295 results match your criteria: "University College London-Queen Square Institute of Neurology[Affiliation]"

Background: Biomarkers are needed to track progression in MS trials. Neurofilament heavy chain (NfH) has been underutilized due to assay limitations.

Objective: To investigate the added value of cerebrospinal fluid (CSF) NfH in secondary progressive multiple sclerosis (SPMS) using contemporary immunoassays.

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Depressive Symptoms and Amyloid Pathology.

JAMA Psychiatry

January 2025

Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.

Importance: Depressive symptoms are associated with cognitive decline in older individuals. Uncertainty about underlying mechanisms hampers diagnostic and therapeutic efforts. This large-scale study aimed to elucidate the association between depressive symptoms and amyloid pathology.

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Aims: To discuss the role of screening and treatment of affective symptoms, like anxiety and depression in patients with LUTD. A review of the literature regarding the bidirectional association and multidisciplinary approaches integrating psychometric assessments with personalized treatment plans to improve diagnostic accuracy and therapeutic outcomes of LUTD.

Methods: This review summarizes discussions and a narrative review of (recent) literature during an International Consultation on Incontinence-Research Society 2024 research proposal with respect to the role of screening for anxiety and depression, effect of mental health symptoms on treatment outcomes and future implications.

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Bi-allelic variants in DAP3 result in reduced assembly of the mitoribosomal small subunit with altered apoptosis and a Perrault-syndrome-spectrum phenotype.

Am J Hum Genet

January 2025

Division of Evolution, Infection and Genomics, School of Biological Sciences, the University of Manchester, Manchester M13 9PL, UK; Manchester Centre for Genomic Medicine, St Mary's Hospital, the University of Manchester NHS Foundation Trust, Manchester M13 9WL, UK. Electronic address:

The mitochondrial ribosome (mitoribosome) synthesizes 13 protein subunits of the oxidative phosphorylation system encoded by the mitochondrial genome. The mitoribosome is composed of 12S rRNA, 16S rRNA, and 82 mitoribosomal proteins encoded by nuclear genes. To date, variants in 12 genes encoding mitoribosomal proteins are associated with rare monogenic disorders and frequently show combined oxidative phosphorylation deficiency.

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Evaluating multiple sclerosis severity loci 30 years after a clinically isolated syndrome.

Brain Commun

December 2024

NMR Research Unit, Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, University College London Queen Square Institute of Neurology, London WC1N 3BG, UK.

The first genome-wide significant multiple sclerosis severity locus, rs10191329, has been pathologically linked to cortical lesion load and brain atrophy. However, observational cohorts such as MSBase have not replicated associations with disability outcomes, instead finding other loci. We evaluated rs10191329 and MSBase loci in a unique cohort of 53 people followed for 30 years after a clinically isolated syndrome, with deep clinical phenotyping and MRI measures of inflammation and neurodegeneration.

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Association of the Cervical Canal Area With Disability and Progression in People With Multiple Sclerosis.

Neurology

January 2025

From the Multiple Sclerosis Centre of Catalonia (Cemcat) & Neurology Department (N.M.-O., P.C.-M., N.B., A.V.-J., M.T., X.M., J.S.-G.), and Section of Neuroradiology (D.P., M.A., C.A., À.R.), Department of Radiology (IDI), Vall Hebron University Hospital, Barcelona; Neuroimaging Research Unit (P.V., M.M., A.M., P.P., M.A.R., M.F.), Division of Neuroscience, Neurology Unit, and Neurorehabilitation Unit (M.M., M.F.), IRCCS San Raffaele Scientific Institute, Milan, Italy; Multiple Sclerosis Center (MSC) (C.G., C.Z.), Department of Neurology, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale; Faculty of Biomedical Sciences (C.G., C.Z.), Università della Svizzera Italiana (USI), Lugano, Switzerland; Faculty of Brain Sciences (F.B.), University College London Queen Square Institute of Neurology, University College London; National Institute for Health Research (F.B.), University College London Hospitals Biomedical Research Centre, United Kingdom; MS Center Amsterdam (F.B., M.M.S., E.M.M.S.), Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC location VUmc, the Netherlands; Clinic of Neurology (A. Gallo, A.B.), and MRI Research Center SUN-FISM (A. Gallo, A.B.), Second University of Naples, Italy; Queen Square MS Centre (O.C., F.D.A., M.C.Y.), Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London; National Institute for Health Research (O.C., F.D.A.), Biomedical Research Centre, University College London Hospitals; Nuffield Department of Clinical Neurosciences (J.P., L.M.), Oxford, United Kingdom; Department of Neurology (A. Gass, P.E.), Mannheim Center of Translational Neurosciences (MCTN), Medical Faculty Mannheim, Heidelberg University; Institute of Neuroradiology (C.L., B.B.), St. Josef-Hospital Bochum, Ruhr University Bochum, Germany; Vita-Salute San Raffaele University (P.P., M.A.R., M.F.); Neurology Unit (P.P., M.A.R., M.F.), and Neuropshysiology Service (M.F.), IRCCS San Raffaele Scientific Institute, Milan, Italy.

