA Trial rationale and protocol', International Journal of Stroke (2012) [E3]
2012 Bivard A, Stanwell PT, Parsons MW, 'MR Spectroscopy: Bio-makers for post stroke recovery', International Journal of Stroke (2012) [E3]
Co-authors Peter Stanwell
2012 Garnett AR, Marsden DL, Parsons MW, Spratt NJ, Watson T, Loudfoot AR, et al., 'The Hunter Rural PAST Protocol: An innovative and effective partnership between ambulance and a regional thrombolysis centre to facilitate access for rural stroke patient to thrombolysis', International Journal of Stroke (2012) [E3]
Co-authors Patrick Mcelduff, Chris Levi, Neil Spratt
2012 Lin L, Bivard A, Kemp D, Parsons MW, Levi CR, 'Comparison of perfusion CT and MR in hyperacute stroke', International Journal of Stroke (2012) [E3]
Co-authors Chris Levi
2012 Bivard A, Levi CR, Parsons MW, 'Assessing the variability of CTP post processing techniques to define the acute infarct core and penumbra', Abstract E-book. 2012 European Stroke Conference (2012) [E3]
Co-authors Chris Levi
2012 Bivard A, Stanwell PT, Levi CR, Parsons MW, 'Clinical utility of subacute Arterial Spin Labelling in stroke', Abstract E-book. 2012 European Stroke Conference (2012) [E3]
Co-authors Peter Stanwell, Chris Levi
2011 Maguire JM, Holliday EG, Sturm J, Golledge J, Lewis M, Koblar S, et al., 'Australian stroke genetics collaborative: Genetic associations with ischaemic stroke functional outcome', International Journal of Stroke (2011) [E3]
Co-authors Lisa Lincz, Jane Maguire, John Attia, Pablo Moscato, Rodney Scott, Liz Holliday, Chris Levi
2011 Bivard A, Parsons MW, 'The clinical reliability and predictability of acute CTP', International Journal of Stroke (2011) [E3]
2011 Bivard A, Parsons MW, 'Validation of arterial spin labeling in 24-hour stoke patients', International Journal of Stroke (2011) [E3]
2011 Bivard A, Spratt NJ, Levi CR, Parsons MW, 'CTP thresholds to detect acute ischeamic stroke tissue pathophysiology', International Journal of Stroke (2011) [E3]
Co-authors Neil Spratt, Chris Levi
2011 Beath A, Bivard A, McElduff P, Parsons MW, Levi CR, 'Clinical predictors of outcome in acute ischaemic stroke patients treated with intravenous tissue plasminogen activator (tPA)', International Journal of Stroke (2011) [E3]
Co-authors Chris Levi, Patrick Mcelduff
2011 Campbell B, Christensen S, Levi CR, Desmond P, Donnan G, Davis G, Parsons MW, 'Comparison of CT perfusion to multimodal MRI in ischemic stroke', International Journal of Stroke (2011) [E3]
Co-authors Chris Levi
2011 Chen X, Huang Y, Wang J, Heeley E, Delcourt C, Lindley R, et al., 'The Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial (INTERACT2): Progress and quality control update', International Journal of Stroke (2011) [E3]
2011 Fuentes S, Huang Y, Wang J, Sharma V, Nguyen HT, Pandian J, et al., 'The Enhanced Control of Hypertension ANd Thrombolysis strokE StuDy (ENCHANTED): Part B - Rationale for a trial of early intensive blood pressure lowering after use of rtPA', International Journal of Stroke (2011) [E3]
Co-authors Chris Levi
2011 Tu H, Campbell B, Christensen S, Churilov L, Parsons MW, De Silva D, et al., 'More severe hypoperfusion leads to greater infarct growth and worse stroke outcome in atrial fibrillation', International Journal of Stroke (2011) [E3]
2011 O'Brien W, Chung K, Levi CR, Spratt NJ, Parsons MW, 'Comparative study of Multimodal Computed Tomography (MdCT) and Magnetic resonance imaging (MRI) in Transient ischaemic attack and minor stroke patient', International Journal of Stroke (2011) [E3]
Co-authors Neil Spratt, Chris Levi
2011 Menon B, O'Brien W, Bivard A, Levi CR, Spratt NJ, Parsons MW, 'Detailed anatomic and physiologic assessment of leptomeningeal collaterals in acute ischemic stroke patients using dynamic time resolved 320 slice CT angiography', International Journal of Stroke (2011) [E3]
Co-authors Chris Levi, Neil Spratt
2011 Hata J, Arima H, Delcourt C, Heeley E, Huang Y, Staph C, et al., 'Determinants of presenting blood pressure in acute intracerebral haemorrhage: Data from 1000 INTERACT subjects', International Journal of Stroke (2011) [E3]
2011 Leroux M, Delcourt C, Heeley E, Huang Y, Stapf C, Lindley R, et al., 'The main intensive blood pressure reduction in acute cerebral haemorrhage trial (INTERACT2): Progress update and future expectations on the largest clinical trial in ICH', International Journal of Stroke (2011) [E3]
2011 Hunter AJ, Snodgrass SN, Quain DA, Parsons MW, Levi CR, 'Orthostatic variation in transcranial Doppler measured cerebral blood flow velocity 24 hours post acute ischaemic stroke', International Journal of Stroke (2011) [E3]
Co-authors Chris Levi, Suzanne Snodgrass
2011 Lillicrap T, Jyoti R, Levi CR, Parsons MW, Spratt NJ, Stanwell P, Lueck C, 'Temperature measurements using MR spectroscopy: Validation and calibration in healthy volunteers', International Journal of Stroke (2011) [E3]
Co-authors Neil Spratt, Chris Levi
2011 Russell ML, Evans MK, Royan AT, Magin PJ, Lasserson D, Attia JR, et al., 'Referral and triage of patients with TIAs to an acute access clinic: Risk-stratification performance in an Australian setting', International Journal of Stroke (2011) [E3]
