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UCL Queen Square Institute of Neurology

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Stroke Research

 

Axial CT scans showing acute cSAH and ICH*

Researching stroke prevention, treatment and management, and functional recovery after stroke.

Lead:

Professor David Werring

Research Team

Research Goals

  • To understand the underlying mechanisms of cerebrovascular disease, with a focus on neuroimaging
  • To improve acute treatment and secondary prevention of stroke
  • To develop innovative treatments to prevent stroke, targeting both small and large artery diseases
  • To investigate how cerebral small vessel disease relates to intracerebral haemorrhage and vascular cognitive impairment
  • To increase knowledge of stroke genetics

Funded Research Projects

  • Prevention of hypertensive injury to the brain by intensive treatment: Intracerebral Haemorrhage. Funded by a Stroke Association Priority Programme Grant for Intracerebral Haemorrhage
  • Carotid Stenting Trialists’ Collaboration. Funded by the Stroke Association
  • Cerebral amyloid angiopathy cohort to characterize the natural history and establish biomarkers relevant to prognosis
  • CROMIS-2 (Clinical Relevance Of Microbleeds in Stroke)
  • PROHIBIT-ICH (Prevention Of Hypertensive Injury to the Brain by Intensive Treatment after IntraCerebral Haemorrhage: a pilot randomized trial of home telemetry-guided treatment)
  • SIGNaL BRC
     
  • OPTIMAS BHF: OPtimal TIMing of Anticoagulation after AF-associated acute ischaemic Stroke: a randomised controlled trial
Recent publications from Stroke Research

Wilson D, Ambler G, Shakeshaft C, Brown MM, Charidimou A, Al-Shahi Salman R, Lip GYH, Cohen H, Banerjee G, Houlden H et al. Cerebral microbleeds and intracranial haemorrhage risk in patients anticoagulated for atrial fibrillation after acute ischaemic stroke or transient ischaemic attach (CROMIS-2): a multicentre observational cohort study. Lancet Neurology 2018; 17(6): 539-547 UCL Discovery

Goren N, Avery J, Dowrick T, Mackle E, Witkowska-Wrobel A, Werring D, Holder D. Multi-frequency electrical impedance tomography and neuroimaging data in stroke patients. Scientific Data 2018; 5:180112 UCL Discovery

Lip GYH, Banerjee A, Boriani G, Chiang CE, Fargo R, Freedman B, Lane DA, Ruff CT, Turakhia M, Werring D et al. Antithrombotic therapy for atrial fibrillation: CHEST Guideline and Expert Panel Report. Chest, 2018 in press UCL Discovery

Banerjee G, Summers M, Chan E, Wilson D, Charidimou a, Cipolotti L, Werring DJ. Domain-specific characterisation of early cognitive impairment following spontaneous intracerebral haemorrhage. Journal of the Neurological Sciences 2018; 391:25-30.

Werring DJ. Winston Churchill's cerebrovascular disease: small vessels with big implications. Journal of the Royal Society of Medicine 2018; 111(9): 314-315.

Ziff OJ, Banerjee G, Ambler G, Werring DJ. Statins and the risk of intracerebral haemorrhage inpatients with stroke: systematic review and meta-analysis. Journal of Neurology, Neurosurgery and Psychiatry, 2018 in press.

Tsivgoulis G, Wilson D, Katsanos AH, Sargento-Freitas J, Marques-Matos C, Azevedo E, Adachi T, von der Brelie C, Aizawa Y, Abe H et al. Neuroimaging and clinical outcomes of oral anticoagulant associated ICH. Annals of Neurology, online 26th September 2018.

Ziff OJ, Werring DJ. Statins after intracranial haemorrhage: seizing a new opportunity? British Journal of Clinical Pharmacology, 2018 in press, UCL Discovery

Hunter E, Cliff M, Armstrong M, Manji H, Jager HR, Chiodini P, Brown M. Active neurocysticercosis at the Hospital for Tropical Diseases, London: a clinical case series. Transactions of the Royal Society of Tropical Medicine and Hygiene 2018; 112(7):326-334.

Al-Shahi Salman R, Dennis MS, Murray GD, Innes K, ….Werring DJ … Roffe J. The Restart or Stop Antithrombotics Randomised Trial (RESTART) after stroke due to intracerebral haemorrhage: study protocol for a randomised controlled trial. Trials 2018; 19-1.

Alg VS, Ke X, Grieve J, Bonner S, Walsh DC, Bulters D, Kitchen N, Houlden H, Werring DJ. Association of functional MMP-2 gene variant with intracranial aneurysms: case-control genetic association study and meta-analysis. British Journal of Neurosurgery, online 15 Jan 2018.

