Featured Publications
Common Pathways of Epileptogenesis in Patients With Epilepsy Post–Brain Injury
Misra S, Khan E, Lam T, Mazumder R, Gururangan K, Hickman L, Goswami V, Funaro M, Eldem E, Sansing L, Sico J, Quinn T, Liebeskind D, Montaner J, Kwan P, Mishra N. Common Pathways of Epileptogenesis in Patients With Epilepsy Post–Brain Injury. Neurology 2023, 101: e2243-e2256. PMID: 37550071, PMCID: PMC10727219, DOI: 10.1212/wnl.0000000000207749.Peer-Reviewed Original ResearchConceptsStandardized mean differencePoststroke epilepsyBrain injuryGenetic susceptibilityDisparate time pointsRisk of epileptogenesisLate-onset seizuresDevelopment of epilepsyBlood glucose levelsTraumatic brain injuryMean biomarker levelsIndividual genetic susceptibilityWeb of ScienceReported biomarkersPrimary outcomeEpileptogenic processBiofluid biomarkersBias assessmentBiomarker levelsCommon biological pathwaysEnrichment analysisGlucose levelsHigh riskPrognostic studiesEpilepsyComparison of Sex-Based In-Hospital Procedural Outcomes and Hospital Readmission Frequency After Patent Foramen Ovale Occluder Device Placement: A Propensity Matched National Cohort
Fakhra S, Sattar Y, Patel N, Aziz S, Titus A, Almas T, Aamir M, Sulaiman S, Mishra N, Elgendy I, Raina S, Jagadeesan V, Daggubati R, Alraies M. Comparison of Sex-Based In-Hospital Procedural Outcomes and Hospital Readmission Frequency After Patent Foramen Ovale Occluder Device Placement: A Propensity Matched National Cohort. Current Problems In Cardiology 2023, 48: 101662. PMID: 36868331, DOI: 10.1016/j.cpcardiol.2023.101662.Peer-Reviewed Original ResearchConceptsAcute kidney injuryAcute ischemic strokeNationwide Readmissions DatabaseMultivariate odds ratiosDevice placementAKI incidenceHospital mortalityCardiac tamponadeIschemic strokeHigher total hospitalization costsNational retrospective cohort studySecondary cardiovascular outcomesRetrospective cohort studyTotal hospitalization costsComparison of sexAKI occurrenceNephrotoxic medicationsReadmission LOSRecurrent strokeCardiovascular outcomesIndex hospitalizationKidney injuryPostprocedural bleedingCohort studyComplication rate
2018
Sex-Specific Outcomes After Transcatheter Aortic Valve Replacement: FDA Patient-Level Meta-Analysis of Premarket Clinical Trials
Zusterzeel R, Mishra NK, Beydoun H, Laschinger J, Wu C, Dong LM, Lin JA, Marinac-Dabic D, Strauss DG, Caños DA. Sex-Specific Outcomes After Transcatheter Aortic Valve Replacement: FDA Patient-Level Meta-Analysis of Premarket Clinical Trials. Journal Of Women's Health 2018, 27: 808-814. PMID: 29741978, DOI: 10.1089/jwh.2017.6760.Peer-Reviewed Original ResearchConceptsTranscatheter aortic valve replacementAortic valve replacementClinical trialsPatient-level dataPremarket clinical trialsLower riskMajor bleedingKidney injuryIschemic strokeValve replacementPacemaker implantationMortality riskDichotomous outcomesEfficacy of TAVRInvasive alternative approachPatient-Level MetaLong-term outcomesSex-specific outcomesLower mortality riskRandom-effects modelReintervention riskTAVR armIndividual comorbiditiesPostprocedural complicationsAcute outcomesTime From Imaging to Endovascular Reperfusion Predicts Outcome in Acute Stroke
