JNNP podcast: Recent Episodes
BMJ Group
JNNP's ambition is to publish the most ground-breaking and cutting-edge research from around the world. Encompassing the entire genre of neurological sciences, our focus is on the common disorders (stroke, multiple sclerosis, Parkinson's disease, epilepsy, peripheral neuropathy, subarachnoid haemorrhage and neuropsychiatry), but with a keen interest in the Gordian knots that present themselves in the field, such as ALS. * The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice and it is not intended to function as a substitute for a healthcare practitioner’s judgement, patient care or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others.
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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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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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.
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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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
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Warren Alpert Medical School, Brown University, Rhode Island, USA
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Neuroendovascular Program, Massachusetts General Hospital, Boston, Massachusetts, USA
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Radiology, Johns Hopkins Medicine, Baltimore, Maryland, 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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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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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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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"
Related links:
European Society for the Study of Tourette Syndrome 2022 criteria for clinical diagnosis of functional tic-like behaviours: International consensus from experts in tic disorders
https://onlinelibrary.wiley.com/doi/10.1111/ene.15672
Tics and functional tic-like movements: can we tell them apart?
https://www.neurology.org/doi/10.1212/WNL.0000000000008372
(1) Department of Neurology (C.G.), Charité University Medicine Berlin, Germany
(2) Warren Alpert Medical School, Brown University, Rhode Island, USA
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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
Related links:
https://www.gov.uk/government/news/nitrous-oxide-to-be-illegal-by-end-of-the-year
(1) Warren Alpert Medical School, Brown University, Rhode Island, USA
(2) Barts Health NHS Trust, London, UK
(3) Preventive Neurology Unit, Centre for Prevention, Diagnosis and Detection, Faculty of Medicine and Dentistry, Queen Mary University of London, Wolfson Institute of Population Health, London, UK
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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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
Please subscribe to the show on Apple Podcasts, Spotify or find it on your platform of choice. Your feedback and reviews are very appreciated.
Follow JNNP on twitter: @JNNP_BMJ
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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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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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
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
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
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 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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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.
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
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 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
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
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
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
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.
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
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
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
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).
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
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
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
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.
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
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
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.
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
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
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
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.
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.
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 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 (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
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.
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
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.
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.
“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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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
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.
Chris Butler speaks to Adam Zeman about new theories of memory systems and networks.
This podcast was recorded at the 2015 BNPA AGM.
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.
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
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
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.
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.
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
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
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.
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.
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.
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
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
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
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.
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
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
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
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
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
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
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.
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
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
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
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:
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Oliver Sacks, best selling author and professor of neurology at NYU School of Medicine
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Peter Gautier Smith, now retired from consulting at Queen Square and author of 31 detective novels
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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
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
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
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
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
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.
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
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
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
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
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
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.
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.
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.
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 https://soundcloud.com/tags/abn%202013.
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
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
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
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
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.
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.
This podcast was recorded at the British NeuroPsychiatry Association’s 2013 AGM. For more information on the association and next year’s meeting, see bnpa.org.uk.
What relevance does consciousness have for our understanding of mental conditions? Geraint Rees, deputy head of the UCL Faculty of Brain Sciences, tells Peter Halligan, professor in the School of Psychology, Cardiff University, about his work in the area.
This podcast was recorded at the British NeuroPsychiatry Association’s 2013 AGM. For more information on the association and next year’s meeting, see bnpa.org.uk.
There is a complex relationship between epilepsy, depression, and anxiety disorders. Adam Zeman, professor of cognitive and behavioural neurology, University of Exeter, discusses the associations and what they mean for practice with Andres Kanner, director of the Comprehensive Epilepsy Center, University of Miami.
This podcast was recorded at the British NeuroPsychiatry Association’s 2013 AGM. For more information on the association and next year’s meeting, see bnpa.org.uk.
How epileptic seizures start is unclear. Mark Richardson, professor of epilepsy, Institute of Psychiatry, is working on elucidating this question using computational models. He talks Markus Reuber, professor of clinical neurology, University of Sheffield, through his research.
