179 results match your criteria: "National Hospital of Neurology and Neurosurgery[Affiliation]"

Classic bladder exstrophy represents the most severe end of all human congenital anomalies of the kidney and urinary tract and is associated with bladder cancer susceptibility. Previous genetic studies identified one locus to be involved in classic bladder exstrophy, but were limited to a restrict number of cohort. Here we show the largest classic bladder exstrophy genome-wide association analysis to date where we identify eight genome-wide significant loci, seven of which are novel.

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Rasch-built overall disability scale for POEMS syndrome (POEMS-RODS).

J Peripher Nerv Syst

December 2022

Queen Square Centre for Neuromuscular Diseases, National Hospital of Neurology and Neurosurgery, Queen Square, University College London Hospitals NHS Foundation Trust, London, UK.

Article Synopsis
  • Patient-reported outcome measures can effectively gauge disease severity and are meaningful for patients' lives, particularly in complex disorders like POEMS, which affects multiple body systems and causes disabling neuropathy.
  • The research introduces a new scale, the Rasch-built Overall Disability Scale (POEMS-RODS), specifically designed for POEMS, created from a preliminary questionnaire which underwent thorough testing and refinement.
  • The final version of the POEMS-RODS includes 23 relevant items that show reliable results, but further international studies are needed to verify its effectiveness and adaptability in different populations.
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Intracranial Aneurysm Classifier Using Phenotypic Factors: An International Pooled Analysis.

J Pers Med

August 2022

Neurosurgery Division, Department of Clinical Neurosciences, Faculty of Medicine, Geneva University Hospitals, 1205 Geneva, Switzerland.

Article Synopsis
  • Intracranial aneurysms (IAs) are often asymptomatic, but those that rupture can lead to severe complications, making it crucial to identify which IAs are at risk of rupture.
  • A study involving 7992 patients across 21 centers found that the location of an IA is the strongest predictor of whether it will rupture or be diagnosed incidentally, and that awareness of risk factors like hypertension and smoking influences diagnosis outcomes.
  • Additionally, the findings suggest that age, IA size, and smoking status vary in their association with ruptured IAs, providing insights for better clinical decision-making and tailored patient care.
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and Cerebral Small Vessel Disease Markers in Patients With Intracerebral Hemorrhage.

Neurology

September 2022

From the Stroke Research Centre (I.C.H., D.S., Duncan Wilson, C.S., G.B., M.M.B., David Werring), University College London, Institute of Neurology; Neurogenetics Laboratory (I.C.H., H.H.), The National Hospital of Neurology and Neurosurgery, London, UK; Department of Neurosurgery (I.C.H.), Cantonal Hospital St. Gallen, Switzerland; Stroke Centre (D.S.), Department of Neurology and Department of Clinical Research, University of Basel and University Hospital Basel; Department of Neurology and Stroke Centre (D.S.), University Hospital Berne; MRC Unit for Lifelong Health and Ageing at UCL (A.W.), London; Department of Statistical Science (G.A.), UCL, London; Department of Clinical and Movement Neuroscience (N.S.), Institute of Neurology, London; Neuroradiological Academic Unit (H.R.J., T.A.Y.), Department of Brain Repair & Rehabilitation, University College London, Institute of Neurology; Haemostasis Research Unit (H.C.), Department of Haematology, University College London; Centre for Clinical Brain Sciences (R.A.-S.S.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart & Chest Hospital; Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark; and Institute of Neuroscience & Psychology (K.M.), University of Glasgow, Queen Elizabeth University Hospital, UK.

Background And Objective: We investigated the associations between the genotype, intracerebral hemorrhage (ICH), and neuroimaging markers of cerebral amyloid angiopathy (CAA).

Methods: We included patients from a prospective, multicenter UK observational cohort study of patients with ICH and representative UK population controls. First, we assessed the association of the genotype with ICH (compared with controls without ICH).

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Pragmatic guide to peripheral nerve disease and the role of clinical biomarkers.

Pract Neurol

July 2022

Centre for Neuromuscular Diseases, National Hospital of Neurology and Neurosurgery, Queen Square, University College London Hospitals NHS Foundation Trust, London, UK

Article Synopsis
  • In clinical neurology, effective serological biomarkers for assessing the peripheral nervous system are limited, leading to reliance on alternative diagnostic methods.
  • Accurate understanding and application of these biomarkers are crucial to prevent misdiagnosis and ensure timely treatment adjustments.
  • The text explores the benefits and drawbacks of existing biomarkers and suggests potential advancements for future use.
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Progressive multifocal leukoencephalopathy (PML) is an opportunistic brain infection with few treatment options and poor survival when reversal of the underlying immune dysfunction is not achievable. JC polyomavirus reactivation resulting in PML can rarely complicate chimeric antigen receptor T-cell (CAR-T) therapy. We describe successful treatment of PML with Programmed death-1 (PD-1) blockade using pembrolizumab, 4 months following axicabtagene ciloleucel.

