JNNP Podcast

Neurocognitive and psychiatric effects after mild COVID-19: meta-analytic evidence

Thu, 04 Sep 2025 11:30:02 +0100

The meta‑analysis discussed in this podcast reveals that adults recovering from COVID‑19 without major medical or psychiatric complications experience mild yet statistically significant cognitive deficits - particularly in processing speed, attention, memory, language, and executive function.
However, as the main author of this paper tells podcast editor and host, Dr Saima Chaudhry, the impairments generally fall below the threshold for clinical concern, with no evidence of profound neuropsychological dysfunction.

Dr Saima Chaudhry is an assistant professor of neurology at the Warren Alpert Medical School, Brown University, Rhode Island, USA.
Dr Stephen Aita is a neuropsychologist in the Department of Neurology at the University of South Alabama, Whiddon College of Medicine, Mobile, Alabama, USA.

Read the paper on the JNNP website: Neurocognitive and psychiatric outcomes associated with postacute covid 19 infection (doi:10.1136/jnnp-2024-333950).

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Vestibular neurology for the generalist

Mon, 16 Jun 2025 09:31:16 +0100

This episode guides the general neurologist through diagnosing and treating dizziness, vertigo, and balance disorders.

Podcast editor and host, Dr Saima Chaudhry, interviews Dr Diego Kaski about his review titled, Vestibular neurology for the generalist. They cover common vestibular conditions, standard assessments, and new advances in genotyping and treatments, allowing a more accessible vestibular neurology.

Dr Saima Chaudhry is an assistant professor of neurology at the Warren Alpert Medical School, Brown University, Rhode Island, USA.
Dr Diego Kaski is a consultant neurologist at the National Hospital for Neurology and Neurosurgery, honorary associate professor at University College London, UK.

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Cyclophosphamide for myasthenia gravis: a comeback?

Thu, 17 Apr 2025 10:18:09 +0100

Patients with refractory or high-risk myasthenia gravis (MG) respond poorly to conventional immunosuppressive therapy, requiring rescue therapies and often experiencing treatment toxicity. The study discussed in this podcast suggests that lower doses of cyclophosphamide can be effective and safe in people with MG, including older age. JNNP's podcast editor, Saima Chaudhry, is joined by Professor Carolina Barnett-Tapia, University of Toronto, University Health Network, who authors the editorial comment 'Cyclophosphamide for myasthenia gravis: a comeback?'(https://jnnp.bmj.com/content/95/12/1095).
The original paper is also free to access: https://jnnp.bmj.com/content/95/12/1096.

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Management methods for acute ischaemic stroke

Thu, 13 Feb 2025 15:26:43 +0000

The effectiveness of endovascular treatment (EVT) in cases of acute ischaemic stroke caused by distal medium vessel occlusion (DMVO) is still unclear. A study in the JNNP assessed the safety and effectiveness of EVT in comparison to the best medical management for DMVO. Podcast host Dr. Saima Chaudhry¹ spoke to some of the paper's authors, Dr. Adam Dmytriw², Dr. Vivek Yedavalli³ and Dr. Hamza Salim³.

Read the paper: Endovascular therapy versus best medical management in distal medium middle cerebral artery acute ischaemic stroke: a multinational multicentre propensity score-matched study

1. Warren Alpert Medical School, Brown University, Rhode Island, USA

2. Neuroendovascular Program, Massachusetts General Hospital, Boston, Massachusetts, USA

3. Radiology, Johns Hopkins Medicine, Baltimore, Maryland, USA

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Distinguishing autoimmune nodopathies from CIDP, with Dr. Ruth Huizinga and Dr. Maarten Titulaer

Mon, 15 Jul 2024 11:03:16 +0100

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) can be difficult to distinguish from autoimmune nodopathy. In this podcast, Dr. Saima Chaudhry (1) is joined from the Netherlands by Dr. Ruth Huizinga (2) and Dr. Maarten Titulaer (3), to discuss their article, "Clinical relevance of distinguishing autoimmune nodopathies from CIDP: longitudinal assessment in a large cohort". They start with explaining what an autoimmune nodopathy really is, patient features to look out for, and the typical testing process for identifying CIDP.

(1) Warren Alpert Medical School, Brown University, Rhode Island, USA

(2) Department of Immunology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands

(3) Department of Neurology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands

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Nutritional peripheral neuropathies, with Dr. Alexander Rossor

Wed, 17 Apr 2024 05:00:00 +0100

The cause of a nutritional neuropathy may not always be obvious when first examining a patient. Restrictive diets with roots in religious practices or personal preferences will be less familiar to neurologists than issues involving bariatric surgery or diseases of malabsorption, and can present as being not overtly malnourished. A recent review in JNNP details links between B-vitamin deficiencies and peripheral neuropathy, and discusses historical trends in the occurrence of nutritional neuropathies. The review's last author, Dr. Alexander Rossor (1), joins host Dr. Saima Chaudhry (2) to talk through how to approach this diagnosis.

Read the paper here: "Nutritional peripheral neuropathies"

(1) UCL Queen Square Institute of Neurology, London, UK
(2) Warren Alpert Medical School, Brown University, Rhode Island, USA

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Distinguishing primary from functional tics

Mon, 19 Feb 2024 05:00:00 +0000

How often do movement disorder specialists agree when classifying tics? A recent study published in JNNP explores this question with a two-stage approach, seeking a diagnosis from experts first based on video evidence alone and then following the provision of additional clinical data. The study's last author, Dr. Christos Ganos (1), joins host Dr. Saima Chaudhry (2) to discuss the results.

Read the paper here: "Distinguishing functional from primary tics: a study of expert video assessments"

Nitrous Oxide Abuse

Fri, 22 Sep 2023 09:54:38 +0100

With the UK government announcing plans to make recreational use of nitrous oxide illegal, JNNP podcast host Dr. Saima Chaudhry (1) is joined by London-based neurologist Dr. Alastair Noyce (2)(3) to examine the findings of his group's recently published research paper, "Nitrous oxide-induced myeloneuropathy: a case series". Read the paper here: https://jnnp.bmj.com/content/94/9/681

Brain Fog Demystified

Tue, 08 Aug 2023 10:08:58 +0100

Social media platforms and clinical patient encounters are abundant in references to brain fog, but how much is it really understood? In this episode, JNNP's podcast host, Dr. Saima Chaudhry (1), speaks with Dr. Laura McWhirter (2) about her recently published article, "What is Brain Fog?"and how further understanding of this can help to better treat patients.

You can read the paper at the following link: https://jnnp.bmj.com/content/94/4/321

(1) Warren Alpert Medical School, Brown University, Rhode Island, USA

(2) Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK

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A roadmap to ALS prevention: strategies and priorities

Thu, 15 Jun 2023 16:07:32 +0100

In this episode, JNNP's new podcast host Dr. Saima Chaudhry (1) speaks with Dr. Michael Benatar (2) about his recently published article, "A roadmap to ALS prevention: strategies and priorities". This explores a new approach to Amyotrophic lateral sclerosis, with an emphasis on earlier treatment before significant damage has occurred. This is important due to the limited capacity of the central nervous system to repair itself. The researchers involved sought to understand contributing factors for ALS risk, and to identify high-risk groups for further study.

Note: The genetic therapy referred to as Tofersen, under review at the time of recording, has been approved by the FDA: https://www.fda.gov/drugs/news-events-human-drugs/fda-approves-treatment-amyotrophic-lateral-sclerosis-associated-mutation-sod1-gene

You can read the paper at the following link: https://jnnp.bmj.com/content/94/5/399

(1) Warren Alpert Medical School, Brown University, Rhode Island, USA

(2) Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA

Please subscribe to the show on Apple Podcasts, Spotify or find it on your platform of choice. Your feedback and reviews are very appreciated.

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MOGAD: Definition, diagnosis and treatment

Mon, 15 May 2023 12:12:00 +0100

In this episode, JNNP's new podcast host Dr. Saima Chaudhry (1) speaks with Dr. Matteo Gastaldi (2) about Myelin oligodendrocyte glycoprotein antibody-associated disease, or MOGAD for short. A multi-centre retrospective study, "Prognostic relevance of quantitative and longitudinal MOG antibody testing in patients with MOGAD", was recently published in JNNP, and Dr. Gastaldi is its first author. Listen to this podcast to learn what MOGAD is, its differential diagnosis and the potential pathogenesis. Plus some discussion of the use of MOG titres in predicting relapse of the disease. You can read the paper at the following link: https://jnnp.bmj.com/content/94/3/201
(1) Warren Alpert Medical School, Brown University, Rhode Island, USA (2) Neuroimmunology Research Unit, IRCCS Mondino Foundation, Pavia, Italy Please subscribe to the show on Apple Podcasts, Spotify or find it on your platform of choice. Your feedback and reviews are very appreciated.

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CGRP in migraine: current therapeutics, future implications and potential off-target effects

Tue, 21 Dec 2021 19:33:00 +0000

In this podcast, JNNP's Podcast Editor, Colin Mahoney, interviews Dr Jason Ray (Neurology, Alfred Health, and Department of Neuroscience, Monash University, Melbourne). Dr Ray discusses the role of calcitonin gene related peptide in migraine and the growing body of evidence for the role of therapies directed against this protein in migraine and beyond. He also highlights emerging off-target side effects to monitor for.

Related article: https://jnnp.bmj.com/content/92/12/1325

Alemtuzumab’s impact on functional and structural integrity of the visual system in MS

Wed, 17 Nov 2021 16:09:00 +0000

Prof Michael Barnett, Director Sydney Neuroimaging Analysis Centre and Professor of Neurology, University of Sydney, joins JNNP's Podcast Editor, Colin Mahoney, to discuss how the use of Alemtuzumab may have longer-term impacts on improving one of the most commonly involved neurological pathways, the visual system, in multiple sclerosis (MS). Prof Barnett discusses his team's results after following up patients with highly active MS for 24 months, using multifocal visual evoked potentials and advanced neuroimaging. He also talks about what this means for future remyelination strategies.

