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1,497 results for “Ischemic stroke”
Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke (POINT) Trial
ClinicalTrials.gov study NCT00991029. IPD Sharing: Not stated. Countries: 10. Publications: 62.
Data from: Early molecular oxidative stress biomarkers of ischemic penumbra in acute stroke
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Lemborexant reduces infarct volume and improves long-term functional recovery in a murine Model of Ischemic stroke
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Supplement to: Sex and race differences in the risk of ischemic stroke associated with fasting blood glucose in REGARDS
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A multi-laboratory preclinical trial to assess treatment candidates for acute ischemic stroke
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Data from: Vegetarian diet and incidence of total, ischemic and hemorrhagic stroke in two cohorts in Taiwan
<p><span><b>Objectives <i>–</i></b> To determine how a vegetarian diet affects stroke incidence in two prospective cohorts, and to explore whether the association is modified by dietary vitamin B12 intakes. </span></p> <p><b>Methods</b><i> –</i>Participants without stroke in the Tzu Chi Health study (Cohort1, n=5,050, recruited in 2007-2009) and the Tzu Chi Vegetarian Study (Cohort2, n=8,302, recruited in 2005) were followed until end of 2014. Diet was assessed through food frequency questionnaires in both cohorts at baseline. Stroke events and baseline comorbidities were identified through the National Health Insurance Database. A subgroup of 1528 participants in Cohort1 were assessed for serum homocysteine, vitamin B12, and folate. Associations between vegetarian diet and stroke incidences were estimated by Cox regression with age as time scale, adjusted for sex, education, smoking, alcohol, physical activities, BMI (only in Cohort1), hypertension, diabetes, dyslipidemia, and ischemic heart diseases.</p> <p><b>Results <i>–</i></b> Vegetarians had lower serum vitamin B12 and higher folate and homocysteine than nonvegetarians. In Cohort1, 54 events occurred in 30,797 person-years follow-up. Vegetarians (vs. nonvegetarians) experienced lower risk of ischemic stroke (HR: 0.26, 95% CI: 0.08-0.88). In Cohort2, 121 events occurred in 76,797 person-years follow-up. Vegetarians (vs. nonvegetarians) experienced lower risk of overall stroke (HR: 0.52, 95% CI: 0.33-0.82), ischemic stroke (HR: 0.41, 0.19-0.88), and hemorrhagic stroke (HR: 034, 95%CI: 0.12-1.00). Our explorative analysis showed that vitamin B12 intake may modify the association between vegetarian diet and overall stroke (<i>p</i>-interaction = 0.046).</p> <p><b><i>Conclusion</i></b> –Taiwanese vegetarian diet is associated with a lower risk of ischemic and hemorrhagic strokes.</p>
Data from: Nanotransfection-based vasculogenic cell reprogramming drives functional recovery in a mouse model of ischemic stroke
<p>Ischemic stroke causes vascular and neuronal tissue deficiencies that could lead to significant functional impairment and/or death. Although progenitor-based vasculogenic cell therapies have shown promise as a potential rescue strategy following ischemic stroke, current approaches face major hurdles. Here we used fibroblasts nanotransfected with <em>Etv2</em>, <em>Foxc2</em>, and <em>Fli1</em> (<em>EFF</em>), to drive reprogramming-based vasculogenesis, intracranially, as a potential therapy for ischemic stroke. Perfusion analyses suggest that intracranial delivery of <em>EFF</em>-nanotransfected fibroblasts led to a dose-dependent increase in perfusion 14 days post-injection. MRI and behavioral tests revealed ~70% infarct resolution and up to ~90% motor recovery for mice treated with <em>EFF</em>-nanotransfected fibroblasts. Immunohistological analysis confirmed increases in vascularity and neuronal cellularity, as well as reduced glial scar formation in response to treatment with <em>EFF</em>-nanotransfected fibroblasts. Altogether, our results suggest that vasculogenic cell therapies based on nanotransfection-driven (i.e., non-viral) cellular reprogramming represent a promising strategy for the treatment of ischemic stroke.</p>
