1,656 results match your criteria: "The National Hospital for Neurology and Neurosurgery.[Affiliation]"

Impairments of object recognition are core features of neurodegenerative syndromes, in particular posterior cortical atrophy (PCA; the 'visual-variant Alzheimer's disease'). These impairments arise from damage to higher-level cortical visual regions and are often missed or misattributed to common ophthalmological conditions. Consequently, diagnosis can be delayed for years with considerable implications for patients.

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Neurological disorders caused by novel non-coding repeat expansions: clinical features and differential diagnosis.

Lancet Neurol

July 2024

Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London, UK; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy. Electronic address:

Nucleotide repeat expansions in the human genome are a well-known cause of neurological disease. In the past decade, advances in DNA sequencing technologies have led to a better understanding of the role of non-coding DNA, that is, the DNA that is not transcribed into proteins. These techniques have also enabled the identification of pathogenic non-coding repeat expansions that cause neurological disorders.

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Validation of the 2023 International Diagnostic Criteria for MOGAD in a Selected Cohort of Adults and Children.

Neurology

July 2024

From the Queen Square MS Centre (J.A.V., G.P., O.A.-M., Z.K., A.P., A.T.T., S.A.T., H.W., D.H.M., C.H., M.S.H., W.B., Y.H., O.C.), Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London; Department of Brain Sciences (J.A.V.), Charing Cross Hospital, Imperial College London; Department of Neurology (D.C., O.A.-M., C.H., Y.H.), Great Ormond Street Hospital for Children; The National Hospital for Neurology and Neurosurgery (T.P., Z.K., A.P., A.T.T., S.A.T., H.W., D.H.M., M.S.H., M.P.L., W.B., O.C.), UCLH NHS Trust, London, United Kingdom; Neuro-ophthalmology Expert Centre (A.P.), Amsterdam UMC, the Netherlands; Moorfields Eye Hospital NHS Foundation Trust (A.P.); Department of Radiology (K.M.), Great Ormond Street Hospital for Children; Neuroimmunology and CSF Laboratory (M.K.L.C., A.J.C., M.S.H., M.P.L.), National Hospital for Neurology and Neurosurgery; National Institute for Health and Care Research (NIHR) (M.S.H., M.P.L., W.B., O.C.), University College London Hospitals Biomedical Research Centre; and Department of Neuromuscular Diseases (M.P.L.), UCL Queen Square Institute of Neurology, University College London, United Kingdom.

Article Synopsis
  • The study evaluated the effectiveness of the 2023 myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) criteria in diagnosing inflammatory demyelinating conditions in both adults and children.
  • It analyzed data from 1,879 patients, confirming MOGAD in 16% of those tested, with follow-up averaging 3.6 years.
  • The new diagnostic criteria demonstrated high sensitivity (96.5%) and specificity (98.9%), with MOG-Ab testing showing slightly lower specificity in adults, indicating the new criteria may improve diagnosis accuracy.
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How far should I manage acute optic neuritis as an ophthalmologist? A United Kingdom perspective.

Eye (Lond)

August 2024

The Medical Eye Unit, Guy's and St Thomas' NHS Foundation Trust, London, UK.

Optic neuritis (ON) is an inflammation of or around the optic nerve, frequently caused by infectious or immune-mediated inflammatory disorders. In the UK, its strongest association is with Multiple Sclerosis (MS), though the combined prevalence of other associated infectious and immune-mediated inflammatory diseases (I-IMID) is similar to that of MS-ON. Prompt identification and understanding of ON's underlying cause informs tailored management and prognosis.

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Article Synopsis
  • The article covers key visual electrodiagnostic tests used in neuro-ophthalmology, focusing on visual evoked potential (VEP) and various electroretinograms (ffERG, PERG, mfERG).
  • It illustrates how these tests help interpret conditions like optic neuropathies and retinal disorders that can mimic them, by providing specific test results for different diseases.
  • The review emphasizes the importance of using multiple electrophysiological techniques for accurate diagnosis and understanding of complex syndromic diseases.
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Pathogenic variants in are one of the most common genetic risk factors for Parkinson's disease (PD). Recently, the lesser-known p.L1795F variant was proposed as a strong genetic risk factor for PD, however, further families are currently lacking in literature.

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Outcomes of Percutaneous Endoscopic Gastrostomy in Huntington's Disease at a Tertiary Center.

Mov Disord Clin Pract

August 2024

Huntington's Disease Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.

