Tufts Vascular Neurology Research Group
I lead the TVNR group, a clinical research team focused on epidemiological research questions related to stroke and other cerebrovascular diseases. Our primary areas of interest are:
  • Stroke in young adults
  • Late complications after ischemic stroke and intracerebral hemorrhage in stroke survivors
  • Health care disparities in stroke
  • Innovative practices in prehospital, in-hospital, and post-acute care for patients with stroke
  • Silent brain infarcts and the prevention of stroke and dementia
Our methodologies include registry-based cohort and case control studies, semi-structured qualitative interviews, quantitative surveys, regression analyses, and predictive modeling.

We collaborate frequently with the Predictive Analytics and Comparative Effectiveness (PACE) Center at Tufts Medical Center.

Recent work from TVNR
Invited Talks, Posters, and Presentations
  • Poster for the International Stroke Conference, Los Angeles, 2016: Leung LY, Caplan LR. “Factors associated with delay in presentation to the hospital for young adults with ischemic stroke.”

  • Poster for the American Academy of Neurology Meeting, Vancouver, 2016: Leung LY et al. “Factors influencing oral anticoagulant prescribing for atrial fibrillation.”

  • Poster for the American Academy of Neurology Meeting, Vancouver, 2016: Leung LY, Caplan LR. “Factors associated with delay in presentation to the hospital for young adults with ischemic stroke.”

  • Poster for the International Stroke Conference, Houston, 2017: Leung LY, et al. “Blood pressure and heart rate measures associated with increased risk for silent brain infarction and worsening leukoaraiosis in older adults.”

  • Poster for the American Academy of Neurology Meeting, Boston, 2017: Huggins H, Jones D, Thaler DE, Han PKJ, Leung LY. “Clinical features of acute stroke in young adults – a qualitative study of patient experiences.”

  • Poster for the American Academy of Neurology Meeting, Boston, 2017: Jones D, Huggins H, Thaler DE, Han PKJ, Leung LY. “Barriers and facilitators for seeking care for young adults with acute stroke – a qualitative study.”

  • Poster for the American Academy of Neurology Meeting, Boston, 2017: Albazli K, Wu S, Kent D, Leung LY. “Silent brain infarction and symptomatic stroke: comparing imaging and patient characteristics.”

  • Poster for the European Stroke Organization Conference, Prague, 2017: Leung LY, Han PKJ, Lundquist C, Weinstein G, Thaler DE, Kent D. “Silent brain infarction – assessing clinical decision making.”

  • Poster for the International Stroke Conference, Honolulu, 2019: Michaels E, Leung LY. “Associations between risk factors and mechanisms of stroke in young adult stroke.”

  • Poster for the International Stroke Conference, Honolulu, 2019: Skeels K, Leung LY. “Two-part intervention to improve transitions of care for stroke patients.”

  • Poster for the American Academy of Neurology Meeting, Philadelphia, 2019: Huggins H, Brady M, Thaler DE, Leung LY. “Differences in presenting symptoms of acute stroke among young and older adults.”

  •  Poster for the International Stroke Conference, Los Angeles, 2020: Gans SD, Michaels E, Thaler DE, Leung LY. “Differences in detection of late complications after stroke in young stroke survivors with active surveillance versus usual care.”

  • Poster for the International Stroke Conference HEADS-UP preconference symposium, Los Angeles, 2020: Scott L, Jijakli A, Leung LY. “Visual stroke symptom triage tool to reduce delays due to limited English proficiency in Emergency Department stroke activations.”

  • Poster for the International Stroke Conference, 2021: Leung LY, Jijakli A, Skeels K. “Late presenter thrombolysis for ischemic stroke: CT perfusion for patient selection between 4.5 to 24 hours after stroke onset.”

  • Poster for the International Stroke Conference, 2021: Jijakli A, Skeels K, Leung LY. “Structured nutritional support pathway using PRESS to guide decision-making with post-stroke dysphagia.”

  • Oral presentation for American Academy of Neurology, 2022: Coté K, Leung LY. “Inequality and recovery: does neighborhood income inequality impact post-stroke disability?”


Publications
  • Leung LY, Caplan LR. “Factors associated with delay in presentation to the hospital for young adults with ischemic stroke.” Cerebrovascular Diseases. 2016;42(1-2):10-14. PMID: 26953591.

