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

What contributes to disability in progressive MS? A brain and cervical cord-matched quantitative MRI study.

Mult Scler

April 2024

NMR Research Unit, Queen Square Multiple Sclerosis Centre, UCL (University College London) Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK.

Background: We assessed the ability of a brain-and-cord-matched quantitative magnetic resonance imaging (qMRI) protocol to differentiate patients with progressive multiple sclerosis (PMS) from controls, in terms of normal-appearing (NA) tissue abnormalities, and explain disability.

Methods: A total of 27 patients and 16 controls were assessed on the Expanded Disability Status Scale (EDSS), 25-foot timed walk (TWT), 9-hole peg (9HPT) and symbol digit modalities (SDMT) tests. All underwent 3T brain and (C2-C3) cord structural imaging and qMRI (relaxometry, quantitative magnetisation transfer, multi-shell diffusion-weighted imaging), using a fast brain-and-cord-matched protocol with brain-and-cord-unified imaging readouts.

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Current methodology used to investigate how shifts in brain states associated with regional cerebral blood volume (CBV) change in deep brain areas, are limited by either the spatiotemporal resolution of the CBV techniques, and/or compatibility with electrophysiological recordings; particularly in relation to spontaneous brain activity and the study of individual events. Additionally, infraslow brain signals (<0.1 Hz), including spreading depolarisations, DC-shifts and infraslow oscillations (ISO), are poorly captured by traditional AC-coupled electrographic recordings; yet these very slow brain signals can profoundly change CBV.

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The energy metabolism of the brain is poorly understood partly due to the complex morphology of neurons and fluctuations in ATP demand over time. To investigate this, we used metabolic models that estimate enzyme usage per pathway, enzyme utilization over time, and enzyme transportation to evaluate how these parameters and processes affect ATP costs for enzyme synthesis and transportation. Our models show that the total enzyme maintenance energy expenditure of the human body depends on how glycolysis and mitochondrial respiration are distributed both across and within cell types in the brain.

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Background: Laquinimod modulates CNS inflammatory pathways thought to be involved in the pathology of Huntington's disease. Studies with laquinimod in transgenic rodent models of Huntington's disease suggested improvements in motor function, reduction of brain volume loss, and prolonged survival. We aimed to evaluate the safety and efficacy of laquinimod in improving motor function and reducing caudate volume loss in patients with Huntington's disease.

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Introduction: Clinical trials show that calcitonin gene-related peptide monoclonal antibodies (CGRP mAbs) are effective preventative treatments for chronic migraine. Their efficacy over longer time periods and in cohorts originally excluded from trials remains uncertain. This study aims to explore the impact of CGRP mAbs in an Australian real-life setting.

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Background: Posterior cortical atrophy is a rare syndrome characterised by early, prominent, and progressive impairment in visuoperceptual and visuospatial processing. The disorder has been associated with underlying neuropathological features of Alzheimer's disease, but large-scale biomarker and neuropathological studies are scarce. We aimed to describe demographic, clinical, biomarker, and neuropathological correlates of posterior cortical atrophy in a large international cohort.

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Genetic screens have been used extensively to probe interactions between nuclear genes and their impact on phenotypes. Probing interactions between mitochondrial genes and their phenotypic outcome, however, has not been possible due to a lack of tools to map the responsible polymorphisms. Here, using a toolkit we previously established in Drosophila, we isolate over 300 recombinant mitochondrial genomes and map a naturally occurring polymorphism at the cytochrome c oxidase III residue 109 (CoIII) that fully rescues the lethality and other defects associated with a point mutation in cytochrome c oxidase I (CoI).

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Background: In multifactorial diseases, alterations in the concentration of metabolites can identify novel pathological mechanisms at the intersection between genetic and environmental influences. This study aimed to profile the plasma metabolome of patients with dementia with Lewy bodies (DLB) and Alzheimer's disease (AD), two neurodegenerative disorders for which our understanding of the pathophysiology is incomplete. In the clinical setting, DLB is often mistaken for AD, highlighting a need for accurate diagnostic biomarkers.

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CADMUS: A Novel MRI-Based Classification of Spontaneous Intracerebral Hemorrhage Associated With Cerebral Small Vessel Disease.