This podcast was recorded at the British NeuroPsychiatry Association’s 2013 AGM. For more information on the association and next year’s meeting, see bnpa.org.uk.
For more on Professor Richardson’s work on brain models in epilepsy, listen to his previous, recently recorded JNNP podcast http://tinyurl.com/b7n8vya.
Markus Reuber, professor of clinical neurology, University of Sheffield, discusses the different cellular mechanisms which allow seizures in epilepsy to happen, and how this understanding could lead to disease modification with John Jefferys, professor of neuroscience, University of Birmingham.
This podcast was recorded at the British NeuroPsychiatry Association’s 2013 AGM. For more information on the association and next year’s meeting, see bnpa.org.uk.
Tim Nicholson, academic clinical lecturer, Institute of Psychiatry, gives Hugh Rickards, consultant in neuropsychiatry, University of Birmingham, an update on autoimmune mechanisms and encephalitis. Dr Nicholson covers where we are with understanding and treating paediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS), and also NMDA-receptor encephalitis.
This podcast was recorded at the British NeuroPsychiatry Association’s 2013 AGM. For more information on the association and next year’s meeting, see bnpa.org.uk.
Eileen Joyce, professor in neuropsychiatry at the Institute of Neurology, gives Hugh Rickards, consultant in neuropsychiatry, University of Birmingham, an update on the use of deep brain stimulation to treat mental disorders, particularly OCD.
This podcast was recorded at the British NeuroPsychiatry Association’s 2013 AGM. For more information on the association and next year’s meeting, see bnpa.org.uk.
Selma Aybek, clinician researcher, Service of Neurology, University of Lausanne, has been examining the process which allows psychological stressors to become physical symptoms in conversion disorder. Chris Butler, academic clinical lecturer in neurology, University of Oxford, asks her what she’s found.
This podcast was recorded at the British NeuroPsychiatry Association’s 2013 AGM. For more information on the association and next year’s meeting, see bnpa.org.uk.
Cliodhna Carroll, along with colleagues at the University of Cambridge, has shown that children who’ve had a posterior fossa tumour have a lower IQ than matched controls. She talks Chris Butler, academic clinical lecturer in neurology, University of Oxford, through the research and its implications.
This podcast was recorded at the British NeuroPsychiatry Association’s 2013 AGM. For more information on the association and next year’s meeting, see bnpa.org.uk.
Chris Butler, academic clinical lecturer in neurology, University of Oxford, talks to Rebecca Cleary, research assistant, Wellcome Trust Centre for Neuro-imaging, UCL, about her research investigating whether the neural substrate in those with depression or anxiety is the same as in those with one of these disorders and also temporal lobe epilepsy.
This podcast was recorded at the British NeuroPsychiatry Association’s 2013 AGM. For more information on the association and next year’s meeting, see bnpa.org.uk.
Neil Greenberg, academic psychiatrist, Kings College London, who’s served in the armed forces for more than 20 years, argued in his JNNP-sponsored keynote at BNPA that we understand many of the issues in military mental health, and that the neuropsychiatric element is relatively small. Alan Carson, JNNP associate editor, talks to him about the impact of being in the military on mental health beyond PTSD.
This podcast was recorded at the British NeuroPsychiatry Association’s 2013 AGM. For more information on the association and next year’s meeting, see bnpa.org.uk.
David Skuse, professor in the Behavioural Sciences Unit, Institute of Child Health, talks to Jeremy Hall, professor of psychiatry and neuroscience at the University of Cardiff, about his work investigating the link between childhood stress and borderline personality disorder.
This podcast was recorded at the British NeuroPsychiatry Association’s 2013 AGM. For more information on the association and next year’s meeting, see bnpa.org.uk.
Alan Carson, JNNP associate editor, talks to Neil Harrison, consultant neuropsychiatrist and head of psychoneuroimmunology, Brighton and Sussex Medical School, about what we currently know about inflammation in mental disorders. Dr Harrison also discusses the potential of anti-inflammatories to treat depression.