Background: Clinically assisted nutrition and hydration via percutaneous endoscopic gastrostomy (PEG) is a therapeutic option to ameliorate the difficulties associated with enhanced catabolism, weight loss, and dysphagia in Huntington's disease (HD).

Objectives: The objective is to provide insights into demographics, staging (Shoulson-Fahn), complications, weight trajectories, and survival rates in people with HD (pwHD) who underwent PEG.

Methods: This retrospective study included 705 consecutive pwHD who attended our HD clinic between July 2006 and March 2024, of whom 52 underwent PEG.

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Lineage specification in glioblastoma is regulated by METTL7B.

Cell Rep

June 2024

Brain Tumour Research Centre, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University London, London, UK. Electronic address:

Glioblastomas are the most common malignant brain tumors in adults; they are highly aggressive and heterogeneous and show a high degree of plasticity. Here, we show that methyltransferase-like 7B (METTL7B) is an essential regulator of lineage specification in glioblastoma, with an impact on both tumor size and invasiveness. Single-cell transcriptomic analysis of these tumors and of cerebral organoids derived from expanded potential stem cells overexpressing METTL7B reveal a regulatory role for the gene in the neural stem cell-to-astrocyte differentiation trajectory.

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Background: Symptomatic thoracic disc herniation (TDH) is a rare pathology that is addressed with relatively challenging surgical approaches, the choice and technical execution of which have been well described in the literature. Interestingly, long-term outcomes, including surgical site pain-related disability, the need for instrumentation, and commonly occurring complications such as cerebrospinal fluid (CSF)-pleural fistula have not been widely addressed. Here, we address the complication profiles and long-term outcomes of different surgical approaches for TDH.

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Long-Term Drug Therapy Following Carotid Endarterectomy Aimed at Reducing Major Adverse Cardiovascular Events.

Ann Vasc Surg

September 2024

Department of Vascular Surgery, Royal Free London NHS Foundation Trust, London, UK.

Background: Timely carotid endarterectomy (CEA) reduces the risk of future stroke. This benefit is maximized with lifelong drug therapy aimed at reducing further major adverse cardiovascular events (MACEs), including stroke. Studies suggest that around half discontinue these drugs within 12 months.

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Article Synopsis
  • - The study investigates cardiovascular autonomic dysfunction in individuals with hereditary transthyretin amyloidosis, revealing that 27% reported symptoms at disease onset, increasing to 78% at the first evaluation (T1) after 4.5 years.
  • - A total of 124 individuals participated, with cardiovascular autonomic failure found in 75% of symptomatic patients and 64% of asymptomatic TTR variant carriers, highlighting a significant underestimate of autonomic issues in early stages.
  • - The findings suggest that autonomic dysfunction can be an early indicator of disease progression, with a faster progression rate observed in individuals reporting autonomic symptoms, emphasizing the need for routine autonomic function testing for better diagnosis and monitoring.
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Increasing appreciation of the phenotypic and biological overlap between amyotrophic lateral sclerosis (ALS) and frontotemporal dementia, alongside evolving biomarker evidence for a pre-symptomatic stage of disease and observations that this stage of disease might not always be clinically silent, is challenging traditional views of these disorders. These advances have highlighted the need to adapt ingrained notions of these clinical syndromes to include both the full phenotypic continuum - from clinically silent, to prodromal, to clinically manifest - and the expanded phenotypic spectrum that includes ALS, frontotemporal dementia and some movement disorders. The updated clinical paradigms should also align with our understanding of the biology of these disorders, reflected in measurable biomarkers.

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Cladribine tablets have been granted marketing authorization in Europe and approved by the Food and Drug Administration (FDA) in the USA to treat relapsing forms of multiple sclerosis (MS). However, people with MS (PwMS) may be more familiar, and therefore more confident, with treatments requiring long-term and frequent dosing. Differences in such treatment strategies can lead to questions relating to how short-course non-continuous treatments, such as cladribine tablets, can work and how well they are tolerated.

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Climate change and disorders of the nervous system.

Lancet Neurol

June 2024

Centre for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, University College London, London, UK; MRC International Centre for Genomic Medicine in Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, University College London, London, UK.

Anthropogenic climate change is affecting people's health, including those with neurological and psychiatric diseases. Currently, making inferences about the effect of climate change on neurological and psychiatric diseases is challenging because of an overall sparsity of data, differing study methods, paucity of detail regarding disease subtypes, little consideration of the effect of individual and population genetics, and widely differing geographical locations with the potential for regional influences. However, evidence suggests that the incidence, prevalence, and severity of many nervous system conditions (eg, stroke, neurological infections, and some mental health disorders) can be affected by climate change.