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Article Synopsis
  • A study analyzed the risk of arterial and venous thromboembolic events (TEEs) associated with intravenous immunoglobulin (Ig) use among participants from the UK Biobank, focusing on various known risk factors.
  • Among the nearly 503,000 individuals, those with a prior history of TEE had a threefold higher incident rate of TEE compared to those without, and intravenous Ig exposure was linked to an increased risk in this group.
  • The findings suggest that for every six people with a history of TEE exposed to intravenous Ig, one additional TEE event could occur, which may affect clinical decision-making regarding consent and management of TEE risks in patients receiving this treatment.
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Traditionally, neurophysiology is the primary diagnostic and prognostic biomarker in peripheral neuropathy clinical practice; however, it may lack responsiveness in the context of slowly progressive neuropathies and where there is significant axonal damage. The development of ultrasensitive platforms for measuring serum proteins at the lower limit of detection of traditional ELISA techniques has transformed the field of blood biomarkers of peripheral neuropathy. A variety of blood biomarkers have been identified from inflammatory cytokines and apokines in diabetic neuropathy through to neuron-specific proteins such as neurofilament light chain, Schwann cell-specific proteins such as TMPRSS5 and microRNAs in other acquired and hereditary neuropathies.

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In this update, we review the recent discovery of autosomal recessive variants in sorbitol dehydrogenase as one of the commonest and potentially treatable causes of hereditary motor neuropathy and CMT2. We also report on recent therapeutic advances in hereditary neuropathy including the use of lipid nanoparticle sequestered antisense oligonucleotides in CMT1A and lipid nanoparticle delivered CRISPR-Cas9 gene editing in ATTR amyloidosis.

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Objectives: Diagnosing atrial fibrillation (AF) in patients following Cryptogenic stroke (CS) has therapeutic implications that can reduce the risk of further strokes. However, it's indolent and paroxysmal nature makes this challenging. Prolonged rhythm monitoring using implantable loop recorders (ILRs) can significantly increase the AF detection rate in the clinical trial paradigm.

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Purpose: Degenerative cervical myelopathy (DCM) is the most common cause of adult spinal cord dysfunction worldwide. However, the current incidence of DCM is poorly understood. The Hospital Episode Statistics (HES) database contains details of all secondary care admissions across NHS hospitals in England.

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Background: The use of lumbar fusion surgery is increasing in developed economies. High levels of patient dissatisfaction are reported post-operatively. To address this need, we developed a theoretically informed rehabilitation programme for use following lumbar fusion surgery (the REFS programme).

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Objectives: Simultaneous intracranial EEG and functional MRI (icEEG-fMRI) recordings in humans, whereby EEG is recorded from electrodes implanted inside the cranium during fMRI scanning, were made possible following safety studies on test phantoms and our specification of a rigorous data acquisition protocol. In parallel with this work, other investigations in our laboratory revealed the damage caused by the EEG electrode implantation procedure at the cellular level. The purpose of this report is to further explore the safety of performing MRI, including simultaneous icEEG-fMRI data acquisitions, in the presence of implanted intra-cranial EEG electrodes, by presenting some histopathological and heat-shock immunopositive labeling observations in surgical tissue samples from patients who underwent the scanning procedure.

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Background: The malignant pleural mesothelioma (MPM) response rate to chemotherapy is low. The identification of imaging biomarkers that could help guide the most effective therapy approach for individual patients is highly desirable. Our aim was to investigate the dynamic contrast-enhanced (DCE) MR parameters as predictors for progression-free (PFS) and overall survival (OS) in patients with MPM treated with cisplatin-based chemotherapy.

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Article Synopsis
  • - The study aimed to investigate the potential link between COVID-19 vaccination and Guillain-Barré syndrome (GBS) using data from the NHS in England and UK hospitals.
  • - A total of 996 GBS cases were reported, with a notable increase in March-April 2021; 198 of these cases occurred within six weeks of receiving the first dose of the ChAdOx1 nCoV-19 vaccine (AstraZeneca).
  • - The study found a slight increase in GBS cases associated with the first dose of the AstraZeneca vaccine, but no excess risk was observed for second doses or for the Pfizer and Moderna vaccines.
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Assessing Neurofilaments as Biomarkers of Neuroprotection in Progressive Multiple Sclerosis: From the MS-STAT Randomized Controlled Trial.