This podcast was recorded at the British NeuroPsychiatry Association’s 2013 AGM. For more information on the association and next year’s meeting, see bnpa.org.uk.
David Skuse, professor in the Behavioural Sciences Unit, Institute of Child Health, asks Chris Brewin, professor of clinical psychology, UCL Faculty of Brain Sciences, about the different forms of PTSD experience, the cognitive processes involved, and how understanding these could inform psychological therapies for the condition.
This podcast was recorded at the British NeuroPsychiatry Association’s 2013 AGM. For more information on the association and next year’s meeting, see bnpa.org.uk.
The human response to threat requires comprehensive change in the network properties of the brain, with the whole organ affected. Alan Carson, JNNP associate editor, asks Guillén Fernández, director of the Donders Center for Neuroscience, Radboud University Nijmegen Medical Center, about his work investigating the effects of stressors on brain structure and function.
This podcast was recorded at the British NeuroPsychiatry Association’s 2013 AGM. For more information on the association and next year’s meeting, see bnpa.org.uk.
In the last JNNP podcast of 2012, we look at what jelly beans and the Andalucian mountains have done for neurology and psychiatry.
Alan Emery, emeritus professor, Green Temple College, University of Oxford, describes studying the family that led him to delineate Emery-Dreifuss muscular dystrophy.
And Jason Warren and Rohani Omar, UCL Institute of Neurology, talk about what their study into flavour identification in frontotemporal lobar degeneration reveals.
See also:
Impact commentary: Unusual type of benign X linked muscular dystrophy http://tinyurl.com/aszzjty
Original paper: Unusual type of benign X linked muscular dystrophy http://tinyurl.com/bjadyod
Flavour identification in frontotemporal lobar degeneration http://tinyurl.com/a8zh35u
This month, Mark Richardson, professor of epilepsy, Kings College London, relates his vision for the future of epilepsy research (1.07).
Alexander Leff, consultant neurologist, Institute of Cognitive Neuroscience, University College London, discusses his online tool for diagnosing and providing treatment for hemianopia, the visual impairment which can follow stroke or brain injury (14.07).
And measuring sensory nerve conduction. Tom Sears, emeritus professor of neurophysiology, King’s College London, recalls the beginnings of the technique (22.39).
See also:
Large scale brain models of epilepsy: dynamics meets connectomics http://tinyurl.com/ab6ggfh
A ‘web app’ for diagnosing hemianopia http://tinyurl.com/ahca28x
Read-Right http://tinyurl.com/37f3y3k
Eye-Search http://tinyurl.com/af3fsz2
Sensory nerve action potentials in patients with peripheral lesions http://tinyurl.com/a7rsj4s
This month, we explore the latest research on treating multiple sclerosis with cannabis extract. Editor Matthew Kiernan speaks to John Zajicek, professor of Clinical Neuroscience, Peninsula College of Medicine and Dentistry, UK. (0.54)
Received wisdom is that if you are disabled shortly after a head injury, you are not going to see this improve. However Tom McMillan, professor of Clinical Neuropsychology, University of Glasgow, explains how he has shown long term outcomes are actually dynamic. (9.08)
And the Scheltens scale. If you work with dementia patients you’ve probably used this simple rating of hippocampal atrophy. Philip Scheltens, director of the Alzheimer Center, VU University Medical Center, Amsterdam, talks about how he put the scale together 20 years ago, and why it still underpins practice. (14.21)
See also:
Multiple Sclerosis and Extract of Cannabis: results of the MUSEC trial http://tinyurl.com/a7vwezb
Atrophy of medial temporal lobes on MRI in “probable” Alzheimer’s disease and normal ageing: diagnostic value and neuropsychological correlates http://tinyurl.com/bxlc2dx
Disability in young people and adults after head injury: 12–14 year follow-up of a prospective cohort http://tinyurl.com/albh9k3
The Queen Square brain bank was set up by Andrew Lees, and whilst there he co-authored two of JNNP’s most highly cited papers – one on the importance of Lewy bodies in Parkinson’s, and the other on the accuracy of clinical diagnosis of the disease. Now director of the Reta Lila Weston Institute of Neurological studies, University College London, he discusses the changing relationship between pathologists and clinicians, and the progress he’s seen in diagnosis.