Co-authors John Attia, Patrick Mcelduff, Neil Spratt, Parker Magin, Chris Levi
2011 Campbell BC, Christensen S, Levi CR, Desmond PM, Donnan GA, Davis SM, Parsons MW, 'Predicting infarct core using CT perfusion - comparison of CT perfusion parameters to concurrent diffusion MRI', Stroke (2011) [E3]
Co-authors Chris Levi
2011 Campbell BC, Purushotham A, Christensen S, Desmond PM, Nagakane Y, Parsons MW, et al., 'The acute diffusion lesion reliably represents infarct core: Clinically relevant reversibility is rare', Stroke (2011) [E3]
Citations Web of Science - 1
2011 Menon BK, O'Brien W, Bivard A, Levi CR, Spratt NJ, Parsons MW, 'Anatomic and physiologic assessment of leptomeningeal collaterals in acute ischemic stroke patients using dynamic time resolved 320 slice CT angiography', Stroke (2011) [E3]
Co-authors Neil Spratt, Chris Levi
2011 Bivard A, Levi CR, Spratt NJ, Parsons MW, 'Delayed perfusion predicts the volume of the perfusion lesion', Stroke (2011) [E3]
Co-authors Neil Spratt, Chris Levi
2011 Tu HT, Campbell BC, Christensen S, De Silva DA, Parsons MW, Churilov L, et al., 'Worse stroke outcome in atrial fibrillation links to more severe hypoperfusion', Stroke (2011) [E3]
Citations Web of Science - 1
2011 Christensen S, Campbell B, Parsons MW, De Silva DA, Ebinger M, Butcher K, et al., 'High tmax values on perfusion MRI often reflect low CBV - A pathophysiological link between the malignant perfusion profile and poor outcome?', Stroke (2011) [E3]
Citations Web of Science - 1
Co-authors Chris Levi
2011 Campbell BC, Tu HT, Christensen S, Desmond PM, Levi CR, Bladin CF, et al., 'Diffusion imaging 24 hours after stroke onset accurately represents final infarct volume', Stroke (2011) [E3]
Co-authors Chris Levi
2011 Frith JLT, Hubbard IJ, Parsons MW, Vyslysel G, Burgman I, James CL, 'Shifting Gears: Resuming driving after stroke', Proceedings of the 24th Occupational Therapy Australia National Conference (2011) [E3]
Co-authors Carole James, Isobel Hubbard
2011 Bivard A, Spratt NJ, Levi CR, Parsons MW, 'Perfusion CT predicts subsequent tissue and clinical outcome in hyperacute ischemic stroke', Cerebrovascular Diseases (2011) [E3]
Co-authors Neil Spratt, Chris Levi
2011 Campbell BCV, Christensen S, Levi CR, Desmond PM, Donnan GA, Davis SM, Parsons MW, 'Predicting infarct core using CT perfusion - Cerebral blood flow thresholds perform best', Cerebrovascular Diseases (2011) [E3]
Co-authors Chris Levi
2011 Hata J, Arima H, Delcount C, Heeley E, Huang Y, Stapf C, et al., 'Determinants of hypertensive response in acute intracerebral haemorrhage: Data from 1000 infarct subjects', Cerebrovascular Diseases (2011) [E3]
2011 Marsden DL, Garnett AR, Watson T, McElduff P, Levi CR, Parsons MW, 'In the field stroke assessment tool for paramedics: The 'Hunter 8'', Cerebrovascular Diseases (2011) [E3]
Co-authors Chris Levi, Patrick Mcelduff
2011 Parsons MW, Bivard A, Campbell B, Chong KK, Miteff F, Bladin C, et al., 'Tenecteplase versus alteplase for acute ischaemic stroke: An imaging based efficacy trial', Cerebrovascular Diseases (2011) [E3]
Co-authors Chris Levi
2010 Perez De La Ossa N, Chandra RV, Campbell BCV, Christensen S, Collins M, Parsons MW, et al., 'Leukoaraiosis is not an independent risk factor for parenchymal hemorrhage after thrombolysis', Cerebrovascular Diseases: European Stroke Conference (2010) [E3]
Co-authors Chris Levi
2010 McVerry F, Levi CR, Muir KW, Parsons MW, 'Detection of penumbra and arterial occlusions using multimodal CT - where should therapy be targeted?', Cerebrovascular Diseases: European Stroke Conference (2010) [E3]
Co-authors Chris Levi
2010 Levi CR, Chambers BR, Young D, Stork J, Abbott A, Wlodarczyk JH, et al., 'The efficacy and safety of 10% dextran 40 in the prevention of stroke complicating carotid endarterectomy - the dextran in carotid endarterectomy (DICE) trial', Cerebrovascular Diseases: European Stroke Conference (2010) [E3]
Co-authors Chris Levi
2010 Hubbard IJ, Parsons MW, Carey LM, 'Translating task-specific, upper limb evidence into stroke recovery intervention and clinical practice', Cerebrovascular Diseases: European Stroke Conference (2010) [E3]
Co-authors Isobel Hubbard
2010 Hubbard IJ, Budd TW, Carey LM, McElduff P, Levi CR, Parsons MW, 'Intensive behavioural upper limb training in acute stroke: an RCT of functional outcomes and brain reorganisation', Cerebrovascular Diseases: European Stroke Conference (2010) [E3]
Co-authors Patrick Mcelduff, Isobel Hubbard, Bill Budd, Chris Levi
2010 Campbell BCV, Costello C, Christensen S, Ebinger M, Parsons MW, Desmond PM, et al., 'Acute infarct hyperintensity is almost universal beyond 3 hours and does not predict hemorrhagic transformation', Cerebrovascular Diseases: European Stroke Conference (2010) [E3]
Co-authors Chris Levi
2010 Campbell BCV, Christensen S, Tu H, Desmond PM, Levi CR, Bladin CF, et al., 'Diffusion imaging 24 hours after stroke onset accurately represents final infarct volume', Cerebrovascular Diseases: European Stroke Conference (2010) [E3]
Co-authors Chris Levi
