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Richard Marigold

Richard Marigold

Stroke Medicine

Dr Richard Marigold is a Consultant Stroke Physician at University Hospital Southampton (UHS) and holder of a Research Leaders Programme (RLP) award.

His research focuses on finding new treatments and improving care for people having a stroke.

Time is of the essence

Stroke is the leading cause of neurological disability. Each year in the UK, around 100,000 people have a stroke, with around 6,000 of these occurring in the Wessex region.

Richard leads the NIHR Hyperacute Stroke Research Centre at UHS, which was set up six years ago. It is now the six highest recruiting stroke centre in the UK.

The term ‘hyperacute’ means that patients who have had a stroke are recruited into studies within nine hours of arriving that the hospital. This is because acting fast greatly improves outcomes.

“The quicker we treat the better,” Richard explains. “We know, for example, that if you’ve got a blocked artery, for every 30 minutes you delay treatment, that patient has a 10 percent lower chance of returning to independent living.”

If patients who have a stroke are not treated in time, a larger area of their brain may be damaged. This can leave them with a lifelong disability, and often means they need ongoing care and support.

Growing Southampton’s stroke research

Richard now plans to use his RLP award to expand the centre’s ability to deliver research trials, including commercial trials. He hopes this will lead to better care for patients at the centre.

The centre already offers some opportunities to take part in research. By joining a trial, he says that patients can get access to new treatments around two or three years earlier.

For example, they recruited 40 patients to a trial assessing the drug tenecteplase, to see if it could help break down blood clots. This is now recommended in national guidelines, and could become a frontline treatment later this year.

He is now looking to build on this, offering more trials and recruiting 12 hours a day, seven days a week. This will allow more patients who have a stroke to take part in research at the centre.

“All these trials are about improving care for patients, delivering earlier treatment, and reducing what can be devastating neurological disability,” he says.

“We know that if a research unit is very research active, they tend to have better clinical outcomes, so the more people we can get into clinical trials the better.”

Building a larger research workforce

In order to be able to offer more opportunities for patients to take part in stroke research, Richard plans to use his RLP award to expand and diversify his research workforce.

While the centre currently has six consultants, there are no postdoctoral research fellows or PhD students. As a new Honorary Senior Lecturer at the University of Southampton, Richard intends to develop new collaborations with academics and attract more early-career researchers.

He also plans to support researchers from career paths other than medicine, such as nurses, pharmacists and allied health professionals. He is interested in involving anyone who treats patients during and after a stroke, such as paramedics, physiotherapists, or speech and language therapists.

Taking stroke research to the next level

Richard says that having protected time each week for research is really valuable, and he’s very grateful to Southampton Academy of Research (SoAR) for giving him this opportunity.

It gives him the time to explore exciting new research opportunities, such as new thrombolysis drugs that can break down blood clots, or neuroprotective drugs to protect the brain and limit damage. He also wants to build collaborations across the university-hospital partnership and Wessex.

“It’s a fantastic opportunity,” he says. “It’s great to have access to the university and the Biomedical Research Centre, and also to have that support and expertise about research methodology and how to put together research grants.

“It’s really about trying to take the Hyperacute Stroke Research Centre to the next level.”

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