PhD Study : Younger stroke patients: an investigation into prevalence and neurophysiological recovery

Summary

This project is associated with a ring fenced PhD studentship for Dr Kennedy.

Stroke is the third largest cause of adult death and the largest cause of adult disability in the United Kingdom (NHS, 2012) with approximately 152,000 people a year having a stroke (Stroke Association , 2017). Stroke is traditionally seen as a disease of older adults, however approximately a quarter of all strokes occur in people aged 20-64 (Stroke Association , 2017; Feigin et al, 2014). There is limited data on prognosis after stroke in younger age group. Long-term prognosis is particularly important in these patients as they will have a longer time to live with any resulting disability. It can also be during a time in their life when they are building their careers and beginning their families (Ellis et al, 2010, Rutten-Jacobs et al, 2013). There is no research investigating any potential biological and neurophysiological differences in patient’s potential recovery across the age span. This is important, as the underlying biological correlates of recovery are associated with improved functional recovery, An increased understanding of these underlying mechanisms allows the targeting of these deficits in rehabilitation. The lack of research in this area leds to the need for a holistic approach to looking at the functional, psychosocial and neurophysiological recovery of stroke patients.

This PhD project aims to help understand the scale of younger stroke in the UK and to quantify the neural correlates of recovery in young stroke survivors. Methods The PhD project will begin with a systematic review on the neurophysiological recovery in younger stroke survivors. The review will explore potential neural correlates of change in younger stroke patients including data from neuroimaging, neurophysiological and neuropsychology studies.

The second part of this programme will involve a database investigation of stroke database (SNAPP) into the prevalence and outcomes for younger stroke patients in the UK. The aim of this section would be to allow for a better picture of the scale of incidence and rates of recovery (in isolation or comparison to older/average age of stroke).

The third part of this programme will involve an experimental study to investigate the neural correlates of recovery in younger stroke survivors, in order to potentially personalise rehabilitation to best meet the needs of younger stroke survivors. It is essential that we understand the recovery mechanisms of the brain and how these interact with functional recovery.  This will involve a case series design, in which a group of younger stroke patients will undergo a battery of outcome measures including neurophysiological, clinical and psychological measures to characterise their recovery profile. These will include measures of brain connectivity, muscle activity and cortical excitability measured by transcranial magnetic stimulation (TMS), a clinical score such as ARAT, stroke impact scale and a quality of life measure. Participants will be recruited from Northern Ireland Chest Heart and Stroke young stroke support group, this has already been agreed by the organisation.

Essential criteria

Applicants should hold, or expect to obtain, a First or Upper Second Class Honours Degree in a subject relevant to the proposed area of study.

We may also consider applications from those who hold equivalent qualifications, for example, a Lower Second Class Honours Degree plus a Master’s Degree with Distinction.

In exceptional circumstances, the University may consider a portfolio of evidence from applicants who have appropriate professional experience which is equivalent to the learning outcomes of an Honours degree in lieu of academic qualifications.

Desirable Criteria

If the University receives a large number of applicants for the project, the following desirable criteria may be applied to shortlist applicants for interview.

• First Class Honours (1st) Degree
• Masters at 70%
• Research project completion within taught Masters degree or MRES
• Experience using research methods or other approaches relevant to the subject domain
• Publications record appropriate to career stage

Funding and eligibility

The University offers the following levels of support:

Department for the Economy (DFE)

The scholarship will cover tuition fees at the Home rate and a maintenance allowance of £19,000 (tbc) per annum for three years (subject to satisfactory academic performance).

This scholarship also comes with £900 per annum for three years as a research training support grant (RTSG) allocation to help support the PhD researcher.

• Candidates with pre-settled or settled status under the EU Settlement Scheme, who also satisfy a three year residency requirement in the UK prior to the start of the course for which a Studentship is held MAY receive a Studentship covering fees and maintenance.
• Republic of Ireland (ROI) nationals who satisfy three years’ residency in the UK prior to the start of the course MAY receive a Studentship covering fees and maintenance (ROI nationals don’t need to have pre-settled or settled status under the EU Settlement Scheme to qualify).
• Other non-ROI EU applicants are ‘International’ are not eligible for this source of funding.
• Applicants who already hold a doctoral degree or who have been registered on a programme of research leading to the award of a doctoral degree on a full-time basis for more than one year (or part-time equivalent) are NOT eligible to apply for an award.

Due consideration should be given to financing your studies. Further information on cost of living