Staff Profile

Research Interests

1: Falls and Syncope

Falls and syncope are closely inter-related topics with enormous scope for high quality clinical and basic science research.

Ongoing research
• Intravenous Adenosine Testing in the Diagnosis of Unexplained Syncope
This is an exciting new field with huge potential, both in academic and clinical terms. My study is the first to comprehensively examine the possible indications for adenosine testing in the context of unexplained syncope, with the results being used to inform a large scale clinical trial. Funding for the pilot study was via a Special Trustees grant, and I am currently working with collaborators to develop the definitive randomised study for submission to the MRC for Trial Grant funding, incorporating substantial quality of life and health economic components. This study has enormous potential in terms of both grant generation and high impact factor publication because of its novelty and the poor quality and paucity of previous research.

• Home Orthostatic Training in Vasovagal Syncope: The HOT-VVS study
Orthostatic training is a promising treatment for vasovagal syncope. This study is the first randomised placebo-controlled attempt to examine the role of such training, and the first to examine cardiovascular and baroreflex changes accounting for symptomatic improvement; again, this pilot study will inform a larger study, with further funding applied for from the British Heart Foundation with the pilot results.

• The Role of Home Activity Monitoring in Falls Prevention
This project is being developed with the Vivatech Company marketing the Wristcare wrist-watch-like home activity monitor. Observational pilot data have shown a 70% reduction in fall rates using the device; I am in negotiations with the company on funding for a randomised, controlled study of Wristcare versus usual care in fallers presenting to the Accident and Emergency service. Additional funding will being sought from Research into Ageing.

• The Pathophysiology of Carotid Sinus Syndrome (CSS)
Surprisingly little is known of the pathophysiology of this common cause of falls and syncope. I am lead investigator on a study building on pilot work I did on cerebral autoregulation in CSS and I hope to unravel some of the reasons why patients with carotid sinus hypersensitivity change from the asymptomatic state to suffering falls and syncope. The study is examining cerebral autoregulation via transcranial Doppler studies in response to graded hypotension induced by lower body negative pressure, with the wider autonomic abnormalities in the disorder studied using MIBG scanning. Substantial funding for a two year fellowship has been approved recently by the Royal College of Physicians/Dunhill Trust and the Special Trustees.

• Early Implantable Loop Recorder (ILR) Investigation in the Management of Syncope in the Older Patient
The diagnosis of syncope in the older patient can be challenging, with investigations stretching over one to two years. The ILR is recommended by the European Society for Cardiology as the final investigation in the diagnosis of syncope, but I believe that early implantation of the ILR will provide a higher diagnostic yield much earlier. I propose to test this with a randomised trial of ILR use versus usual care and am currently developing this study for submission via the HTA open call route. A sub-study is planned in older patients with cognitive impairment, and again quality of life and health economic data will form vital components of the study.

Future Research

While continuing a strong interest in clinical research in falls and syncope (with a multicentre treatment study in vasovagal syncope in the early stages of planning, as well as a comparison of provocative tilt studies), I am developing a stronger research strand in the pathophysiology of vasovagal syncope.

I was recently lead collaborator for Newcastle in a multi-centre study examining the role of implantable loop recorders in the diagnosis of unexplained syncope (ISSUE 2), and am co-investigator (with Dr M Reuber, University of Sheffield) on a project studying psychogenic syncope.

I have recently been asked to be a steering group member developing a randomised study of a novel pacing algorithm in the management of vasovagal syncope (led by Prof Richard Sutton, Hon Prof Clinical Cardiology at Imperial College, London).