Related paper: https://jnnp.bmj.com/content/92/12/1319

Guidelines for the management of functional speech and communication disorders

Mon, 27 Sep 2021 11:56:00 +0100

A/Prof Jan Baker, Speech Pathologist, Flinders University and UTS. Dr Laura McWhirter, University of Edinburgh joins editor Colin Mahoney to discuss the first comprehensive guidelines developed to assist speech and language professionals in the management of functional communication, voice, swallow and cough disorders. As part of a global team they have developed a set of clinically focused guidelines in the recognition and management of theses disorders and discuss the highlights on the Podcast. https://jnnp.bmj.com/content/92/10/1112

The impact of traumatic brain injury on neurocognitive outcomes in children

Tue, 31 Aug 2021 07:58:00 +0100

Mark Goh and Shu-Ling Chong, Duke-NUS Medical School and KK Women's and Children's Hospital, Singapore joins editor Colin Mahoney to discuss their systematic review and meta-analysis spanning 6000 articles dealing with neurocognitive outcomes following traumatic brain injury (TBI) in children. They highlight how dose of TBI impacts executive function and memory with potentially long term impacts. https://jnnp.bmj.com/content/92/8/847

Cerebral Microbleeds: from depiction to interpretation

Mon, 05 Jul 2021 10:58:00 +0100

Cerebral Microbleeds are increasingly recognised due to increased availability of neuroimaging and are known to be associated with increased risk of stroke, in particular intracerebral haemorrhage. In this podcast Dr Laurent Puy joins editor Colin Mahoney to discuss their histopathology, epidemiology and impact on clinical decision making in a state-of-the-art review published in June's JNNP.

https://jnnp.bmj.com/content/92/6/598

Motor functional neurological disease, a decade of progress

Fri, 25 Jun 2021 07:31:00 +0100

Over the last ten years, huge progress has been made in the common but often poorly understood condition of motor Functional Neurological Disorder (mFND). In this podcast, Dr W. Curt La France, Jr., Professor of Neurology and Psychiatry, Brown University, USA, joins editor Colin Mahoney to discuss diagnosis, insights on disease mechanisms, and emerging therapeutic approaches. They also highlight the stigma associated with mFND and ways to improve outcomes for patients.

Read the paper on the JNNP website and the journal's June issue: https://jnnp.bmj.com/content/92/6/668

COVID - 19 Vaccination and risk of large vessel arterial stroke

Thu, 03 Jun 2021 08:24:00 +0100

The Oxford Astra Zeneca vaccine has been associated with a rare complication of cerebral venous sinus thrombosis. Dr Colin Mahoney, JNNP Podcast Editor, interviews Prof David Werring, Professor of Clinical Neurology, UCL Queen Square Institute of Neurology, UK, about the new evidence which supports an association between vaccination and more common large vessel arterial stroke. They also discuss several cases, including treatment, and emerging biological evidence relating to causation. Read the paper "Ischaemic stroke as a presenting feature of ChAdOx1 nCoV-19 vaccine-induced immune thrombotic thrombocytopaenia", on the JNNP website: https://jnnp.bmj.com/content/early/2021/05/20/jnnp-2021-326984.

Related editorial paper: https://jnnp.bmj.com/content/early/2021/05/20/jnnp-2021-327057

Drug repurposing for progressive multiple sclerosis

Tue, 02 Mar 2021 08:44:00 +0000

Prof Alaisdair Coles and Dr Nick Cunniffe, The University of Cambridge joins editor Colin Mahoney to discuss:

The work carried out by a team of researchers alongside the MS Society in the United Kingdom. The authors discuss the process of identifying therapies to repurpose in future MS trials and why they think this drugs may work. https://jnnp.bmj.com/content/92/3/295

Isaacs syndrome the crossroads of Neurology, Psychiatry and Immunology

Wed, 25 Nov 2020 11:48:00 +0000

Rick Thurbon, patient editorial board member. Prof Matthew Kiernan and A/Prof Susanna Park from The University of Sydney joins editor Colin Mahoney to discuss:

In 1960 a landmark paper was published by Hyam Isaac on a syndrome of continuous muscle activity. The spectrum of Isaac's Syndrome has broadly widened since then and we reflect on this with patients and experts in this field. https://jnnp.bmj.com/content/91/12/1243

Apathy, cerebral small vessel disease and future dementia risk

Mon, 28 Sep 2020 12:18:00 +0100

Jonathan Tay joins our podcast editor Colin Mahoney to discuss the findings from two large cohort studies of cerebral small vessel disease, highlighting the fact that apathy can predict future dementia risk in these patients. https://jnnp.bmj.com/content/91/9/953

Performance validity tests - Their role in neuropsychology assessments

Mon, 14 Sep 2020 11:39:00 +0100

Dr Laura Mc Whirter joins our podcast editor Colin Mahoney to discuss her recent systematic review of performance validity tests used across a range of neurological and psychiatric disorders. Are these tests useful and which conditions are the most likely to be helpful in. Join us to find out. https://jnnp.bmj.com/content/91/9/945

Parkinson’s disease: etiopathogenesis and treatment

Tue, 18 Aug 2020 08:59:00 +0100

Prof Joseph Jankovic, Distinguished Chair in Movement Disorders, Baylor College of Medicine joins Podcast editor Colin Mahoney.

Prof Jankovic provides a historical look back on the key developments in our understanding of the causes of Parkinson's disease and key treatments. https://jnnp.bmj.com/content/91/8/795

Outcome measurement in functional neurological disorder a systematic review and recommendations

Mon, 20 Jul 2020 09:45:00 +0100

Dr Timothy Nicholson joins Podcast editor Colin Mahoney to discuss their recent systematic review of outcome measures used across the spectrum of functional neurological disorders. As well as identifying key domains for assessment he also discusses the challenges and future directions in developing more rigorous validated outcome measures for these increasingly recognised disorders. https://jnnp.bmj.com/content/91/6/638

Clinical profiles of patients with dementia and chronic traumatic encephalopathy

Mon, 22 Jun 2020 11:21:00 +0100

Dr Christian Lobue, lead author joins Podcast Editor Colin Mahoney to discuss his original research which examines the clinical, neuropsychological and neuropsychiatric features of those with confirmed chronic traumatic encephalopathy (CTE) at autopsy. He compares the features with patients with CTE and those with Alzheimer's disease. https://jnnp.bmj.com/content/91/6/586

Visual hallucinations in neurological and ophthalmological disease

Wed, 27 May 2020 09:43:00 +0100

Prof John O'Brien (University of Cambridge) and Dr Dominic Ffytche (Kings College London) join Dr Colin Mahoney (Podcast Editor)

Visual hallucinations have complex origins and can have significant impact on patients. The recent UK based SHAPED consortium has aimed to design a common framework for assessment, management and research in this area. John O'Brien and Dominic Ffytche discuss disorders which cause visual hallucinations as well as their pathobiology and management in this Podcast: https://jnnp.bmj.com/content/91/5/512

Primary Lateral Sclerosis: new consensus criteria

Tue, 12 May 2020 08:28:00 +0100

Prof Martin Turner, University of Oxford, joins Dr Colin Mahoney to discuss the newest consensus clinical criteria to aid in the diagnosis of Primary Lateral Sclerosis. This will enable neurologists to make the diagnosis sooner and will be important in the design of future treatment

trials. https://jnnp.bmj.com/content/91/4/373

Neurology in the time of COVID - 19

Mon, 04 May 2020 17:08:00 +0100

Dr Hadi Manji joins Colin Mahoney to discuss the recent paper by Liu and colleagues as well as providing a commentary on how COVID-19 may impact the nervous system and steps to mitigate this. He also discusses the impact of COVID-19 in delivering care at the

National Hospital for Neurology and Neurosurgery, located in one of the new epicentres for this disease. https://jnnp.bmj.com/content/early/2020/04/20/jnnp-2020-323414

Lithium: a slow burner

Mon, 20 Apr 2020 09:14:00 +0100

Prof Andrew Lees, Professor of Neurology National Hospital for Neurology and Neurosurgery. Colin Mahoney JNNP Podcast Editor As part of our 2020 Vision centenary Prof Andrew Lees reviews how Lithium (eventually) became established in the treatment of psychiatric illness, reviewing the 1954 paper by Schou and colleagues.

https://jnnp.bmj.com/content/jnnp/91/4/335.full

Plasma glial fibrillary acidic protein is raised in progranulin-associated frontotemporal dementia

Thu, 26 Mar 2020 09:02:00 +0000

Colin Mahoney, JNNP Podcast editor, is joined by Dr Jonathan Rohrer, MRC Clinician Scientist, Dementia Research Centre, UCL Institute of Neurology. Carolin Heller, Dementia Research Centre and UK Dementia Research Institute. to discuss how increased levels of GFAP may be used to detect advancing neurodegeneration and clinical change in those with Progranulin associated Frontotemporal Dementia. https://jnnp.bmj.com/content/91/3/263

Multifocal motor neuropathy: controversies and priorities

Thu, 05 Mar 2020 14:15:00 +0000

Prof Bruce Taylor, Menzies Institute for Medical Research, University of Tasmania and Dr Colin Mahoney JNNP Podcast editor

Prof Bruce Taylor joins our podcast editor Colin Mahoney to discuss recent advances in the diagnosis and management of multifactorial neuropathy. They discuss the current state-of-the art on pathogenesis, new diagnostic approaches and management. https://jnnp.bmj.com/content/91/2/140.info

Multiple Systems Atrophy: the nature of the beast revisited

Wed, 12 Feb 2020 10:11:00 +0000

As part of our 2020 Vision Series reviewing the most seminal papers in JNNP's past Prof Niall Quinn, joins Colin Mahoney to discuss his 1989 paper which provided the first clinical criteria for MSA. He discusses how the last 30 years of science has shaped this original work, and he also shares his experiences of his mentor Prof David Marsden who previously served as the editor of JNNP. https://jnnp.bmj.com/content/91/1/3

Employment and MS - a patient’s perspective

Wed, 15 Jan 2020 10:34:00 +0000

Sharon Roman, a patient advocate who suffers with Multiple Sclerosis, discusses the complexities of measures of disease activity and employment in MS. https://jnnp.bmj.com/content/91/1/5

Approaches to Chemotherapy induced peripheral neurotoxicity

Mon, 02 Dec 2019 09:29:00 +0000

Dr Susanna Park joins Colin Mahoney to discuss neurophysiological, imaging and other methods to study an increasingly recognised problem of chemotherapy induced peripheral neurotoxicity. Dr Park outlines the pathology and current techniques to diagnose and monitor this problem, and outline new areas of research as well as recommendations from the Toxic Neuropathy Consortium to improve clinical care and research in this area.

https://jnnp.bmj.com/content/90/12/1361

Neural circuitry of anxiety

Mon, 18 Nov 2019 10:22:00 +0000

Dr Oliver Robinson joins Colin Mahoney to discuss the neural circuitry of anxiety, outlining our current understanding the anatomical basis for anxiety, as well as paradigms used to explore the shared circuits which lead to pathological levels of anxiety. Dr Robinson also outlines the future research goals in this important area.