Data from: Endovascular treatment in older adults with acute ischemic stroke in the MR CLEAN Registry
<p><strong>Objective</strong>: To explore clinical outcomes in older adults with acute ischemic stroke treated with endovascular thrombectomy (EVT).</p> <p><strong>Methods</strong>: We included consecutive patients (2014–2016) with an anterior circulation occlusion undergoing EVT from the MR CLEAN Registry. We assessed the effect of age (dichotomized at ≥80 years, and as continuous variable) on the modified Rankin Scale [mRS] score at 90 days, symptomatic intracranial hemorrhage (sICH), and reperfusion rate. The association between age and mRS was assessed with multivariable ordinal logistic regression, and a multiplicative interaction term was added to the model to assess modification of reperfusion by age on outcome.</p> <p><strong>Results</strong>: 380/1526 (25%) of patients were 80 years or older (=older adults). Older adults had a worse functional outcome than younger patients (adjusted common OR for an mRS shift towards better outcome: 0.31, 95%CI 0.24–0.39). Mortality was also higher in older adults (51% vs. 22%, aOR 3.12, 95%CI 2.33–4.19). There were no differences in proportion of patients with mRS 4-5, sICH, or reperfusion rates. Successful reperfusion was more strongly associated with a shift towards good functional outcome in older adults than in younger patients (acOR 3.22, 95%CI 2.04–5.10 vs. 2.00, 95%CI 1.56–2.57, P<sub>interaction</sub>=0.026).</p> <p><strong>Conclusion</strong>: Older age is associated with an increased absolute risk of poor clinical outcome, while the relative benefit of successful reperfusion seems to be higher in these patients. These results should be taken into consideration when selecting older adults for EVT.</p>
Data from: White matter hyperintensity load on stroke recurrence and mortality at 1 year after ischemic stroke
Objective: We set out to define the role and risks associated with white matter hyperintensity (WMH) load in a stroke population with respect to recurrent stroke and mortality after ischemic stroke. Methods: A total of 7,101 patients at a network of university hospitals presenting with ischemic strokes were followed for one year. Multivariable Cox proportional-hazards model and competing risk analysis were used to examine the independent association between quartiles of WMH load and stroke recurrence and mortality at one year. Results: Overall recurrent stroke risk at one year was 6.7%/yr, divided between 5.6%/yr for recurrent ischemic and 0.5%/yr for recurrent hemorrhagic strokes. There was a stronger association between WMH volume and recurrent hemorrhagic stroke by quartile (Hazard ratios [HR] of 7.32, 14.12, and 33.52, respectively) than for ischemic recurrence (HR of 1.03, 1.37, and 1.61, respectively), but the absolute incidence of ischemic recurrence by quartile was higher (3.8%/yr, 4.5%, 6.3%, and 8.2% by quartiles) versus hemorrhagic recurrence (0.1%/yr, 0.4%, 0.6%, and 1.3%). Mortality of all-cause (10.5%) showed a marked association with WMH volume (HR of 1.06, 1.46, and 1.60), but this was attributable to non-vascular, rather than vascular causes. Conclusions: There is an association between WMH volume load and stroke recurrence, and this association is stronger for hemorrhagic than for ischemic stroke, although the absolute risk of ischemic recurrence remains higher. This data should be helpful to practitioners seeking to find the optimal preventative/treatment regimen for post-stroke patients and to individualize risk-benefit ratios.