2010 Campbell BCV, Christensen S, Desmond PM, Parsons MW, Barber PA, De Silva DA, et al., 'Major infarct growth beyond 6 hours is associated with collateral circulation failure', Cerebrovascular Diseases: European Stroke Conference (2010) [E3]
Co-authors Chris Levi
2010 Bivard A, McElduff P, Spratt NJ, Levi CR, Parsons MW, 'Validating perfusion-computed tomography in defining extent of irreversible brain ischemia', Circulation (2010) [E3]
Co-authors Chris Levi, Neil Spratt, Patrick Mcelduff
2010 Lillicrap T, Stanwell P, Parsons MW, Spratt NJ, Hudson S, Levi CR, 'MR spectroscopy in brain temperature measurement and application to induced hypothermia therapy', Circulation (2010) [E3]
Co-authors Chris Levi, Peter Stanwell, Neil Spratt
2010 Tu HT, Campbell BC, Christensen S, Butcher KS, Collins M, Parsons MW, et al., 'The Effects of Atrial Fibrillation on Infarct Evolution and Outcome', STROKE (2010) [E3]
Citations Web of Science - 1
Co-authors Chris Levi
2010 Christensen S, Parsons MW, De Silva DA, Ebinger M, Butcher K, Fink J, et al., 'Testing the mismatch hypothesis in the randomized EPITHET data set: The effect of treatment, mismatch and their interaction on infarct growth', Stroke (2010) [E3]
Citations Web of Science - 3
Co-authors Chris Levi
2010 Bivard A, McElduff P, Levi CR, Spratt NJ, Parsons MW, 'Defining the extent of irreversible brain ischemia using perfusion computed tomography', Stroke (2010) [E3]
Citations Web of Science - 1
Co-authors Patrick Mcelduff, Neil Spratt, Chris Levi
2010 Campbell BC, Christensen S, Parsons MW, Desmond PM, Barber PA, Butcher KS, et al., 'Very low cerebral blood volume predicts hemorrhagic transformation better than diffusion lesion volume in acute ischemic stroke', Stroke (2010) [E3]
Citations Web of Science - 1
Co-authors Chris Levi
2010 Lillicrap TP, Hudson S, Stanwell P, Parsons MW, Spratt NJ, Levi CR, 'MR spectroscopy and diffusion-weighted MRI can accurately measure both reduced and increased brain temperature', Stroke (2010) [E3]
Co-authors Neil Spratt, Peter Stanwell, Chris Levi
2009 McLeod DD, Spratt NJ, Levi CR, Beautement S, Roworth B, Buxton D, et al., 'Experimental validation of perfusion computed tomography in acute middle cerebral artery occlusion', ACBRC 2009 Abstracts (2009) [E3]
Co-authors Damian Mcleod, Neil Spratt, Chris Levi
2009 McLeod DD, Parsons MW, Levi CR, Beautement S, Roworth B, Buxton D, et al., 'An experimental model to investigate CT brain perfusion after stroke', ANS 2009 Abstracts: Posters (2009) [E3]
Co-authors Neil Spratt, Damian Mcleod, Chris Levi
2009 Butcher K, Christensen S, Parsons MW, De Silva D, Ebinger M, Levi CR, et al., 'Post-treatment blood pressure control predicts thrombolysis related hemorrhagic transformation', Stroke (2009) [E3]
DOI 10.1161/strokeaha.108.000015
Citations Web of Science - 1
Co-authors Chris Levi
2009 Christensen S, Parsons MW, De Silva D, Ebinger M, Butcher K, Fink J, et al., 'Optimising MR criteria for penumbral selection trials', Stroke (2009) [E3]
DOI 10.1161/strokeaha.108.000015
Citations Web of Science - 6
Co-authors Chris Levi
2009 Tan A, Coughlan K, Bray J, Parsons MW, Bladin C, 'CT angiography and CT perfusion: Single or dual imaging targets: Which is better for stroke thrombolysis?', Stroke (2009) [E3]
DOI 10.1161/strokeaha.108.000015
2009 McLeod DD, Spratt NJ, Levi CR, Beautement S, Roworth B, Buxton D, et al., 'Perfusion computed tomography for acute stroke: A model for experimental validation', Cerebrovascular Diseases (2009) [E3]
DOI 10.1159/000221776
Co-authors Chris Levi, Neil Spratt, Damian Mcleod
2009 Brekenfeld C, De Silva DA, Christensen S, Churilov L, Parsons MW, Levi CR, et al., 'Dual target (mismatch and vessel obstruction) at baseline MRI does not improve stroke patient selection for thrombolysis 3-6 h', Cerebrovascular Diseases (2009) [E3]
DOI 10.1159/000221772
Co-authors Chris Levi
2009 Butcher K, Christensen S, Parsons MW, De Silva D, Ebinger M, Levi CR, et al., 'Hemorrhagic transformation in the echoplanar imaging thrombolysis evaluation trial (EPITHET) is predicted by post-treatment blood pressure control and infarct volume', Cerebrovascular Diseases (2009) [E3]
DOI 10.1159/000221772
Co-authors Chris Levi
2009 Campbell BCV, Christensen S, Butcher KS, Gordon I, Parsons MW, Desmond PM, et al., 'Very low cerebral blood volume (VLCBV) predicts hemorrhagic transformation better than DWI volume in acute ischemic stroke', Cerebrovascular Diseases (2009) [E3]
DOI 10.1159/000221773
Co-authors Chris Levi
2009 Tan A, Bladin CF, Parsons MW, Coughlan K, Bray JE, 'Patient selection for stroke thrombolysis based on CT angiography and/or CT perfusion: 'Single' or 'dual' target CT imaging', Cerebrovascular Diseases (2009) [E3]
DOI 10.1159/000221780
2009 Tan A, Parsons MW, Bray JE, Bladin CF, 'TIMI grading of cerebral vascular occlusion: Is it reliable?', Cerebrovascular Diseases (2009) [E3]
DOI 10.1159/000221779
2008 Budd TW, Parsons MW, Hubbard IJ, Carey L, Levi CR, 'A longitudinal fMRI study of cortical sensorimotor reorganization in stroke recovery', NeuroImage (2008) [E3]
Co-authors Bill Budd, Chris Levi, Isobel Hubbard
