Publications by authors named "Ross Paterson"

Neurofilament light chain is an established marker of neuroaxonal injury that is elevated in CSF and blood across various neurological diseases. It is increasingly used in clinical practice to aid diagnosis and monitor progression and as an outcome measure to assess safety and efficacy of disease-modifying therapies across the clinical translational neuroscience field. Quantitative methods for neurofilament light chain in human biofluids have relied on immunoassays, which have limited capacity to describe the structure of the protein in CSF and how this might vary in different neurodegenerative diseases.

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Article Synopsis
  • White matter hyperintensities (WMH) correlate with major dementia causes, particularly arteriolosclerosis and amyloid pathology; the study aimed to pinpoint specific WMH locations linked to vascular risk and amyloid-β (Aβ42) status.* -
  • Data from 3,132 patients were analyzed, revealing that vascular risk was associated with WMH in the anterior/superior corona radiata and middle cerebellar peduncle, while Aβ42 positivity linked to WMH in the posterior thalamic radiation and splenium.* -
  • The findings suggest WMH patterns differ between vascular risk factors and Aβ42 pathology, indicating the need for further research on how these factors impact white matter
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Introduction: The spatial distribution of white matter hyperintensities (WMH) on MRI is often considered in the diagnostic evaluation of patients with cognitive problems. In some patients, clinicians may classify WMH patterns as "unusual", but this is largely based on expert opinion, because detailed quantitative information about WMH distribution frequencies in a memory clinic setting is lacking. Here we report voxel wise 3D WMH distribution frequencies in a large multicenter dataset and also aimed to identify individuals with unusual WMH patterns.

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As disease-modifying therapies are now available for Alzheimer's disease (AD), accessible, accurate and affordable biomarkers to support diagnosis are urgently needed. We sought to develop a mass spectrometry-based urine test as a high-throughput screening tool for diagnosing AD. We collected urine from a discovery cohort (n = 11) of well-characterised individuals with AD (n = 6) and their asymptomatic, CSF biomarker-negative study partners (n = 5) and used untargeted proteomics for biomarker discovery.

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Human prion diseases are remarkable for long incubation times followed typically by rapid clinical decline. Seed amplification assays and neurodegeneration biofluid biomarkers are remarkably useful in the clinical phase, but their potential to predict clinical onset in healthy people remains unclear. This is relevant not only to the design of preventive strategies in those at-risk of prion diseases, but more broadly, because prion-like mechanisms are thought to underpin many neurodegenerative disorders.

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Introduction: Impact of white matter hyperintensities (WMH) on cognition likely depends on lesion location, but a comprehensive map of strategic locations is lacking. We aimed to identify these locations in a large multicenter study.

Methods: Individual patient data (n = 3525) from 11 memory clinic cohorts were harmonized.

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Despite recent advances in fluid biomarker research in Alzheimer's disease (AD), there are no fluid biomarkers or imaging tracers with utility for diagnosis and/or theragnosis available for other tauopathies. Using immunoprecipitation and mass spectrometry, we show that 4 repeat (4R) isoform-specific tau species from microtubule-binding region (MTBR-tau and MTBR-tau) increase in the brains of corticobasal degeneration (CBD), progressive supranuclear palsy (PSP), frontotemporal lobar degeneration (FTLD)-MAPT and AD but decrease inversely in the cerebrospinal fluid (CSF) of CBD, FTLD-MAPT and AD compared to control and other FTLD-tau (for example, Pick's disease). CSF MTBR-tau measures are reproducible in repeated lumbar punctures and can be used to distinguish CBD from control (receiver operating characteristic area under the curve (AUC) = 0.

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Background: Neurological COVID-19 disease has been reported widely, but published studies often lack information on neurological outcomes and prognostic risk factors. We aimed to describe the spectrum of neurological disease in hospitalised COVID-19 patients; characterise clinical outcomes; and investigate factors associated with a poor outcome.

Methods: We conducted an individual patient data (IPD) meta-analysis of hospitalised patients with neurological COVID-19 disease, using standard case definitions.

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Although cerebrospinal fluid (CSF) biomarker testing is incorporated into some current guidelines for the diagnosis of dementia (such as England's National Institute for Health and Care Excellence (NICE)), it is not widely accessible for most patients for whom biomarkers could potentially change management. Here we share our experience of running a clinical cognitive CSF service and discuss recent developments in laboratory testing including the use of the CSF amyloid-β 42/40 ratio and automated assay platforms. We highlight the importance of collaborative working between clinicians and laboratory staff, of preanalytical sample handling, and discuss the various factors influencing interpretation of the results in appropriate clinical contexts.

