Brian Buck

Associate Professor, Faculty of Medicine & Dentistry - Medicine Dept

Contact Overview Publications

Contact

Associate Professor, Faculty of Medicine & Dentistry - Medicine Dept

Email: bbuck@ualberta.ca
Address: 7-112 Clinical Sciences Building
11304 83 Ave NW

Edmonton AB

T6G 2G3

Overview

Area of Study / Keywords

atrial fibrillation stroke diagnostics machine learning neuroimaging secondary prevention

About

Personal Statement:

One of my goals is to ensure swift, consistent and effective treatment is available to anyone who suffers a stroke, no matter where they live in Alberta. In addition to effective treatment, I want to see stroke survivors get the rehabilitation and support they need in order to live their lives to the fullest.

Stroke neurologist Dr. Brian Buck is a graduate of the University of Toronto’s medical school. He completed his neurology residency at the University of British Columbia and stroke fellowship training at UCLA Medical Center and Sunnybrook Health Sciences Centre (UofT) in Toronto. He was recruited to the University of Alberta in 2007.

Leadership and Collaborations:

Dr. Buck started his career in Edmonton at the Grey Nuns Community Hospital where he helped (along with Dr. M. Siddiqui) establish a comprehensive stroke program that includes an inpatient stroke unit, programs for stroke prevention and clinical trials, neurology consultation, and neurology resident education. He has since shifted his primary clinical practice to the University of Alberta Hospital where he works on both the acute stroke and ward services, and at the AH Owens Stroke Prevention Clinic.

Dr. Buck is involved in improving the quality of stroke care through a number of provincial and national leadership positions. He serves on the executive boards of the Canadian Stroke Consortium and Canadian Neurological Society. Dr. Buck is also currently co-chair of the Cardiovascular Health and Stroke Strategic Clinical Network (SCN) TIA and Stroke Expert working group, which aims to improve the prevention, treatment and management of vascular disease for stroke patients and their caregivers. As part of his work with the SCN, he helped lead a project to develop an integrated vascular risk reduction program at three pilot sites in Alberta and is a member of the Cardiovascular and Stroke Strategic Clinical Network’s Arrhythmia Expert Working Group.

Currently, he is a co-principal investigator on a newly funded Canadian Institutes of Health Research clinical trial called ACT-QuICR that will test in Alberta whether tenecteplase may is better able to dissolve clots blocking brain arteries while also being safer than alteplase when used in patients with acute stroke. He is co-investigator on a research project called SECRET (Study of Early Rivaroxaban for cerebral venous thrombosis), which was funded in 2017 and also the recently CIHR funded study INTERRAcT: Thrombus characteristics for predicting Reperfusion with Alteplase compared to Tenecteplase.

Clinical Interests

Dr. Buck is a consultant neurologist at the University of Alberta Hospital and Grey Nuns Community Hospital and in Edmonton. His clinical work involves covering the acute stroke and telestroke service, stroke ward, and stroke prevention clinic.

Research

Dr. Buck is a principal investigator, co-investigator or member of research collaborations funded by grants from various regional, national and international funding agencies, including the Canadian Institutes of Health Research, University of Alberta Hospital Foundation and Alberta Innovates. While his research focuses primarily on stroke prevention and stroke care delivery improvement, and he has a particular interest in stroke imaging and developing new methods of stroke detection.

Dr. Buck is an active clinical trialist with several studies around stroke screening and stroke therapies funded by pharmaceuticals and medical device companies such as GlaxoSmithKline, Asubio Pharmaceuticals, and Brainsgate as well as granting agencies such as the Canadian Institutes of Health Research, the Canadian Stroke Consortium and the Canadian Stroke Network.

He has authored and co-authored many publications resulting from his research that have appeared in peer-reviewed publications such as the JAMA, International Journal of Stroke, AHA Stroke, and the Canadian Medical Association Journal.

1) Stroke and atrial fibrillation

Dr Buck the principal investigator for the Post-Embolic Rhythm Detection With Implantable Versus External Monitoring (PER DIEM) randomized trial. https://clinicaltrials.gov/ct2/show/NCT02428140

PER DIEM is a randomized, controlled trial comparing ELR (external loop recorder) to ILR (implanted loop recorder) ECG monitoring in non-cryptogenic stroke. PER DIEM will randomize (1:1) 300 TIA/stroke patients in Edmonton and Calgary without known AF to 30 days monitoring with an ELR (Sorin SpiderFlash) or 12 months with an ILR (Medtronic LINQ with CareLink). Unlike recently completed cardiac monitoring trials, in PER DIEM the majority of patients included will have at least one determined TIA/stroke etiology. The primary endpoint is clinically actionable AF lasting 2 minutes or longer. The final results of the study were recently published (see PER DIEM RCT).

2) Development of methods to improve the early (prehospital) diagnosis of stroke

Current projects include a collaboration with Prof. Russ Greiner, Pierre Boulanger and Kyle Mathewson to explore novel methods to detect stroke in the prehospital setting. Methods include using a novel EEG device embedded in a portable headframe that will be fitted on stroke patients in the ambulance and mobile stroke unit.