2008 Hubbard IJ, Budd TW, Parsons MW, 'Arm function, fMRI and early reorganisation mapping in stroke (AFfERMS): Findings from the pilot phase', Internal Medicine Journal (2008) [E3]
DOI 10.1111/j.1445-5994.2008.01755_7.x
Co-authors Isobel Hubbard, Bill Budd
2008 Miteff F, Parsons MW, Bateman GA, Spratt NJ, Levi CR, 'Does collateral vessel status on CT angiography add to perfusion CT in the prediction of outcome after acute ischaemc stroke?', Internal Medicine Journal (2008) [E3]
DOI 10.1111/j.1445-5994.2008.01755_7.x
Co-authors Chris Levi, Neil Spratt
2008 Tan A, Coughlan K, Bray J, Parsons MW, Bladin C, 'Is CT dual target imaging a valid basis for stroke thrombolysis?', Internal Medicine Journal (2008) [E3]
DOI 10.1111/j.1445-5994.2008.01755_7.x
2008 Christensen S, Parsons MW, De Silva DA, Ebinger M, Butcher K, Fink J, et al., 'Optimizing mismatch definitions in acute stroke MRI: An epithet post hoc study', Internal Medicine Journal (2008) [E3]
DOI 10.1111/j.1445-5994.2008.01755_7.x
Co-authors Chris Levi
2008 Hubbard R, Day K, Baker K, Parsons MW, 'Assessment of the upper limb in acute stroke: The validity of the hierarchal scoring method for the motor assessment scale', Internal Medicine Journal (2008) [E3]
DOI 10.1111/j.1445-5994.2008.01755_7.x
2008 Hubbard IJ, Carey L, Parsons MW, 'The evidence concerning task-specific therapy for upper limb function: A literature review', Internal Medicine Journal (2008) [E3]
DOI 10.1111/j.1445-5994.2008.01756.x
Co-authors Isobel Hubbard
2008 Selmes C, Levi CR, Parsons MW, Miteff F, 'The incidence of anterior cerebral artery flow reversal in high-grade internal carotid artery stenotic disease or occlusion', Internal Medicine Journal (2008) [E3]
DOI 10.1111/j.1445-5994.2008.01756.x
Co-authors Chris Levi
2008 Prosser JF, Allport L, Butcher K, Parsons MW, Desmond P, Tress B, Davis SM, 'The influence of ischemic stroke subtype on infarct expansion, penumbral fate and reperfusion', Stroke (2008) [E3]
2008 Wang JG, Anderson C, Huang YN, Arima H, Neal B, Peng B, et al., 'The intensive blood pressure reduction in acute cerebral haemorrhage trial (INTERACT): Results of the vanguard phase', Journal of Hypertension. Supplement (2008) [E3]
2008 Christensen S, Parsons MW, De Silva D, Ebinger M, Butcher K, Fink J, Davis S, 'Optimal mismatch definitions for detecting treatment response in acute stroke', Cerebrovascular Diseases (2008) [E3]
DOI 10.1159/000132088
2008 Desilva DA, Ebinger M, Christensen S, Levi CR, Parsons MW, Peeters A, et al., 'The impact of diabetes and admission in blood glucose on outcomes in the Echoplanar Imaging Thrombolytic Evaluation Trial (EPITHET)', Cerebrovascular Diseases (2008) [E3]
DOI 10.1159/000132093
Co-authors Chris Levi
2008 Ebinger M, Christensen S, Desilva DA, Parsons MW, Levi CR, Peeters A, et al., 'Expediting MRI-based proof of concept stroke trials using an earlier primary endpoint', Cerebrovascular Diseases (2008) [E3]
DOI 10.1159/000132088
Co-authors Chris Levi
2007 Maguire J, Sturm J, Attia JR, Whyte S, Bisset L, Lincz L, et al., 'A case-control genetic association study to examine platelet glycoprotein polymorphisms and ischaemic stroke risk', Internal Medicine Journal (2007) [E3]
Co-authors Lisa Lincz, Chris Levi, John Attia
2007 Butcher K, Parsons MW, Allport L, Lee SB, Barber PA, Tress B, et al., 'Standardizing quantitative and qualitative perfusion-diffusion mismatch assessment', Stroke (Volume 38, Issue 2) (2007) [E3]
2005 Selmes C, Evans MK, Levi C, Parsons M, Royan A, Russell M, et al., 'PREVALENCE OF INTRACRANIAL LARGE ARTERY DISEASE IN THE HUNTER REGION', Internal Medicine Journal (2005)
Co-authors Chris Levi
2005 Evans MK, russell M, royan A, moore A, parsons M, levi C, 'THE ACUTE STROKE NURSE: AN INTEGRAL PART OF THE STROKE TEAM', Internal Medicine Journal (2005)
Co-authors Chris Levi
2005 Butcher K, Parsons M, Allport L, Lee SB, Barber PA, Tress B, et al., 'MR ASPECTS (Alberta Stroke Program early CT scores) predicts PWI-DWI msmatch with good inter-rater reliability', JOURNAL OF THE NEUROLOGICAL SCIENCES (2005)
2005 Butcher KS, Lee SB, Parsons M, Levi C, Allport L, Prosser J, et al., 'Increased blood volume maintains viability in tissue with isolated focal swelling on CT in acute stroke', STROKE (2005)
Citations Web of Science - 4
Co-authors Chris Levi
2004 Butcher KS, Macgregor L, Parsons MW, Barber PA, Levi C, Chalk J, et al., 'Multiple definitions of PWI-DWI mismatch reliably predict infarct growth', STROKE (2004)
Citations Web of Science - 2
Co-authors Chris Levi
2004 Butcher KS, Parsons M, Barber A, Newcastle HH, Levi C, Chalk J, et al., 'The frequency of perfusion-diffusion mismatch decreases with objective definition', STROKE (2004)
Citations Web of Science - 2
Co-authors Chris Levi
2004 Loh PS, Butcher K, Parsons M, MacGregor I, Desmond P, Tress R, Davis S, 'ADC thresholds do not predict the response to acute stroke thrombolysis', STROKE (2004)
2004 Wang Y, Levi CR, Parsons MW, Selmes CM, Evans M, Royan A, et al., 'Predictors of in-hospital Neurological Deterioration in Acute Ischaemic Stroke', Predictors of in-hospital Neurological Deterioration in Acute Ischaemic Stroke (2004) [E3]
Co-authors Chris Levi
Show 165 more conferences
Edit