Neurol Neuroimmunol Neuroinflamm

March 2022

From the Queen Square Multiple Sclerosis Centre (T.E.W., A.E., J.C.), Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London; National Hospital of Neurology and Neurosurgery (T.E.W., J.C.), London; London School of Hygiene and Tropical Medicine (K.P.H., J.M.N., T.K., C.F.); and UK Dementia Research Institute at UCL (H.W., A.H., H.Z.), United Kingdom.

Background And Objectives: Improved biomarkers of neuroprotective treatment are needed in progressive multiple sclerosis (PMS) to facilitate more efficient phase 2 trial design. The MS-STAT randomized controlled trial supported the neuroprotective potential of high-dose simvastatin in secondary progressive MS (SPMS). Here, we analyze serum from the MS-STAT trial to assess the extent to which neurofilament light (NfL) and neurofilament heavy (NfH), both promising biomarkers of neuroaxonal injury, may act as biomarkers of simvastatin treatment in SPMS.

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Purpose: The aim of this study was to demonstrate features predictive of treatment response for patient-tailored overactive bladder (OAB) intervention with an implantable tibial neurostimulator using patient and technical prediction factors.

Materials And Methods: This study was designed as a follow-up study based on parameter settings and patients' preferences during the pilot and extended study of the implantable tibial nerve stimulator (RENOVA™ iStim system). For this study, we compared all treatment parameters (stimulation amplitude, frequency, and pulse width) and usage data (duration of treatment) during the different follow-up visits.

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Objectives: This study used a mixed-method approach to explore cultural and ethnic influences on the perception of, and decision to engage with or not to engage with, physical activity and exercise therapy in patients with chronic kidney disease (CKD).

Design: Qualitative research was conducted through the use of semistructured interviews and focus groups. Self-reported physical activity levels were measured using the General Practice Physical Activity Questionnaire (GPPAQ), and self-efficacy for exercise with Bandura's Self-Efficacy for Exercise Scale.

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Background: Cerebral amyloid angiopathy (CAA), a common cause of intracerebral hemorrhage (ICH), is diagnosed using the Boston criteria including magnetic resonance imaging (MRI) biomarkers (cerebral microbleeds (CMBs) and cortical superficial siderosis (cSS). The simplified Edinburgh criteria include computed tomography (CT) biomarkers (subarachnoid extension (SAE) and finger-like projections (FLPs)). The underlying mechanisms and diagnostic accuracy of CT compared to MRI biomarkers of CAA are unknown.

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Predicting long-term trends in inflammatory neuropathy outcome measures using latent class modelling.

J Peripher Nerv Syst

March 2022

MRC Centre for Neuromuscular Diseases, National Hospital of Neurology and Neurosurgery, Queen Square, University College London Hospitals NHS Foundation Trust, London, UK.

Article Synopsis
  • This study analyzes the effectiveness of immunoglobulin (Ig) treatment for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and multifocal motor neuropathy with conduction block (MMNCB) over a period from 2009 to 2020, focusing on monitoring patient outcomes through grip strength and disability scales.
  • Results indicate minimal group changes in outcome measures over time, but significant intra-individual variation is noted, with a considerable percentage of patients showing changes exceeding the minimal clinically important differences (MCID).
  • The study identifies trends of improvement and deterioration among patients, particularly linking older age with deterioration in CIDP, and highlights the complexity of interpreting outcome measures to guide
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Neurogenic arthrogryposis and the power of phenotyping.

Neuromuscul Disord

October 2021

Department of Neuromuscular Disease, Queen Square, UCL Institute of Neurology and the National Hospital of Neurology and Neurosurgery, London WC1N 3BG, England.

In this article we review the commonest cause of neurogenic arthrogryposis, termed Spinal Muscular Atrophy Lower Extremity Dominant (SMALED), due to variants in DYNC1H1 and BICD2. We discuss the characteristic clinical and radiological phenotype of this disorder and how this has facilitated the identification of the genetic cause of SMALED2. We also review the similarities and differences between the human SMALED phenotype and mouse models and how this has informed our understanding of the potential mechanisms governing motor neuron loss in these disorders.

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Introduction: Spinal cord injury (SCI) disrupts autonomic control of the cardiovascular system, which may lead to autonomic dysfunction. Growing amounts of evidence support the possibility that systemic and cerebral hemodynamic dysfunctions may contribute to cognitive deficits in patients with SCI.

Case Presentation: We present a case of autonomic cardiovascular dysfunction in a 55-year old female patient following non-traumatic cervical SCI.

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