More information and results can be found at:

Predicting stroke severity with a 3-min recording from the Muse portable EEG system for rapid diagnosis of stroke | Scientific Reports (nature.com)

Portable headband with EEG technology may help diagnosis of stroke patients | Folio (ualberta.ca)

3) Developing novel imaging strategies to improve the selection of patients for reperfusion therapy and measuring reperfusion post EVT. For example see: Improvement of automatic ischemic stroke lesion segmentation in CT perfusion maps using a learned deep neural network - ScienceDirect

Teaching

Dr. Buck gives clinical instruction to neurology residents and supervises research trainees at all levels of education. He is passionate about teaching and helping trainees become equipped to diagnose and treat TIA and stroke.

Featured Publications

Poor Cortical Venous Opacification on Baseline Computed Tomography Angiography Predicts Parenchymal Hemorrhage After Thrombectomy

Fouzi Bala, Nishita Singh, Bijoy K. Menon, Andrew M. Demchuk, Alexandre Y. Poppe, Ryan A. McTaggart, Raul G. Nogueira, Brian H. Buck, Mayank Goyal, Michael D. Hill, Mohammed A. Almekhlafi and the ESCAPE-NA1 investigators

Stroke: Vascular and Interventional Neurology. 2022 June; 10.1161/SVIN.121.000299

Timing of Anticoagulation after Acute Ischemic Stroke in Patients with Atrial Fibrillation.

Alrohimi, A., Jickling, G., Buck, B., Butcher, K.

CANADIAN JOURNAL OF NEUROLOGICAL SCIENCES. 2022 June; doi:10.1017/cjn.2022.268

Management of Cerebral Venous Thrombosis Due to Adenoviral COVID-19 Vaccination

Scutelnic A., Krzywicka K., Mbroh J., van de Munckhof A., van Kammen M.S., de Sousa D.A., Lindgren E., Jood K., Günther A., Hiltunen S., Putaala J., Tiede A., Maier F., Kern R., Bartsch T., Althaus K., Ciccone A., Wiedmann M., Skjelland M., Medina A., Cuadrado-Godia E., Cox T., Aujayeb A., Raposo N., Garambois K., Payen J.F., Vuillier F., Franchineau G., Timsit S., Bougon D., Dubois M.C., Tawa A., Tracol C., De Maistre E., Bonneville F., Vayne C., Mengel A., Michalski D., Pelz J., Wittstock M., Bode F., Zimmermann J., Schouten J., Buture A., Murphy S., Palma V., Negro A., Gutschalk A., Nagel S., Schoenenberger S., Frisullo G., Zanferrari C., Grillo F., Giammello F., Martin M.M., Cervera A., Burrow J., Esperon C.G., Chew B.L.A., Kleinig T.J., Soriano C., Zimatore D.S., Petruzzellis M., Elkady A., Miranda M.S., Fernandes J., Vogel Å.H., Johansson E., Philip A.P., Coutts S.B., Bal S., Buck B., Legault C., Blacquiere D., Katzberg H.D., Field T.S., Dizonno V., Gattringer T., Jacobi C., Devroye A., Lemmens R., Kristoffersen E.S., di Poggio M.B., Ghiasian M., Karapanayiotides T., Chatterton S., Wronski M., Ng K., Kahnis R., Geeraerts T., Reiner P., Cordonnier C., Middeldorp S., Levi M., van Gorp E.C.M., van de Beek D., Brodard J., Kremer Hovinga J.A., Kruip M.J.H.A., Tatlisumak T., Ferro J.M., Coutinho J.M., Arnold M., Poli S., Heldner M.R.

ANNALS OF NEUROLOGY. 2022 June; 10.1002/ana.26431

Alteplase Compared to Tenecteplase in patients with Acute Ischemic Stroke (AcT) Trial: Protocol for a Pragmatic Registry linked Randomized Clinical Trial

Tolulope Sajobi, Nishita Singh, Mohammed A. Almekhlafi, Brian Buck, Ayoola Ademola, Shelagh B. Coutts, Yan Deschaintre, Houman Khosravani, Ramana Appireddy, Francois Moreau, Stephen Phillips, Gord Gubitz, Aleksander Tkach, Luciana Catanese, Dar Dowlatshahi, George Medvedev, Jennifer Mandzia, Aleksandra Pikula, J.J. Shankar, Heather Williams, Thalia S. Field, Alejandro Manosalva, Muzaffar Siddiqui, Atif Zafar, Oje Imoukhoude, Gary Hunter, Arshia Sehgal, Qiao Zhang, Craig Doram, Michael D. Hill, Michel Shamy, Carol Kenney, Richard H. Swartz and Bijoy K. Menon

Stroke: Vascular and Interventional Neurology. 2022 May; 10.1161/SVIN.121.000447

Intravenous Alteplase compared to Tenecteplase in Acute Ischemic Stroke The AcT RCT

European Stroke Organisation (ESO) 8th ESO Conference . 2022 May;

Understanding Physician and Patient Preferences for Thrombolysis in Ischemic Stroke Eligible for Endovascular Thrombectomy

Nishita Singh, Nima Kashani, Aravind Ganesh, Carol Kenney, David Ben-Israel, Raed Joundi, Aristeidis H Katsanos, Anas Alrohimi, Fouzi Bala, Michel Shamy, Aleksander Tkach, Richard H Swartz, Brian H Buck, Andrew M Demchuk, Michael D Hill, Kednapa Thavorn, Tolulope Sajobi, Mohammed Almekhlafi, Dar Dowlatshahi, Bijoy K Menon

STROKE. 2022 March; 10.1161/SVIN.121.000218