• Allan LM, Wheatley A, Smith A, Flynn E, Homer T, Robalino S, Beyer FR, Fox C, Howel D, Barber R, Connolly JA, Robinson L, Parry SW, Rochester L, Corner L, Bamford C. An intervention to improve outcomes of falls in dementia: the DIFRID mixed-methods feasibility study. Health Technology Assessment 2019, 23(59), 1-208.
• Wheatley A, Bamford C, Shaw C, Flynn E, Smith A, Beyer F, Fox C, Barber R, Parry SW, Howel D, Homer TM, Robinson AL, Allan L. Developing an Intervention for Fall-Related Injuries in Dementia (DIFRID): an integrated, mixed-methods approach. BMC Geriatrics 2019, 19, 57.
• Chen M, Jamnadas-Khoda J, Broadhurst M, Wall M, Grunewald R, Howell SJL, Koepp M, Parry SW, Sisodiya SM, Walker M, Hesdorffer D, Reuber M. Value of witness observations in the differential diagnosis of transient loss of consciousness. Neurology 2019, 92(9), e895-e904.
• Adams N, Skelton D, Bailey C, Howel D, Coe D, Lampitt R, Wilkinson J, Fouweather T, de Jong L, Gawler S, Gray J, Deary V, Waterman H, Parry S. Visually Impaired OLder people’s Exercise programme for falls prevenTion: a feasibility study. Public Health Research 2019, 7(4), 1-147.
• Adams N, Skelton DA, Howel D, Bailey C, Lampitt R, Fouweather T, Gray J, Coe D, Wilkinson J, Gawler S, De Jong LD, Waterman H, Deary V, Clarke M, Parry SW. Feasibility of trial procedures for a randomised controlled trial of a community based group exercise intervention for falls prevention for visually impaired older people: the VIOLET study. BMC Geriatrics 2018, 18(1), 307.
• Allan LM, Wheatley A, Flynn E, Smith A, Fox GC, Howel D, Barber R, Homer TM, Robinson AL, Parry SW, Corner L, Connolly J, Rochester L, Bamford C. Is it feasible to deliver a complex intervention to improve the outcome of falls in people with dementia? A protocol for the DIFRID feasibility study. Pilot and Feasibility Studies 2018, 4, 170.
• Mitchell AL, Devine K, Lal V, Galloway P, House M, White K, Watson J, Parry S, Miller M, Morris M, James RA, Perros P, Pearce SHS, Quinton R. Improving the prehospital safety of steroid-dependent patients in northern England: A hospital-initiated ambulance service registration pathway. Clinical Endocrinology 2017, 87(6), 881-882.
• Frith J, Parry SW. New Horizons in orthostatic hypotension. Age and Ageing 2017, 46(2), 168-174.
• Rawlings GH, Jamnadas-Khoda J, Broadhurst M, Grunewald RA, Howell SJ, Koepp M, Parry SW, Sisodiya SM, Walker MC, Reuber M. Panic symptoms in transient loss of consciousness: Frequency and diagnostic value in psychogenic nonepileptic seizures, epilepsy and syncope. Seizure 2017, 48, 22-27.
• Parry SW, Hill H, Lawson J, Lawson N, Green D, Trundle H, McNaught J, Strassheim V, Caldwell A, Mayland R, Earley P, McMeekin P. A Novel Approach to Proactive Primary Care-Based Case Finding and Multidisciplinary Management of Falls, Syncope, and Dizziness in a One-Stop Service: Preliminary Results. Journal of the American Geriatrics Society 2016, 64(11), 2368-2373.
• Parry SW, Bamford C, Deary V, Finch TL, Gray J, MacDonald C, McMeekin P, Sabin NJ, Steen IN, Whitney SL, McColl EM. Cognitive behavioural therapy-based intervention to reduce fear of falling in older people: therapy development and randomised controlled trial the Strategies for Increasing Independence, Confidence and Energy (STRIDE) study. Health Technology Assessment 2016, 20(56), 1-206.
• Reuber M, Chen M, Jamnadas-Khoda J, Broadhurst M, Wall M, Grunewald RA, Howell SJ, Koepp M, Parry S, Sisodiya S, Walker M, Hesdorffer D. Value of patient-reported symptoms in the diagnosis of transient loss of consciousness. Neurology 2016, 87(6), 625-633.
• Tan MP, Murray A, Hawkins T, Chadwick TJ, Kerr SRJ, Parry SW. Cardiac Iodine-123-Meta-Iodo-Benzylguanidine Uptake in Carotid Sinus Hypersensitivity. PLoS ONE 2015, 10(6), e0126241.
• Matthews IG, Tresham IAE, Parry SW. Syncope in the Older Person. Cardiology Clinics 2015, 33(3), 411-421.
• Matthews IG, Lawson J, Parry SW, Davison J. A survey of the management of transient loss of consciousness in the emergency department. Journal of the Royal College of Physicians of Edinburgh 2014, 44(1), 10-13.
• Hill H, McMeekin P, Parry SW. Does the falls efficacy scale international version measure fear of falling: a reassessment of internal validity using a factor analytic approach. Age and Ageing 2014, 43(4), 559-562.
• Finch TL, Bamford C, Deary V, Sabin N, Parry SW. Making sense of a cognitive behavioural therapy intervention for fear of falling: qualitative study of intervention development. BMC Health Services Research 2014, 14, 436.
• Frith J, Newton JL, Parry SW. Measuring and defining orthostatic hypotension in the older person. Age and Ageing 2014, 43(2), 168-170.
• Parry SW, Green D, Lawson N, Trundle H, Strassheim V, Jaafar A, Vardy E, Early P, Gray S, Lawson J. Screening for Falls and Syncope Risk Factors in Primary Care is Clinically Effective: Preliminary Evaluation of the North Tyneside Falls Prevention Service (NTFPS). In: British Geriatrics Society Communications. 2014, Yorkshire, UK: Oxford University Press.