Tsai JP, Mlynash M, Christensen S, Kemp S, Kim S, Mishra NK, Federau C, Nogueira RG, Jovin TG, Devlin TG, Akhtar N, Yavagal DR, Bammer R, Straka M, Zaharchuk G, Marks MP, Albers GW, Lansberg MG. Time From Imaging to Endovascular Reperfusion Predicts Outcome in Acute Stroke. Stroke 2018, 49: 952-957. PMID: 29581341, PMCID: PMC5875452, DOI: 10.1161/strokeaha.117.018858.Peer-Reviewed Original ResearchMeSH KeywordsActivities of Daily LivingAgedAngiography, Digital SubtractionCerebral AngiographyCohort StudiesEndovascular ProceduresFemaleHumansInfarction, Middle Cerebral ArteryMaleMiddle AgedPerfusion ImagingPrognosisRecovery of FunctionReperfusionStrokeThrombectomyTime-to-TreatmentTomography, X-Ray ComputedTreatment OutcomeConceptsTarget mismatch profileReperfusion timeFunctional independenceMismatch profileInfarct growthCTP scansLarger final infarct volumeTarget mismatch patientsAcute ischemic strokeCohort of patientsFinal infarct volumeTarget mismatchSuccessful endovascular reperfusionMismatch patientsEndovascular reperfusionInfarct volumeRadiological outcomesSuccessful reperfusionAcute strokeIschemic strokeRadiographic outcomesEndovascular therapyBaseline imagingMalignant profileTomographic perfusion
2017
Computed tomographic perfusion to Predict Response to Recanalization in ischemic stroke
Lansberg MG, Christensen S, Kemp S, Mlynash M, Mishra N, Federau C, Tsai JP, Kim S, Nogueria RG, Jovin T, Devlin TG, Akhtar N, Yavagal DR, Haussen D, Dehkharghani S, Bammer R, Straka M, Zaharchuk G, Marks MP, Albers GW, Investigators F. Computed tomographic perfusion to Predict Response to Recanalization in ischemic stroke. Annals Of Neurology 2017, 81: 849-856. PMID: 28486789, PMCID: PMC5521988, DOI: 10.1002/ana.24953.Peer-Reviewed Original ResearchConceptsBaseline CT perfusionSymptom onsetEndovascular therapyCT perfusionTomographic perfusionConsecutive acute stroke patientsSmall ischemic coreTarget mismatch profileMulticenter cohort studyAcute stroke patientsFavorable clinical responseSelection of patientsTarget mismatchRate of reperfusionCT perfusion studyMagnetic resonance imagingAnn NeurolCritical hypoperfusionEndovascular reperfusionClinical responseCohort studyIschemic strokeIschemic coreStroke patientsPatient population
2016
Comorbid Parkinson's disease, falls and fractures in the 2010 National Emergency Department Sample
Beydoun HA, Beydoun MA, Mishra NK, Rostant OS, Zonderman AB, Eid SM. Comorbid Parkinson's disease, falls and fractures in the 2010 National Emergency Department Sample. Parkinsonism & Related Disorders 2016, 35: 30-35. PMID: 27887896, PMCID: PMC5663222, DOI: 10.1016/j.parkreldis.2016.11.005.Peer-Reviewed Original ResearchConceptsICD-9-CM codesParkinson's diseaseBone fracturesHospital deathNational Emergency Department SamplePD diagnosisAssociation of PDComorbid Parkinson's diseaseElderly patient visitsEmergency Department SampleFall-related injuriesConfidence intervalsEmergency department settingLogistic regression modelsBone fracture locationPD admissionsU.S. EDsED dischargeElderly patientsED admissionHospitalization lengthFracture prevalenceWorse prognosisMost injuriesDepartment settingComparison of stroke volume evolution on diffusion-weighted imaging and fluid-attenuated inversion recovery following endovascular thrombectomy
Federau C, Christensen S, Mlynash M, Tsai J, Kim S, Zaharchuk G, Inoue M, Straka M, Mishra NK, Kemp S, Lansberg MG, Albers GW. Comparison of stroke volume evolution on diffusion-weighted imaging and fluid-attenuated inversion recovery following endovascular thrombectomy. International Journal Of Stroke 2016, 12: 510-518. PMID: 27811306, DOI: 10.1177/1747493016677985.Peer-Reviewed Original ResearchConceptsInfarct lesion volumeFluid-attenuated inversion recoveryDiffusion-weighted imagingLesion volumeEndovascular thrombectomyInversion recoveryDay 5Fluid-attenuated inversion recovery lesionsPost-stroke onsetDegree of reperfusionStroke lesion volumeFluid-attenuated inversion recovery imagesInversion recovery imagesInfarct volumeInfarct growthStroke onsetSymptom onsetLesion growthPatientsRecovery imagesInterquartile rangeThrombectomyProcedure images
