A5056608238- Parkinson's Disease Mechanisms and Treatments
- Transcranial Magnetic Stimulation Studies
- Neurological disorders and treatments
- Motor Control and Adaptation
- Muscle activation and electromyography studies
- Restless Legs Syndrome Research
- Genetic Neurodegenerative Diseases
- Spatial Neglect and Hemispheric Dysfunction
- Peripheral Neuropathies and Disorders
- Autism Spectrum Disorder Research
- Spinal Hematomas and Complications
- Glycogen Storage Diseases and Myoclonus
- Amyotrophic Lateral Sclerosis Research
- Prion Diseases and Protein Misfolding
- Neurology and Historical Studies
- Neurological and metabolic disorders
- Visual perception and processing mechanisms
- Epilepsy research and treatment
- Pharmacological Effects and Toxicity Studies
- Hereditary Neurological Disorders
- Dementia and Cognitive Impairment Research
- Vestibular and auditory disorders
- Infectious Encephalopathies and Encephalitis
- Alcoholism and Thiamine Deficiency
- Alzheimer's disease research and treatments
Northampton General Hospital NHS Trust
2015-2025
Northampton General Hospital
2011-2020
University of Oxford
1997-2017
Parkinson's UK
2015-2017
John Radcliffe Hospital
2008-2015
Oxford University Hospitals NHS Trust
2014
Battle Hospital
2002-2003
King's College Hospital
2003
Valproate is a first-line treatment for patients with newly diagnosed idiopathic generalised or difficult to classify epilepsy, but not women of child-bearing potential because teratogenicity. Levetiracetam increasingly prescribed these patient populations despite scarcity evidence clinical effectiveness cost-effectiveness. We aimed compare the long-term and cost-effectiveness levetiracetam compared valproate in participants unclassifiable epilepsy.We did an open-label, randomised controlled...
Levetiracetam and zonisamide are licensed as monotherapy for patients with focal epilepsy, but there is uncertainty to whether they should be recommended first-line treatments because of insufficient evidence clinical effectiveness cost-effectiveness. We aimed assess the long-term cost-effectiveness levetiracetam compared lamotrigine in people newly diagnosed epilepsy.This randomised, open-label, controlled trial treatment epilepsy. Adult paediatric neurology services across UK recruited...
Vaccination against viruses has rarely been associated with Guillain-Barré syndrome (GBS), and an association the COVID-19 vaccine is unknown. We performed a population-based study of National Health Service data in England multicentre surveillance from UK hospitals to investigate relationship between vaccination GBS. Firstly, case dates GBS identified retrospectively Immunoglobulin Database 8 December 2021 July were linked receipt vaccines using Immunisation Management System England. For...
The threshold for corticomotor excitation by magnetic stimuli is a clinically important parameter in the assessment of central motor conduction. Hitherto, arbitrary criteria have been adopted to define and there are few published data using figure eight coil. A new method described which highest stimulus intensity evoking responses relaxed first dorsal interosseous muscle with probability zero [lower (LT)] lowest one [upper (UT)] determined. method, utilizes coil located optimally oriented...
ABSTRACT The impact of Parkinson's disease (PD) dementia is substantial and has major functional socioeconomic consequences. Early prediction future cognitive impairment would help target interventions. Montreal Cognitive Assessment (MoCA), the Mini‐Mental State Examination (MMSE), fluency tests were administered to 486 patients with PD within 3.5 years diagnosis, results compared those from 141 controls correcting for age, sex, educational years. Eighteen‐month longitudinal assessments...
<h3>Background</h3> Concomitant REM sleep behaviour disorder (RBD) is commonly observed in patients with Parkinson9s disease (PD). Although the brainstem structures responsible for symptoms of RBD correspond to premotor stages PD, association motor and non-motor features early PD remains unclear. <h3>Methods</h3> The study evaluated 475 within 3.5 years diagnosis presence probable (pRBD) using Sleep Behaviour Disorder Screening Questionnaire (RBDSQ). A neurologist a trained research nurse...
Background: Within Parkinson's there is a spectrum of clinical features at presentation which may represent sub-types the disease.However no widely accepted consensus how best to group patients.Objective: Use data-driven approach unravel any heterogeneity in phenotype well-characterised, population-based incidence cohort.Methods: 769 consecutive patients, with mean disease duration 1.3 years, were assessed using broad range motor, cognitive and non-motor metrics.Multiple imputation was...
The pathogenesis of idiopathic amyotrophic lateral sclerosis (ALS) remains unknown, but accumulating evidence suggests a neu roexcitotoxic mechanism may have some credence. Glutamate-induced hyperexcitability cortical or spinal motoneurons be expected to manifest itself as reduced threshold for activation these structures. We measured corticomotor the first dorsal interosseous (FDI) muscles 48 patients with sporadic ALS using magnetic brain stimulation and correlated findings physical signs...
The syndrome of progressive encephalopathy with limb rigidity has been historically termed encephalomyelitis and myoclonus (PERM) or stiff-person plus.The case is presented a previously healthy 28-year-old man rapidly fatal form PERM developing over 2 months.Serum antibodies to both NMDA receptors (NMDAR) glycine (GlyR) were detected postmortem, examination the brain confirmed an autoimmune encephalomyelitis, particular involvement hippocampal pyramidal cerebellar Purkinje cells relative...
ABSTRACT Nonmotor symptoms (NMS) are an important prodromal feature of Parkinson's disease (PD). However, their frequency, treatment rates, and impact on health‐related quality life (HRQoL) in the early motor phase is unclear. Rates NMS enriched at‐risk populations, such as first‐degree PD relatives, have not been delineated. We assessed cohort PD, relatives control subjects to address these questions. In total, 769 population‐ascertained within 3.5 years diagnosis, 98 287 were at baseline...
The threshold for corticomotor excitation by magnetic stimuli is a clinically important parameter in the assessment of central motor conduction. Hitherto, arbitrary criteria have been adopted to define and there are few published data using figure eight coil. A new method described which highest stimulus intensity evoking responses relaxed first dorsal interosseous muscle with probability zero [lower (LT)] lowest one [upper (UT)] determined. method, utilizes coil located optimally oriented...
The case of a 39-year-old with intractable spontaneous intracranial hypotension (SIH) is presented. He developed bilateral and symptomatic subdural hygromas that were drained in response to clinical deterioration, but proved ineffective. An initial MRI the lumbar region suggested lumbosacral CSF leak, he failed respond local blood patching. Subsequent CT myelography revealed thoracic dural leak second directed patch effective. aetiology, pitfalls management SIH are summarized.
We devised a method to investigate the cortical organization of corticomotoneurons (CMs) upper limb muscles. A spike-triggering technique was used, in which tonically discharging single motor unit (SMU) triggered transcranial magnetic stimulation (TMS) cortex, and probability producing short-latency discharges (primary excitatory responses [PERs]) measured. PER probabilities were mapped 34 SMUs, using 16 cm(2) scalp grid with central reference point having 0.5. Maps showed optimum...
A male patient in his 60s presented with subacute-onset progressively worsening encephalopathy, myoclonus, paranoia, behavioural changes, confusion and cognitive decline, all on a background of paranoid schizophrenia. Extensive investigations, including blood tests cerebrospinal fluid analysis, were inconclusive. MRI the brain demonstrated cortical ribboning, high signals noted caudate nucleus internal capsule bilaterally T2/fluid-attenuated inversion recovery diffusion-weighted imaging....