UNSW Sydney Brain Centre

Professor Mark Parsons and Associate Professor Andrew Bivard are Program Leads and Investigators for the Australian Stroke Alliance, which includes national and state government, academic, health, consumer, and commercial partners. The Alliance aims to trial and implement innovative technical and tele-health solutions to radically transform access to early pre-hospital. Rather than transporting patients to hospital, we drive or fly Australian-designed life-saving brain scanning equipment and time-critical stroke treatment directly to the patient, whether they live in out-metropolitan, rural, regional or remote communities, transforming their chances of survival and recovery.

The stroke capable ambulance is one of the Alliance studies currently being implemented in South West Sydney LHD and the Royal Melbourne Hospital and John Hunter Hospital, focusing on implementing new models of care and novel technologies including communication apps and imaging into Ambulances for earlier more accurate diagnosis of stroke in the field, and faster access to time-critical treatments. 

INSPIRE is the world’s largest stroke perfusion imaging registry, with >5000 stroke patients with advanced imaging and clinical data from Australian, Chinese, Canadian, Japanese and Indian centres. INSPIRE aims to establish an internationally unique web-based database of imaging and clinical stroke data to:

• Measure outcomes of advanced CT stroke imaging.
• Assess whether the implementation of quality use of advanced CT imaging improves the safe and effective delivery of reperfusion treatment.
• Develop a Quality Assurance Framework for advanced CT imaging in stroke with standardisation of the post-processing and reporting of advanced CT.

MOSES aims to develop a framework for comparing imaging and clinical data in thrombectomy patients between Comprehensive Stroke Centres and use these data to:

• Develop more specific clinical and imaging selection guidelines for thrombectomy patient selection. This will include guidelines to better select which patients (using multimodal CT and telestroke) should be transported from regional Primary Stroke Centres (PSCs) for thrombectomy.
• Develop a decision-assistance tool using clinical and multimodal CT data to help guide clinicians in patient selection for acute reperfusion therapy (thrombectomy and/or IV thrombolysis)

• Profiling risk-factors and stroke outcomes in CALD communities
• Validation of new measure of pre-and post-stroke function, collected face-to-face, via telephone and AI. 

A multifactorial risk prediction model for imaging characteristics of malignant infarction and unfavourable clinical outcomes in acute stroke survivors from First Nations communities.  

Our group has been at the forefront of some of the most ground-breaking stroke trials of the last decade. In partnership with First Nations communities, we now seek to empower stroke survivors with a world-first model of care that integrates culturally specific risk factor assessments with advanced imaging, to enable personalised treatment decisions. This project has the potential to show substantial reductions in adverse stroke outcomes and, by recognising the unique characteristics of stroke in FN people, will be in the vanguard of a paradigm shift in stroke care.

Aims/Objectives

• To identify both modifiable and nonmodifiable risk factors that predict malignant (large core or fast core growth) hyperacute imaging profiles in First Nations peoples presenting with acute stroke.
• To identify both modifiable and nonmodifiable risk factors that predict poor functional outcomes in First Nations stroke survivors.
• To establish a multifactorial risk model to predict the likelihood of the emergence of malignant (large core or fast core growth) brain imaging features and unfavourable clinical outcomes in First Nations stroke patients, and to understand how the two interact.
• To translate this multifactorial risk model into a risk management and harm minimisation tool for clinical application in First Nations communities.

Deena Alysha Coilpillai Chelliah Vernon, ILP student 2023

Deena’s ILP project profiling risk factors and stroke outcomes in the Vietnamese community was completed as part of an ongoing research program in CALD communities with UNSW, Sydney Brain Centre, SWSLHD and strong community engagement. Rates of ICAD and ICH were significantly higher in Vietnamese patients compared to Caucasian patients. Only 11.8% (30) of Vietnamese patients received acute stroke intervention, compared to 29.3% (29) of Caucasian patients. Patients of Vietnamese background exhibited a higher in-hospital mortality rate and received acute stroke interventions less frequently. All-case in-hospital deaths were 87 (21.5%) in Vietnamese patients and 18 (12.5%) in Caucasians.

Pui Lok Annette Fung, UNSW Honours student 2023 

Annette’s 2023 Honours project aimed to evaluate the feasibility of using AI to detect whether a person has experienced a stroke from different speech, language, eye gaze and facial symmetry patterns. This study demonstrated that AI models could differentiate LVO stroke participants from healthy controls through analysis of automated speech and voice features. This research was completed as part of an ongoing program of research validating a new measure of pre-and post-stroke function, the DBS24 (Driving Banking Shopping 24 hrs).