https://jnnp.bmj.com/content/90/12/1353

Dementia after traumatic brain injury

Wed, 30 Oct 2019 08:31:00 +0000

Dr Neil Graham and Prof David Sharp, from Imperial College London, discuss the interaction between traumatic brain injury and dementia. They outline the epidemiology, pathogenesis and emerging biomarkers in an area which is seeing increased attention. Read the full paper here: https://jnnp.bmj.com/content/90/11/1221.long

Mindfullness in multiple sclerosis

Fri, 27 Sep 2019 14:37:00 +0100

Dr Robert Simpson (University of Glasgow, UK) discusses the merits and limitations of mindfullness based treatments for mental well-being in Multiple Sclerosis (MS). Read the full paper here: https://jnnp.bmj.com/content/90/9/1051

CIDP an update

Wed, 11 Sep 2019 10:37:00 +0100

Professor Helmar Lehmann (University Hospital of Cologne) provides an update on Chronic inflammatory demyelinating polyneuropathy (CIDP) and discusses recent advances in diagnosis and treatment. Read the full paper here: https://jnnp.bmj.com/content/90/9/981.long

Movement disorders and seizures

Thu, 15 Aug 2019 10:05:00 +0100

Elizabeth Highton (podcast editor) is joined by Professor Alfonso Fasano (Toronto Western Hospital, Ontario, Canada) to discuss the overlapping phenomenology and diagnostic challenges in movement disorders and seizures. Read the paper here: https://jnnp.bmj.com/content/90/8/920.long

The role of functional neuroimaging in functional neurological disorders

Wed, 31 Jul 2019 09:27:00 +0100

Dr. David Perez (Massachusetts General Hospital, USA) speaks with JNNP Podcast Editor, Elizabeth Highton about stepwise functional connectivity, a novel brain imaging technique, and how it might help us better understand the biology of functional neurological disorders. Read this month's Patient's Choice article here: https://jnnp.bmj.com/content/90/8/929

Emotional processing in functional neurological disorder (FND)

Wed, 12 Jun 2019 10:24:00 +0100

Dr. Susannah Pick (King’s College London, UK) discusses emotional processing in functional neurological disorder, and how further understand of emotional processing deficits may help contribute to a unified explanatory model for FND.

Can cocoa help with fatigue in MS

Tue, 28 May 2019 12:11:00 +0100

Dr Shelly Coe (Oxford Brookes University, Oxford) discusses a new randomized control trial looking at the use of cocoa for management of fatigue in multiple sclerosis. Read the full paper here: https://jnnp.bmj.com/content/90/5/507

Neurorehabilitation in chronic stroke

Wed, 08 May 2019 09:52:00 +0100

JNNP Associate Editor, Professor Nick Ward (Queens Square, London) tells us all about the Queen Square Upper Limb Neurorehabilitation programme, and specifically, what clinical gains in chronic stroke patients were observed after high intensity neurorehabilitation. Read the full paper here:

https://jnnp.bmj.com/content/90/5/498

The real patient value

Thu, 18 Apr 2019 10:38:00 +0100

The JNNP recently launched the patient editorial board in an effort to drive more meaningful patient outcomes. One of our newly appointment board members, Sharon Roman (Vancouver Canada) discusses why she believes the patient perspective leads to better healthcare and what the patient partnership looks like at the JNNP. Read Sharon’s editorial here: https://jnnp.bmj.com/content/jnnp/90/4/371.full.pdf

Medical conferences - what do we get out of them?

Thu, 04 Apr 2019 10:33:00 +0100

A special edition podcast - based on an essay discussing the value of medical conferences and whether it is time to consider what is gained from these events, and for whom. Emeritus Professor Michael Swash (The Royal London Hospital and Barts and the London School of Medicine) joins Elizabeth Highton to discuss the merits of the medical congress. Read the commentary here: https://jnnp.bmj.com/content/early/2018/10/18/jnnp-2018-319248

Oral immunotherapies in MS a comparison of efficacy.

Mon, 25 Mar 2019 10:03:00 +0000

Associate Professor Tomas Kalincik (University of Melbourne, Australia) discusses oral immunotherapies, and what we know about the effects of these treatments on patient relapse and disability. Read the full paper here: https://jnnp.bmj.com/content/early/2019/01/12/jnnp-2018-319831

Therapeutic trial design in frontotemporal dementias

Wed, 20 Mar 2019 10:25:00 +0000

Editor’s Choice: Associate Professor Dr Mario Masellis (University of Toronto) and Assistant Professor Philippe Desmarais (University of Montreal) discuss the complexities of designing trials in frontotemporal dementia (FTD) and how precision medicine might help disentangle this Gordian knot in the future. Read the full paper here: https://jnnp.bmj.com/content/jnnp/early/2018/11/01/jnnp-2018-318603.full.pdf

Do genes affect age of onset in ALS?

Mon, 11 Mar 2019 09:57:00 +0000

Professor Ammar Al-Chalabi (King’s College London, London, UK) joins Elizabeth Highton (podcast editor) to discuss motor neurone disease, also known as amyotrophic lateral sclerosis or ALS, a rapidly progressive illness resulting from the degeneration of both upper and lower motor neurons. Studies have shown that age of onset is younger in people with a family history – but it this due to a heightened knowledge of the disease or due to genetics lowering the age of onset? Read the full paper here: https://jnnp.bmj.com/content/jnnp/90/3/268.

The lifetime risk of common neurological disorders in the elderly population

Mon, 18 Feb 2019 11:12:00 +0000

We have a good understanding of our risk of developing cancer or heart disease – but what do we know about the risk of developing a common neurological disorder in later-life? Dr. Silvan Licher (Department of Epidemiology, University Medical Center Rotterdam, Netherlands) discusses the lifetime risk of developing dementia, stroke, and Parkinson’s disease, and how we need to better prioritise preventive interventions. Read the full paper here: https://jnnp.bmj.com/content/jnnp/90/2/148.full.pdf

PMA and PLS: are they really restricted phenotypes?

Mon, 04 Feb 2019 14:11:00 +0000

Dr. Michael van Es (University Medical Center Utrecht, Netherlands) examines whether cognitive and behavioural changes can be seen across the motor neurone disease spectrum, and how this helps inform our understanding of these as multidimensional diseases. Read the editorial commentary by Professor Martin Turner here: https://jnnp.bmj.com/content/90/2/122

Statins and the risk of recurrent intracerebral haemorrhage (ICH) – what does the evidence say?

Mon, 21 Jan 2019 11:49:00 +0000

Do statins increase the risk of intracerebral haemorrhage (ICH) in patients with a previous stroke? Professor David Werring (Stroke Research Centre, UCL Institute Of Neurology, Queen Square, London, UK) joins Elizabeth Highton (JNNP podcast editor) for the first JNNP podcast of 2019. Read the full paper here: https://jnnp.bmj.com/content/90/1/75

Functional impairment and improvement

Mon, 10 Dec 2018 11:06:00 +0000

Elizabeth Highton (podcast editor) hosts the final JNNP podcast for 2018, an episode on functional improvement after stroke (Dr. Aravind Ganesh, University of Oxford, UK- https://jnnp.bmj.com/content/89/12/1301) and cognitive impairment in functional neurological disorders (Dr. Jeremy Isaacs (St George’s University and Hospital, London, UK - https://jnnp.bmj.com/content/89/12/1308).

Can computational models help us understand complex movement disorders?

Mon, 29 Oct 2018 09:52:00 +0000

Professor Mark Humphries (University of Nottingham, UK) discusses how computational modelling could be a crucial tool in untangling the complexities of diseases like Parkinson’s disease. Can this type of modelling help us understand causes, and eventually lead to treatment options? Read the full paper here: https://jnnp.bmj.com/content/early/2018/04/17/jnnp-2017-315922.long

Idiopathic intracranial hypertension: guidelines for diagnosis and management

Mon, 08 Oct 2018 11:08:00 +0100

In collaboration with many different specialists, professions and patient representatives, Mollan et al (2018) have developed the first ever guidelines for the investigation and management of idiopathic intracranial hypertension (IIH). Senior author, Dr Alexandra Sinclair (University of Birmingham) discusses these with the JNNP podcast editor, Elizabeth Highton. Read the full guidelines here: https://jnnp.bmj.com/content/89/10/1088 Access the Practical Neurology infographic summary here: https://pn.bmj.com/content/early/2018/08/28/practneurol-2018-002009

Nusinersen for SMA

Wed, 29 Aug 2018 11:29:00 +0100

Elizabeth Highton (JNNP Podcast Editor) speaks with Dr. Michelle Farrar (University of New South Wales) discussing nusinersen, the first disease-modifying therapy for spinal muscular atrophy type 1 (SMA). https://jnnp.bmj.com/content/89/9/937

Expanding clinical spectrums in both Kennedy’s disease and poststroke syndromes

Mon, 06 Aug 2018 11:08:00 +0100

Dr. Carlo Rinaldi (University of Oxford) discusses how the traditional view of Kennedy’s disease is evolving, to extend beyond pure motor symptoms. What non-motor features may be present in Kennedy's, and crucially how do they impact on patient's care and management? Read the full paper here: https://jnnp.bmj.com/content/89/8/808. Helle Stangeland and Vaughan Bell join us to discuss a much overlooked clinical syndrome in stroke: poststroke psychosis. Just how often does it occur and how can it be treated? Read their systematic review here: https://jnnp.bmj.com/content/89/8/879.

The use of cannabis in epilepsy, and surgery for tremor

Mon, 02 Jul 2018 14:20:00 +0100

Around 20-30% of patients with epilepsy can demonstrate resistance to commonly used medications. Cannabidiol (CBD) is a compound found in cannabis, which can be used for the treatment of epilepsy, shown to actively modulate seizure activity. Dr Emily Stockings (University of New South Wales in Sydney, Australia ) outlines how CBD can be helpful for patients with drug-resistant epilepsy. Read the full paper here: http://jnnp.bmj.com/content/89/7/741.long

Dr Georg Kaji (Kantonsspital, St.Gallen, Switzerland) provides a historical overview of surgical techniques and incisionless interventions for tremor – how have interventions changed over time? Read the full paper here: http://jnnp.bmj.com/content/89/7/727.long

Epilepsy an evidence update

Thu, 31 May 2018 09:13:00 +0100

Is the mesial temporal lobe the seat of psychosis in epilepsy? James Allebone (University of Melbourne, Australia) discusses what neuroimaging can tell us about psychosis in epilepsy. Read the paper here: http://jnnp.bmj.com/content/89/6/611.