Banerjee G, Alvares D, Bowen J, Adams ME, Werring DJ. Minimally symptomatic cerebral amyloid angiopathy-related inflammation: three descriptive case reports. Journal of Neurology, Neurosurgery, and Psychiatry, online 13 March 2018.

Banerjee G, Wilson D, Ambler G, Osei-Bonsu Appiah K, Shakeshaft C, Lunawat S, Cohen H, Yousry T, Lip GYH, Muir KW, Brown MM, Al-Shahi Salman R, Jäger HR, Werring DJ, CROMIS-2 Collaborators. Cognitive impairment before intracerebral hemorrhage is associated with cerebral amyloid angiopathy. Stroke, online 1 January 2018.

Dineen RA, Pszczolkowski S, Flaherty K … Werring DJ …. Sprigg N. Does tranexamic acid lead to changes in MRI measures of brain tissue health in patients with spontaneous intracerebral haemorrhage? Protocol for a MRI substudy nested within the double-blind randomised controlled TICH-2 trial. BMJ Open 2018; 8-2:e019930.

Hilkens NA, Van Asch CJJ, Werring DJ, Wilson D…Jäger HR … DIAGRAM study group. Predicting the presence of macrovascular causes in non-traumatic intracerebral haemorrhage: the DIAGRAM prediction score. Journal of Neurology, Neurosurgery and Psychiatry, 2018; 18.

Kotecha D, Breithardt G, Camm AJ …. Werring D ….Kirchhof P. Integrating new approaches to atrial fibrillation management: the 6th AFNET/EHRA Consensus Conference. Europace, online 2 Jan 2018.

MacGregor Sharp M, Bulters D, Brandner S, Holton J, Verma A, Werring DJ, Carare RO. The fine anatomy of the perivascular compartment in the human brain: relevance to dilated perivascular spaces in cerebral amyloid angiopathy. Neuropathology and Applied Neurobiology, online 27 Feb 2018.

Phyu P, Merwick A, Davagnanam I, Bolsover F, Jichi F, Wheeler-Kingshott C, Golay X, Hughes D, Cipolotti L, Murphy E, Lachmann RH, Werring DJ. Increased resting cerebral blood flow in adult Fabry disease: MRI arterial spin labelling study. Neurology 2018; 90(16):e1379-1385.

Seiffge DJ, Kägi G, Michel P ….Werring D …NOACISP study group. Rivaroxaban plasma levels in acute ischemic stroke and intracerebral haemorrhage. Annals of Neurology, online 2 Feb 2018.

Skrobot OA, Black SE, Chen C, DeCarli C, Erkinjuntti T, Ford GA, Kalaria RN, O’Brien J, Pantoni L, Pasquier F et al. Progress toward standardized diagnosis of vascular cognitive impairment: Guidelines from the Vascular Impairment of Cognition Classification Consensus Study. Alzheimer’s and Dementia 2018; 14-3:280-292.

 

Werring DJ. CT scanning to diagnose CAA: Back to the future? The Lancet Neurology, online 10 January 2018.

Jang YK, Kim HJ, Lee JS, Kim YJ, Kim KW, Kim Y, Jang H, Lee J, Lee JM, Kim S-J et al.  Distinctive clinical effects of haemorrhagic markers in cerebral amyloid angiopathy.  Scientific Reports 22 November 2017; 7(1):15984.  DOI: 10.1038/s41598-017-16298-1

Banerjee G, Summers M, Chan E, Wilson D, Charidimou A, Cipolotti L, Werring DJ.  Domain-specific characterisation of cognitive impairment following intracerebral haemorrhage.  International Journal of Stroke, online 1 November 2017.

Banerjee G, Carare R, Cordonnier C, Greenberg SM, Schneider JA, Smith EE, Buchem MV, Grond JV, Berbeek MM, Werring DJ.  The increasing impact of cerebral amyloid angiopathy: essential new insights for clinical practice.  Journal of Neurology, Neurosurgery and Psychiatry 2017; 88(11): 982-994.  DOI: 10.1136/jnnp-2016-314697

Yakushiji Y, Charidimou A, Noguchi T, Nishihara M, Eriguchi M, Nanri Y, Kawaguchi A, Hirotsu T, Werring DJ, Hara H.  Total small vessel disease score in neurologically healthy Japanese adults in the Kashima scan study.  Internal Medicine, online 16 October 2017.  DOI:  10.2169/internalmedicine.8393-16