Background And Objectives: In multiple sclerosis (MS), brain reserve serves as a protective factor against cognitive impairment. Previous research has suggested a structural counterpart in the spine-spinal cord reserve-seemed to be associated with physical disability. This study aimed to investigate the potential of the cervical canal area (CCaA) as a proxy for spinal cord reserve in a multicentric cohort of people with MS (PwMS).

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In this study, heterozygous expression of a common Parkinson-associated GBA1 variant, the L444P mutation, was found to exacerbate α-synuclein aggregation and spreading in a mouse model of Parkinson-like pathology targeting neurons of the medullary vagal system. These neurons were also shown to become more vulnerable to oxidative and nitrative stress after L444P expression. The latter paralleled neuronal formation of reactive oxygen species and led to a pronounced accumulation of nitrated α-synuclein.

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Over the past two decades there has been increased interest in orphan drug development for rare diseases. However, hurdles to clinical trial design for these disorders remain. This phase 1a/1b study addressed several challenges, while evaluating the safety and tolerability of the novel oral molecule KL1333 in healthy volunteers and subjects with primary mitochondrial disease.

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Article Synopsis
  • A significant number of patients with cardiomyopathy have undetermined genetic causes, prompting researchers to analyze mtDNA variants in these cases through the 100,000 genomes project.
  • The study scrutinized 1,363 genomes, identifying the pathogenic MT-TI m.4300A>G variant in four hypertrophic cardiomyopathy patients who had previously been undiagnosed, representing 0.6% of HCM cases without a known genetic cause.
  • Findings suggest that MT-TI should be included in the initial genetic testing for non-syndromic hypertrophic cardiomyopathy to aid in diagnosing patients.
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Article Synopsis
  • This study examines the relationship between mitochondrial diseases and hearing impairments, focusing on how specific genetic mutations affect auditory functions.
  • An observational study was conducted with 72 adults, utilizing various tests to assess both cochlear and central auditory capabilities, revealing significant hearing deficits linked to the m.3243A>G/T genetic variants.
  • The findings highlight the complexity of hearing impairment in mitochondrial diseases, suggesting that tailored auditory evaluations and management approaches may improve outcomes based on individual genetic profiles.
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Measuring Disease Progression in Multiple Sclerosis Clinical Drug Trials and Impact on Future Patient Care.

CNS Drugs

January 2025

Department of Neuroinflammation, Faculty of Brain Sciences, Queen Square Multiple Sclerosis Centre, University College London Queen Square Institute of Neurology, University College London, London, WC1B 5EH, UK.

Multiple sclerosis (MS) is a chronic immune-mediated disease of the central nervous system characterised by inflammation, demyelination and neurodegeneration. Although several drugs are approved for MS, their efficacy in progressive disease is modest. Addressing disease progression as a treatment goal in MS is challenging due to several factors.

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Introducing heterozygous humanized tau to App knock-in mice results in the first mouse model of Alzheimer's disease in which age and amyloid-β pathology interact to initiate neurofibrillary tau tangle pathology, not dependent on mutations in MAPT. Gradual progression from amyloid-β to tau pathology in NLFTau mice opens possibilities for understanding processes precipitating clinical stages of Alzheimer's disease and development of translatable therapies to prevent the onset of tau pathology.

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The Association of British Neurologists last published guidelines on disease-modifying treatment (DMT) in multiple sclerosis (MS) in 2015. Since then, additional DMTs have been licensed and approved for prescribing within the National Health Service for relapsing-remitting MS, early primary progressive MS and active secondary progressive MS. This updated guidance provides a consensus-based approach to using DMTs.

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Neuromodulation with Transcranial Magnetic Stimulation in Epilepsia Partialis Continua: Scoping review and clinical experience.

Seizure

December 2024

Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, United Kingdom; Department of Clinical Neurophysiology, King's College Hospital, London, United Kingdom; Department of Clinical Neurophysiology, Alder Hey Children's Hospital, London, United Kingdom.

Article Synopsis
  • Epilepsia Partialis Continua (EPC) is a complex condition that may respond to repetitive transcranial magnetic stimulation (rTMS), which offers both diagnostic and therapeutic potential.
  • A review of literature involving cases of EPC treated with rTMS, alongside two in-house patient cases, highlights the varying efficacy of rTMS in reducing seizure activity.
  • Results indicate that while some patients experienced no change, low frequency rTMS led to temporary improvements in seizure frequency and motor function in two patients, suggesting its possible role in guiding further treatment.
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Article Synopsis
  • The study aimed to determine the effectiveness and safety of starting direct oral anticoagulants (DOACs) early versus delayed in patients with acute ischaemic stroke and atrial fibrillation.
  • Conducted as a multicenter, randomized controlled trial across 100 UK hospitals, 3,648 patients were initially assigned to either early initiation (within 4 days) or delayed initiation (7-14 days) of anticoagulation.
  • The primary outcome measured was the incidence of complications like recurrent stroke or bleeding within 90 days, with results being analyzed by an independent committee to ensure objectivity.
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Drug repurposing in status epilepticus.