Patients with epilepsy are often not permitted to drive, but can this change after surgery? Professor John Duncan (University College London, UK) provides a crucial update on measuring relative risk of seizures following epilepsy surgery, and how this impacts on UK driving regulations. Read the paper here: http://jnnp.bmj.com/content/89/6/599

Evolution or revolution? Should we re-think clinical practice?

Mon, 30 Apr 2018 14:37:00 +0100

Do old habits of screening for potassium channel antibodies stand up to scrutiny? Should clinical neurologists focus on screening for LGI1 and CASPR2 antibodies? Professor Sarosh Irani (John Radcliffe Hospital, Oxford) discusses antibody testing, and whether recent evidence calls for a revolution of clinical practice. Read the full paper here: http://jnnp.bmj.com/content/89/5/526.

In the second half of this podcast, Professor Ryuji Kaji (Tokushima University, Japan) discusses the pathogenesis of dystonia (uncontrolled movements). Is it a basal ganglia or cerebellar disorder? Or both? Read the full paper here: http://jnnp.bmj.com/content/89/5/488.

The Use of Frankincense Extract In MS

Wed, 04 Apr 2018 13:44:00 +0100

Patients with multiple sclerosis (MS) often show interest in complementary and alternative medicines, particularly when on long-term anti-inflammatory treatments. Is frankincense a safe and tolerable treatment? Dr Klarissa Stürner (Christian-Albrechts University, Kiel) discuss the pilot trial (conducted at the Institute of Neuroimmunology and Multiple Sclerosis, Hamburg). Read the paper here: http://jnnp.bmj.com/content/89/4/330.long

Read the editorial here: http://jnnp.bmj.com/content/89/4/327

A new questionnaire to measure quality of life in inflammatory neuropathies

Wed, 07 Mar 2018 12:39:00 +0000

Quality of life (QoL) is one of the most important outcomes for chronic diseases, although it remains remarkably difficult to quantify. Dr. Thomas Draak (Maastricht University, The Netherlands) discusses his new questionnaire, and how it aims to capture the patient’s perspective. Read the full paper here:

http://jnnp.bmj.com/content/jnnp/early/2017/11/24/jnnp-2017-316634.full.pdf

Marriage and a reduced risk of dementia

Wed, 28 Feb 2018 13:14:00 +0000

Recent research has indicated that being married is associated with a reduced risk of dementia. What is it about marriage? Dr Andrew Sommerlad (University College London) discusses this question and more. Read the full paper here: http://jnnp.bmj.com/content/early/2017/10/30/jnnp-2017-316274

Anti-inflammatory approaches to stroke prevention; monitoring disease progression in ALS

Thu, 08 Feb 2018 13:19:00 +0000

Atherosclerosis is a major contributor to increased risk of stroke. Our patient’s choice, Professor Peter Kelly (University College Dublin, Dublin, Ireland) discusses the evidence base implicating inflammation as a key process in the pathogenesis of atherosclerosis, leading to thromboembolic events. Read the full paper here: http://jnnp.bmj.com/content/89/2/211.

How do you measure disease progression in a highly variable and heterogeneous clinical population, such as amyotrophic lateral sclerosis (ALS)? Can plasma creatinine act as a robust surrogate biomarker in clinical trials? Dr. Ruben P A van Eijk (University Medical Center, Utrecht, The Netherlands) discusses this month’s editor’s choice. Read the full paper here: http://jnnp.bmj.com/content/89/2/156.

Nodes and paranodes; alternative treatments in MS

Fri, 26 Jan 2018 01:25:00 +0000

People with multiple sclerosis (MS) use complementary and alternative treatments (CAM), but what does the evidence say? Patient’s Choice, Professor Bruce Taylor (University of Tasmania) discusses the modern evidence for CAM use. Read the paper here: http://jnnp.bmj.com/content/89/1/34. What roles do nodes and paranodes play in complex neuropathies? Dr Simon Rinaldi (University of Oxford) summarises the involvement of these specialised domains as this month’s Editor’s Choice. Read the full paper here: http://jnnp.bmj.com/content/89/1/61.

Read the JNNP's January 2018 issue here: http://jnnp.bmj.com/content/89/1.

Pathophysiology of functional neurological disorder

Wed, 13 Dec 2017 11:26:00 +0000

Despite the prevalence of the disease, neurologists and psychiatrists can be wary of treating patients with functional neurological disorder (FND). Assistant Professor David Perez (Massachusetts General Hospital, USA) discusses how FND sits between neurological and psychiatric disciplines, the relationship between poor health status and affective symptoms, and associations with grey matter volumetric profiles. Read more here: http://jnnp.bmj.com/content/88/12/1052.

Is methamphetamine use linked to stroke in young adults?

Tue, 28 Nov 2017 10:32:00 +0000

Is methamphetamine use linked to strokes in young adults? Important clinical implications discussed by Dr. Julia Lappin (University of New South Wales) in this month’s JNNP podcast.

http://jnnp.bmj.com/content/88/12/1079

Cerebral Amyloid Angiopathy: New Insights For Clinical Practice

Wed, 08 Nov 2017 09:35:00 +0000

Cerebral amyloid angiopathy (CAA) has been gaining attention over the past few years, thanks to increased research in the field. Professor David Werring (UCL Institute of Neurology, Queens Square, London) discusses the recent advances in biomarkers analysis, as well as providing an overview of the clinical spectrum of CAA. Read the full paper here: http://jnnp.bmj.com/content/early/2017/08/26/jnnp-2016-314697

Cortical Influences in ALS

Tue, 31 Oct 2017 08:30:00 +0000

Professor Emeritus Andrew Eisen (University of British Columbia, Canada) discusses the theory of corticofugal primary in amyotrophic lateral sclerosis. ALS can be viewed as a primarily human disorder mediated by corticomotorneuronal pathways, originating in the cerebral cortex. Read the full paper here: http://jnnp.bmj.com/content/88/11/917.

Intravenous immunoglobulin in CIDP

Mon, 23 Oct 2017 11:04:00 +0100

Can IViG be used as a longer term maintenance therapy for CIDP patients? JNNP Associate Editor, Professor Satoshi Kuwabara (Chiba University Hospital, Japan) joins us for this podcast, discussing recent trial results and their implications for patient care. Read the full paper here: http://jnnp.bmj.com/content/88/10/832

Complex inherited neuropathies: a new approach to diagnosis?

Wed, 18 Oct 2017 09:18:00 +0100

Professor Mary Reilly (Institute of Neurology, Queens Square, London) discusses how complex inherited neuropathies can be a daunting diagnosis for clinicians. However, through exciting advances in next generation sequencing and knowledge of distinct syndromic categories, a new diagnostic approach emerges. Her review and her interview provide excellent over of this new approach, and how it may serve as a resource for clinicians. Link to paper here: http://dx.doi.org/10.1136/jnnp-2016-313960.

Cerebellum and neurodegeneration; autoantibodies and psychological development in children

Mon, 04 Sep 2017 23:37:00 +0100

The September 2017's JNNP podcast is a double episode. The first conversation is with Professor Michael Hornberger from the Norwich Medical School, University of East Anglia, UK. The cerebellum is often overlooked when looking at neurodegenerative diseases, a practice which Professor Hornberger and his team are challenging. Their recent JNNP paper looks at patterns of grey matter atrophy in the cerebellum across neurodegenerative diseases. What they found may surprise some listeners. Read the paper here: http://jnnp.bmj.com/content/88/9/780.

Elizabeth also speaks with Dr Ester Coutinho from the Nuffield Department of Clinical Neurosciences, University of Oxford, UK. Dr Coutinho & colleagues have been looking into maternal transfer of autoantibodies during pregnancy. In particular, their research has focused on antibodies which may be linked to disorders of psychological development in children. Read the paper here: http://jnnp.bmj.com/content/88/9/718.

Time Matters - part 2: how the real costs of multiple sclerosis are being concealed

Mon, 07 Aug 2017 18:29:00 +0100

“Take a comprehensive economic approach to evaluating treatment cost-effectiveness in MS”. Jacqueline Palace (Consultant Neurologist, Nuffield Department of Clinical Neurosciences, University of Oxford) and Ruth Geraldes (Neurologist, Department of Clinical Neurosciences, University of Oxford) examine the economic burden of multiple sclerosis, which was debated at the international roundtable “Time Matters in MS”, organised by the BMJ and the JNNP on World MS Day 2017, in Lisbon. Read more, watch the videos and access all the information about the event on the JNNP's website special page: jnnp.bmj.com/pages/time-matters-in-ms/.

“Time Matters in preventing disabilities from MS” was supported by an unrestricted educational grant from F. Hoffmann-La Roche and Roche Farmacêutica e Química.

Survival and cause of death in Multiple Sclerosis

Wed, 19 Jul 2017 09:20:00 +0100

There has been an increase in life expectancies for the general population over the last few decades. A similar trend has also been identified in patients with Multiple Sclerosis (MS). To investigate this trend further, Dr Lunde and colleagues, from the Norwegian Multiple Sclerosis Competence Centre, investigated survival and cause of death in an MS cohort.

Dr Lunde discusses the findings with Elizabeth Highton in the August 2017's JNNP podcast. Download the paper here: http://jnnp.bmj.com/content/88/8/621.

Time Matters - part 1: delay is “expensive” in all aspects of multiple sclerosis

Mon, 10 Jul 2017 11:51:00 +0100

Professor Emeritus Alastair Compston (University of Cambridge) discusses with JNNP’s Publisher Janet O'Flaherty the issues raised by the discussion “Brain health matters in multiple sclerosis” (MS), which was part of the international roundtable “Time Matters in MS”, organised by the BMJ and the JNNP on World MS Day 2017, in Lisbon. Read more, watch the videos and access all the information about the event on the JNNP's website special page: http://jnnp.bmj.com/pages/time-matters-in-ms/.

“Time Matters in preventing disabilities from MS” was supported by an unrestricted educational grant from F. Hoffmann-La Roche and Roche Farmacêutica e Química.

