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  • Long-Term Risk of Myocardial Infarction Compared to Recurrent Stroke After Transient Ischemic Attack and Ischemic Stroke: Systematic Review and Meta-Analysis.

    26 April 2018

    BACKGROUND: Uncertainties remain about the current risk of myocardial infarction (MI) after ischemic stroke or transient ischemic attack. METHODS AND RESULTS: We undertook a systematic review to estimate the long-term risk of MI, compared to recurrent stroke, with temporal trends in ischemic stroke/transient ischemic attack patients. Annual risks and 95% confidence intervals (95% CI) of MI and recurrent stroke were estimated using random-effect meta-analyses. We calculated incidence ratios of MI/recurrent stroke, for fatal and nonfatal events, using similar analyses. Rate ratios for MI in patients with potential risk factors compared to those without were calculated using Poisson regression.A total of 58 studies (131 299 patients) with a mean (range) follow-up of 3.5 (1.0-10.0) years were included. The risk of MI was 1.67%/y (95% CI 1.36-1.98, Phet<0.001 for heterogeneity) and decreased over time (Pint=0.021); 96% of the heterogeneity between studies was explained by study design, study period, follow-up duration, mean age, proportion of patients on antithrombotic therapy, and incident versus combined ischemic stroke/transient ischemic attack. The risk of recurrent stroke was 4.26%/y (95% CI 3.43-5.09, Phet<0.001), with no change over time (Pint=0.63). The risk of fatal MI was half the risk of recurrent strokes ending in fatality (incidence ratio=0.51, 95% CI 0.14-0.89, Phet=0.58). The risk of nonfatal MI was 75% smaller than the risk of recurrent nonfatal stroke (incidence ratio=0.25, 95%CI 0.02-0.50, Phet=0.68). Male sex, hypertension, coronary and peripheral artery diseases were associated with a doubled risk of MI. CONCLUSIONS: After ischemic stroke/transient ischemic attack, the risk of MI is currently <2%/y, and recurrent stroke is a more common cause of death than MI.

  • Shared genetic contribution to ischemic stroke and Alzheimer's disease

    18 May 2018

    © 2016 The Authors. Annals of Neurology published by Wiley Periodicals, Inc. on behalf of American Neurological Association. Objective Increasing evidence suggests epidemiological and pathological links between Alzheimer's disease (AD) and ischemic stroke (IS). We investigated the evidence that shared genetic factors underpin the two diseases. Methods Using genome-wide association study (GWAS) data from METASTROKE + (15,916 IS cases and 68,826 controls) and the International Genomics of Alzheimer's Project (IGAP; 17,008 AD cases and 37,154 controls), we evaluated known associations with AD and IS. On the subset of data for which we could obtain compatible genotype-level data (4,610 IS cases, 1,281 AD cases, and 14,320 controls), we estimated the genome-wide genetic correlation (rG) between AD and IS, and the three subtypes (cardioembolic, small vessel, and large vessel), using genome-wide single-nucleotide polymorphism (SNP) data. We then performed a meta-analysis and pathway analysis in the combined AD and small vessel stroke data sets to identify the SNPs and molecular pathways through which disease risk may be conferred. Results We found evidence of a shared genetic contribution between AD and small vessel stroke (rG [standard error] = 0.37 [0.17] ; p = 0.011). Conversely, there was no evidence to support shared genetic factors in AD and IS overall or with the other stroke subtypes. Of the known GWAS associations with IS or AD, none reached significance for association with the other trait (or stroke subtypes). A meta-analysis of AD IGAP and METASTROKE + small vessel stroke GWAS data highlighted a region (ATP5H/KCTD2/ICT1) associated with both diseases (p = 1.8 × 10 -8 ). A pathway analysis identified four associated pathways involving cholesterol transport and immune response. Interpretation Our findings indicate shared genetic susceptibility to AD and small vessel stroke and highlight potential causal pathways and loci. Ann Neurol 2016;79:739-747

  • Carotid artery disease and risk of ischaemic stroke and coronary events

    26 February 2018

    Carotid artery stiffness, intima-media thickness and early plaque formation are useful predictors of the risk of both ischaemic stroke and coronary heart disease in asymptomatic populations. Early carotid arterial wall disease also predicts coronary artery disease on angiography and subsequent coronary vascular events in populations at risk of coronary heart disease. Carotid stenosis and plaque surface morphology predict both ischaemic stroke and coronary vascular events. © 2004, Elsevier Science B.V. All rights reserved.