Banerjee G, Wilson D, Ambler G, Osei-Bonsu Appiah K, Shakeshaft C, Lunawat S, Cohen H, Yousry T, Lip GYH, Muir KW, Brown MM, Al-Shahi Salman R, Jager HR, Werring DJ, CROMIS-2 Collaborators.  Cognitive impairment before intracerebral hemorrhage is associated with cerebral amyloid angiopathy.  Stroke, online 15 December 2017. DOI: 10.1161/STROKEAHA.117.019409

Skrobot OA, Black SE, Chen C, DeCarli C, Erkinjuntti T, Ford GA, Kalaria RN, O'Brien J, Pantoni L, Pasquier F, Roman GC, Wallin A, Sachdev P, Skoog I, VICCCS group et al.   Progress toward standardized diagnosis of vascular cognitive impairment: Guidelines from the Vascular Impairment of Cognition Classification Consensus Study.  Alzheimers Dement, online 19 October 2017.  DOI:  10.1016/j.jalz.2017.09.007

Jakel L, Van Nostrand WE, Nicoll JAR, Werring DJ, Verbeek MM.  Animal models of cerebral amyloid angiopathy.  Clin Sci (Lond) 2017; 131(19):2469-2488.  DOI: 10.1042/CS20170033

Hostettler Moreno I, Alg V, Shabi N, Jichi F, Bonner S, Walsh D, Bulters D, Kitchen N, Brown M, Houlden H et al. Characteristics of unruptured compared to ruptured intracranial aneurysms: A multicentre case-control study. Neurosurgery 2017 Jul 25. doi: 10.1093/neuros/nyx365. [Epub ahead of print]

Turner D, Scully M, Stone S, Werring DJ. Recurrent brain ischaemia and deep vein thrombosis: the clot thickens. Practical Neurology 2017 Oct;17(5):380-382. doi: 10.1136/practneurol-2016-001581. Epub 2017 Jun 3.

Skrobot OA, Love s, Kehoe PG, O’Brien J, Black S, Chen C, DeCarli C, Erkinjuntti T, ford GA, Kalaria RN et al. The vascular impairment of cognition classification consensus study. Alzheimer’s and Dementia 2017; 13(6):624-633 doi: 10.1016/j.jalz.2016.10.007. Epub 2016 Dec

Koohi N, Vickers DA, Lakshmanan R, Chandrashekar H, Werring DJ, Warren JD, Bamiou D-E. Hearing characteristics of stroke patients: prevalence and characteristics of hearing impairment and auditory processing disorders in stroke patients. Journal of the American Academy of Audiology 2017; 28(6):491-505 10.doi: 10.3766/jaaa.15139.

Wilson D, Seiffge DJ, Traenka C, Basir G, Purrucker JC, Rizos T, Sobowale OA, Sallinen H, Yeh S-J, Wu TY et al. Outcome of intracerebral haemorrhage associated with different oral anticoagulants. Neurology 2017; 88(18):1693-1700 doi: 10.1212/WNL.0000000000003886. Epub 2017 Apr 5.

Banerjee G, Kim HJ, Fox Z, Jaeger HR, Wilson D, Charidimou A, Na HK, Na DL, Seo SW, Werring DJ. MRI-visible perivascular space location is associated with Alzheimer’s disease independently of amyloid burden. Brain 2017; 140:1107-1116 doi: 10.1093/brain/awx003.

Koohi N, Vickers D, Warren J, Werring D, Bamiou DE. Long-term use benefits of personal frequency-modulated systems for speech in noise perception in patients with stroke with auditory processing deficits: A non-randomised controlled trial study. BMJ Open 2017; 7(4) http://dx.doi.org/10.1136/bmjopen-2016-013003

Wilson D, Chatterjee F, Farmer SF, Rudge P, McCarron MO, Cowley P, Werring DJ. Infratentorial superficial siderosis: classification, diagnostic criteria, and rational investigation pathway. Annals of Neurology 2017; 81(3):333-343 doi: 10.1002/ana.24850. Epub 2017 Jan 28.

Wilson D, Hostettler IC, Ambler G, Banerjee G, Jager HR, Werring DJ. Convexity subarachnoid haemorrhage has a high risk of intracerebral haemorrhage in suspected cerebral amyloid angiopathy. Journal of Neurology 2017; 264(4):664-673 doi: 10.1007/s00415-017-8398-y. Epub 2017 Feb 2.

Croall ID, Lohner V, Moynihan B, Khan U, Hassan A, O-Brien JT, Morris RG, Tozer DJ, Cambridge VC, Harkness K. Using DTI to assess white matter microstructure in cerebral small vessel disease (SVD) in multicentre studies. Clinical Science 2017; 131(2):1361-1373 doi: 10.1042/CS20170146. Print 2017 Jun 1.