Seven tesla MRI In Neurodegenerative Dementias

Fri, 16 Jun 2017 08:17:00 +0100

MRI is an important clinical tool to study dementia symptoms in vivo. However, certain pathologies (microbleeds, plaques, tangles) can evade current imaging techniques. Seven tesla (7T) MRI provides a potentially exciting new opportunity to visualise these pathologies in vivo. Dr. Elizabeth McKiernan (University of Cambridge) discusses the literature around 7T MRI, and its scope in neurodegenerative dementias.

Read the review in the JNNP website: http://jnnp.bmj.com/content/early/2017/03/03/jnnp-2016-315022.

Conversational Laughter In Dementia

Fri, 05 May 2017 09:26:00 +0100

Laughter serves a fundamental social purpose, the appropriate use of which requires recognition of social norms. So what happens when these interpersonal abilities are affected, such as in the frontotemporal dementias? Does use of laughter change too? Dr Peter Pressman (Rocky Mountain Alzheimer’s Disease Center, University of Colorado, USA) talks to Elizabeth Highton about observing conversational laughter in frontotemporal dementia. This paper was chosen for this month’s Editor’s Choice and can be found here: http://jnnp.bmj.com/content/88/5/418.

Narrative and Neurology: The Andrew Lees Experiment

Thu, 06 Apr 2017 17:42:00 +0100

Professor Andrew Lees discusses his book "Mentored by a Madman: The William Burroughs Experiment" with Dr Sean O’Sullivan and Elizabeth Highton. Andrew speaks to the importance of looking beyond one’s area of expertise for mentorship, the relationship between art and science in neurology, Parkinson's disease and how William Burroughs played an unlikely role in his own medical career.

You can read Sean O’Sullivan’s review of the book on the JNNP website: http://jnnp.bmj.com/content/88/3/280.

April 2017: deconstructing dilemmas in Amyotrophic Lateral Sclerosis and Guillain-Barré Syndrome

Mon, 27 Mar 2017 12:43:00 +0100

Both patient and editor's choices are discussed in this monthly episode of the JNNP podcast. The clinical care of patients with Guillain-Barré syndrome (GBS) can often be complex; a disease with a highly variable clinical course. Professor Bart Jacobs, from the Department of Neurology at Erasmus Medical Centre (Rotterdam) provides an overview of some of the dilemmas that may arise when treating patients with GBS. The full article: http://jnnp.bmj.com/content/88/4/346. In the second part of this podcast: The C9orf72 repeat expansion is reported to have a negative impact on prognosis in amyotrophic lateral sclerosis (ALS). Until now, researchers have not been able to examine the relationship between C9orf72 and factors such as age, site of onset or gender. Dr James Rooney discusses how he and colleagues examined the prognostic impact of the C9orf72 repeat expansion in more detail.

The full article is available here: http://jnnp.bmj.com/content/88/4/281.1.

Zika virus and Guillain-Barré Syndrome: what do we know?

Mon, 13 Mar 2017 17:29:00 +0000

There is concern that, despite being a rare complication of the Zika virus, we could see a steady rise in the number of cases of Guillain-Barré Syndrome (GBS). In preparation for this, it is important that clinicians are able to appropriately identify and differentiate between Zika-associated GBS and other neurological disorders. In this podcast, Professor Antonino Uncini (University ‘G’ d’Annunzio’, Chieti, Italy) discusses Guillain-Barré Syndrome (GBS) and it’s associations with Zika virus, as well as its clinical and electrophysiological subtypes.

Read the full paper by Uncini, A., Shahrizaila, N., & Kuwabara, S. here: http://jnnp.bmj.com/content/88/3/266.

Immunomodulatory therapy in advanced multiple sclerosis

Mon, 13 Feb 2017 14:44:00 +0000

Could currently available immunomodulatory therapies modify disability trajectories in patients with moderately advanced and advanced multiple sclerosis (MS)? Tomas Kalincik, Department of Medicine, University of Melbourne, Australia, discusses the findings from the MSbase cohort study with Elizabeth Highton.

Read the full article here: http://jnnp.bmj.com/content/88/3/196.

The relationship between orthostatic hypotension and cognitive impairment in α-synucleinopathies

Wed, 30 Nov 2016 15:34:00 +0000

Dr Mario Masellis and Dr. Sean Udow from the Sunnybrook Health Sciences Centre, University of Toronto, Canada, look at the potential association between orthostatic hypotension and cognitive impairment in α-synucleinopathies such as Parkinson’s disease, dementia with Lewy bodies and multiple system atrophy.

Read the review published by JNNP here: http://jnnp.bmj.com/content/early/2016/09/09/jnnp-2016-314123.abstract.

A clinical tool for predicting survival in motor neurone disease

Wed, 30 Nov 2016 13:22:00 +0000

Elizabeth Highton spoke to Professor Ammar Al-Chalabi from King’s College London about the development of a simple and clinically useful graphical model of predicting survival for motor neurone disease (MND) patients.

Read the article here: http://jnnp.bmj.com/content/early/2016/07/26/jnnp-2015-312908.abstract

Latitude and disease severity in Multiple Sclerosis

Tue, 15 Nov 2016 17:31:00 +0000

Elizabeth Highton and Prof. Bruce Taylor discuss higher latitudes and its association with earlier age of onset of Multiple Sclerosis (MS). The international study, published by the JNNP, links latitude to the age at which symptoms of MS first start. Each 10ᵒ increase in latitude is associated with a 10 month earlier onset of symptoms among those of European descent.

Read the full article here: https://goo.gl/BmHXFo.

Do your kids play rugby? Risks for rugby union players from repeated concussions

Mon, 07 Nov 2016 17:16:00 +0000

Associate Editor of JNNP Alan Carson interviews Tom McMillan, Professor at the Institute for Health & Wellbeing, University of Glasgow, UK, about the paper "Long Term Health Outcomes after Exposure to Repeated Concussion in Elite Level Rugby Union Players". Despite a high number of concussions in retired male Scottish international rugby players, the researchers didn’t find differences in mental health, social or work functioning late after injury. However, subtle group differences were detected on two cognitive tests. Listen to this podcast for full details.

You can access this article here: http://jnnp.bmj.com/content/early/2016/10/05/jnnp-2016-314279.full.

Genetics and the clinical course of multiple sclerosis

Tue, 18 Oct 2016 11:46:00 +0100

Professor Bruce Taylor and Elizabeth Highton discuss how certain genetic risk variants may predict the clinical course and progression of Multiple Sclerosis.

This podcast relates to the Patient Choice paper published in the JNNP November 2016 issue and is accessible here: http://jnnp.bmj.com/content/87/11/1204.full.

Is it time to focus on the common pathways linking neurodegenerative diseases?

Thu, 13 Oct 2016 14:05:00 +0100

Dr. Rebekah Ahmed talks about her recent JNNP review: Neuronal network disintegration and the common pathways linking neurodegenerative diseases. Dr. Ahmed and colleagues critically evaluate a new approach to neurodegenerative disease, a focus on phenotypic presentation opposed to syndromic diagnosis. Via collaborative efforts, should we be looking at the commonalities between the neurodegenerative diseases?

Read the full article here: http://jnnp.bmj.com/content/early/2016/05/12/jnnp-2014-308350.full.

October 2016 Edition: long-term outcomes after stroke; hereditary and inflammatory neuropathies

Thu, 22 Sep 2016 14:41:00 +0100

In this JNNP podcast, Elizabeth Highton speaks with Dr. Siobhan Crichton and Dr. Benjamin Bray about their study looking at patient outcomes up to 15 years after stroke. Read their full paper here: http://jnnp.bmj.com/content/early/2016/07/22/jnnp-2016-313361.full. She is also joined over Skype by Professor Yusuf Rajabally who discusses his review examining the distinction between hereditary and inflammatory neuropathies and the instances whereby the distinction between the two is less clear.

His report is out in the JNNP and can be read here: http://jnnp.bmj.com/content/early/2016/03/23/jnnp-2015-310835.full.

Selective vulnerability in clinical variants of Alzheimer’s Disease

Tue, 30 Aug 2016 15:24:00 +0100

Elizabeth Highton spoke with Professor Henrik Zetterberg from Sahlgrenska University in Sweden. They discuss his recent JNNP review looking at clinical variants of Alzheimer's Disease and whether selective vulnerability in the nervous system may help explain some of the different phenotypic expressions of the same disease.

Smoking: a negative prognostic for survival in motor neurone disease patients

Fri, 19 Aug 2016 15:11:00 +0100

Elizabeth Highton is joined by Prof. Adriano Chio to talk about his study: Influence of cigarette smoking on ALS outcome: a population-based study. His large population-based cohort study of patients with amyotrophic lateral sclerosis (ALS), commonly known as motor neurone disease, demonstrated that smoking is linked to their shorter survival and smokers also tended to be younger when the symptoms first appeared. Read the full article here: http://jnnp.bmj.com/content/early/2016/08/19/jnnp-2016-313793.full.

The press release is available here: http://jnnp.bmj.com/content/suppl/2016/09/20/jnnp-2016-313793.DC1/jnnp-2016-313793supp_Pressrelease.pdf.

Review: Amyotrophic Lateral Sclerosis and Motor Neuron Syndromes in Asia

Wed, 27 Jul 2016 17:45:00 +0100

In this podcast, Dr Nortina Shahrizaila, a neurologist from the University of Malaya, talks about her review regarding Amyotrophic lateral sclerosis and motor neuron syndromes in Asia. She discusses with Elizabeth Highton what is known of ALS in Asia from an epidemiological perspective through to disease characterisation and particular phenotypes which can be seen in Asian patients. They also discuss the Pan-Asian Consortium for Treatment and Research in ALS (PACTALS), whereby clinicians and researchers across the region have joined in collaborative effort to understand and treat this illness. Read the full paper here:

http://jnnp.bmj.com/content/87/8/821.full.

Automated brain volumetrics in multiple sclerosis, plus migraine and psychiatric co-morbidities

Thu, 30 Jun 2016 14:38:00 +0100

In this July podcasts, Associate Professor Michael Barnett explains the details of his short report comparing Structural Image Evaluation using Normalisation of Atrophy-Cross Sectional (SIENAX) to Neuroquant and MSmetrix for assessment of cross-sectional Whole Brain Volume (WBV) in patients with Multiple Sclerosis (MS). Michael Barnett, from the Sydney Neuroimaging Analysis Centre at the Brain and Mind Centre, University of Sydney, discusses with Elizabeth Highton the potential clinical utility of automated brain volumetrics as a disease monitoring tool in routine clinical practice. The paper, which was selected as Editor's choice for the July issue of JNNP, is available here: http://jnnp.bmj.com/content/87/7/754.full. The second half of this podcast is about migraine and its psychiatric co-morbidities. Dr Mia. Minen, Director of the Headache Centre at the New York Langone Medical Centre, discusses migraine, a common concern for patients, and the high prevalence of psychiatric co-morbidities associated with migraine. Other topics of this conversation include which psychiatric disorders are associated with migraine, whether a bi-directional relationship exists between migraine and psychiatric co-morbidities and does this ultimately have implication for patient treatment.

