The Time Is Brain Review
Stroke evidence. Critically reviewed.
Exercise Adherence and Long-Term Quality of Life After Ischemic Stroke
Higher exercise adherence was associated with better quality of life over two years after ischemic stroke; causality remains unproven.
Contemporary achievement of guideline recommendations for blood pressure management after stroke in the CONVINCE trial
A longitudinal analysis of CONVINCE trial participants found that many did not meet the blood-pressure targets assessed, while leaving the effects of target-driven treatment intensification unanswered.
Dual Transcranial Direct Current Stimulation Modulates Hierarchical Functional Network Organization in Post‐Stroke Cognitive Impairment: A Randomized Controlled Trial
Among 74 participants with post-stroke cognitive impairment, active dual-tDCS was associated with greater four-week cognitive and functional-score improvements than sham, but the small single-center trial had no long-term follow-up.
Square-Step Exercise After Ischemic Stroke: A Two-Ward Trial
A small two-ward trial found lower fear-of-falling scores after square-step exercise, but cannot establish a reduction in actual falls.
Clinical and neurophysiological effects of manual acupuncture for upper-limb motor dysfunction after ischemic stroke: a three-arm randomized controlled trial
A three-arm randomized trial found a short-term upper-limb motor benefit from manual acupuncture added to rehabilitation after ischemic stroke, but its single-center design and exploratory biomarkers limit generalization.
Impact of a Decision-Support Interface on Mental Workload and Stress in Prehospital Stroke Triage: A Randomized Crossover Trial
In a 35-person simulated crossover trial, a hospital-selection interface was associated with lower EMT workload, but patient outcomes were not assessed.
Association between tirofiban administration and sex in outcomes following endovascular treatment for large vessel occlusion stroke — prognosis is not treatment interaction
This exploratory RESCUE BT reanalysis found no statistically significant sex-by-tirofiban interaction, despite lower functional independence among women than men within the tirofiban arm.
Temporal synchrony promotes motor recovery and ipsilesional cortical reorganization in BCI-based stroke rehabilitation: a randomized controlled trial
Contingent robotic feedback improved short-term motor impairment and daily function compared with asynchronous and sham training, but cortical-reorganization findings remain exploratory.
Robot-assisted integrated cognitive-motor rehabilitation in chronic stroke — a motor signal, not a cognitive win
Robotic dual-task training did not outperform paper-based therapy on cognition; an exploratory motor signal needs an active motor comparator.
Performing lifestyle changes and reducing stroke risk — the implementation behind Make My Day
A mixed-methods process evaluation suggests that realistic goals, skilled facilitation and supportive group dynamics matter when implementing lifestyle-based stroke prevention, but it does not establish fewer clinical strokes.
Efficacy and Mechanisms of Combined Central-Peripheral Magnetic Stimulation on Prefrontal-Sensorimotor Cortex Connectivity in Post-Stroke Dysphagia after Supratentorial Stroke: A Randomized, Single-Blind, Parallel-Controlled Trial — promising swallowing gains, not yet proof of synergy
Combined central and peripheral magnetic stimulation improved swallowing measures in a small post-stroke dysphagia trial; superiority over central stimulation alone and durable clinical benefit remain unproven.
Hierarchical composite outcomes in acute ischaemic stroke with large infarct: a win ratio analysis of the TENSION trial — survival drives the signal
A 2026 secondary analysis of TENSION supports hierarchical win statistics as a complement to disability outcomes, with survival contributing most of the observed net pairwise advantage for thrombectomy.
Tirofiban for Branch Atheromatous Disease–Related Stroke: The STRATEGY Randomized Clinical Trial
In STRATEGY, adding a short intravenous tirofiban infusion to aspirin did not significantly reduce early neurological deterioration or new stroke after MRI-defined branch atheromatous disease–related stroke.
Tai Ji for stroke rehabilitation: a randomized controlled trial on improving upper limb function and cortico-muscular coupling in stroke patients — more practice, or a specific effect?
Adding four weeks of supervised Tai Ji was associated with better arm function and daily activities, but unequal training time and incomplete follow-up prevent attribution to Tai Ji alone.
Immersive virtual reality with synchronous neurostimulation for upper-limb recovery after stroke — a promising feasibility signal
In a 25-person randomized feasibility trial, immersive VR plus synchronized sensory stimulation improved arm motor scores more than dose-matched rehabilitation, supporting larger trials rather than routine replacement of therapy.
Robot-assisted gait training in people with subacute and chronic stroke: a randomized controlled trial — complement, not replacement
In a 100-person inpatient trial, robot-assisted gait training plus physiotherapy did not demonstrate superior walking independence or basic activities of daily living compared with time-matched conventional physiotherapy.
Intensive Rehabilitation With Adjunctive Bilateral Anodal tDCS in Post-Stroke Dysphagia: A Multicenter Randomized Controlled Trial
Intensive swallowing rehabilitation was associated with improvement in both arms, but adjunctive bilateral anodal tDCS did not demonstrate overall superiority to sham; an infratentorial subgroup signal remains exploratory.
Endovascular Treatment for Patients Aged ≥80 Years with Large Ischemic Stroke — association is not age-invariant benefit
In a pooled observational comparison of patients aged at least 80 with large ischemic stroke, EVT was associated with better 90-day disability outcomes and lower mortality, but more hemorrhage; selection bias and inconsistent age analyses limit causal interpretation.
RESTART: Antiplatelets After Intracerebral Hemorrhage — Reassurance, Not a Blank Check
RESTART's 2019 trial: qualified reassurance about antiplatelets after intracerebral hemorrhage, not proof of benefit or a universal restart rule.
GOLDEN BRIDGE II — Clinical Decision Support for Acute Ischaemic Stroke
GOLDEN BRIDGE II: a stroke CDSS improved care processes and reduced 3-month vascular events across 77 Chinese hospitals.
Short-term Risk of Recurrent Stroke in Symptomatic Carotid Near-Occlusion
Full-collapse near-occlusion marked higher 48-hour recurrence risk; pooled observational data do not prove revascularisation benefit.
Remote ischaemic conditioning in patients with supratentorial intracerebral haemorrhage (RICH-2): a multicentre, randomised, sham-controlled phase 3 trial in China
This sham-controlled phase 3 trial found no functional benefit from seven days of remote ischaemic conditioning in selected non-surgical supratentorial ICH, despite a radiographic haematoma-clearance signal.
Post-transfer reassessment for endovascular treatment: factors associated with changes in EVT eligibility
A single-network cohort links neurologic change and baseline imaging to interval recanalization or infarct progression after EVT transfer; prospective validation is needed before selective pathways are used.
Scalp acupuncture coupled with speech-language therapy modulates the ventral-dorsal structural brain network in patients with post-stroke anomia: a randomized clinical and DTI neuroimaging trial
A single-center randomized trial found greater immediate naming-score improvement when scalp acupuncture was added to speech-language therapy, but the small per-protocol analysis, lack of sham control and unblinded treatment limit causal interpretation.
Oedema reduction mediates thrombectomy benefit in large core stroke: secondary analysis of the TENSION trial
A selected CT-based secondary analysis of TENSION links EVT with less 24-hour net water uptake and estimates an oedema-mediated pathway to 90-day outcome, but the mediation is hypothesis-generating.