Publications by authors named "Graham Nsn"

An accurate diagnosis of neurodegenerative disease and traumatic brain injury is important for prognostication and treatment. Neurofilament light and glial fibrillary acidic protein (GFAP) are leading biomarkers for neurodegeneration and glial activation that are detectable in blood. Yet, current recommendations require rapid centrifugation and ultra-low temperature storage post-venepuncture.

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Article Synopsis
  • Urinary tract infections (UTIs) significantly contribute to hospitalizations and fatalities among individuals with dementia compared to matched controls and those with diabetes.
  • A large study analyzed data from over 2.4 million people aged 50+ in Wales between 2000-2021, finding that UTIs in dementia and diabetes were linked to increased mortality rates, especially in those with both conditions.
  • Delayed or untreated UTIs led to a notable increase in the risk of death, with 5.4% of untreated individuals with dementia dying within 60 days after diagnosis, rising to 5.9% for those also having diabetes.
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Introduction: Although limited, recent research suggests that contact sport participation might have an adverse long-term effect on brain health. Further work is required to determine whether this includes an increased risk of neurodegenerative disease and/or subsequent changes in cognition and behaviour. The Advanced BiomaRker, Advanced Imaging and Neurocognitive Health Study will prospectively examine the neurological, psychiatric, psychological and general health of retired elite-level rugby union and association football/soccer players.

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There is growing concern that elite rugby participation may negatively influence brain health, but the underlying mechanisms are unclear. Cortical thickness is a widely applied biomarker of grey matter structure, but there is limited research into how it may be altered in active professional rugby players. Cross-sectional MRI data from 44 active elite rugby players, including 21 assessed within 1 week of head injury, and 47 healthy controls were analysed.

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Article Synopsis
  • Traumatic brain injury (TBI) is linked to chronic neurodegeneration, potentially due to systemic inflammation signaling the brain and activating microglia, which can lead to widespread brain damage.
  • The study, TBI-braINFLAMM, will analyze data from two major TBI research projects—CREACTIVE and BIO-AX-TBI—to assess the relationship between systemic inflammation, injury severity, and ongoing neurodegeneration.
  • Ethical approval has been obtained, and findings will be shared through peer-reviewed publications and conferences to enhance understanding and inform future research in this area.
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Background: Online technology could potentially revolutionise how patients are cognitively assessed and monitored. However, it remains unclear whether assessments conducted remotely can match established pen-and-paper neuropsychological tests in terms of sensitivity and specificity.

Methods: This observational study aimed to optimise an online cognitive assessment for use in traumatic brain injury (TBI) clinics.

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Introduction: Outcomes of traumatic brain injury (TBI) are highly variable, with cognitive and psychiatric problems often present in survivors, including an increased dementia risk in the long term. Military personnel are at an increased occupational risk of TBI, with high rates of complex polytrauma including TBI characterising the UK campaign in Afghanistan. The ArmeD SerVices TrAuma and RehabilitatioN OutComE (ADVANCE)-TBI substudy will describe the patterns, associations and long-term outcomes of TBI in the established ADVANCE cohort.

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Introduction: Traumatic brain injury (TBI) is a dementia risk factor, with Alzheimer's disease (AD) more common following injury. Patterns of neurodegeneration produced by TBI can be compared to AD and aging using volumetric MRI.

Methods: A total of 55 patients after moderate to severe TBI (median age 40), 45 with AD (median age 69), and 61 healthy volunteers underwent magnetic resonance imaging over 2 years.

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Axonal injury is a key determinant of long-term outcomes after traumatic brain injury (TBI) but has been difficult to measure clinically. Fluid biomarker assays can now sensitively quantify neuronal proteins in blood. Axonal components such as neurofilament light (NfL) potentially provide a diagnostic measure of injury.

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The recognition, diagnosis and management of mild traumatic brain injuries are difficult and confusing. It is unclear how the severity and number of injuries sustained relate to brain injuries, such as diffuse axonal injury, diffuse vascular injury and progressive neurodegeneration. Advances in neuroimaging techniques enable the investigation of neuropathologies associated with acute and long-term effects of injury.

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Poor outcomes after traumatic brain injury (TBI) are common yet remain difficult to predict. Diffuse axonal injury is important for outcomes, but its assessment remains limited in the clinical setting. Currently, axonal injury is diagnosed based on clinical presentation, visible damage to the white matter or via surrogate markers of axonal injury such as microbleeds.

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Article Synopsis
  • The study focuses on understanding and predicting cognitive impairments caused by traumatic brain injury (TBI) through biomarkers of axonal injury.
  • It involves a prospective longitudinal analysis across multiple European centers, aiming to recruit at least 250 patients and assess various fluid and neuroimaging biomarkers related to clinical outcomes.
  • Ethical approvals have been secured from various ethics committees across different European locations to ensure the study meets regulatory standards.
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Traumatic brain injury is associated with elevated rates of neurodegenerative diseases such as Alzheimer's disease and chronic traumatic encephalopathy. In experimental models, diffuse axonal injury triggers post-traumatic neurodegeneration, with axonal damage leading to Wallerian degeneration and toxic proteinopathies of amyloid and hyperphosphorylated tau. However, in humans the link between diffuse axonal injury and subsequent neurodegeneration has yet to be established.

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Objectives: To understand SARS-Co-V-2 infection and transmission in UK nursing homes in order to develop preventive strategies for protecting the frail elderly residents.

Methods: An outbreak investigation involving 394 residents and 70 staff, was carried out in 4 nursing homes affected by COVID-19 outbreaks in central London. Two point-prevalence surveys were performed one week apart where residents underwent SARS-CoV-2 testing and had relevant symptoms documented.

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Background And Purpose: To describe the epidemiology and associations of poststroke epilepsy (PSE) because there is limited evidence to inform clinicians and guide future research.

Methods: Data were collected from the population-based South London Stroke Register of first strokes in a multiethnic inner-city population with a maximum follow-up of 12 years. Self-completed forms and interviews notified study organizers of epilepsy diagnosis.

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