Read the full Patient choice paper here: http://jnnp.bmj.com/content/87/7/741.full.

Coffee consumption and multiple sclerosis

Tue, 07 Jun 2016 15:13:00 +0100

Can coffee impact on the health of neurons? And what are the effects of its consumption on the risk of developing multiple sclerosis? These are some of the questions Dr Ellen Mowry answers in this podcast. She is an Associate Professor of Neurology at the Johns Hopkins Hospital and one of the authors of the study, “High consumption of coffee is associated with decreased multiple sclerosis risk; results from two independent studies”, which was selected as Patient choice article for the May issue of JNNP. Full article available here: http://jnnp.bmj.com/content/early/2016/02/03/jnnp-2015-312176.full. Read also the Editorial: http://jnnp.bmj.com/content/87/5/453.extract.

This podcast is conducted by Elizabeth Highton, who highlights another research paper of this issue: ‘Risk factors for predicting progression from mild cognitive impairment to Alzheimer’s disease: a systematic review and meta-analysis of cohort studies’. Read the full Editor’s choice paper here:jnnp.bmj.com/content/87/5/476.full.

June Edition: Parkinson’s disease and the rate of ALS progression

Tue, 24 May 2016 11:48:00 +0100

In this podcast, Elizabeth Highton investigates the details of two studies selected for the June 2016 edition of JNNP. Professor Steve Vucic, from the Department of Neurology at Westmead Hospital, Sydney, talks about the details of his study, which concludes that the rate of ALS progression appears to be a simple and sensitive clinical prognostic biomarker in the disease that could be potentially utilised in clinical practice and future therapeutic trials. The paper “Rate of Disease Progression: A Prognostic Biomarker in ALS”, which was selected as Patient choice this month, can be read here: http://jnnp.bmj.com/content/87/6/628.full . Dr Helen Ling, Senior Research Associate at UCL Institute of Neurology in London, explains the correlations of the diagnosis of Parkinson’s disease with the phenomenon of SWEDD.

Read the full study selected for Editor’s Choice, “Parkinson’s disease without nigral degeneration: a pathological correlate of scans without evidence of dopaminergic deficit (SWEDD)?” here: http://jnnp.bmj.com/content/87/6/633.full.

Sudden Unexpected Death in Epilepsy: basic mechanisms and implications for prevention

Fri, 08 Apr 2016 10:10:00 +0100

In this podcast, Dr Brian J Dlouhy explains the mechanisms behind sudden unexpected death in epilepsy (SUDEP), one of the most common cause of death in patients with intractable epilepsy. “Sudden unexpected death in epilepsy: basic mechanisms and clinical implications for prevention” was selected for the April 2016 Patient Choice of the JNNP.

Read the full review here: http://jnnp.bmj.com/content/87/4/402.full.

Re-evaluating the treatment of acute optic neuritis

Wed, 10 Feb 2016 16:36:00 +0000

In this podcast, Professor Elliot Frohman discusses the treatment of acute optic neuritis and its connection with multiple sclerosis. Elliot Frohman is Professor of Neurology and Neurotherapeutics and Ophthalmology and Director of the Multiple Sclerosis and Neuroimmunology Program, at the University of Texas. Read the full paper here:

http://jnnp.bmj.com/content/early/2014/10/29/jnnp-2014-308185.full

BNPA 2015: Spatial Neglect

Mon, 08 Jun 2015 10:30:00 +0100

Kieran O'Driscoll, Neuropsychiatrist, Manchester, speaks to Giuseppe Vallar, Professor of Psychobiology and Physiological Psychology, University of Milano-Bicocca, about spatial neglect.

This podcast was recorded at the 2015 BNPA AGM.

BNPA 2015: New theories of memory systems and networks

Mon, 08 Jun 2015 09:56:00 +0100

Chris Butler speaks to Adam Zeman about new theories of memory systems and networks.

This podcast was recorded at the 2015 BNPA AGM.

BNPA 2015: Phantom phenomena

Tue, 24 Feb 2015 13:47:00 +0000

David Linden, neuropsychiatrist, Cardiff, Wales, talks to Peter Brugger, Department of Neurology, University Hospital Zurich, about phantom phenomena.

This podcast was recorded at the BNPA 2015 AGM.

Clinical neurology: why this still matters in the 21st century

Tue, 27 Jan 2015 15:35:00 +0000

David Nicholl argues that even with the tremendous advances in diagnostic neuroimaging that the clinical skills involved in clinical neurology remain key. In a recent JNNP review he writes that recent audits suggest that large numbers of patients are failing to be assessed properly with a risk of patient harm, costly, unnecessary or inappropriate investigations, or delayed diagnosis. In this podcast Matthew Kiernan asks Dr Nicholl, Department of Neurology, City Hospital, Birmingham, why patients are not being assessed properly neurologically, and what a solution could look like. Read the full review (for free): http://jnnp.bmj.com/content/86/2/229.full

Don't forget to follow JNNP's twitter feed for updates from the journal: @JNNP_BMJ

Imaging outcomes for trials of remyelination in multiple sclerosis

Thu, 11 Dec 2014 12:32:00 +0000

Trials of potential neuroreparative agents are becoming more important in the spectrum of multiple sclerosis research. Appropriate imaging outcomes are required that are feasible from a time and practicality point of view, as well as being sensitive and specific to myelin, while also being reproducible and clinically meaningful. Conventional MRI sequences have limited specificity for myelination. With colleagues Shahrukh Mallik, Department of Neuroinflammation, NMR Research Unit, Queen Square Multiple Sclerosis Centre, evaluated the imaging modalities which are potentially more specific to myelin content in vivo. He explains what they found. Read the full paper:

http://goo.gl/chxZq7

BNPA 2014: Oxytocin and social cognition

Tue, 02 Dec 2014 16:47:00 +0000

Individual differences in our capacity to read other people’s emotions and to remember faces we have seen before are highly variable in the general population. Some people are super-recognizers; others have difficulty remembering their own family members. Such abilities are also highly heritable, implying our genetic makeup exerts an important influence. But what genes are involved in social perception? Where do they act when our brains process social signals? What happens if the social perception system malfunctions? How does it affect our social behaviour? Professor Peter Halligan, Director of the BNPA, asks David Skuse, Professor of Behavioural and Brain Sciences at the Institute of Child Health, University College London, the answers to these questions.

This podcast was recorded at the 2014 British NeuroPsychiatry Association AGM.

BNPA 2014: Schizophrenia and cognition

Tue, 02 Dec 2014 16:36:00 +0000

Cognitive impairment is generally considered an important facet of the schizophrenia syndrome but how fundamental is it? In this podcast Alan Carson discusses the question with Eileen Joyce, Consultant Neuropsychiatrist at the National Hospital for Neurology and Neurosurgery. She argues that there is a limited general resource in schizophrenia that constrains the performance of a wide range of specific cognitive functions and underlies the development of psychotic symptoms as well as determining functional outcome. She also outlines the possible neurobiological underpinnings.

This podcast was recorded at the 2014 British NeuroPsychiatry Association AGM.

Advances in epilepsy surgery

Thu, 27 Nov 2014 12:19:00 +0000

Exciting recent and forthcoming advances will impact on the surgical management of epilepsy in the near future. Mark Nowell and John Duncan, both Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, have conducted a review on where the treatment is headed, and discuss the three broad directions where they see the next major advances occurring.

Read the full paper, for free: http://goo.gl/f35bPF

Brain atrophy and disability progression in multiple sclerosis patients

Mon, 13 Oct 2014 15:39:00 +0100

Dr Robert Zivadinov, Department of Neurology, School of Medicine and Biomedical Sciences, Buffalo Neuroimaging Analysis Center, discusses his paper which aimed to identify MRI biomarkers associated with long-term disability progression in patients with multiple sclerosis (MS), and to define the rate of evolution of global, tissue-specific and regional atrophy in patients with MS over long-term.

Read the full paper (for free): http://jnnp.bmj.com/content/85/10/1109.full

BNPA 2014: Joint hypermobilty and autonomic hyperactivity

Wed, 17 Sep 2014 17:40:00 +0100

Chis Butler, MRC Clinician Scientist and Honorary Consultant Neurologist at the University of Oxford, talks to Jessica Eccles, MRC Clinical Research Training Fellow, Brighton and Sussex Medical School, about her work into joint hypermobilty and autonomic hyperactivity, and their relevance to neurodevelopmental disorders. Read the abstract: http://jnnp.bmj.com/content/85/8/e3.40.abstract

This podcast was recorded at the 2014 British NeuroPsychiatry Association AGM.

BNPA 2014: Post-Ictal psychosis

Wed, 17 Sep 2014 17:34:00 +0100

Hugh Rickards, consultant in Neuropsychiatry and honorary reader in Neuropsychiatry at Birmingham University, talks to Georgy Pius, ST6 Trainee, North West Deanery, about his case-control study examining post-ictal psychosis. Read the abstract: http://jnnp.bmj.com/content/85/8/e3.39.abstract

This podcast was recorded at the 2014 British NeuroPsychiatry Association AGM.

BNPA 2014: TREM2 variants and risk of dementia

Wed, 17 Sep 2014 17:30:00 +0100

Chris Butler, MRC Clinician Scientist and Honorary Consultant Neurologist at the University of Oxford, talks to Catherine Slattery, Clinical Research Associate, Institute of Neurology, about her work looking at TREM2 and associated risk of dementia. Read the abstract: http://goo.gl/SkJVXr

This podcast was recorded at the 2014 British NeuroPsychiatry Association AGM.

Neurosurgical procedures for psychiatric illness

Wed, 17 Sep 2014 17:16:00 +0100

This month, how to safely and ethically carry out stereotactic surgery for psychiatric illness. Bart Nuttin, Department of Neurosurgery, University of Leuven, has put together pragmatic guidelines, with the input of international psychiatric and neurosurgical societies.Here he gives us an overview.

Read the guidelines in full: http://jnnp.bmj.com/content/85/9/1003.full

Can stress trigger Parkinson’s? And new criteria for frontotemporal dementia syndromes.