Assessing response to dopamine replacement therapy is essential for diagnosing idiopathic Parkinson’s disease, and for adjusting dose. One measure is to ask the patient how they feel, others are more objective such as the UPDRS or timed tests. However a paper in this month’s issue shows they are not always correlated. First author David McGhee (clinical research fellow in the division of Applied Health Sciences, University of Aberdeen) talks about the findings.
And, movement disorders: where are we now? This month’s journal focuses on these conditions, so JNNP editor Matthew Kiernan and associate editors Nick Ward and Alan Carson debate the most important advances.
See also:
October’s JNNP: Movement disorder special http://tinyurl.com/a32m868
Movement disorders: what lies beneath? http://tinyurl.com/a32m868
A MODERN PERSPECTIVE ON THE TOP 100 CITED JNNP PAPERS OF ALL TIME: The relevance of the Lewy Body to the pathogenesis of idiopathic Parkinson’s disease: Accuracy of clinical diagnosis of idiopathic Parkinson’s disease http://tinyurl.com/as9dq32
Comparison of patient rated treatment response with measured improvement in Parkinson’s disease http://tinyurl.com/bj57hu2
In 1974 Oliver Sacks was hiking through a remote part of Norway when he suffered a nasty injury to one leg. Although he managed to get to help and was successfully operated on, he struggled to relearn to walk and felt alienated from the limb. Jon Stone (consultant neurologist in the Department of Clinical Neurosciences, University of Edinburgh) explains why from Sacks’s writing he thinks this was a case of functional paralysis, and why the account is so valuable.
And progressive multifocal leukoencephalopathy: the rare but potentially fatal condition which can follow monoclonal antibody treatment. Dirk Mentzer (Department of Safety of Medicinal Products and Medical Devices, Paul-Ehrlich-Institute, Germany) talks us through his new case definition, and offers some clinical advice.
See also:
‘A Leg to Stand On’ by Oliver Sacks: a unique autobiographical account of functional paralysis http://tinyurl.com/bc4oavv
Case definition for progressive multifocal leukoencephalopathy following treatment with monoclonal antibodies http://tinyurl.com/aa2pmsq
A poster presentation of the PML case definition http://tinyurl.com/b2db26e
Derick Wade (professor and consultant in neurological rehabilitation at the Oxford Centre for Enablement) and Nick Ward (JNNP associate editor and reader in clinical neurology at UCL) discuss the past, present and future of measuring and predicting recovery after stroke.
And poor effort, exaggeration and malingering can be used to explain why individuals post-concussion report persistent symptoms inconsistent with the severity of their injury. However Jonathan Silver (clinical professor of Psychiatry at New York University School of Medicine) writes in August’s JNNP that social psychology and behavioural economics reveal other factors. Killian Welch (consultant neuropsychiatrist in Edinburgh, UK) discusses them with him.
See also:
Functional abilities after stroke: measurement, natural history and prognosis http://tinyurl.com/awo4hv5
Effort, exaggeration and malingering after concussion http://tinyurl.com/a7tgcf2
Despite current standard care for glioblastoma being aggressive, mean survival is around 14 months. Clark Chen (director of Clinical Neuro-oncology, Beth Israel Deaconess Medical Center, Boston) argues we need a better understanding of the therapeutic concepts that have evolved over the past three decades to develop treatment, and in a JNNP article this month he lays out seven of these key ideas. Peter Warnke (JNNP associate editor) discusses them with him.
See also:
Key concepts in glioblastoma therapy http://tinyurl.com/ao8g8m3
This month, editor Matthew Kiernan discusses new guidelines for recognising central nervous system neuronal surface antibody associated symptoms with Angela Vincent (emeritus professor of neuroimmunology at Oxford University).
Danielle Cath (psychiatrist at Altrecht Academic Anxiety Outpatients Clinics, Utrecht University) explains what her review of the relationship between obsessive compulsive disorder and movement disorders reveals.