Epilepsy Behav

December 2024

Department of Clinical and Experimental Epilepsy, University College London Queen Square Institute of Neurology, London WC1N 3BG, UK. Electronic address:

The treatment of status epilepticus (SE) has changed little in the last 20 years, largely because of the high risks and costs of new drug development for SE. Moreover, SE poses specific challenges to drug development, such as patient diversity, logistical hurdles, and the need for acute treatment strategies that differ from chronic seizure prevention. This has reduced the appetite of industry to develop new drugs in this area.

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Myotubularin-Related Protein 5 (MTMR5) is an inactive, poorly characterized D3-phosphatidylinositol phosphatase. Mutations in MTMR5 have been linked to Charcot-Marie-Tooth Disease Type 4B3 (CMT4B3), a rare, early-onset, recessive peripheral neuropathy. Here, we describe the establishment and validation of three human induced pluripotent stem cell (iPSC) lines derived from unrelated CMT4B3 patients, each harboring homozygous MTMR5/Sbf1 mutations.

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Introduction: Assessing treatments for Alzheimer's disease (AD) relies on reliable tools for measuring AD progression. In this analysis, we evaluate the sensitivity of clinical progression measures in AD within randomized controlled trials (RCTs) with confirmed positive amyloid (Aβ+) status prior to trial enrollment.

Methods: Excluding trials targeting non-cognitive symptoms, we conducted meta-analyses on progression measures from 25 selected RCTs using R version 4.

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Article Synopsis
  • Cervical flexion-induced myelopathy, or Hirayama disease (HD), primarily affects young males aged about 17.8 years, leading to asymmetric weakness and wasting in distal upper limbs, with future emphasis on early diagnosis and treatment.
  • Retrospective analysis of 140 patients showed that nearly half had unilateral symptoms, and most had ongoing progression of the disease; abnormal electromyography findings were common, with significant MRI changes noted.
  • Early identification and management of HD are crucial to prevent severe disability, emphasizing the need for dynamic MRI and aggressive treatment strategies in affected individuals.
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Article Synopsis
  • Therapeutic strategies to lower mutant huntingtin (mHTT) levels show promise in reversing Huntington's disease (HD) symptoms in animal models, highlighting the need for effective biomarkers to evaluate these therapies.
  • Neurofilament light chain (NfL) is a neurodegeneration biomarker that increases in the cerebrospinal fluid (CSF) and blood as HD progresses, but its role in assessing treatment efficacy remains unclear.
  • In studies with YAC128 mice, NfL levels were elevated compared to control mice, and while lowering mHTT before disease symptoms had minimal impact on plasma NfL, it led to a significant reduction in CSF NfL, especially when treatment was started after disease onset.
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An increasing number of repeat expansion disorders have been found to cause both rare and common neurological disease. This is exemplified in recent discoveries of novel repeat expansions underlying a significant proportion of several late-onset neurodegenerative disorders, such as CANVAS (cerebellar ataxia, neuropathy and vestibular areflexia syndrome) and spinocerebellar ataxia type 27B. Most of the 60 described repeat expansion disorders to date are associated with neurological disease, providing substantial challenges for diagnosis, but also opportunities for management in a clinical neurology setting.

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Poly ADP-ribose signaling is dysregulated in Huntington disease.

Proc Natl Acad Sci U S A

October 2024

Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON L8S 3Z5, Canada.

Article Synopsis
  • Research indicates that DNA repair and mitochondrial health pathways are linked to HD, with study findings showing elevated DNA damage even before the disease manifests.
  • Findings reveal that mutation carriers have lower levels of poly ADP-ribose (PAR) in their cerebrospinal fluid, and while wild-type HTT boosts PARP1 activity, the mutant form does not, highlighting potential pathways for developing early preventive treatments for HD.
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WONOEP appraisal: Genetic insights into early onset epilepsies.

Epilepsia

November 2024

Saul R. Korey Department of Neurology, Isabelle Rapin Division of Child Neurology, Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, Bronx, New York, USA.

Early onset epilepsies occur in newborns and infants, and to date, genetic aberrations and variants have been identified in approximately one quarter of all patients. With technological sequencing advances and ongoing research, the genetic diagnostic yield for specific seizure disorders and epilepsies is expected to increase. Genetic variants associated with epilepsy include chromosomal abnormalities and rearrangements of various sizes as well as single gene variants.

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Glucocerebrosidase (GBA1) variants constitute numerically the most common known genetic risk factor for Parkinson's disease (PD) and are distributed worldwide. Access to GBA1 genotyping varies across the world and even regionally within countries. Guidelines for GBA1 variant counseling are evolving.

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