Stroke
Stroke is a leading cause of death and disability. Our research spans the translational pipeline from basic experimental biology and trials of healthcare interventions through to implementing findings into practice.
We focus on understanding mechanisms of neuroimmune and vascular dysfunction, how they contribute to acute cerebrovascular diseases and the impact of these conditions. We carry forward this knowledge to improve the process and outcomes of care and, ultimately, the quality of life for stroke survivors and their carers.
Our research is unique in combining life sciences, interdisciplinary clinical research and implementation science. We cover all clinical subtypes of stroke (ischaemic and haemorrhagic) and include all stages of clinical care (hyperacute through to community) for people with stroke.
Areas of research activity
This interdisciplinary approach is underpinned by active patient, carer and public involvement and engagement. Our research activity can be grouped into four categories:
- Basic biology and pre-clinical science
- Mechanisms of inflammation and how neurovascular dysfunction and inflammation contribute to cerebrovascular disease (Allan, Brough, Pinteaux, Lawrence, Smith, Rothwell, Kostarelos)
- Understanding how comorbidity contributes to and impacts brain disease (Allan, Brough, Pinteaux, Lawrence, Boutin)
- Intracranial haemorrhage (Kasher, Parry-Jones, Allan, Brough)
- Minimising brain damage after stroke
- Anti-inflammatory therapies in stroke (Tyrrell, Patel, King, Vail, Bowen)
- Intracranial haemorrhage (Parry-Jones)
- Promoting repair and recovery of function
- Mouth hygiene, dysphagia and infections (Smith, Hamdy)
- Communication difficulties after stroke (aphasia) (Lambon Ralph, Halai)
- Sensory and motor difficulties including vision and arm function (Howard, Hammerbeck)
- Managing persisting disabilities and organising care
- Cognitive and communication difficulties after stroke e.g. unilateral spatial neglect, apraxia, pre-existing cognitive difficulties (Patchick, Bowen, Vail, Mitchell, Conroy, Abel)
- Motor difficulties including balance (Tyson, Vail)
- Organisation and delivery of care across acute and community settings (Tyrrell, Boaden, Rothwell, Tyson, Bowen, Vail, Patel, Parry-Jones)
- Life after stroke, psychological support, fatigue, return to work, support for carers (Tyrrell, Bowen, Patchick, Rothwell, Rhodes)
Major projects
Stroke connected health cities
Part of a £20 million Health North initiative, led by Dr Adrian Parry-Jones, stroke researchers are looking at using technology and data to improve the diagnosis and treatment of strokes across Greater Manchester.
Contribution of neuro-inflammation to cerebral ischaemia
Dr David Brough, Professor Stuart Allan, Professor Kostas Kostarelos and Professor Dame Nancy Rothwell are leading a MRC funded project investigating how inflammasomes contribute to brain injury after stroke. This project is also harnessing the power of nanotechnologies to interrogate mechanisms of inflammation and how they contribute.
SSNAPIEST
An NIHR-funded observational study led by Professor Sarah Tyson, using data from the Stroke Sentinel National Audit Programme to investigate the effectiveness of stroke therapy in the UK.
OSCARSS
Organising Support for Carers of Stroke Survivors is a large cluster randomised controlled trial, process evaluation and economic study funded by the NIHR CLAHRC in partnership with Stroke Association led by Professor Audrey Bowen and Dr Emma Patchick.
Featured researchers
Dr Ulrike Hammerbeck
Ulrike Hammerbeck is a physiotherapist and Stroke Association post-doctoral fellow investigating proximal arm recovery processes in the acute period after stroke.
Dr Jack Rivers-Auty
Dr Jack Rivers-Auty is a BBSRC Future Leaders Fellow who is exploring how dietary zinc and inflammation impact healthy ageing in the brain.
Dr Emma Patchick
Emma Patchick is a research psychologist in the CLAHRC GM. Her role includes implementing six month reviews of need after stroke for care home residents, and the OSCARSS carer study (featured above).