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De novo variants in ATXN7L3 lead to developmental delay, hypotonia and distinctive facial features.

Brain

August 2024

Institut de Génétique et de Biologie Moléculaire et Cellulaire, 67404 Illkirch, France.

Deubiquitination is crucial for the proper functioning of numerous biological pathways, such as DNA repair, cell cycle progression, transcription, signal transduction and autophagy. Accordingly, pathogenic variants in deubiquitinating enzymes (DUBs) have been implicated in neurodevelopmental disorders and congenital abnormalities. ATXN7L3 is a component of the DUB module of the Spt-Ada-Gcn5 acetyltransferase (SAGA) complex and two other related DUB modules, and it serves as an obligate adaptor protein of three ubiquitin-specific proteases (USP22, USP27X or USP51).

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Mechanical insufflation-exsufflation (MI-E) is essential for secretion clearance, especially in neuromuscular disorders. For the best outcomes, initiation of MI-E should be started at the correct time with regular evaluation to the response to treatment. Typically, cough peak flow has been used to evaluate cough effectiveness with and without MI-E.

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Background: Eye emergencies constitute a significant portion of attendances to general Emergency Departments (EDs) in the UK, therefore it is important to assess the confidence of doctors who work in this setting in managing these potentially sight- and life-threatening presentations. This systematic review aims to assess the confidence of UK doctors working in general EDs in managing ophthalmic emergencies.

Methods: MEDLINE (Ovid), EMBASE (Ovid), ProQuest Central and Web of Science databases and grey literature were searched from inception to 1 October 2022 for publications that (1) featured doctors working in UK general EDs, (2) assessed doctors' confidence in managing ophthalmic emergencies, (3) contained original data, (4) were full-text, and (5) written in English.

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Background: Persons with multiple sclerosis (pwMS) frequently suffer from bladder problems that are not identified and managed optimally, reducing quality of life and increasing risk of health consequences.

Objective: This study aimed to investigate associations between bladder problems and well-being of pwMS.

Methods: The study included 1872 pwMS from France, Germany, Italy, and the UK self-reporting on demographics, MS status, bladder problems and management, and well-being.

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Article Synopsis
  • Chronic idiopathic urinary retention (CIUR) in young women is often linked to psychological issues, with 97% of 91 evaluated women showing psychiatric comorbidities such as depression and anxiety.
  • Notably, those with Fowler's syndrome tend to be younger and experience symptoms for a shorter duration than those without this condition.
  • The study highlights the importance of recognizing and addressing these psychological factors during the urological assessment to improve patient care and engagement.
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Background: Nurses work at headache centres throughout Europe, and their care for migraine patients is acknowledged. However, the specific roles and tasks of nursing vary, and a unified understanding is lacking, posing challenges to knowledge sharing and research.

Objectives: Using an e-Delphi study method, the objective is to obtain healthcare professional headache experts' opinions on nursing-specific roles and tasks and combine this into consensus statements for nurse recommendations for migraine treatment.

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Genome sequence analyses identify novel risk loci for multiple system atrophy.

Neuron

July 2024

Neurodegenerative Diseases Research Unit, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA; Department of Neurology, Johns Hopkins University Medical Center, Baltimore, MD, USA. Electronic address:

Article Synopsis
  • Multiple system atrophy (MSA) is a neurodegenerative disease that leads to symptoms like parkinsonism and ataxia, but its genetic causes are not well understood and treatment options are limited to supportive care.
  • A comprehensive study involving the whole genome sequencing of nearly 900 MSA patients and over 7,000 controls discovered four key genetic risk factors associated with the disease.
  • The research identified potential susceptibility genes and provided insights into how genetic variations influence gene expression in brain cells, offering a valuable resource for further studies on similar diseases.
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Facioscapulohumeral muscular dystrophy (FSHD) is the third most common form of hereditary myopathy. Sixty per cent of the world's population lives in Asia, so a significant percentage of the world's FSHD participants is expected to live there. To date, most FSHD studies have involved individuals of European descent, yet small-scale studies of East-Asian populations suggest that the likelihood of developing FSHD may vary.

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Background: Migraine is the second most common prevalent disorder worldwide and is a top cause of disability with a substantial economic burden. Many preventive migraine medications have notable side effects that affect different body organs.

Method: We systematically searched for published randomised controlled trials (RCTs) using terms for migraine/headache and preventive medications.

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