Data from: Socioeconomic determinants of outcome after childhood arterial ischemic stroke
Objective: To determine whether lower socioeconomic status (SES) is associated with worse one-year neurological outcomes and reduced access to rehabilitation services in children with arterial ischemic stroke (AIS). Methods: From 2010-2014, Vascular Effects of Infection in Pediatric Stroke observational study prospectively enrolled and confirmed 355 children (29 days -18 years) with AIS at 37 international centers. SES markers measured via parental interview included annual household income (US dollars (USD)) at time of enrollment, maternal education level, and rural/suburban/urban residence. Receipt of rehabilitation services was measured by parental report. Pediatric Stroke Outcome Measure (PSOM) scores were categorized as 0-1, 1.5-3, 3.5-6, 6.5-10. Univariate and multivariable ordinal logistic regression models examined potential predictors of outcome. Results: At 12±3 months post-stroke, 320 children had documented outcome measurements, including 15 who had died. In univariate analysis, very low income (<$10,000 USD), but not other markers of SES, was associated with worse outcomes (OR 3.13, 95% CI:1.43-6.88; p=0.004). In multivariable analysis, including adjustment for stroke etiology, this association persisted (OR 3.17, 95% CI:1.18-8.47; p=0.02). Income did not correlate with receiving rehabilitation services at one-year post-stroke; however, quality and quantity of services were not assessed. Conclusions: In a large multinational, prospective cohort of children with AIS, low income was associated with worse neurological outcomes when compared to those with higher income levels. This difference was not explained by stroke type, neurological comorbidities, or reported use of rehabilitation services. The root causes of this disparity are not clear, and warrant further investigation.
Data from: Three-month modified Rankin Scale as a determinant of five-year cumulative costs after ischemic stroke: an analysis of 11,136 patients in Korea
Objective: Stroke is a devastating and costly disease; however, there is a paucity of information on long-term costs and on how they differ according to 3-month modified Rankin scale (mRS), which is a primary outcome variable in acute stroke intervention trials. Methods: We analyzed a prospective multicenter stroke registry (Clinical Research Collaboration for Stroke in Korea) database through linkage with claims data from the National Health Insurance Service with follow up to December 2016. Healthcare expenditures were converted into daily cost individually, and annual and cumulative costs up to 5 years were estimated and compared according to the 3-month mRS. Results: Between January 2011 and November 2013, 11,136 patients were enrolled in the study. The mean age was 68 years, and 58% were men. The median follow-up period was 3.9 years (range 0–5 years). Mean cumulative cost over 5 years was $117,576 US dollar (USD); the cost in the first year after stroke was the highest ($38,152 USD), which increased markedly from the cost a year before stroke ($8,718 USD). The mean 5-year cumulative costs differed significantly according to the 3-month mRS (P<.001); the costs for a 3-month mRS score of 0 or 5 were $53,578 USD and $257,486 USD, respectively. Three-month mRS was an independent determinant of long-term costs after stroke. Conclusions: We shows that 3-month mRS plays an important role in the prediction of long-term costs after stroke. Such estimates relating to 3-month mRS categories may be valuable when undertaking health economic evaluations related to stroke care.
Immigration status, ethnicity, and outcomes following ischemic stroke
<p>Objective: To assess the association between immigration status and ethnicity and the outcomes of mortality and vascular event recurrence following ischemic stroke in Ontario, Canada.</p> <p>Methods: We conducted a retrospective cohort study using linked administrative and clinical registry-based data from 2002 to 2018 and compared hazards of all-cause mortality and vascular event recurrence in immigrants and long-term residents using inverse probability of treatment weighting accounting for age, sex, income and comorbidities. We stratified analyses by age (≤ 75 and > 75 years) and used interaction terms to evaluate if the association between immigration status and outcomes varied with age or ethnicity.