2015
Response to endovascular reperfusion is not time-dependent in patients with salvageable tissue
Lansberg MG, Cereda CW, Mlynash M, Mishra NK, Inoue M, Kemp S, Christensen S, Straka M, Zaharchuk G, Marks MP, Bammer R, Albers GW, Saver J, Fayad P, Howard G, Tomsick. T, Jovin T, Wechsler L, DeCesare S, Thai D, Sherr A, Wilder M, Tricot A, Lutsep H, McDaneld L, Larsen D, Czartoski T, Keogh B, Malik A, Brown A, Bernstein R, Muskovich K, Chang C, Stern T, Warach S, Davis L, Fazekas F, Seifert-Held T. Response to endovascular reperfusion is not time-dependent in patients with salvageable tissue. Neurology 2015, 85: 708-714. PMID: 26224727, PMCID: PMC4553034, DOI: 10.1212/wnl.0000000000001853.Peer-Reviewed Original ResearchConceptsGood functional outcomeEndovascular reperfusionFunctional outcomeSalvageable tissueLesion volumeLesion growthRandomized placebo-controlled trialModified Rankin Scale scorePerfusion Imaging EvaluationPerfusion lesion volumeTarget mismatch profilePlacebo-controlled trialRankin Scale scorePerfusion-diffusion mismatchSubgroup of patientsRadiologic outcomesCohort studyEndovascular therapyEarly followStroke patientsImaging evaluationReperfusionDay 90PatientsScale scoreReperfusion of Very Low Cerebral Blood Volume Lesion Predicts Parenchymal Hematoma After Endovascular Therapy
Mishra NK, Christensen S, Wouters A, Campbell BC, Straka M, Mlynash M, Kemp S, Cereda CW, Bammer R, Marks MP, Albers GW, Lansberg MG. Reperfusion of Very Low Cerebral Blood Volume Lesion Predicts Parenchymal Hematoma After Endovascular Therapy. Stroke 2015, 46: 1245-1249. PMID: 25828235, PMCID: PMC4414872, DOI: 10.1161/strokeaha.114.008171.Peer-Reviewed Original ResearchConceptsParenchymal hemorrhageIntravenous alteplaseEndovascular therapyBaseline imagingLesion volumeLow cerebral blood volumePerfusion Imaging EvaluationIschemic stroke patientsEndovascular reperfusion therapySingle independent predictorRoutine clinical practiceCerebral blood volumeMagnetic resonance imagingRegional reperfusionParenchymal hematomaReperfusion therapyIndependent predictorsEarly followRisk stratificationStroke patientsImaging evaluationNormal perfusionVLCBVBlood volumePatients
2014
Comparison of Magnetic Resonance Imaging Mismatch Criteria to Select Patients for Endovascular Stroke Therapy
Mishra NK, Albers GW, Christensen S, Marks M, Hamilton S, Straka M, Liggins JT, Kemp S, Mlynash M, Bammer R, Lansberg MG. Comparison of Magnetic Resonance Imaging Mismatch Criteria to Select Patients for Endovascular Stroke Therapy. Stroke 2014, 45: 1369-1374. PMID: 24699054, PMCID: PMC4007191, DOI: 10.1161/strokeaha.114.004772.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCarotid Artery DiseasesCerebrovascular DisordersDiffusion Magnetic Resonance ImagingFemaleHumansInfarction, Middle Cerebral ArteryMagnetic Resonance AngiographyMaleMiddle AgedMultimodal ImagingPerfusion ImagingReperfusionSeverity of Illness IndexStrokeTreatment OutcomeConceptsFavorable clinical responseMRA-DWI mismatchClinical responseMagnetic resonance angiographyDay 30Endovascular stroke trialsPerfusion Imaging EvaluationHealth Stroke ScaleGood functional outcomeEndovascular stroke therapyPerfusion-diffusion mismatchPWI-DWI mismatchInternal carotid arteryDEFUSE 2Endovascular reperfusionM1 occlusionMismatch criteriaNIHSS scoreStroke ScalePatient selectionStroke therapyStroke trialsFunctional outcomeImaging evaluationVessel occlusion