And Charles Warlow (emeritus professor of medical neurology at the University of Edinburgh) looks back on his highly cited 1988 paper on incidence, outcome and type of stroke in Oxfordshire.
See also:
Central nervous system neuronal surface antibody associated syndromes: review and guidelines for recognition http://tinyurl.com/avn64sl
Relationship between movement disorders and obsessive–compulsive disorder: beyond the obsessive–compulsive–tic phenotype. A systematic review http://tinyurl.com/b8vk32g
A prospective study of acute cerebrovascular disease in the community: the Oxfordshire Community Stroke Project, 1981–86 http://tinyurl.com/ax26xlk
This month Beau Bruce (assistant professor of ophthalmology and neurology, Emory University School of Medicine, Atlanta) discusses what we do and don’t know about idiopathic intracranial hypertension, and offers some clinical advice on the syndrome for neurologists.
And Charles Bolton (professor in the Department of Medicine, Queen’s University, Ontario, Canada) talks us through his investigations in the 1980s which discovered critical illness could cause neurological problems.
See also:
Update on the pathophysiology and management of idiopathic intracranial hypertension http://tinyurl.com/bhjc9h6
Polyneuropathy in critically ill patients http://tinyurl.com/bbze6jc
In April’s podcast, we put a spotlight on amyotrophic lateral sclerosis and frontotemporal dementia.
Maxime Bertoux, a neuropsychologist at Paris-Sorbonne University, discusses the problem of misdiagnosis of the behavioural variant of FTD, and how he’s shown the Social Cognition and Emotional Assessment is a more powerful tool than others in use (20.50).
And Martin Turner, consultant neurologist at Oxford University Nuffield Department of Clinical Neuroscience, talks about early tractography work in ALS (13.23).
We also take a look at corticobasal syndrome. JNNP editor Matthew Kiernan asks John Hodges, Neuroscience Research Australia, about his work looking to standardise diagnostic criteria (1.16).
See also:
Nerve fibre degeneration in the brain in amyotrophic lateral sclerosis http://tinyurl.com/ar8bolm
Diagnostic criteria for corticobasal syndrome: a comparative study http://tinyurl.com/a7sskux
Social Cognition and Emotional Assessment differentiates frontotemporal dementia from depression http://tinyurl.com/bkpfrru
JNNP podcast: Martin Turner on athleticism and ALS http://tinyurl.com/an724hs
This issue we look at short-term outcomes used to assess multiple sclerosis treatments, and their power to predict long-term disability, with Douglas Goodin (professor of clinical neurology, University of California, San Francisco).
We return to the association between cerebral amyloid angiopathy and intracerebral haemorrhage, as Neshika Samarasekera (Division of Clinical Neurosciences, University of Edinburgh) talks us through her research examining the link.
And Angela Vincent (emeritus professor at the Nuffield Department of Clinical Neurosciences, University of Oxford) looks back at the beginning of her career investigating autoantibodies in neurological diseases.
See also:
Relationship between early clinical characteristics and long term disability outcomes: 16 year cohort study (follow-up) of the pivotal interferon β-1b trial in multiple sclerosis http://tinyurl.com/ab7sdd9
The association between cerebral amyloid angiopathy and intracerebral haemorrhage: systematic review and meta-analysis http://tinyurl.com/bewdkzf
Acetylcholine receptor antibody as a diagnostic test for myasthenia gravis: results in 153 validated cases and 2967 diagnostic assays http://tinyurl.com/axg6a98
This month, cerebral amyloid angiopathy. David Werring (Stroke Research Group, UCL Institute of Neurology and the National Hospital for Neurology and Neurosurgery) discusses the importance of detecting it, especially as he feels it is under-recognised by physicians.
What impact does a healthy lifestyle have on mortality following stroke? Amytis Towfighi (Division of Stroke and Critical Care, Department of Neurology, University of Southern California) tells us what her research found.
