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Personal profile

Biography

I lead the Research to Understand Stroke due to Haemorrhage (RUSH) programme, which is dedicated to improving the outcome for adults who have diseases that may cause, or have caused, intracranial haemorrhage. The fundamental study designs of clinical epidemiology - such as randomised controlled trials, community- or population-based cohort and case-control studies, brain banking, and meta-analysis - are the foundation of my focus on the frequency, prognosis, treatment, and pathophysiology of intracranial haemorrhage. I also care for people with these conditions, audit their care, and help undergraduate and postgraduate students to develop and answer research questions within the RUSH programme.

I became interested in neurology during undergraduate medical training at Cambridge University. I was inspired to work on common neurological problems by Charles Warlow and the stroke research group in Edinburgh, which I joined in 1998 as an MRC clinical training fellow, progressing to MRC patient-oriented clinician scientist and senior clinical fellowships until 2016. Since becoming a professor of clinical neurology at the University of Edinburgh in August 2013, the depth and breadth of my research has expanded beyond stroke and intracranial haemorrhage in response to several of the global challenges in non-communicable diseases, vascular multi-morbidity, cerebral small vessel diseases, and therapeutic dilemmas provoked by vascular ageing.

My lived experience of clinical research has made me concerned about increasing the value of biomedical research by minimising waste in the choice of research question, study design, study conduct, regulation, and reporting.  This led to me becoming one of the lead authors of The Lancet's 2014 Series on Increasing Value and Reducing Waste in Research (www.thelancet.com/series/research) and the related campaign (www.thelancet.com/campaigns/efficiency), as well as a founding member of the REWARD Alliance (http://rewardalliance.net).

Current Research Interests

  • Therapeutic dilemmas in everyday clinical practice provoked by mutlimorbidity with intracranial haemorrhage (RESTARTSoSTART, TRIDENT, PROHIBIT-ICH, ENRICH-AF, and SATURN randomised controlled trials)
  • Translational approaches to identifying therapeutic targets for inflammatory pathways after intracerebral haemorrhage (NICHE programme)
  • Causes and consequences of stroke due to intracerebral haemorrhage (LATCH community-based cohort study and LINCHPIN genetic, imaging, and neuropathology study)
  • Prognosis and treatment of intracranial vascular malformations in adults (SAIVMs population-based cohort study)
 

My research in a nutshell

The deadliest type of stroke is caused by spontaneous bleeding from blood vessels into the brain, known as brain haemorrhage. This disease affects about 10,000 adults in the UK, and about 2 million adults in the world, each year. Two out of five people affected die within one month of the bleed and another two remain dependent on their families or carers, leaving only one person out of five independent.

I use a variety of clinical research designs, including systematic reviews, case-control and cohort studies, and randomised controlled trials to better understand the causes, consequences, and treatment of brain haemorrhage.

Positions available

I am keen to attract motivated clinical research fellows to work on the projects that I am running, or to set up projects of their own. I have a track record of obtaining independently-funded fellowships from the MRC, and my department has a programme dedicated to supporting trainees obtain such fellowships: http://www.ed.ac.uk/schools-departments/clinical-brain-sciences/postgraduate-training

Websites

Administrative Roles

 

Teaching

Clinical Expertise and Specialisation

  • Neurology
  • Stroke

Education/Academic qualification

Doctor of Philosophy (PhD), University of Edinburgh

Award Date: 1 Jan 2005

Bachelor of Medicine, University of Cambridge

Award Date: 1 Jan 1994

Bachelor of Surgery, University of Cambridge

Award Date: 1 Jan 1994

Bachelor of Arts, University of Cambridge

Award Date: 1 Jan 1991

External positions

President, British Association of Stroke Physicians (BASP)

1 Jan 202031 Dec 2021

Board Member, Efficacy & Mechanism Evaluation funding committee, National Institute for Health Research

2018 → …

President Elect, British Association of Association of Stroke Physicians

1 Dec 201730 Nov 2019

Board of DIrectors, European Stroke Organisation

20162020

Member, Secretary of State for Transport’s Honorary Medical Advisory Panel on Driving and Disorders of the Nervous system

20152020

Stroke Association in Scotland Advisory Committee, Stroke Association

2015 → …

Member, Trials Network Committee, European Stroke Organisation

2014 → …

Scientific Advisory Board, Angioma Alliance

2010 → …

Editorial board member, Cochrane Stroke Group

2009 → …

Keywords

  • RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
  • Stroke
  • Intracerebral haemorrhage
  • Subarachnoid haemorrhage
  • Observational studies
  • Epidemiology
  • Randomised controlled trials
  • Meta-analysis
  • Systematic review
  • R Medicine (General)
  • Clinical neurology
  • Clinical audit

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