  • Leung LY, McAllister ML, Selim M, Fisher M. “Factors influencing oral anticoagulant prescribing for atrial fibrillation.” Journal of Stroke. 2017 May;19(2):232-235. PMID: 28460492. PMCID: PMC5466293.

  • Leung LY, Melkumova E, Thaler DE. “Longitudinal care for young adults with stroke.” JAMA Neurol. 2017 Oct1;74(10):1163-1164. PMID: 28828467.

  • Leung LY, Bartz TM, Rice K, et al. “Blood pressure and heart rate measures associated with increased risk of covert brain infarction and worsening white matter in older adults.” Arterioscler Thromb Vasc Biol. 2017 Aug;37(8):1579-1586. PMID: 28663254. PMCID: PMC5551454.

  • Leung LY, Han PKJ, Lundquist C, Weinstein G, Thaler DE, Kent D. “Clinicians’ perspectives on incidentally discovered silent brain infarction – a qualitative study.” PLOS One. 2018;13(3):e0194971. PMID: 29596459.
  • Fu S, Leung LY et al. “Natural language processing for the identification of silent brain infarcts from neuroimaging reports.” Journal of Medical Internet Research. 2019;7(2):e12109. PMID: 31066686.

  • Ridha M, Malek A, Arkun K, Leung LY. The utility of histopathologic characteristics of thrombi in large vessel occlusions. Neurol Clin Pract. 2019;9(6). PMID: 32042484.

  • Leung LY, Han PKJ, Lundquist C, Weinstein G, Thaler DE, Kent D. “Patients’ perspectives on incidentally discovered silent brain infarction – a qualitative study.” Journal of Patient-Reported Outcomes. 2019;3(1):23. PMID: 30982930. PMCID: PMC6462438.

  • McCarty J, Leung L, Peterson R, Sitton C, Sarraj A, Riascos R, Brinjikj W. Ischemic Infarction in Young Adults: A Review for Radiologists. Radiographics. 2019;39(6). 1629-1648. PMID: 31589580.

  • Williams H, Leung LY, Gordon-Davis C, Tunik E, Pavel M, Yarossi M, et al. A huge, life-changing thing: a qualitative survey of priorities and goals of young stroke survivors. Arch Phys Med Rehab. 2019 July 1:100(7):E5-E6. DOI: https://doi.org/10.1016/k.apmr.2019.05.018

  • Huggins HE, Brady M, Thaler DE, Leung LY. Differences in presenting symptoms of acute stroke among young and older adults. J Stroke Cerebrovasc Dis. 2020;29:104871. PMID: 32689591.

  • Dmytriw AA, Phan K, Schirmer C, Settecase F, Heran MKS, Efendizade A, et al. Ischaemic stroke associated with COVID-19 and racial outcome disparity in North America. Journal of Neurology, Neurosurgery, and Psychiatry. 2020 Dec;91(12):1362-1364. PMID: 32801118.

  • Carneiro T, Dashkoff J, Leung LY, Nobleza COHS, Marulanda-Londono E, Hathidara M, et al. Intravenous tPA for Acute Ischemic Stroke in Patients with COVID-19. J Stroke Cerebrovasc Dis. 2020;29(11):105201. PMID: 33066885.

  • Gans S, Michaels E, Thaler DE, Leung LY. Detection of symptoms of late complications after stroke in young survivors with active surveillance versus usual care. Disabil Rehabil. 2021 Feb 19;1-5. PMID: 33065166.

  • Nogueira RG, Qureshi MM, Abdalkader M, Martins SO, Yamagami H, Qiu Z, et al. Global impact of COVID-19 on stroke care and IV thrombolysis. Neurology. 2021 Jun 8;96(23):e2824-e2838. PMID: 337566997.

  • Nogueira RG, Abdalkader M, Qureshi MM, Frankel MR, Mansour OY, Yamagami H, et al. Global impact of COVID-19 on stroke care. Int J Stroke. 2021 Mar 29: online ahead of print. PMID 33459583.

  • Koh MH, Yen SC, Leung LY, Gans S, Sullivan K, Adibnia Y, Pavel M, Hasson CJ. Exploiting telerobotics for sensorimotor rehabilitation: a locomotor embodiment. J Neuroeng Rehabil. 2021;18(1):66.

  • Dmytriw AA, Dibas M, Schirmer CM, Settecase F, Heran MKS, Efendizade A, et al. Age and acute ischemic stroke outcome in North American patients with COVID-19. J Am Heart Assoc. 2021 Jul 3:e021046, online ahead of print. PMID: 34219466.

