Dr Emily Ball gains PhD
19th July 2022
Dr Emily Ball has successfully defended her PhD thesis, entitled “Predicting post-stroke cognitive impairment using acute stroke neuroimaging and other biomarkers”.
Supervised by Dr Susan Shenkin and Professor Gillian Mead (University of Edinburgh), Dr Terry Quinn (University of Glasgow) and Professor Dorota Religa (Karolinska Institutet), Emily’s thesis aimed to identify clinically relevant risk factors associated with post-stroke cognitive impairment.
Emily’s PhD research asked three key research questions:
- Can acute stroke CT and MR brain scans help to predict who will develop cognitive problems after stroke?
Results from Emily’s first systematic review and meta-analysis highlighted that white matter hyperintensities (WMH), cerebral atrophy, and pre-existing stroke lesions, present on acute stroke CT scans, were associated with a two-to-three fold increased risk of post-stroke dementia (paper available here). WMH was also associated with post-stroke cognitive impairment.
Her second systematic review focused on identifying acute stroke MR features associated with post-stroke cognitive impairment/dementia. This meta-analysis highlighted that severity of WMH, presence of cerebral atrophy, cerebral microbleeds, and cerebral small vessel disease were associated with an increased risk of cognitive problems after stroke.
Her third PhD study involved linking two existing research cohorts of stroke survivors (N=185) to electronic health records to identify whether the participants subsequently developed dementia. The research datasets contained coded reports of acute stroke CT brain scans. This study highlighted that moderate-to-severe WMH and presence of cerebral atrophy were associated with an increased risk of post-stroke dementia.
Emily also contributed as an author to international guidelines for post-stroke cognitive impairment.
- Can blood tests help to predict which stroke survivors will develop dementia?
Emily was interested in addressing her research questions on a larger scale by using National Swedish Registries. During her PhD, she set up an international collaboration with researchers in Sweden to explore blood biomarkers associated with post-stroke dementia.
- If we could predict who is at risk of post-stroke dementia, is it helpful to discuss this risk with people who have recently had a stroke?
Finally, Emily explored healthcare professionals’ views on discussing risk of dementia at the time of stroke (published article available here). This survey found that although healthcare professionals thought it may be beneficial to discuss risk of dementia with patients/relatives at the time of stroke, many said they rarely discussed this risk in acute stroke clinical practice. Most survey respondents thought that between 1-6 months after a stroke is the most appropriate time to discuss risk of dementia.
We asked Emily how she felt about gaining her PhD.
“I feel very proud to have completed my PhD at the University of Edinburgh. My PhD journey was interesting and rewarding, and has provided me with a variety of skills in systematic reviews, data linkage studies, and data analysis.
I would like to say a huge thank you to my PhD supervisors: Dr Susan Shenkin, Professor Gillian Mead, Dr Terry Quinn and Professor Dorota Religa for their advice and support, and for facilitating interesting opportunities throughout my PhD.
I am looking forward to developing my skills in data science going forward.”