Charidimou A, Imaizumi T, Moulin S, Biffi A, Samarasekera N, Yakushiji Y, Peeters A, Vandermeeren Y, Laloux P, Baron J-C et al. Brain Hemorrhage recurrence, small vessel disease type, and cerebral microbleeds: A meta-analysis. Neurology, 2017 Aug 22;89(8):820-829. doi: 10.1212/WNL.0000000000004259. Epub 2017 Jul 26.

Charimidou A, Turc G, Oppenheim C, Yan S, Scheitz JF, Erdur H, Klinger-Gratz PP, El-Koussy M, Takahashi W, Moriya Y et al. Microbleeds, cerebral haemorrhage, and functional outcome after stroke thrombolysis: individual patient data meta-analysis. Stroke, published online 18th July 2017 doi: 10.1161/STROKEAHA.116.012992. [Epub ahead of print]

Chan E, Altendorff S, Healy C, Werring DJ, Cipolotti L. The test accuracy of the Montreal Cognitive Assessment (MoCA) by stroke lateralisation. J Neurol Sci. 2017 Feb 15;373:100-104.doi: 10.1016/j.jns.2016.12.028. Epub 2016 Dec 19.

Charidimou A, Schmitt A, Wilson D, Yakushiji Y, Gregoire SM, Fox Z, Jäger HR, Werring DJ. The Cerebral Haemorrhage Anatomical RaTing inStrument (CHARTS): Development and assessment of reliability. J Neurol Sci. 2017 Jan 15;372:178-183.doi: 10.1016/j.jns.2016.11.021. Epub 2016 Nov 12. 

Jiad E, Gill SK, Krutikov M, Turner D, Parkinson MH, Curtis C, Werring DJ. When the heart rules the head: ischaemic stroke and intracerebral haemorrhage complicating infective endocarditis. Pract Neurol. 2017 Jan;17(1):28-34. doi: 10.1136/practneurol-2016-001469. Epub 2017 Jan 3.

Kongbunkiat K, Wilson D, Kasemsap N, Tiamkao S, Jichi F, Palumbo V, Hill MD, Buchan AM, Jung S, Mattle HP, Henninger N, Werring DJ. Leukoaraiosis, intracerebral hemorrhage, and functional outcome after acute stroke thrombolysis. Neurology. 2017 Feb 14;88(7):638-645. doi: 10.1212/WNL.0000000000003605. Epub 2017 Jan 27.

Koohi N, Vickers D, Chandrashekar H, Tsang B, Werring D, Bamiou DE2. Auditory rehabilitation after stroke: treatment of auditory processing disorders in stroke patients with personal frequency-modulated (FM) systems. Disabil Rehabil. 2017 Mar;39(6):586-593. doi: 10.3109/09638288.2016.1152608. Epub 2016 Mar 23.

Muir KW, Ford GA, Messow CM, Ford I, Murray A, Clifton A, Brown MM, Madigan J, Lenthall R, Robertson F, Dixit A, Cloud GC, Wardlaw J, Freeman J, White P; PISTE Investigators. Endovascular therapy for acute ischaemic stroke: the Pragmatic Ischaemic Stroke Thrombectomy Evaluation (PISTE) randomised, controlled trial. J Neurol Neurosurg Psychiatry. 2017 Jan;88(1):38-44. doi: 10.1136/jnnp-2016-314117. Epub 2016 Oct 18.

Wilson D, Werring DJ. Antithrombotic therapy in patients with cerebral microbleeds. Curr Opin Neurol. 2017 Feb;30(1):38-47. doi: 10.1097/WCO.0000000000000411.

Stroke Research Centre staff:

Amy Ashton (CRN Team)
Azra Banaras (CRN Team Lead)
Jonathan Best
Ekatherina Biggs
Simone Browning (SIGNaL)
Shahena Butt (PROHIBIT-ICH)
Hatice Capar (SIGNaL)
Edgar Chan
Abi Chandrakumar (ELAN)
Lucinda Crook (CRN Team)
Schederazade Feerick (CRN Team)
Nina Francia (CRN Team)
Florence Mantey (CRN Team)
Marilena Marinescu (CRN Team)
John Mitchell (SIGNaL)
Siobhan McLernan
Sabaa Obarey (CRN Team)
Dr Richard Perry
Dr Robert Simister
David Werring (HoD BRR - Stroke Lead)

 

Further information

* Wilson et al. (2017) Convexity subarachnoid haemorrhage has a high risk of intracerebral haemorrhage in suspected cerebral amyloid angiopathy. Journal of Neurology, April 2017, Volume 264, Issue 4, pp 664–673. doi: 10.1007/s00415-017-8398-y.