Tue, 05 Aug 2014 16:15:00 +0100

Does emotional stress trigger Parkinson's disease? Andrew Lees, Reta Lila Weston Institute of Neurological Studies, talks us through the evidence so far.

And Glenda Halliday, Neuroscience Research Australia, and colleagues, have examined the clinical and pathological diagnostic implications of new criteria for frontotemporal dementia syndromes. She discusses the highlights.

Read both the papers, for free:

New criteria for frontotemporal dementia syndromes: clinical and pathological diagnostic implications http://goo.gl/87At72

Can stress trigger Parkinson's disease? http://goo.gl/bS8igN

Listen to the PN podcast reviewing Michael J Fox's memoir, Lucky Man http://goo.gl/1XCpDP

HIV and multiple sclerosis: beginning to unravel a mystery

Wed, 02 Jul 2014 16:58:00 +0100

Julian Gold, professor in the department of neuroscience and trauma, Queen Mary, University of London, and senior staff specialist, Albion Centre, Prince of Wales Hospital, Sydney, discusses his paper which investigates whether or not HIV protects against developing MS.

Read the paper, for free:

HIV and lower risk of multiple sclerosis: beginning to unravel a mystery using a record-linked database study http://goo.gl/j0G3SR

BNPA 2014: Neuropsychiatry of social knowledge and moral motivation

Tue, 24 Jun 2014 19:12:00 +0100

JNNP editor Alan Carson asks Roland Zahn, senior clinical lecturer, King's College London, about the neuroanatomy of moral behaviour, particularly his work into the neural mechanism of moral emotion in depression.

This podcast was recorded at the 2014 British NeuroPsychiatry Association AGM.

DBS in essential tremor, and genetic counselling for ALS

Thu, 22 May 2014 17:44:00 +0100

This month, genetic counselling for amyotrophic lateral sclerosis (ALS). Adriano Chiò, Turin ALS Expert Center, ‘Rita Levi Montalcini’ University of Turin, tells us what it can and can't do, who should have it, and how to go about it.

And deep brain stimulation for essential tremor. Joseph Jankovic, Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, explains what his study on long-term outcomes reveals.

Read the papers:

Genetic counselling in ALS: facts, uncertainties and clinical suggestions http://goo.gl/bYaqtQ

The safety and efficacy of thalamic deep brain stimulation in essential tremor: 10 years and beyond http://goo.gl/OhCsIh

Mortality and morbidity 15 years after hospital admission with mild head injury

Wed, 30 Apr 2014 17:39:00 +0100

Head injury is very common, and we know those admitted to hospital with a severe head injury have a high mortality rate in the proceeding year. However less is known about later mortality, and even less about late survival after mild head injury, which accounts for 95% of all head injuries.

Tom McMillan, Institute of Health and Wellbeing, MVLS, University of Glasgow, and colleagues, have followed up patients 15 years after admission with a mild head injury, and recently published the results in JNNP.

In this podcast, Alan Carson, JNNP associate editor, asks him what they found.

Read the full paper:

Mortality and morbidity 15 years after hospital admission with mild head injury: a prospective case-controlled population study http://goo.gl/9aTU4Z

Informed decision making in MS, and the striatum in neurodegeneration

Fri, 04 Apr 2014 14:27:00 +0100

What's the role of the striatum, in changes in cognition and behaviour in neurodegeneration? Michael Hornberger, University of Cambridge, explains why it may be more pivotal than we currently think.

And how best to support patients just diagnosed with multiple sclerosis, who are facing difficult decisions around their treatment? Sascha Köpke, University of Lübeck, discusses the results of his trial comparing two programmes.

Read the papers, for free:

Beyond and below the cortex: the contribution of striatal dysfunction to cognition and behaviour in neurodegeneration http://goo.gl/IZJi2o

Evidence-based patient information programme in early multiple sclerosis: a randomised controlled trial http://goo.gl/nQdJ15

BNPA special: Autoimmune encephalitis

Fri, 14 Mar 2014 15:49:00 +0000

Angela Vincent, emeritus professor of neuroimmunology at the University of Oxford, gives Adam Zeman, professor of cognitive and behavioural neurology, University of Exeter, an overview of autoimmune disorders of the central nervous system.

This podcast is one of several recorded with the British Neuropsychiatry Association, more of which will be published over the next few months. For all the podcasts in this series, see: soundcloud.com/tags/bnpa%202014

BNPA special: The prospects of a vaccine for Alzheimer’s disease

Thu, 13 Mar 2014 11:07:00 +0000

Adam Zeman, professor of cognitive and behavioural neurology, University of Exeter, asks James Nicoll, professor of neuropathology, University of Southampton, about the progress being made in preventative treatments for Alzheimer's.

For more on early treatment for Alzheimer's, watch Nick Fox's talk on presymptomatic treatment for the dementias on JNNP's YouTube channel: http://goo.gl/95sVXB

Both this podcast and the Professor Fox's talk were recorded with with the British Neuropsychiatry Association. More BNPA podcasts will be published over the next few months, for all those in the series see: soundcloud.com/tags/bnpa%202014

An unusual variant of Guillain–Barré syndrome, and dopamine dysregulation syndrome

Tue, 04 Mar 2014 17:48:00 +0000

This month, an unusual variant of Guillain Barre syndrome - the pharyngeal cervical brachial variant. Benjamin Wakeley, a consultant neurologist at the Gloucester Hospitals NHS Foundation trust talks through what clinicians need to know.

Also, a look at an uncommon but difficult to resolve complication of Parkinson’s disease therapy - that of dopamine dysregulation syndrome. Robert Cilia, from the Parkinson Institute in Milan, discusses his paper examining the characterisation, management and long-term outcome.

If you found that useful you may want to listen to our accompanying podcast on impulse control disorder in Parkinson’s disease, produced with the British Neuropsychiatry association. David Okai, a consultant in psychological medicine in Oxford discusses assessing and managing the disorder. Listen here: goo.gl/gEsUUA

Read the articles:

Dopamine dysregulation syndrome in Parkinson's disease: from clinical and neuropsychological characterisation to management and long-term outcome goo.gl/AEH3vr

Pharyngeal-cervical-brachial variant of Guillain–Barré syndrome goo.gl/HFIqla

BNPA special: Impulse control disorder in Parkinson’s

Mon, 03 Mar 2014 13:27:00 +0000

Kieran O'Driscoll, consultant neuropsychiatrist in Liverpool, talks to David Okai, a consultant in psychological medicine in Oxford and researcher at King's College London, discusses assessing and managing impulse control disorder in Parkinson's.

See also:

Impulse control disorder in patients with Parkinson's disease under dopamine agonist therapy: a multicentre study goo.gl/45jOZm

Trial of CBT for impulse control behaviors affecting Parkinson patients and their caregivers goo.gl/6AB4QB

Impulse control disorders and dopamine dysregulation in Parkinson's disease: a broader conceptual framework goo.gl/nX5P6S

Diagnosing and treating functional symptoms

Fri, 10 Jan 2014 17:37:00 +0000

February's JNNP is a neuropsychiatry special issue, with papers on a broad range of disorders which lie between neurology and psychiatry. Associate editor Alan Carson discusses the contents, and the thinking behind the edition.

To accompany the issue, JNNP and the Association of British Neurologists convened a roundtable of experts to discuss, and advise on, diagnosing and treating functional symptoms. Dr Carson takes part in this, along with:

Kailash Bhatia, professor of neurology, Institute of Neurology

Mark Edwards, neurologist at the National Hospital for Neurology and Neurosurgery

Jon Stone, neurologist, University of Edinburgh, Western General Hospital

This podcast is one of a series produced in collaboration with the Association of British Neurologists. You can find all the podcasts in the series here: soundcloud.com/tags/abn%202013

Solving the case, making the diagnosis: Neurology and detective writing

Thu, 09 Jan 2014 17:22:00 +0000

When searching for clues to reach a diagnosis, neurologists often empathise with the detective who is trying to solve a case, write Peter Kempster and Andrew Lees in JNNP sister journal Practical Neurology bit.ly/1dqReQq. In this podcast, journal editor Phil Smith and Andrew Lees, director of the Queen Square Brain Bank in London, discuss how neurologists draw upon detective skills. They also talk about neurologists who have turned these skills to crime fiction writing, and the use of narrative in clinical case histories. The expert witnesses called upon are: - Oliver Sacks, best selling author and professor of neurology at NYU School of Medicine - Peter Gautier Smith, now retired from consulting at Queen Square and author of 31 detective novels - Chris Goetz, who worked at Rush University Medical Centre with Harold Klawans, crime fiction writer and authority on Parkinson’s disease Listen to the full interviews here: Andrew Lees bit.ly/1cPaoxM Peter Gautier-Smith bit.ly/1d5HhKj Harold Klawans bit.ly/19cXR

Oliver Sacks bit.ly/1hBsbgz

Radiation for brain metastases, and the genetics of ischaemic stroke

Tue, 26 Nov 2013 16:25:00 +0000

This month, whole brain radiation vs radiosurgery for cerebral metastases. Does the former cause significantly more cognitive defects, and are any blanket, mopping up effects worth it? Clark Chen, vice chairman of neurosurgery, University of California San Diego, talks us through his review.

And a clinical guide to the genetics of ischaemic stroke, from Pankaj Sharma, Imperial College Cerebrovascular Research Unit.

Read the full papers:

Review: Genetics of ischaemic stroke bit.ly/1aptzNl

Neurocognitive assessment following whole brain radiation therapy and radiosurgery for patients with cerebral metastases http://bit.ly/1aptIjQ

Education special: Headache

Tue, 26 Nov 2013 16:16:00 +0000

Callum Duncan, neurologist at Aberdeen Royal Infirmary, convenes a round table of experts to discuss advances in headache, particularly the pathophysiological understanding of cluster headache, managing cluster headache and migraine, and new onset chronic daily headache.

Taking part are:

Phillip Holland, postdoctoral researcher, Centre for Cognitive and Neural Systems, University of Edinburgh

Manjit Matharu, clinical lead of the Headache Group at The National Hospital for Neurology and Neurosurgery, London

Alok Tyagi, neurologist, Southern General Hospital, Glasgow

This podcast is one of a series produced in collaboration with the Association of British Neurologists, of which there will be more to come over the next few months. You can find all the podcasts in the series here: soundcloud.com/tags/abn%202013

Aggressive MS, and disappointment following deep brain stimulation for Parkinson’s

Fri, 25 Oct 2013 16:03:00 +0100

This month, getting a handle on aggressive multiple sclerosis. Suresh Menon and Helen Tremlett, both from the Department of Medicine, University of British Columbia, talk us through their recent step towards a definition of the disease.