Grants and Funding

Summary

Number of grants 48
Total funding $21,214,118

Click on a grant title below to expand the full details for that specific grant.


20161 grants / $344,047

HMRI MRSP Infrastructure (12-16) Brain and Mental Health Program – Stroke and Brain Injury$344,047

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Doctor Neil Spratt, Professor Mark Parsons
Scheme NSW MRSP Infrastructure Grant
Role Investigator
Funding Start 2016
Funding Finish 2016
GNo G1600733
Type Of Funding Other Public Sector - State
Category 2OPS
UON Y

20153 grants / $6,437,352

Tenecteplase versus Alteplase for Stroke Thrombolysis Evaluation (TASTE) Trial$3,989,898

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Professor Mark Parsons, Conjoint Professor Chris Levi, Doctor Patrick McElduff, Professor Richard Lindley, Professor Patricia Desmond, Professor Gregory Albers, Professor Werner Hacke, Professor Hugh Markus, Dr Bruce Campbell, Professor Thanh Phan
Scheme Project Grant
Role Lead
Funding Start 2015
Funding Finish 2019
GNo G1400012
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON Y

Centre for Research Excellence in Stroke Rehabilitation and Brain Recovery$1,223,727

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Associate Professor Julie Bernhardt, Professor Michael Nilsson, Dr Leeanne Carey, Professor Paulette Van Vliet, Dr Dominique Cadilhac, Professor Christopher Bladin, Professor Sandy Middleton, Professor Geoff Donnan, Professor Mark Parsons, Conjoint Professor Chris Levi
Scheme Centres of Research Excellence (CRE) - Centres of Clinical Research Excellence
Role Investigator
Funding Start 2015
Funding Finish 2019
GNo G1401448
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON Y

Centre for Research Excellence in Stroke Rehabilitation and Brain Recovery$1,223,727

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Associate Professor Julie Bernhardt, Professor Michael Nilsson, Dr Leeanne Carey, Professor Paulette Van Vliet, Dr Dominique Cadilhac, Professor Christopher Bladin, Professor Sandy Middleton, Professor Geoff Donnan, Professor Mark Parsons, Conjoint Professor Chris Levi
Scheme Centres of Research Excellence (CRE) - Centres of Clinical Research Excellence
Role Investigator
Funding Start 2015
Funding Finish 2019
GNo G1401448
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON Y

20147 grants / $1,062,000

Tenecteplase versus Alteplase for Stroke Thrombolysis Evaluation (TASTE) Trial$640,000

Funding body: National Heart Foundation of Australia

Funding body National Heart Foundation of Australia
Project Team Professor Mark Parsons
Scheme Future Leader Fellowship
Role Lead
Funding Start 2014
Funding Finish 2018
GNo G1300638
Type Of Funding Aust Competitive - Non Commonwealth
Category 1NS
UON Y

Tenecteplase versus Alteplase for Stroke Thrombolysis Evaluation (TASTE) trial$300,000

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Professor Mark Parsons
Scheme Project Grant
Role Lead
Funding Start 2014
Funding Finish 2016
GNo G1400615
Type Of Funding Grant - Aust Non Government
Category 3AFG
UON Y

Neuroimaging Biomarkers of Recovery: Longitudinal Imaging Study in the rehabilitation Phase post-Acute Ischemic Stroke (NEUROLISS)$50,000

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Doctor Andrew Bivard, Professor Mark Parsons, Conjoint Professor Chris Levi
Scheme Project Grant
Role Investigator
Funding Start 2014
Funding Finish 2014
GNo G1401437
Type Of Funding Grant - Aust Non Government
Category 3AFG
UON Y

Mapping whole-brain metabolic networks$25,000

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Doctor Renate Thienel, Associate Professor Frini Karayanidis, Associate Professor Juanita Todd, Associate Professor Peter Stanwell, Professor Mark Parsons, Conjoint Professor Chris Levi
Scheme Project Grant
Role Investigator
Funding Start 2014
Funding Finish 2014
GNo G1301285
Type Of Funding Grant - Aust Non Government
Category 3AFG
UON Y

Individually tailoring stroke rehabilitation using advanced imaging$22,000

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Doctor Andrew Bivard, Professor Mark Parsons
Scheme Project Grant
Role Investigator
Funding Start 2014
Funding Finish 2014
GNo G1401506
Type Of Funding Grant - Aust Non Government
Category 3AFG
UON Y

Directors Award for Mid-Career Research$15,000

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Professor Mark Parsons
Scheme Project Grant
Role Lead
Funding Start 2014
Funding Finish 2014
GNo G1401398
Type Of Funding Grant - Aust Non Government
Category 3AFG
UON Y

Tenecteplase versus Alteplase for Stroke Thrombolysis Evaluation (TASTE) Trial$10,000

Funding body: University of Newcastle

Funding body University of Newcastle
Project Team Professor Mark Parsons, Conjoint Professor Chris Levi, Doctor Patrick McElduff
Scheme Near Miss Grant
Role Lead
Funding Start 2014
Funding Finish 2014
GNo G1301401
Type Of Funding Internal
Category INTE
UON Y

20132 grants / $103,000

Greater Charitable Foundation Fellows in Stroke Research$100,000

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Doctor Neil Spratt, Professor Mark Parsons, Conjoint Professor Chris Levi
Scheme Stroke Research Project Grant
Role Investigator
Funding Start 2013
Funding Finish 2013
GNo G1300508
Type Of Funding Contract - Aust Non Government
Category 3AFC
UON Y

The role of brain vascular flow and white matter lesions in the decline of cognitive ability in older adults$3,000

Funding body: National Stroke Foundation

Funding body National Stroke Foundation
Project Team Associate Professor Frini Karayanidis, Professor Mark Parsons, Ms Jaime Rennie
Scheme Honours Grant
Role Investigator
Funding Start 2013
Funding Finish 2013
GNo G1201085
Type Of Funding Grant - Aust Non Government
Category 3AFG
UON Y

20128 grants / $9,440,722

Improving Stroke Outcomes: Attenuating Progression and Recurrence$8,707,355

Funding body: National Health and Medical Research Council

Funding body National Health and Medical Research Council
Project Team

Prof Geoffrey Donnan

Scheme Program Grant
Role Investigator
Funding Start 2012
Funding Finish 2016
GNo
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON N

Cognitive flexibility from adolescence to senescence: Variability associated with cognitive strategy and brain connectivity$387,000

Funding body: ARC (Australian Research Council)

Funding body ARC (Australian Research Council)
Project Team Associate Professor Frini Karayanidis, Associate Professor Birte Forstmann, Professor Rhoshel Lenroot, Professor Mark Parsons, Emeritus Professor Patricia Michie, Associate Professor Natalie Phillips, Associate Professor Eric-Jan Wagenmakers
Scheme Discovery Projects
Role Investigator
Funding Start 2012
Funding Finish 2014
GNo G1100074
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON Y

Project EVA: an environmentally responsible facility for interdisciplinary supercomputing applications$263,000

Funding body: University of Newcastle

Funding body University of Newcastle
Project Team Professor Pablo Moscato, Laureate Professor Jon Borwein, Conjoint Professor Keith Jones, Conjoint Professor Chris Levi, Professor Mark Parsons, Professor Michael Ostwald, Professor Hugh Craig, Conjoint Professor Peter Greer, Associate Professor Stephan Chalup, Associate Professor Regina Berretta
Scheme Equipment Grant
Role Investigator
Funding Start 2012
Funding Finish 2012
GNo G1100627
Type Of Funding Internal
Category INTE
UON Y