2013
J. T. P. Liggins et al.
Liggins JT, Yoo AJ, Mishra NK, Wheeler HM, Straka M, Leslie‐Mazwi T, Chaudhry ZA, Kemp S, Mlynash M, Bammer R, Albers GW, Lansberg MG, Investigators D. J. T. P. Liggins et al. International Journal Of Stroke 2013, 10: 705-709. PMID: 24207136, PMCID: PMC4048330, DOI: 10.1111/ijs.12207.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAgingBrain IschemiaCohort StudiesDatabases, FactualDiffusion Magnetic Resonance ImagingFemaleFibrinolytic AgentsHumansLogistic ModelsMaleMiddle AgedMulticenter Studies as TopicOutcome Assessment, Health CareSeverity of Illness IndexStrokeTissue Plasminogen ActivatorTreatment OutcomeConceptsPoor functional outcomeDiffusion-weighted imaging scoreFunctional outcomeImaging scoresTherapy scoreClinical responseDiffusion-weighted imaging volumeModified Rankin Scale scoreAcute stroke interventionAcute ischemic strokePercentage of patientsPredictive scoring systemRankin Scale scorePredictors of outcomeCharacteristic curveDiffusion-Weighted ImagingIschemic strokeEndovascular therapyIndependent predictorsPatient ageStroke interventionEndovascular treatmentValidation cohortClinical variablesLesion volumePostthrombolysis outcomes in acute ischemic stroke patients of Asian race‐ethnicity
Mishra NK, Chan BP, Teoh H, Meng C, Lees KR, Chen C, Sharma VK, collaboration F. Postthrombolysis outcomes in acute ischemic stroke patients of Asian race‐ethnicity. International Journal Of Stroke 2013, 8: 95-99. PMID: 23490069, DOI: 10.1111/ijs.12012.Peer-Reviewed Original ResearchConceptsVirtual International Stroke Trials ArchiveThrombolytic therapyStroke patientsAsian patientsHealth Stroke Scale scorePropensity score-matched patientsAcute ischemic stroke patientsTissue plasminogen activator therapyAsian stroke patientsBaseline National InstitutesPropensity-matched cohortStroke Scale scoreIschemic stroke patientsProportional odds logistic regression analysisPlasminogen activator therapyNational University HospitalLogistic regression analysisNational InstituteRace-ethnic differencesNeurological outcomeRankin scoreThrombolyzed patientsPropensity matchingTertiary centerActivator therapyThrombolysis in Stroke Despite Contraindications or Warnings?
Frank B, Grotta JC, Alexandrov AV, Bluhmki E, Lyden P, Meretoja A, Mishra NK, Shuaib A, Wahlgren NG, Weimar C, Lees KR. Thrombolysis in Stroke Despite Contraindications or Warnings? Stroke 2013, 44: 727-733. PMID: 23391774, DOI: 10.1161/strokeaha.112.674622.Peer-Reviewed Original ResearchConceptsHealth Stroke ScoreAlteplase treatmentStroke ScoreOdds ratioBaseline National InstitutesIntravenous alteplase treatmentPretreatment National InstitutesSingle antiplatelet agentTrial selection criteriaAcute ischemic strokeIschemic stroke patientsProportional odds logistic regression analysisSubgroup of patientsAdjusted odds ratioCommon clinical situationsNational InstituteLogistic regression analysisInternational normalizedIntravenous thrombolysisOral anticoagulationPrior strokeComprehensive retrospective analysisIschemic strokeRankin ScaleUntreated patientsThe Modified Graeb Score
Morgan TC, Dawson J, Spengler D, Lees KR, Aldrich C, Mishra NK, Lane K, Quinn TJ, Diener-West M, Weir CJ, Higgins P, Rafferty M, Kinsley K, Ziai W, Awad I, Walters MR, Hanley D. The Modified Graeb Score. Stroke 2013, 44: 635-641. PMID: 23370203, PMCID: PMC6800016, DOI: 10.1161/strokeaha.112.670653.Peer-Reviewed Original ResearchConceptsVirtual International Stroke Trials ArchiveGraeb scalePoor outcomeIVH volumeB studyModified Rankin ScaleIntraventricular hemorrhage volumeModified Graeb scoreRankin ScaleMGS scoresVISTA studyHemorrhage volumeGraeb scoreAccelerated ResolutionPrognostic validitySemiquantitative scaleClinical practiceClot lysis
2011
Thrombolysis outcomes in acute ischemic stroke patients with prior stroke and diabetes mellitus
Mishra NK, Ahmed N, Davalos A, Iversen HK, Melo T, Soinne L, Wahlgren N, Lees KR. Thrombolysis outcomes in acute ischemic stroke patients with prior stroke and diabetes mellitus. Neurology 2011, 77: 1866-1872. PMID: 22094479, DOI: 10.1212/wnl.0b013e318238ee42.Peer-Reviewed Original ResearchConceptsNIH Stroke Scale scoreBaseline NIH Stroke Scale scoreConcomitant diabetes mellitusPrior strokeIschemic stroke patientsDiabetes mellitusThrombolytic therapyStroke patientsOdds ratioScale scoreAcute ischemic stroke patientsInfluence of DMOutcomes of patientsStroke Scale scoreRankin Scale scoreConfidence intervalsDistribution of mRSAlteplase treatmentProportional odds logistic regressionMRS outcomesThrombolysis outcomesPatientsHaenszel testEuropean approvalCochran-MantelLow Body Temperature Does Not Compromise the Treatment Effect of Alteplase