Dr Paul Kasher
Paul Kasher is a translational neuroscience research fellow with expertise in the generation and characterisation of experimental models of neurological disease and recent recipient of a Stroke Association lectureship.
Case studies
Our stroke research led to three successful REF2014 impact case studies around services for people with communication, cognition and swallowing difficulties, and the introduction of six month reviews for patients.
Improving stroke services
A third of stroke survivors experience communication problems. Professor Audrey Bowen and Dr Anne Hesketh recognised unmet service needs for these people. Their study, ACT NoW, evaluated the effectiveness and cost effectiveness of speech and language therapy following, actively seeking service users' and carers' views on the subject.
The findings of their study and systematic reviews, as well as ongoing trials, have had a direct influence on national and international stroke guidelines for the management and rehabilitation of cognition and communication after stroke.
Helping stroke patients swallow
Our pioneering research led to the introduction of the world's first effective throat stimulation treatment for stroke patients with swallowing problems (dysphagia).
This potentially life-threatening condition affects half of stroke patients and costs the NHS an estimated £400 million each year.
Having identified a number of areas within the brain that are associated with swallowing, Professor Shaheen Hamdy patented a device to help patients with dysphagia and speed up recovery. It is now used in the UK, Europe and the Middle East, and it is hoped it will lead to shorter hospital stays and significant financial savings to the NHS.
Improving health through an evidence-based implementation programme
Life for those in England who have had a stroke has been improved through assessment of their needs six months after their stroke, followed up with support so that these needs are met.
A team at Manchester led by Professor Ruth Boaden developed GM-SAT, a simple evidence-based assessment tool which can be used to identify and address individuals’ long term, unmet post-stroke needs. It can be tailored to reflect local care pathways, services and resources available. GM-SAT can be used free by a range of practitioners and is now in use across England, enabling the fulfilment of national strategy and improved care for patients.
Public and patient engagement
Our research benefits from strong patient, carer and public involvement and we regularly conduct public engagement activities around stroke science and art. Examples include:
ReaDySpeech
A feasibility randomised controlled trial for people with dysarthria, a disordered speech production which is a common symptom after stroke.
Read a blog by project lead Claire Mitchell about living with dysarthria.
OSCARSS research user group
An active user group of carers support the development of all aspects of the design and roll out of the OSCARSS study.
Watch a video about this project featuring members of the user group.
Stroke: Stories of the Self Through Art and Science
The Stroke Association and The University of Manchester ran a set of visual arts workshops and exhibitions at Manchester Central Library and Manchester Museum to tell Stroke survivors’ stories.
Read a blog by artist Elisa Artesero who facilitated the workshops.
Social responsibility in the medical teaching curriculum
Stroke, Self and Brain, a social responsibility project funded by the University in partnership with the Stroke Association, brought together stroke survivors with medical students for workshops to share knowledge and experience of the brain before and after stroke through the creation of original artworks.
Watch a video about the workshops.
PhD opportunities
We have a vibrant postgraduate research community of 30 PhD students. We offer a range of PhD opportunities from working in discovery science through to cognitive neuroscience and applied research.
MRC DTP projects
- Learning from your mistakes? Using electrophysiological indices of error monitoring to optimise treatment of stroke aphasia (Dr Anna Woollams)
- Understanding immune cell function in stroke (Professor Stuart Allan)
- Understanding what causes the brain to bleed (Dr David Brough)
- Mesenchymal stem cells preconditioning as therapeutic tool to promote recovery from stroke (Dr Emmanuel Pinteaux)
- Understanding the role of SAMHD1 in haemorrhagic stroke (Dr Paul Kasher)
- Investigating the gut-brain axis: immunological consequences of brain disease (Dr Catherine Lawrence)
Contact
Pre-clinical
Dr David Brough
Email: david.brough@manchester.ac.uk
Tel: (+44)161 275 5039
Clinical
Professor Audrey Bowen
Email: audrey.bowen@manchester.ac.uk
Tel: (+44)161 275 1235 (University), (+44)161 206 4349 (Salford Royal Foundation Trust)