Tomago Aluminium$26,000

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Associate Professor Frini Karayanidis, Conjoint Associate Professor Grant Bateman, Professor Mark Parsons, Emeritus Professor Patricia Michie, Mr Todd Jolly, Conjoint Professor Chris Levi, Ms Jaime Rennie
Scheme Project Grant
Role Investigator
Funding Start 2012
Funding Finish 2012
GNo G1200517
Type Of Funding Contract - Aust Non Government
Category 3AFC
UON Y

Experimental brain imaging to investigate novel protective mechanisms of short duration body cooling after stroke$20,000

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Doctor Damian McLeod, Doctor Neil Spratt, Professor Mark Parsons, Conjoint Professor Chris Levi
Scheme Project Grant
Role Investigator
Funding Start 2012
Funding Finish 2012
GNo G1101116
Type Of Funding Contract - Aust Non Government
Category 3AFC
UON Y

Transcranial Direct Current Stimulation (tDCS): A new modality in stroke rehabilitation$17,367

Funding body: National Stroke Foundation

Funding body National Stroke Foundation
Project Team Mrs Jodie Marquez, Professor Mark Parsons, Associate Professor Jim Lagopoulos, Associate Professor Frini Karayanidis, Professor Paulette Van Vliet
Scheme Research Grant
Role Investigator
Funding Start 2012
Funding Finish 2012
GNo G1101038
Type Of Funding Grant - Aust Non Government
Category 3AFG
UON Y

Beyond Perfusion: MRS to Characterise Metabolic Changes in the Ischaemic Brain$16,000

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Professor Mark Parsons, Associate Professor Peter Stanwell
Scheme Stroke Research Project Grant
Role Lead
Funding Start 2012
Funding Finish 2012
GNo G1101119
Type Of Funding Contract - Aust Non Government
Category 3AFC
UON Y

2011 Awards for Research Excellence - Shared Account$4,000

Funding body: University of Newcastle

Funding body University of Newcastle
Project Team Professor Mike Calford, Professor Mark Parsons, Associate Professor Juanita Todd, Doctor Robert Imre, Doctor Michael Ondaatje, Conjoint Professor Dmitri Kavetski
Scheme Award for Research Excellence
Role Investigator
Funding Start 2012
Funding Finish 2012
GNo G1200056
Type Of Funding Internal
Category INTE
UON Y

20114 grants / $1,145,824

Implementation of quality use of advanced CT imaging in acute stroke$1,075,461

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Professor Mark Parsons, Conjoint Professor Chris Levi, Professor Geoff Donnan, Professor Stephen Davis, Professor John Attia, Professor Christopher Bladin, Mr Qing Yang, Associate Professor Peter Mitchell, Associate Professor Stacy Goergen, Professor Ramamohanarao Kotagiri
Scheme Partnership Projects
Role Lead
Funding Start 2011
Funding Finish 2015
GNo G1000535
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON Y

Relationships between white matter lesions and cognitive and motor functioning in patients with minor ischaemic stroke: A structural and functional brain imaging study - RhD 2yr$40,000

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Mr Todd Jolly, Associate Professor Frini Karayanidis, Professor Mark Parsons, Conjoint Professor Chris Levi, Emeritus Professor Patricia Michie, Conjoint Associate Professor Grant Bateman, Conjoint Associate Professor Peter Schofield
Scheme Research Higher Degree Support Grant
Role Investigator
Funding Start 2011
Funding Finish 2011
GNo G1100061
Type Of Funding Contract - Aust Non Government
Category 3AFC
UON Y

Exploring Chronic Traumatic Encephalopathy (CTE) amongst current and former professional rugby league players$20,863

Funding body: NSW Sporting Injuries Committee

Funding body NSW Sporting Injuries Committee
Project Team Doctor Frances Kay-Lambkin, Dr Andrew Gardner, Associate Professor Peter Stanwell, Conjoint Professor Chris Levi, Professor Mark Parsons
Scheme Research & Injury Prevention Scheme
Role Investigator
Funding Start 2011
Funding Finish 2012
GNo G1100822
Type Of Funding Other Public Sector - State
Category 2OPS
UON Y

Transcranial Direct Current Stimulation (tDCS): The potential to improve stroke recovery$9,500

Funding body: University of Newcastle

Funding body University of Newcastle
Project Team Mrs Jodie Marquez, Professor Mark Parsons, Associate Professor Frini Karayanidis
Scheme Early Career Researcher Grant
Role Investigator
Funding Start 2011
Funding Finish 2011
GNo G1000942
Type Of Funding Internal
Category INTE
UON Y

20106 grants / $950,575

Evaluating the effectiveness of a strategy to increase the adoption of best evidence practice. A cluster randomised controlled trial in acute stroke care$772,950

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Laureate Professor Robert Sanson-Fisher, Conjoint Professor Chris Levi, Associate Professor Christine Paul, Conjoint Professor Cate d'Este, Professor Mark Parsons, Professor Christopher Bladin, Professor Richard Lindley, Professor John Attia
Scheme Partnership Projects
Role Investigator
Funding Start 2010
Funding Finish 2016
GNo G0189781
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON Y

Improving patient selection for acute stroke therapies - an experimental model of CT brain perfusion after stroke$50,000

Funding body: BellBerry Limited

Funding body BellBerry Limited
Project Team Professor Mark Parsons, Doctor Neil Spratt, Conjoint Professor Chris Levi, Doctor Damian McLeod, Dr Peter Stanwell
Scheme Near Miss
Role Lead
Funding Start 2010
Funding Finish 2012
GNo G0900222
Type Of Funding Grant - Aust Non Government
Category 3AFG
UON Y

Evaluating the effectiveness of a strategy to increase the adoption of best evidence practice. A cluster randomised controlled trial in acute stroke care $50,000

Funding body: Victorian Department of Health

Funding body Victorian Department of Health
Project Team Laureate Professor Robert Sanson-Fisher, Conjoint Professor Chris Levi, Associate Professor Christine Paul, Conjoint Professor Cate d'Este, Professor Mark Parsons, Professor Christopher Bladin, Professor Richard Lindley, Professor John Attia
Scheme Project Grant
Role Investigator
Funding Start 2010
Funding Finish 2014
GNo G1100824
Type Of Funding Other Public Sector - State
Category 2OPS
UON Y

Implementation of thrombolytic therapy in acute stroke. A cluster randomised trial$30,000

Funding body: BellBerry Limited

Funding body BellBerry Limited
Project Team Conjoint Professor Chris Levi, Professor John Attia, Associate Professor Christine Paul, Professor Mark Parsons, Professor Christopher Bladin, Professor Richard Lindley, Conjoint Professor Cate d'Este
Scheme Near Miss
Role Investigator
Funding Start 2010
Funding Finish 2014
GNo G0900221
Type Of Funding Grant - Aust Non Government
Category 3AFG
UON Y