• Tan MP, Chadwick TJ, Kerr SRJ, Parry SW. Symptomatic Presentation of Carotid Sinus Hypersensitivity Is Associated With Impaired Cerebral Autoregulation. Journal of the American Heart Association 2014, 3(3), e000514.
• Matthews IG, Sutton R, Blanc JJ, Parry SW. The adenosine triphosphate test in the diagnosis of unexplained syncope: a test looking for a home. Europace 2014.
• Parry SW, Deary V, Finch T, Bamford C, Sabin N, McMeekin P, O'Brien J, Caldwell A, Steen N, Whitney SL, Macdonald C, McColl E. The STRIDE (Strategies to Increase confidence, InDependence and Energy) study: cognitive behavioural therapy-based intervention to reduce fear of falling in older fallers living in the community - study protocol for a randomised controlled trial. Trials 2014, 15, 210.
• Frith J, Parry SW. Tilt-table testing: down but not out. Clinical Practice 2014, 11(3), 265-268.
• Parry SW, Early P, Gray S, Green D, Lawson N, Trundle H, Strassheim V, Jaafar AF, Vardy E, Lawson J. Timed Up and Go Test Results in Patients Found Through General Practice Falls Risk Screening. Preliminary Evaluation of the North Tyneside Falls Prevention Service. In: British Geriatrics Society Communications. 2014, Yorkshire, UK: Oxford University Press.
• Parry SW, Finch T, Deary V. How should we manage fear of falling in older adults living in the community?. BMJ 2013, 346, f2933.
• Matthews IG, Plummer CJ, Parry SW. Positive versus Negative Adenosine Tests in Unexplained Syncope Presenting to Acute Medical Services. In: British Geriatrics Society Spring Meeting. 2013, Belfast, Ireland: Oxford University Press.
• Parry SW, Matthews IG. Update on the Role of Pacemaker Therapy in Vasovagal Syncope and Carotid Sinus Syndrome. Progress in Cardiovascular Diseases 2013, 55(4), 434-442.
• Colloby SJ, Firbank MJ, He JB, Thomas AJ, Vasudev A, Parry SW, O'Brien JT. Regional cerebral blood flow in late-life depression: arterial spin labelling magnetic resonance study. British Journal of Psychiatry 2012, 200(2), 150-155.
• Marrison VK, Fletcher A, Parry SW. The older patient with syncope: Practicalities and controversies. International Journal of Cardiology 2012, 155(1), 9-13.
• Vasudev A, O'Brien JT, Tan MP, Parry SW, Thomas AJ. A study of orthostatic hypotension, heart rate variability and baroreflex sensitivity in late-life depression. Journal of Affective Disorders 2011, 131(1-3), 374-378.
• Colloby SJ, Firbank MJ, Vasudev A, Parry SW, Thomas AJ, O'Brien JT. Cortical thickness and VBM-DARTEL in late-life depression. Journal of Affective Disorders 2011, 133(1-2), 158-164.
• Parry SW. Current issues with prediction rules for syncope. Canadian Medical Association Journal 2011, 183(15), 1694-1695.
• Allan LM, Rowan EN, Firbank MJ, Thomas AJ, Parry SW, Polvikoski TM, O'Brien JT, Kalaria RN. Long term incidence of dementia, predictors of mortality and pathological diagnosis in older stroke survivors. Brain 2011, 134(12), 3716-3727.
• Colloby SJ, Vasudev A, O'Brien JT, Firbank MJ, Parry SW, Thomas AJ. Relationship of orthostatic blood pressure to white matter hyperintensities and subcortical volumes in late-life depression. British Journal of Psychiatry 2011, 199(5), 404-410.
• Colloby SJ, Firbank MJ, Thomas AJ, Vasudev A, Parry SW, O'Brien JT. White matter changes in late-life depression: A diffusion tensor imaging study. Journal of Affective Disorders 2011, 135(1-3), 216-220.
• Colloby S, Firbank M, Thomas A, O'Brien J, Vasudev A, Parry S. White matter changes in late-life depression: A diffusion tensor imaging study. In: International Psychogeriatrics: 15th International Congress of the International Psychogeriatric Association Reinventing Aging through Innovation. 2011, The Hague, The Netherlands: Cambridge University Press.
• Duncan GW, Tan MP, Parry SW. The Head-up tilt-table test – a diagnostic tool for vasovagal syncope. The Foundation Years Journal 2008, 2, 289-294.
• Parry SW, Baptist MT, Steen N, Kenny RM. Cerebral autoregulation is impaired in patients with carotid sinus hypersensitivity presenting with drop attacks. In: Journal of the American Geriatrics Society: Annual Scientific Meeting of the American Geriatrics Society. 2003, Baltimore, Maryland, USA: Wiley-Blackwell Publishing, Inc.
• Parry SW, Baptist M, Steen N, Kenny RA. Cerebral autoregulation is impaired in patients with carotid sinus hypersensitivity presenting with drop attacks. In: Heart: Annual Scientific Conference of the British Cardiac Society. 2003, Glasgow, UK: BMJ Group.
• Seifer CM, Parry SW. Monitoring devices for falls and syncope. Clinics in Geriatric Medicine 2002, 18(2), 295-306.
• Parry SW, Gray JC, O'Shea D, Baptist M, Kenny RA. Shortening the duration of the head-up tilt table test: A randomised controlled trial of 20-minute sublingual glyceryl trinitrate-provoked versus 40-minute passive protocols as initial investigations in the diagnosis of vasovagal syncope. In: Journal of the American College of Cardiology. 2001, Elsevier Inc.
• Parry SW. Ethics of identification. Lancet 2000, 356(9234), 1036-1036.