And lastly, another dig into the JNNP archives. Mark Hallett (chief of the Human Motor Control Section at the US National Institute of Neurological Disorders and Stroke, NIH) has looked back on his early research on patterns of motor control for the third of our impact commentaries. He talks about how this opened a window onto movement disorder pathophysiology.
See also:
Sporadic cerebral amyloid angiopathy revisited: recent insights into pathophysiology and clinical spectrum http://tinyurl.com/anvtsek
Impact of a healthy lifestyle on all-cause and cardiovascular mortality after stroke in the USA http://tinyurl.com/b3hjexr
EMG analysis of stereotyped voluntary movements in man http://tinyurl.com/a2fvef4
In this first podcast of 2012 editor Matthew Kiernan talks about JNNP’s new impact commentaries - a series which will explore influential papers from the journal. A paper by Simon Wessely (King’s College London) comparing postviral fatigue with that of neuromuscular and affective disorders is the first covered, and he and Matthew discuss this seminal research.
Also, Jon Stone (University of Edinburgh) explains what his investigation into the nature of functional weakness onset indicates about the mechanism of the condition.
See also:
A MODERN PERSPECTIVE ON SOME OF THE MOST HIGHLY CITED JNNP PAPERS OF ALL TIME: The nature of fatigue: a comparison of chronic “postviral” fatigue with neuromuscular and affective disorders http://tinyurl.com/ajr665z
What is impact? http://tinyurl.com/ah23rze
Functional weakness: clues to mechanism from the nature of onset http://tinyurl.com/a8c6h33
This month we discuss the issue of diagnosing delirium in older hospital patients. Despite being linked to a range of poor outcomes, the syndrome is often missed and evidence on its measurement is sparse.
Professor Alasdair MacLullich tells us how a device he’s designed with colleagues at the University of Edinburgh, which tests for delirium’s attentional deficits, can benefit clinicians and researchers.
See also:
Detecting deficits of sustained visual attention in delirium http://tinyurl.com/aswwbaw
In this edition Richard Kanaan (Institute of Psychiatry, King’s College London) talks about his work on conversion disorder, and gives his advice for neurologists and psychiatrists on making this tricky diagnosis.
And Vicki Goodwin (Peninsula College of Medicine and Dentistry, University of Exeter) discusses her trial on whether an exercise intervention could prevent falls in those with Parkinson’s disease.
See also:
Conversion disorder: a problematic diagnosis http://tinyurl.com/agrtdxs
An exercise intervention to prevent falls in people with Parkinson’s disease: a pragmatic randomised controlled trial http://tinyurl.com/b2d697b
Current treatments for Parkinson’s ameliorate the core, motor symptoms. However as we look for therapies to modify the underlying course of the disease there’s a need to better understand its development. Jonathan Evans, from the Cambridge Centre for Brain Repair, University of Cambridge, UK, explains what his work has revealed, and how it can progress treatment.
And the latest evidence in the debate on whether multiple sclerosis prevalence increases with latitude. Steve Simpson Jnr, Menzies Research Institute, Tasmania, Australia, tells editor Matthew Kiernan how his meta-analysis supports the link, and clears up some of the questions around the association.
See also:
The natural history of treated Parkinson’s disease in an incident, community based cohort http://tinyurl.com/bc6grnc
Latitude is significantly associated with the prevalence of multiple sclerosis: a meta-analysis http://tinyurl.com/bedfy9c
Movement disorders following head trauma are well recognised, but we know much less about those occuring after a peripheral injury. Diana van Rooijen, Leiden Medical Center, the Netherlands, tells us what her review on this group of conditions reveals (0.58).
Clinicians are used to seeing ALS patients who are or have been athletic. So is there a link, and if so, could exercise have a direct effect on the condition? Dr Martin Turner, John Radcliffe University Hospital, Oxford, talks us through his investigations (8.58).