A structural and functional brain imaging study of how white matter lesions in patients with minor ischaemic strike affect cognitive and motor control processes$24,600

Funding body: Hunter Children`s Research Foundation

Funding body Hunter Children`s Research Foundation
Project Team Associate Professor Frini Karayanidis, Professor Mark Parsons, Emeritus Professor Patricia Michie, Conjoint Professor Chris Levi, Ms Sharna Jamadar, Mr Matthew Hughes, Conjoint Associate Professor Peter Schofield, Conjoint Associate Professor Grant Bateman
Scheme Research Grant
Role Investigator
Funding Start 2010
Funding Finish 2010
GNo G0900150
Type Of Funding Grant - Aust Non Government
Category 3AFG
UON Y

Minor stroke and Transient Ischaemic Attack pathways of care: a pilot of a cohort study based in general practice$23,025

Funding body: John Hunter Hospital Charitable Trust

Funding body John Hunter Hospital Charitable Trust
Project Team Professor Mark Parsons, Dr Daniel Lasserson, Conjoint Professor Parker Magin, Conjoint Professor Chris Levi
Scheme Research Grant
Role Lead
Funding Start 2010
Funding Finish 2011
GNo G1000933
Type Of Funding Other Public Sector - State
Category 2OPS
UON Y

20094 grants / $761,228

Prediction of tissue fate and functional outcome in acute ischemic stroke with advanced imaging analysis - experimental validation and translational studies$686,400

Funding body: ARC (Australian Research Council)

Funding body ARC (Australian Research Council)
Project Team Professor Mark Parsons
Scheme Future Fellowships
Role Lead
Funding Start 2009
Funding Finish 2013
GNo G0189746
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON Y

A functional MRI study of upper limb therapy in community dwelling stroke survivors$41,828

Funding body: National Stroke Foundation

Funding body National Stroke Foundation
Project Team Professor Mark Parsons, Dr Leeanne Carey, Doctor Isobel Hubbard
Scheme Research Grant
Role Lead
Funding Start 2009
Funding Finish 2011
GNo G0189945
Type Of Funding Grant - Aust Non Government
Category 3AFG
UON Y

Establishing Computed Tomography Perfusion (CTP) imaging in an animal stroke model$20,000

Funding body: National Stroke Foundation

Funding body National Stroke Foundation
Project Team Doctor Damian McLeod, Doctor Neil Spratt, Professor Mike Calford, Conjoint Professor Chris Levi, Professor Mark Parsons
Scheme Research Grant
Role Investigator
Funding Start 2009
Funding Finish 2009
GNo G0189942
Type Of Funding Contract - Aust Non Government
Category 3AFC
UON Y

Towards better early imaging in stroke: Use of an experimental model to investigate CT brain perfusion$13,000

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Doctor Neil Spratt, Professor Mark Parsons, Doctor Damian McLeod, Conjoint Professor Chris Levi
Scheme Stroke Research Project Grant
Role Investigator
Funding Start 2009
Funding Finish 2009
GNo G0189810
Type Of Funding Contract - Aust Non Government
Category 3AFC
UON Y

20084 grants / $482,180

Low-dose tenecteplase vs standard-dose alteplase for acute ischaemic stroke: An imaging based safety and efficacy study$335,500

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Professor Mark Parsons, Professor Stephen Davis, Professor Christopher Bladin, Dr Romesh Markus, Associate Professor Helen Dewey, Conjoint Professor Chris Levi
Scheme Project Grant
Role Lead
Funding Start 2008
Funding Finish 2010
GNo G0187651
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON Y

A randomised controlled trial of mild hypothermia in acute ischaemic stroke$117,176

Funding body: National Heart Foundation of Australia

Funding body National Heart Foundation of Australia
Project Team Conjoint Professor Chris Levi, Professor Mark Parsons, Professor Christopher Bladin, Doctor Neil Spratt
Scheme Grant-In-Aid
Role Investigator
Funding Start 2008
Funding Finish 2009
GNo G0187644
Type Of Funding Aust Competitive - Non Commonwealth
Category 1NS
UON Y

A functional MRI study of upper limb therapy in community dwelling stroke survivors$19,504

Funding body: University of Newcastle - Faculty of Health and Medicine

Funding body University of Newcastle - Faculty of Health and Medicine
Project Team Professor Mark Parsons
Scheme Pilot Grant
Role Lead
Funding Start 2008
Funding Finish 2008
GNo G0189041
Type Of Funding Internal
Category INTE
UON Y

PULSE Early Career Researcher$10,000

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Professor Mark Parsons
Scheme PULSE Early Career Researcher of the Year Award
Role Lead
Funding Start 2008
Funding Finish 2008
GNo G0188537
Type Of Funding Donation - Aust Non Government
Category 3AFD
UON Y

20072 grants / $24,539

A functional MRI and tractography study of the effect of early upper limb therapy on brain plasticity after stroke$19,039

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Doctor Bill Budd, Professor Mark Parsons, Conjoint Professor Chris Levi
Scheme Project Grant
Role Investigator
Funding Start 2007
Funding Finish 2007
GNo G0187254
Type Of Funding Contract - Aust Non Government
Category 3AFC
UON Y

A functional MRI study of upper limb therapy in acute stroke.$5,500

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Professor Mark Parsons, Doctor Bill Budd, Conjoint Professor Chris Levi
Scheme Research Grant
Role Lead
Funding Start 2007
Funding Finish 2007
GNo G0187321
Type Of Funding Contract - Aust Non Government
Category 3AFC
UON Y

20062 grants / $142,456

A functional MRI study of upper limb therapy in acute stroke$122,474

Funding body: National Heart Foundation of Australia

Funding body National Heart Foundation of Australia
Project Team Professor Mark Parsons, Doctor Bill Budd, Conjoint Professor Chris Levi, Doctor Isobel Hubbard
Scheme Grant-In-Aid
Role Lead
Funding Start 2006
Funding Finish 2007
GNo G0186201
Type Of Funding Aust Competitive - Non Commonwealth
Category 1NS
UON Y

Supplementary oxygen for acute ischaemic stroke: an imaging-based efficacy trial (SOS trial)$19,982

Funding body: University of Newcastle

Funding body University of Newcastle
Project Team Professor Mark Parsons, Conjoint Professor Chris Levi
Scheme Pilot Grant
Role Lead
Funding Start 2006
Funding Finish 2006
GNo G0186701
Type Of Funding Internal
Category INTE
UON Y