  • Schematic beliefs and problem solving performance predict depression in people experiencing persecutory delusions.

    9 May 2018

    Depression occurring alongside psychosis is an important treatment target, both in its own right and as a potential maintenance factor for positive psychotic symptoms. The present paper reports a prospective longitudinal analysis of depression and its predictors over six months in a group of 60 participants experiencing persecutory delusions. We hypothesised that negative schematic beliefs about the self and problem solving difficulties would predict the persistence of depression over time. The results showed, as hypothesised, that more negative schematic beliefs about the self and poorer problem solving predicted higher depression scores six months later, beyond what could be predicted by baseline depression scores. These findings support a proposed role for schematic beliefs and problem solving difficulties in the perpetuation of depression occurring alongside psychosis, as has been substantiated for major depressive disorder. Interventionist research is warranted to confirm causal effects.

  • Neurovascular dysfunction in dementia - human cellular models and molecular mechanisms.

    7 May 2018

    From the earliest stages of development, when cerebral angiogenesis and neurogenesis are entwined, to the end of life, the interplay between vascular and neural systems of the brain is critical in health and disease. Cerebral microvascular endothelial cells constitute the blood-brain barrier and in concert with pericytes or smooth muscle cells, glia and neurons, integrate into a functional neurovascular unit (NVU). This multicellular NVU maintains homoeostasis of the brain's microenvironment by restricting the entry of systemic pathogens and neurotoxins as well as meeting the metabolic demands of neural activity. Recent evidence of cerebral microvascular pathologies in vascular diseases and dementia, including Alzheimer's disease, has challenged the notion that vascular events are merely the consequence of neuronal pathology. This review focuses on molecular mechanisms of neurovascular dysfunction in dementia and outlines currently employed in vitro models to decode such mechanisms. Deciphering neurovascular crosstalk is likely to be more important in understanding the molecular mechanisms of disease than previously anticipated and may offer novel therapeutic opportunities for dementia and related conditions.

  • Altered Perception of Facially Expressed Tiredness in Insomnia.

    26 April 2018

    The present study compared normal sleepers and individuals displaying insomnia symptoms in their ratings for the expression intensity of tiredness and alertness whilst observing tired and neutral faces. Fifty-six normal sleepers and 58 individuals with insomnia symptoms observed 98 facial photographs (49 neutral, 49 tired). Using a visual analogue scale, participants were required to rate the extent to which each face appeared as tired and alert. Tired faces were created by manipulating neutral photographs to include previously identified facial tiredness cues. All participants rated sleep-related faces as more tired and less alert relative to neutral photographs. A significant Group × Face × Rating interaction demonstrated that, compared with normal sleepers, the insomnia symptoms group showed lower ratings for the expression of tiredness, but not alertness, whilst observing the tired faces. The findings suggest that the presence of insomnia symptoms is associated with reduced ratings of expression intensity for sleep-related facial photographs displaying tiredness. These outcomes add to the body of literature on how facial cues of tiredness are perceived by those with insomnia symptoms. Further work is required to elucidate the mechanisms underlying the relationship between insomnia symptoms and reduced perceptions of facially expressed tiredness.

  • Published Paper: Frontiers in Physiology

    27 April 2017

    "An ultra­-high field Magnetic Resonance Spectroscopy study of post exercise lactate, glutamate and glutamine change in the human brain" - Dennis et al. 2015

  • SEND

    20 September 2016

    SEND is an electronic vital signs system that has been jointly developed by Oxford University and Oxford University Hospitals NHS Foundation Trust. The system is now live in all adult inpatient areas across the Trust.

  • Osler Travel Award for student to visit PiNG group

    21 June 2016

    Julia Nantes awarded grant to visit PiNG Group in the Autumn

  • Primary Schools

    6 October 2016

    Our scientists love showing primary school children how MRI works and giving them a chance to make up their own experiments to do on our scanners.

  • Secondary Schools

    6 October 2016

    We regularly go out into secondary schools to speak about neuroscience and invite secondary school students into the lab to find out what neuroscience research is really like.

  • The Creative Brain

    6 October 2016

    Bringing together people from a wide range of disciplines, providing a forum to provoke thought and dialogue about how our understanding of neuroscience can impact on all aspects of our lives, and how insights from other fields can enrich our study of neuroscience.

  • Museums and Festivals

    6 October 2016

    Our scientists regularly attend science fairs and put on exhibitions at local museums.

  • Media

    6 October 2016

    Our scientists regularly appear on national media to explain the impact that our work has.

  • Lifestyle

    26 August 2016