</p> <p>Results: We followed 31,918 adult patients, of whom 2740 (8.6%) were immigrants, for a median follow-up of 5 years. Immigrants had a lower mortality than long-term residents (46.1% vs. 64.5%) which was attenuated after adjustment (hazard ratio 0.94; 95% confidence interval 0.88-1.00), but persisted in those aged under 75 years (HR 0.82; 0.74-0.91). Compared to their respective ethnic long-term resident counterparts, the adjusted hazard of death was higher in South Asian immigrants, similar in Chinese immigrants, and lower in other immigrants (P value for interaction = 0.003). The adjusted hazard of vascular event recurrence (HR 1.01; 0.92-1.11) was similar in immigrants and long-term residents, and this observation persisted across all age and ethnic groups.</p> <p>Conclusions: Long-term mortality following ischemic stroke is lower in immigrants and long-term residents, but is similar after adjustment of baseline characteristics, and it is modified by age at the time of stroke and by ethnicity.</p>
Agonistic analog of growth hormone-releasing hormone promotes neurofunctional recovery and neural regeneration in ischemic stroke Dataset
<p>Agonistic analog of growth hormone-releasing hormone promotes neurofunctional recovery and neural regeneration in ischemic stroke Dataset</p> <p>R19111110_BKDL192544031-Sham 1</p> <p>R19111110_BKDL192544032-Sham 2</p> <p>R19111110_BKDL192544033-Sham 3</p> <p>R19111110_BKDL192544034-Sham 4</p> <p>R19111110_BKDL192544035-Model 2</p> <p>R19111110_BKDL192544036-Model 3</p> <p>R19111110_BKDL192544037-Model 4</p> <p>R19111110_BKDL192544038-Model 5</p> <p>R19111110_BKDL192544039-Model 1</p> <p>R19111119_BKDL192544040-Model+Drug 1</p> <p>R19111119_BKDL192544041-Model+Drug 2</p> <p>R19111119_BKDL192544042-Model+Drug 3</p> <p>R19111119_BKDL192544043-Model+Drug 4</p> <p>R19111119_BKDL192544044-Model+Drug 5</p> <p> </p>
Supplemental files for Clinical outcome after endovascular treatment in patients with active cancer and ischemic stroke: a MR CLEAN Registry substudy
<p>Supplemental files for Clinical outcome after endovascular treatment in patients with active cancer and ischemic stroke: a MR CLEAN Registry substudy</p>
Safety and efficacy of remote ischemic postconditioning after thrombolysis in patients with stroke
<p><span><b>Objective: </b>To determine the effect of remote ischemic post-conditioning (RIPC) on acute ischemic stroke (AIS) patients undergoing intravenous thrombolysis (IVT).</span></p> <p><span><b>Methods: </b>A single-center, randomized controlled trial was performed with AIS patients receiving IVT. Patients in the RIPC group were administered RIPC treatment (after IVT) during hospitalization. The primary endpoint was a score of 0 or 1 on the modified Rankin scale (mRS) at day 90. The safety, tolerability and neuroprotection biomarkers associated with RIPC were also examined.</span></p> <p><span><b>Results: </b>We collected data from both RIPC (n=34) and controls (n=34). The average duration of hospitalization was 11.2 days. There was no significant difference between the two groups at admission for the NIHSS score (p=0.364) or occur to treatment time (p=0.889). An excellent recovery (mRS 0–1) at 3 months was obtained in 71.9% of the patients in the RIPC group vs 50.0% in the control group (adjusted risk ratio, 9.85; 95% CI, 1.54 to 63.16; P = 0.016). We further found significantly lower plasma S100 β (p=0.007) and higher vascular endothelial growth factor (p = 0.003) levels in the RIPC group than in controls.</span></p> <p><span><b>Conclusions: </b>Repeated RIPC combined with IVT can significantly facilitate recovery of nerve function and improve clinical prognosis of patients with AIS.</span></p>
Multi-omics data for ischemic stroke etiology biomarker discovery
<p>Multi-omics data for ischemic stroke etiology biomarker discovery</p>
BRAIN CT PERFUSION IN ACUTE ISCHEMIC STROKE PATIENTS IN THE EARLY TIME WINDOW
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Association between plasma lipids and ischemic stroke: a multivariable and drug-target Mendelian randomization study
<p>The sensitivity analysis results using the leave-one-out approach revealed that no individual SNP substantially drove the association between plasma lipids and each disease outcome (Figure S1-S4).</p> <p> </p> <p>The STROBE-MR checklist is also attached.</p>
Efficacy Argatroban in Ischemic Stroke With Early Deterioration (EASE)
ClinicalTrials.gov study NCT04275180. IPD Sharing: Not stated. Countries: 1. Publications: 1.
Cranial Temperature Early Diagnose Hemorrhagic and Ischemic Stroke
ClinicalTrials.gov study NCT02601183. IPD Sharing: YES. Countries: 1. Publications: 2.
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Allen Brain Atlas
Allen Brain Atlas is an Allen Institute collection of brain map atlases, datasets, APIs, and analysis tools covering mouse, human, and non-human primate brain resources.
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