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Article Synopsis
  • SARS-CoV-2 infection can lead to various neurological problems, but the mechanisms behind this damage are not well understood.
  • This study examined biomarkers in 21 patients with COVID-19 neurological syndromes compared to 23 healthy controls, focusing on signs of neuronal injury, neuroinflammation, and astrocyte activation.
  • Findings indicated that patients with neurological syndromes exhibited impaired amyloid processing, increased neuronal injury markers, enhanced inflammation, and reduced astrocyte activation, suggesting a complex interplay affecting brain health in COVID-19 cases.
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Pathological cerebral white matter changes in Alzheimer's disease have been shown using diffusion tensor imaging. Superficial white matter changes are relatively understudied despite their importance in cortico-cortical connections. Measuring superficial white matter degeneration using diffusion tensor imaging is challenging due to its complex organizational structure and proximity to the cortex.

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Background: A high prevalence of antiphospholipid antibodies has been reported in case series of patients with neurological manifestations and COVID-19; however, the pathogenicity of antiphospholipid antibodies in COVID-19 neurology remains unclear.

Methods: This single-centre cross-sectional study included 106 adult patients: 30 hospitalised COVID-neurological cases, 47 non-neurological COVID-hospitalised controls, and 29 COVID-non-hospitalised controls, recruited between March and July 2020. We evaluated nine antiphospholipid antibodies: anticardiolipin antibodies [aCL] IgA, IgM, IgG; anti-beta-2 glycoprotein-1 [aβGPI] IgA, IgM, IgG; anti-phosphatidylserine/prothrombin [aPS/PT] IgM, IgG; and anti-domain I βGPI (aD1β2GPI) IgG.

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  • - Preliminary research indicates that SARS-CoV-2 may harm the nervous system, prompting a study involving serum and cerebrospinal fluid (CSF) from 34 COVID-19 patients with neurological symptoms to determine the extent and nature of this damage.
  • - Biomarkers of neuronal damage, particularly neurofilament light, were found at significantly higher levels in the CSF of patients with serious CNS conditions, like encephalitis, compared to other neurological conditions and control groups.
  • - Elevated neurofilament light levels were present in hospitalized COVID-19 patients regardless of neurological symptoms, but no significant increases were observed in community cases, suggesting minimal neurological damage in milder cases; astrocytic activation was not linked to neuronal damage in
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Introduction: Cerebral amyloid angiopathy (CAA) is associated with symptomatic intracerebral haemorrhage. Biomarkers of clinically silent bleeding events, such as cerebrospinal fluid (CSF) ferritin and iron, might provide novel measures of disease presence and severity.

Methods: We performed an exploratory study comparing CSF iron, ferritin, and other metal levels in patients with CAA, control subjects (CS) and patients with Alzheimer's disease (AD).

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Objectives: In response to a commissioned research update on dementia during the COVID-19 pandemic, a UK-based working group, comprising dementia researchers from a range of fields and disciplines, aimed to describe the impact of the pandemic on dementia wellbeing and identify priorities for future research.

Methods: We supplemented a rapid literature search (including unpublished, non-peer reviewed and ongoing studies/reports) on dementia wellbeing in the context of COVID-19 with expert group members' consensus about future research needs. From this we generated potential research questions the group judged to be relevant that were not covered by the existing literature.

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Induced pluripotent stem cell (iPSC) technology enables the generation of human neurons in vitro, which contain the precise genome of the cell donor, therefore permitting the generation of disease models from individuals with a disease-associated genotype of interest. This approach has been extensively used to model inherited forms of Alzheimer's disease and frontotemporal dementia. The combination of iPSC-derived neuronal models with targeted mass spectrometry analysis has provided unprecedented insights into the regulation of specific proteins in human neuronal physiology and pathology.

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Objectives: We examined whether providing a quantitative report (QReport) of regional brain volumes improves radiologists' accuracy and confidence in detecting volume loss, and in differentiating Alzheimer's disease (AD) and frontotemporal dementia (FTD), compared with visual assessment alone.

Methods: Our forced-choice multi-rater clinical accuracy study used MRI from 16 AD patients, 14 FTD patients, and 15 healthy controls; age range 52-81. Our QReport was presented to raters with regional grey matter volumes plotted as percentiles against data from a normative population (n = 461).

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  • This study investigated the potential link between COVID-19 and Guillain-Barré syndrome (GBS) by analyzing GBS cases in the UK before and during the COVID-19 pandemic.
  • The researchers found that GBS incidence decreased during the pandemic and did not show a correlation with COVID-19 infection rates across different regions.
  • Although some GBS cases were associated with COVID-19, there were no significant differences in clinical features between COVID-19 positive and negative cases, suggesting no strong evidence linking the virus as a cause of GBS.
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Sporadic Creutzfeldt-Jakob disease (sCJD) presents as a rapidly progressive dementia which is usually fatal within six months. No clinical blood tests are available for diagnosis or disease monitoring. Here, we profile blood microRNA (miRNA) expression in sCJD.

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Article Synopsis
  • * In a study of 43 patients, most were confirmed or probable COVID-19 cases, revealing five main categories of neurological disorders: encephalopathies, inflammatory central nervous system syndromes, ischemic strokes, peripheral neurological disorders, and other central disorders.
  • * Treatment outcomes varied, with many patients showing full or partial recovery, particularly those with encephalopathy and inflammatory CNS syndromes, while some experienced severe conditions like stroke or Guillain-Barré syndrome.
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