  • Kent DM, Leung LY, Zhou Y, Luetmer PH, Kallmes DF, Nelson JN, et al. Association of silent cerebrovascular disease identified using natural language processing and future ischemic stroke. Neurology. 2021 Sep 28;97(13):e1313-1321. PMID: 34376505.

  • Leung LY, Zhou Y, Fu S, Zheng C, Luetmer P, Kallmes DF, et al. Risk factors for silent brain infarcts and white matter disease in a real-world cohort identified by NLP. Mayo Clinic Proceedings. 2022;97(6):1114-1122. PMID: 35487789

  • Wang AY, Leung LY, Puttock EJ, Luetmer PH, Kallmes DF, Nelson J, et al. Stratifying future stroke risk with incidentally discovered white matter disease severity and covert brain infarct site. Cerebrovasc Dis. 2022 Jun 27:1-5. PMID: 35760063.

  • Kent DM, Leung LY, Puttock EJ, Wang AY, Luetmer PH, Kallmes DF, et al. Development of Parkinson’s disease and its relationship with incidentally-discovered white matter disease and covert brain infarction in a real-world cohort. Ann Neurol. 2022 Jul 22. PMID: 35866711.

  • Kent DM, Leung LY, Zhou Y, Luetmer PH, Kallmes DF, Nelson J, et al. Association of incidentally discovered covert cerebrovascular disease identified using natural language processing and future dementia. J AM Heart Assoc. 2023 Jan 3;12(1):e027672. PMID: 36565208.

  • Leung LY, Zebelean D, Melkumova E, Skeels K, Madan N, Thaler DE. Late presenter thrombolysis for ischemic stroke between 4.5-24 hours after last known well: a retrospective cohort study. medRxiv. [Preprint] June 12, 2023. Available from: https://doi.org/10.1101/2023.06.08.23291176

  • Meinel TR, Triulzi CB, Kaesmacher J, Mujanovic A, Pasi M, Leung LY, et al. Management of covert brain infarction survey: a call to care for and trial this neglected population. Eur Stroke J. 2023 Jul 10:23969873231187444. PMID: 37427426.

  • Pudlo ME, Cote KE, Jost-Price E, Leung LY. Hypertension associated with functional status early after hospitalization for ischemic stroke: a cohort study. Research Square. [Preprint] August 25, 2023. Available from: https://doi.org/10.21203/rs.3.rs-3246809/v1

  • Cote KE, Pudlo ME, Jost-Price E, Leung LY. Neighborhood income inequality associated with functional independence after ischemic stroke: a cohort study. Research Square. [Preprint] August 29, 2023. Available from: https://doi.org/10.21203/rs.3.rs-3299153/v1

  • Shen J, Corlin L, Cote KE, Pudlo ME, Leung LY. Patient and hospital characteristics associated with disparities in acute stroke treatment in community and academic hospitals. [Prepint] September 25, 2023. Available from: https://doi.org/10.1101/2023.09.25.23296119

  • Wang AY, Leung LY, Puttock EJ, Luetmer PH, Kallmes DF, Nelson J, Fu S, Zheng C, Liu H, Chen W, Kent DM. Stratifying future stroke risk with incidentally-discovered white matter disease severity and covert brain infarct site. Cerebrovasc Dis. 2023 Nov 7. doi: 10.1159/000534581. Epub ahead of print. PMID: 37935160.
TVNR Members
Lester Y. Leung, MD, MSc - PI
Emiliya Melkumova, MD - Co-investigator

2016
Khaled Albazli, MD
Dylan Jones, MS, MPH
Pierre Martin, MD

2017
Nick Cunningham, MD
Sharon Wu, MD
Nilufer Yalcin, MD

2018
Merrill Brady, MD
Sarah Gans, MD
Haley Huggins, MD
Elena Michaels, MD
Katelyn Skeels, NP

2019
Yasaman Adibnia, MD

2020
Kathryn Coté, MD
Megan Pudlo, MD
Emma Jost Price, BA

2021
Jerry Shen, MD
Aya Shnawa, MD
Jeff Swarz, MD
Leidy Guzman, M.Eng, BS

2022
Bo Lan, MD
Christopher Kwon
Leah Gomes

2023
Ambreen Zaidi, MD
Matthew Siegel, MD
J.P. Miller, MD
Camelia Valhuerdi Porto, MD
Wenzheng Yu, MD
Nazanin Sheibani, MD
Colette Fritsche, MD