20053 grants / $264,055

Acute Stroke: Imaging the Ischaemic Penumbra with Perfusion CT$239,250

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Professor Mark Parsons, Professor Stephen Davis, Professor Brian Tress, Dr Romesh Markus, Dr Stephen Read, Conjoint Professor Chris Levi
Scheme Project Grant
Role Lead
Funding Start 2005
Funding Finish 2007
GNo G0183962
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON Y

Acute Stroke: Imaging the Ischaemic Penumbra with Perfusion CT$13,500

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Professor Mark Parsons
Scheme Stroud Rodeo Committee
Role Lead
Funding Start 2005
Funding Finish 2005
GNo G0185103
Type Of Funding Contract - Aust Non Government
Category 3AFC
UON Y

Neural consequences of cardiac surgery: a study using magnetic resonance measures of functional brain activation and brain metabolism$11,305

Funding body: University of Newcastle

Funding body University of Newcastle
Project Team Conjoint Associate Professor Mick Hunter, Emeritus Professor Patricia Michie, Professor Mark Parsons
Scheme Project Grant
Role Investigator
Funding Start 2005
Funding Finish 2005
GNo G0184634
Type Of Funding Internal
Category INTE
UON Y

20042 grants / $56,140

Acute Stroke: Imaging the Ischaemic Penumbra with Perfusion CT$28,140

Funding body: Ramaciotti Foundations

Funding body Ramaciotti Foundations
Project Team Professor Mark Parsons
Scheme Major Equipment Award
Role Lead
Funding Start 2004
Funding Finish 2005
GNo G0184438
Type Of Funding Aust Competitive - Non Commonwealth
Category 1NS
UON Y

Novel genetic and environmental risk factors in atherothrombosis: The role of variation in Cox-2, tpA and PAI-1 activity$28,000

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Conjoint Professor Chris Levi, Conjoint Professor David Henry, Dr Patricia McGettigan, Professor John Attia, Professor Mark Parsons, Dr Michael Seldon, Professor Rodney Scott
Scheme Research Grant
Role Investigator
Funding Start 2004
Funding Finish 2004
GNo G0183749
Type Of Funding Contract - Aust Non Government
Category 3AFC
UON Y
Edit

Research Supervision

Number of supervisions

Completed4
Current9

Total current UON EFTSL

PhD3.7

Current Supervision

Commenced Level of Study Research Title / Program / Supervisor Type
2015 PhD Patient Profiling Using Advanced Imaging and Biomarkers in Acute Ischemic Stroke
PhD (Medicine), Faculty of Health and Medicine, The University of Newcastle
Co-Supervisor
2014 PhD Optimizing Tissue Pathophysiology with Perfusion Imaging in Ischemic Stroke
PhD (Medicine), Faculty of Health and Medicine, The University of Newcastle
Principal Supervisor
2014 PhD Advanced Imaging of Stroke
PhD (Medicine), Faculty of Health and Medicine, The University of Newcastle
Principal Supervisor
2014 PhD Predicting recovery after stroke using neuroimaging
PhD (Physiotherapy), Faculty of Health and Medicine, The University of Newcastle
Co-Supervisor
2013 PhD Exploration and Application of Biochemical Markers to Aid Diagnosis and Prognosis of Neuro-Inflammation
PhD (Medicine), Faculty of Health and Medicine, The University of Newcastle
Principal Supervisor
2013 PhD Imaging Biomarkers in Improving Diagnostic Accuracy and Prognosticating Outcomes in Acute Neurovascular Syndromes
PhD (Medicine), Faculty of Health and Medicine, The University of Newcastle
Principal Supervisor
2012 PhD The Effect of Transcranial Direct Current Stimulation on Motor Control
PhD (Psychology - Science), Faculty of Science and Information Technology, The University of Newcastle
Co-Supervisor
2011 PhD Understanding the Role of Prehospital Intubation and Advanced Brain Imaging in Patients Suffering from Severe Traumatic Brain Injury
PhD (Medicine), Faculty of Health and Medicine, The University of Newcastle
Co-Supervisor
2010 PhD Transcranial Direct Current Stimulation (tDCS): the Potential to Improve Stroke Recovery
PhD (Physiotherapy), Faculty of Health and Medicine, The University of Newcastle
Principal Supervisor

Past Supervision

Year Level of Study Research Title / Program / Supervisor Type
2015 PhD Upper Limb Recovery and Brain Reorganisation Post-Stroke
PhD (Medicine), Faculty of Health and Medicine, The University of Newcastle
Principal Supervisor
2015 PhD Whole-Brain CTP in Acute Ischemic Stroke
PhD (Medicine), Faculty of Health and Medicine, The University of Newcastle
Principal Supervisor
2013 PhD Perfusion Imaging in Acute and Evolving Brain Ischemia
PhD (Medicine), Faculty of Health and Medicine, The University of Newcastle
Principal Supervisor
2011 PhD The investigation of acute brain ischaemia with perfusion CT
Medical Science, The University of Melbourne
Co-Supervisor
Edit

News

Professor Brian Kelly

Mental health trailblazer

November 5, 2014

On an evening when more than 70 donor-funded grants worth $3.5 million were awarded or acknowledged, mental health trailblazer Professor Brian Kelly has been heralded as the HMRI Researcher of the Year for 2014.

Andrew Bivard

Stroke trial lures imaging research expert

February 21, 2014

The Hunter's renowned stroke research group is to be bolstered by the return of award-winning imaging expert Dr Andrew Bivard to work on acute care and rehabilitation projects.

Professors Mark Parsons

International stroke trial

December 3, 2013

A Hunter stroke drug trial that yielded rapid treatment benefits for patients will expand nationally and internationally.

Professor Mark Parsons

Professor Mark Parsons presents at the Chinese Neurological Society meeting

October 24, 2013

President of the Stroke Society of Australia (SSA) and University of Newcastle researcher, Professor Mark Parsons, was recently a keynote speaker at the Chinese Neurological Society meeting in Nanjing, China.

Professor Mark Parsons

Position

National Heart Foundation Fellow and Brawn Career Development Fellow
School of Medicine and Public Health
Faculty of Health and Medicine

Contact Details

Email mark.parsons@newcastle.edu.au
Phone 13490
Fax 13488

Office

Room JHH
Building John Hunter Hospital
Location Callaghan
University Drive
Callaghan, NSW 2308
Australia
Edit