Neurology

January 2024

From the Departments of Neurology (M.B.G., M.M., B.M.S., T.R.M., L.C., M.A., U.F., D.J.S., W.J.Z.G.) and Neurosurgery (D.B., W.J.Z.G.), and the University Institute for Diagnostic and Interventional Neuroradiology (W.V., P.R., A.H., J.K., R.W.), Inselspital Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.G., B.M.S.) and CTU Bern (M.B.), University of Bern, Switzerland; Stroke Research Centre (M.B.G., W.Z., H.O., M.L., Y.D., D.J.W.), University College London Queen Square Institute of Neurology, United Kingdom; Service of Neurology (D.S.), Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Radiology (T.F.), Cantonal Hospital St. Gallen; Department of Internal Medicine (F.M.), Stroke Unit and Division of Neurology, HFR Fribourg-Cantonal Hospital; Stroke Center Hirslanden (N.P.), Klinik Hirslanden Zurich; Stroke Research Group (E.C.), Department of Clinical Neurosciences, University Hospital and Faculty of Medicine, Geneva; Department of Radiology and Medical Informatics (K.-O.L.), University of Geneva; Department of Radiology and Nuclear Medicine (G.M.K.), Luzerner Kantonsspital; Stroke Center EOC (C.W.C.), Neurocenter of Southern Switzerland; Stroke Unit (J.N.), GHOL, Hôpital de zone de Nyon; Stadtspitäler Triemli und Waid (M.-L.M.), Zurich; Department of Neurology (A.M., S.W.), University Hospital and University of Zurich; Department of Radiology and Nuclear Medicine (S.S.), Kantonsspital Winterthur; Department of Neurology and Stroke Center (A.A.P., V.A., M.K., U.F., L.H.B.) and Center for Rehabilitation Rheinfelden (L.H.B.), University Hospital Basel and University of Basel; Diagnostic and Interventional Neuroradiology (M.P.), Department of Radiology and Nuclear Medicine, University Hospital Basel; Department of Neurology (R.S.), Kantonsspital Graubünden, Chur; Department of Radiology/Neuroradiology (C.N.), Kantonsspital Graubünden, Chur; Department of Neurology (M.S.), and Department of Radiology (C.B.T.), Buergerspital Solothurn; Division of Neurology (S.R.), Pourtalès Hospital, Neuchâtel; Department of Radiology (K.M.K.), Réseau Hospitalier Neuchâtelois, Switzerland; Comprehensive Stroke Service (R.J.S., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair & Rehabilitation, University College London Hospital, United Kingdom; and New Zealand Brain Research Institute (D.W.), Christchurch.

Article Synopsis
  • Cerebral small vessel disease (SVD) is a key cause of intracerebral hemorrhage (ICH), and researchers created a new MRI-based classification system, known as CADMUS, to categorize ICH subtypes associated with SVD.
  • A retrospective study analyzed data from two patient cohorts to classify ICH types based on MRI findings, assessing reliability and tracking subsequent strokes or hemorrhages.
  • The findings revealed a diverse distribution of ICH phenotypes among patients, with the CADMUS classification showing good reliability and potential for enhancing clinical and research practices in identifying SVD-related ICH types.
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Article Synopsis
  • Alzheimer's disease is a significant health issue for older adults with Down syndrome, and typical diagnostic methods, like MRI, are often not suitable due to difficulties with prolonged scan times.
  • This study used automated analysis of CT scans from 98 individuals with Down syndrome to identify correlations between brain structure changes and the severity of dementia stages, alongside specific Alzheimer’s biomarkers.
  • The findings indicated that increased dementia severity was linked to reduced gray and white matter volumes in the temporal lobe, suggesting a promising new method for assessing Alzheimer’s in populations that struggle with traditional imaging techniques.
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Deep Brain Stimulation for Obsessive-Compulsive Disorder: Optimal Stimulation Sites.

Biol Psychiatry

July 2024

Center for Brain Circuit Therapeutics, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany; Einstein Center for Neurosciences Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany; Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.