Lees JS, Mishra NK, Saini M, Lyden PD, Shuaib A. Low Body Temperature Does Not Compromise the Treatment Effect of Alteplase. Stroke 2011, 42: 2618-2621. PMID: 21757664, DOI: 10.1161/strokeaha.110.611210.Peer-Reviewed Original ResearchConceptsBaseline body temperatureAcute ischemic strokeRankin Scale scoreIschemic strokeAlteplase treatmentBaseline severityBody temperatureScale scoreVirtual International Stroke Trials ArchiveRankin Scale distributionsBaseline National InstitutesHealth Stroke ScaleIschemic stroke modelTreatment effectsStroke ScaleThrombolytic therapyImproved outcomesTherapeutic effectTreatment responseStroke modelTreatment groupsAlteplaseCochran-MantelLow body temperatureStrokeHome Time Is Extended in Patients With Ischemic Stroke Who Receive Thrombolytic Therapy
Mishra NK, Shuaib A, Lyden P, Diener HC, Grotta J, Davis S, Davalos A, Ashwood T, Wasiewski W, Lees KR. Home Time Is Extended in Patients With Ischemic Stroke Who Receive Thrombolytic Therapy. Stroke 2011, 42: 1046-1050. PMID: 21350199, DOI: 10.1161/strokeaha.110.601302.Peer-Reviewed Original ResearchConceptsHealth Stroke ScaleBaseline National InstitutesPresence of diabetesAcute stroke trialsStroke ScaleRankin ScaleBarthel IndexStroke trialsNational InstituteDay 90Use of alteplaseHome timeCountry of enrollmentLevel of consciousnessAlteplase useIschemic strokeStroke onsetIschemic lesionsThrombolytic therapyPatient enrollmentBaseline severityOrdinal logistic regressionTreatment responsivenessOutcome measuresAnalysis of covariance
2010
Influence of Age on Outcome From Thrombolysis in Acute Stroke
Mishra NK, Diener HC, Lyden PD, Bluhmki E, Lees KR. Influence of Age on Outcome From Thrombolysis in Acute Stroke. Stroke 2010, 41: 2840-2848. PMID: 21030710, DOI: 10.1161/strokeaha.110.586206.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeHealth scale scoresControl subjectsIschemic strokeInfluence of ageScale scoreBaseline National InstitutesRankin Scale scoreNational InstituteLimited trial dataNeuroprotection trialsRankin scoreThrombolysis treatmentAcute strokeYounger patientsAge decilesPoor outcomeBaseline severityImproved outcomesPatientsHaenszel testTrial dataCochran-MantelThrombolysisLogistic regressionThrombolysis Is Associated With Consistent Functional Improvement Across Baseline Stroke Severity
Mishra NK, Lyden P, Grotta JC, Lees KR. Thrombolysis Is Associated With Consistent Functional Improvement Across Baseline Stroke Severity. Stroke 2010, 41: 2612-2617. PMID: 20947852, DOI: 10.1161/strokeaha.110.589317.Peer-Reviewed Original ResearchConceptsRankin Scale score distributionBaseline stroke severityBaseline NIHSSAssociation of treatmentScale score distributionStroke severityOdds ratioModified Rankin scale score distributionCochran-MantelVirtual International Stroke Trials ArchiveBaseline National InstitutesConsistent functional improvementsHealth Stroke ScaleProportional odds logistic regression analysisClinical trial enrollmentLogistic regression analysisNeuroprotection trialsUntreated comparatorsStroke ScaleTrial enrollmentAdjusted outcomesThrombolysed patientsNonrandomized comparisonBaseline severityFunctional improvementComparison of Outcomes Following Thrombolytic Therapy Among Patients With Prior Stroke and Diabetes in the Virtual International Stroke Trials Archive (VISTA)
Mishra NK, Davis SM, Kaste M, Lees KR, . Comparison of Outcomes Following Thrombolytic Therapy Among Patients With Prior Stroke and Diabetes in the Virtual International Stroke Trials Archive (VISTA). Diabetes Care 2010, 33: 2531-2537. PMID: 20843977, PMCID: PMC2992183, DOI: 10.2337/dc10-1125.Peer-Reviewed Original ResearchConceptsVirtual International Stroke Trials ArchivePrior strokeUse of alteplaseBaseline National InstitutesHealth Stroke ScaleProportional odds logistic regression analysisInfluence of diabetesInteraction of diabetesComparison of outcomesLogistic regression analysisConcomitant diabetesEligible patientsNeurological outcomeStroke ScaleIschemic strokeThrombolytic treatmentThrombolytic therapyThrombolysed patientsFunctional outcomeControl subjectsOutcome measuresPatientsDiabetesHaenszel testCochran-Mantel