And Parkinson's patients who are disappointed after deep brain stimulation, despite gaining motor benefits and quality of life improvements. Catherine Lewis and Franziska Maier, both from the Department of Neurology, University of Cologne, explain how to predict who may end up feeling negative about the procedure, and how to support them.

Read the papers:

Characterising aggressive multiple sclerosis bit.ly/168RLWo

Patients’ expectations of deep brain stimulation, and subjective perceived outcome related to clinical measures in Parkinson's disease: a mixed-method approach bit.ly/Hlup68

Vitamin D, sunlight, and MS

Tue, 15 Oct 2013 15:42:00 +0100

October's JNNP takes another step towards demystifying the relationship between sunlight, vitamin D, and MS, featuring a paper which reveals sun exposure may have direct effects on neurodegeneration independently of the vitamin.

Murali Ramanathan, co-author of the study and professor of pharmaceutical sciences and neurology at the State University of New York at Buffalo, talks us through the research.

Read the full paper, for free, here: bit.ly/171jo6N

Education special: Neurogenetics update

Tue, 15 Oct 2013 15:30:00 +0100

Ralph Gregory, secretary for the Association of British Neurologists and consultant neurologist in Dorset, gets an update on neurogenetics research and implications for practice from Nick Wood, professor of clinical neurogenetics, Institute of Neurology.

Diagnosing and treating neuromyelitis optica

Mon, 19 Aug 2013 10:51:00 +0100

Neuromyelitis optica (NMO) is an autoimmune inflammatory disorder with predilection for the optic nerves and spinal cord. Many recent advances, in particular, the discovery of NMO-IgG, an NMO-specific autoantibody, have furthered our understanding of the condition.

Anu Jacob, consultant neurologist, The Walton Centre for Neurology and Neurosurgery, Liverpool, summarises what clinicians need to know in terms of diagnosing and treating NMO and its spectrum disorders.

Read the full review, for free, here: http://goo.gl/fidlGL

Diagnosing the dementias

Tue, 23 Jul 2013 12:18:00 +0100

This month, we get an update on the latest in clinically diagnosing the dementias, with a roundtable of experts convened by the Association of British Neurologists.

Taking part are John Greene, Southern General Hospital, Glasgow, Chris Butler, Department of Clinical Neurology, University of Oxford, Nick Fox, Dementia Research Centre, UCL Institute of Neurology, and Huw Morris, Cardiff University School of Medicine.

And using theory of mind deficits as an early marker of frontotemproal dementia. Matteo Pardini, Department of Neurosciences, University of Genoa, talks us through his research.

See also:

Isolated theory of mind deficits and risk for frontotemporal dementia: a longitudinal pilot study http://bit.ly/19figvN

Anti-GQ1b antibody syndrome, and ALS and language deficits

Fri, 05 Jul 2013 14:23:00 +0100

We know that ALS is associated with executive dysfunction, but what about language deficits? Steven Wing, specialist neurology registrar at Addenbrooke’s Hospital, Cambridge, talks to Laura Goldstein, professor of Clinical Neuropsychology at the Institute of Psychiatry, about her recent paper investigating this.

And anti-GQ1b antibody syndrome, or Bickerstaff brainstem encephalitis and Fisher syndrome. Editor Matthew Kiernan talks to Nobuhiro Yuki, Department of Medicine, National University of Singapore, about how the syndrome was first identified, and what we currently understand about it.

See also:

Is language impairment more common than executive dysfunction in amyotrophic lateral sclerosis? http://bit.ly/1a6cRIz

Bickerstaff brainstem encephalitis and Fisher syndrome: anti-GQ1b antibody syndrome http://bit.ly/1aJrTmK

Striatal cell transplants for Huntington’s disease: where are we now?

Fri, 05 Jul 2013 14:13:00 +0100

In Huntington’s disease the striatum takes a big hit early. This has prompted trials of foetal stratal transplantation, in the hope that this may provide some relief to patients.

Stevan Wing, specialist neurology registrar at Addenbrooke’s Hospital, and researcher, University of Cambridge, speaks to Professor Roger Barker, John van Geest Centre for Brain Repair, University of Cambridge, about his experience of leading a transplant trial with the NEST-UK consortium.

See also:

The long-term safety and efficacy of bilateral transplantation of human fetal striatal tissue in patients with mild to moderate Huntington’s disease http://jnnp.bmj.com/content/84/6/657.long

Education special: MS update

Tue, 11 Jun 2013 16:32:00 +0100

Ralph Gregory, secretary for the Association of British Neurologists and consultant neurologist in Dorset, gets an update on multiple sclerosis research and implications for practice from Neil Robertson, professor of neurology, Cardiff University.

They discuss new therapeutics BG-12 and alemtuzumab, the understanding of treatment risks, prognosis, prevalence and incidence, and MS and pregnancy.

Education special: Peripheral nerve disease update

Tue, 11 Jun 2013 16:29:00 +0100

Ralph Gregory, secretary for the Association of British Neurologists and consultant neurologist in Dorset, gets an update on peripheral nerve disease research and practice from James Overell, consultant neurologist, Institute of Neurological Sciences, Glasgow.

They discuss treatment for CIDP, differences in neuropathy prevention and management in type 1 and type 2 diabetes, chronic inflammatory neuropathies, and hereditary motor sensory neuropathies.

Stem cells in neurology, and enlarged perivascular spaces and intracerebral haemorrhage

Tue, 11 Jun 2013 16:25:00 +0100

Where are we with stem cell treatments for stroke and Parkinson’s disease? At the Association of British Neurologists’ recent annual meeting in Glasgow, Neil Scolding, director of the Bristol Institute of Clinical Neurosciences, spoke to Keith Muir, Institute of Neuroscience and Psychology, Univeristy of Glasgow, and Roger Barker, John van Geest Centre for Brain Repair, University of Cambridge, about current research, and the expensive, unproven treatments already on the market.

And using enlarged perivascular spaces to identify arteriopathy in intracerabral haemorrhage. Nick Ward, JNNP associate editor, asks David Werring, reader in neurology, UCL Institute of Neurology, what his MRI study reveals.

See also:

Enlarged perivascular spaces as a marker of underlying arteriopathy in intracerebral haemorrhage: a multicentre MRI cohort study http://bit.ly/12iZWie

Striatal cell transplants for Huntington’s disease: where are we now? http://bit.ly/18InWwa

Parkinson’s disease subtypes: lost in translation?

Wed, 01 May 2013 16:31:00 +0100

This month Connie Marras, assistant professor of neurology, University of Toronto, talks us through her review of Parkinson’s disease subtypes.

What definitions do we have so far, what could they tell us about the condition, and how can we get them incorporated into research more?

See also:

Parkinson’s disease subtypes: lost in translation? http://bit.ly/12mKxYL

The latest on stroke

Wed, 01 May 2013 16:30:00 +0100

In this special edition of the podcast, JNNP associate editor Nick Ward looks into some of the latest research into stroke.

Tracking cognitive function in those recovering from stroke in routine. Owen White, associate professor, Department of Neurology, Royal Melbourne Hospital, describes how assessing ocular motor deficits is a sensitive way of doing this. Furthermore, he describes the computerised programme he’s come up with to treat these, and why he believes doing so will lead to improvement in both sensory and motor areas.

Tatu Kauranen has also been looking into assessing cognitive function, and discusses the value of this in predicting return to work after stroke.

And Peter Rothwell explains why it’s safe and effective to treat those who’ve had an acute minor stroke as outpatients.

See also:

Stroke: mechanisms, stratification and implementation http://bit.ly/16o2YmF

Ischaemic stroke: the ocular motor system as a sensitive marker for motor and cognitive recovery http://bit.ly/ZmHFdT

Could saccadic function be a useful marker of stroke recovery? http://bit.ly/10VojTz

The severity of cognitive deficits predicts return to work after a first-ever ischaemic stroke http://bit.ly/ZVjeJg

Return to work after stroke: the role of cognitive deficits http://bit.ly/10VorCv

Feasibility, safety and cost of outpatient management of acute minor ischaemic stroke: a population-based study http://bit.ly/11VFocM

Is the outpatient management of acute minor stroke feasible and safe? http://bit.ly/11VFocM

The JNNP stroke special edition jnnp.bmj.com/content/84/3

Follow Nick Ward’s lab at UCL on Twitter http://bit.ly/18cNstj

Dopamine agonist withdrawal syndrome

Wed, 01 May 2013 16:25:00 +0100

The problem of those with Parkinson’s disease becoming addicted to dopamine replacement therapy is well know, but it’s also now emerging that some patients have trouble coming of dopamine agonists.

Margarita Pondal, from the Movement Disorders Centre, University of Toronto, talks us through her study looking at the prevalence of the syndrome, and the patients who are most likely to be affected.

See also:

Clinical features of dopamine agonist withdrawal syndrome in a movement disorders clinic http://bit.ly/12VwBI6

Dopamine agonist withdrawal syndrome (DAWS): perils of flicking the dopamine ‘switch’ http://bit.ly/18cN2Tu

BNPA 2013: The impact of epilepsy on cognitive function

Mon, 18 Feb 2013 11:51:00 +0000

Cognitive impairment in those with epilepsy is common. Adam Zeman, professor of cognitive and behavioural neurology, University of Exeter, ask Christoph Helmstaedter, associate professor for clinical neuropsychology, the University Clinic of Epileptology in Bonn, about the association, including the effects antiepileptic drugs can have on cognition.

Further resources:

Helmstaedter C, Witt JA. Clinical neuropsychology in epilepsy: theoretical and practical issues. Handb Clin Neurol. 2012;107:437-59.

Neuropsychology in the Care of People with Epilepsy, in the Progress in Epileptic Disorders Series. John Libbey, 2011.

Christoph Helmstaedter spoke on this topic at the British NeuroPsychiatry Association’s 2013 AGM. For more information on the association and next year’s meeting, see bnpa.org.uk.

BNPA 2013: Psychedelic drugs, magical thinking and psychosis

Mon, 18 Feb 2013 11:50:00 +0000

Robin Carhart-Harris, post-doctoral researcher, Division of Brain Sciences, Imperial College London, explains his hypothesis on the shared neurobiology of psychosis, psychedelic states and spontaneous spiritual experiences to Peter Halligan, professor in the School of Psychology, Cardiff University.