Article Synopsis
  • Deep brain stimulation (DBS) is being explored as an effective treatment for severe obsessive-compulsive disorder (OCD), with various potential targets in the brain, especially around the anterior limb of the internal capsule and ventral striatum.
  • A study involving 82 OCD patients identified two key stimulation sites linked to significant symptom improvements: one near the anterior limb of the internal capsule and another near the inferior thalamic peduncle, while also showing that stimulation at certain locations can lead to better outcomes for depression and anxiety.
  • The findings suggest that refining the targeting of DBS could enhance treatment effectiveness and help optimize DBS programming for patients already receiving therapy.
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Low serum levels of 25-hydroxyvitamin D [25(OH)D] and low sunlight exposure are known risk factors for the development of multiple sclerosis. Add-on vitamin D supplementation trials in established multiple sclerosis have been inconclusive. The effects of vitamin D supplementation to prevent multiple sclerosis is unknown.

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Article Synopsis
  • Misdiagnosis of multiple sclerosis (MS) is a significant issue in clinical settings, prompting the need for better diagnostic tools to differentiate MS from other neurological conditions based on MRI findings.
  • A multicenter study analyzed MRI data of 1,051 participants, comparing cortical lesions (CLs) and the central vein sign (CVS) between those diagnosed with MS or clinically isolated syndrome (CIS) and individuals with non-MS conditions.
  • The study aimed to evaluate the effectiveness of CLs and CVS in diagnosing MS by calculating various performance metrics like sensitivity, specificity, and accuracy, while also comparing these new markers against conventional MRI features.
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The abnormal aggregation and accumulation of alpha-synuclein (aSyn) in the brain is a defining hallmark of synucleinopathies. Various aSyn conformations and post-translationally modified forms accumulate in pathological inclusions and vary in abundance among these disorders. Relying on antibodies that have not been assessed for their ability to detect the diverse forms of aSyn may lead to inaccurate estimations of aSyn pathology in human brains or disease models.

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Article Synopsis
  • Intracranial arterial dolichoectasia (IADE) is a common vascular condition that often occurs in large intracranial blood vessels and is linked to risk factors like high blood pressure, especially in ischemic stroke patients.
  • A systematic review and meta-analysis of studies examined the relationship between IADE and small vessel disease (CSVD) markers, analyzing data from six studies with over 6,100 ischemic stroke patients.
  • Results indicated that patients with IADE had significantly higher rates of CSVD markers—such as lacunes, cerebral microbleeds, and white matter hyperintensities—suggesting a need for further research to understand these connections and their implications for treatment.
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Purpose: We sought to delineate a multisystem disorder caused by recessive cysteine-rich with epidermal growth factor-like domains 1 (CRELD1) gene variants.

Methods: The impact of CRELD1 variants was characterized through an international collaboration utilizing next-generation DNA sequencing, gene knockdown, and protein overexpression in Xenopus tropicalis, and in vitro analysis of patient immune cells.

Results: Biallelic variants in CRELD1 were found in 18 participants from 14 families.

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Objective: Concern about climate change among the general public is acknowledged by surveys. The health care sector must play its part in reducing greenhouse gas emissions and adapting to a changing climate, which will require the support of its stakeholders including those with epilepsy, who may be especially vulnerable. It is important to understand this community's attitudes and concerns about climate change and societal responses.

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Introduction: Antiseizure medications (ASMs) and antipsychotic drugs are frequently coadministered with the potential for drug-drug interactions. Interactions may either be pharmacokinetic or pharmacodynamic, resulting in a decrease or increase in efficacy and/or an increase or decrease in adverse effects.

Areas Covered: The clinical evidence for pharmacokinetic and pharmacodynamic interactions between ASMs and antipsychotics is reviewed based on the results of a literature search in MEDLINE conducted in April 2023.

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Article Synopsis
  • - The study investigates the genetic factors affecting the long-term disease progression and severity of multiple sclerosis (MS) in a cohort of patients who have experienced clinically isolated syndrome (CIS) for 30 years.
  • - Over this period, patients underwent multiple assessments, and researchers analyzed the association of 27 genes with clinical outcomes like disability progression, relapse rates, and MRI findings, such as white matter lesions.
  • - Results showed that patients with certain genetic markers had worse clinical outcomes, including faster accumulation of white matter lesions and a greater increase in disability scores over the 30 years compared to those without these markers.
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Background And Purpose: Acute encephalitis is associated with psychiatric symptoms. Despite this, the extent of mental health problems following encephalitis has not been systematically reported.

Methods: We recruited adults who had been diagnosed with encephalitis of any aetiology to complete a web-based questionnaire.

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