University of Glasgow
Institute of Cardiovascular and Medical Sciences
Jesse Dawson is a Professor of Stroke Medicine at the Institute of Cardiovascular and Medical Sciences and Associate at the School of Medicine, Dentistry and Nursing, University of Glasgow. Professor Dawson is a Consultant Physician in the Queen Elizabeth University Hospital, Glasgow. He is Clinical Lead for the Scottish Stroke Research Network and recently chaired the European Stroke Organization Conference. Professor Dawson has research interests in clinical trials on prevention and rehabilitation in stroke survivors, with special focus on improving long-term outcomes.

Moderator of 1 Session

Session Type
Main Theme Symposium
Date
29.10.2021, Friday
Session Time
08:00 - 09:30
Room
MAIN THEME B
Session Icon
Live Session

Presenter of 2 Presentations

Vagal Nerve Stimulation for Motor Recovery

Session Type
Main Theme Symposium
Date
29.10.2021, Friday
Session Time
08:00 - 09:30
Room
MAIN THEME B
Lecture Time
08:17 - 08:34

Abstract

Abstract Body

This talk will cover the preclinical and clinical evidence for use of vagus nerve stimulation paired with intensive rehabilitation for upper limb motor recovery after ischemic stroke. The main focus will be on review of the latest clinical data but also consideration of next steps, both for research and for clinical implementation.

The therapy protocols used in the clinical studies will be described along with the experiences of a home exercise programme repaired with vagus nerve stimulation.

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XANTHINE OXIDASE INHIBITION FOR IMPROVEMENT OF LONG-TERM OUTCOMES FOLLOWING ISCHAEMIC STROKE AND TRANSIENT ISCHAEMIC ATTACK (XILO-FIST)

Session Type
Plenary Session
Date
28.10.2021, Thursday
Session Time
11:30 - 13:30
Room
PLENARY
Lecture Time
12:40 - 12:50

Abstract

Background and Aims

People who suffer an ischaemic stroke are at risk of recurrent vascular events. We assessed whether allopurinol, a xanthine oxidase inhibitor, reduced white matter hyperintensity progression (WMH) and systolic blood pressure (SBP) following ischaemic stroke.

Methods

In this multicenter, prospective, randomised, blinded, controlled trial we assigned participants within 30-days of ischaemic stroke or TIA to receive allopurinol 300mg twice daily or placebo for 104 weeks (registration number NCT02122718). All participants had brain MRI performed at baseline and week 104 and ambulatory blood pressure monitoring at baseline, week 4 and week 104. The primary outcome was the WMH Rotterdam Progression Score (RPS). Secondary outcomes included change in day-time SBP. Analyses were by intention to treat.

Results

We randomised 464 participants (232 per group). A total of 372 (189 with placebo and 183 with allopurinol) attended for week 104 MRI and were included in analysis of the primary outcome. The RPS was 1.33 (SD 1.79) with allopurinol and 1.51 (SD 1.89) with placebo, between group difference -0.17, 95% CI -0.52 to 0.17, p=0.33. The change in day-time SBP at week 4 was -2.3 mmHg (SD 12.92) with allopurinol and 0.8 (SD 10.74) with placebo, between group difference -3.33, 95% CI -5.55 to -1.11, p=0.0034. At week 104, the between group difference in day-time SBP was -2.95 mmHg, 95% CI -6.00 to 0.10, p=0.058.

Conclusions

Allopurinol use did not reduce WMH progression in people with recent ischaemic stroke or TIA but did lower SBP. Further research should explore whether this blood pressure change is clinically important.

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