See also:
Concordance between site of onset and limb dominance in amyotrophic lateral sclerosis http://tinyurl.com/b3bdzc7
Peripheral trauma and movement disorders: a systematic review of reported cases http://tinyurl.com/b977yzm
Intravenous thrombolysis is the only curative treatment for acute ischaemic stroke, but is only licensed for patients up to 80 years old. Dr Paul Guyler, Southend Hospital NHS Trust, UK, discusses the evidence for outcomes in those over this limit, and whether or not doctors should treat off-licence.
Also in this July edition, Dr Alan Carson, Western General Hospital, Edinburgh, UK, on his research into disability, distress and employment in neurology outpatients who’s symptoms can’t be explained organically, and why they don’t fit the stereotypes.
See also:
Intravenous thrombolysis in acute ischaemic stroke: a systematic review and meta-analysis to aid decision making in patients over 80 years of age http://tinyurl.com/ar9emm3
Disability, distress and unemployment in neurology outpatients with symptoms ‘unexplained by organic disease’ http://tinyurl.com/acmtha7
Dizziness can significantly complicate peoples’ lives, especially if it does not have a satisfactory medical explanation. We talk to Dr Gabriele Schmid of the Department of Psychosomatic Medicine and Psychotherapy, Technical University of Munich, Germany, about how psychotherapy might be beneficial for these patients.
Also in this month’s podcast, Professor Ammar Al-Chalabi of King’s College London discusses the link between prenatal testosterone levels and ALS.
See also:
Psychotherapy in dizziness: a systematic review http://tinyurl.com/a4eughg
Low index-to-ring finger length ratio in sporadic ALS supports prenatally defined motor neuronal vulnerability http://tinyurl.com/ay29ovu
Recent clinical, neuropsychological, imaging, genetic and pathological developments have changed our understanding of frontotemporal dementia, its classification and criteria. Dr Jonathan Rohrer, Dementia Research Centre, UCL Institute of Neurology, London, talks about these advances and future research directions.
Also in this edition, Dr Shaun O’Keeffe, Merlin Park University Hospital, Dublin, explains how simple questions about time are, and should be, used to assess dementia and delirium.
See also:
Clinical, genetic and pathological heterogeneity of frontotemporal dementia: a review http://tinyurl.com/barrt7s
Orientation to time as a guide to the presence and severity of cognitive impairment in older hospital patients http://tinyurl.com/ajaqsa4
This month Robert Wilson, Rush University Medical Center, Chicago, USA, on how dementia affects our knowledge of words, and the neuropathology which underlies this.
Also, the use of deep brain stimulation to treat Parkinson’s disease. Tom Foltynie describes the image guided, rather than microelectrode guided, technique used at the National Hospital of Neurology and Neurosurgery, London, UK, and the success they’ve had.
See also:
MRI-guided STN DBS in Parkinson’s disease without microelectrode recording: efficacy and safety http://tinyurl.com/a5nnod9
Loss of basic lexical knowledge in old age http://tinyurl.com/a3fpnjc
It’s been known for years that the prevalence of MS increases the further you go from the equator, but not why. Roisin Lonergan, from St Vincent’s University Hospital, Dublin, Ireland, describes her investigations into a genetic factor and vitamin D levels, and if they can help explain this.
Also Quinton Deeley, from the Institute of Psychiatry at London’s King’s College, UK, talks about hysteria and hypnosis, and why they could stem from similar brain processes.
See also
Multiple sclerosis prevalence in Ireland: Relationship to vitamin D status and HLA genotype http://tinyurl.com/a7c5xmj
Dissociation in hysteria and hypnosis: evidence from cognitive neuroscience http://tinyurl.com/a66mpdp
This month Harriet Vickers (BMJ’s multimedia intern), talks to Solveig Glad about how long patients with benign multiple sclerosis stay in work, and what could help them hold down jobs.
Also Colette Donaghy explains how examining eye movements in amyotrophic lateral sclerosis could help with diagnosis, and tell us more about the pathophysiology of the disease.
See also:
How long can you keep working with benign multiple sclerosis? http://tinyurl.com/bxjogdo
Eye movements in amyotrophic lateral sclerosis and its mimics: a review with illustrative cases http://tinyurl.com/aojsuza
In this month’s podcast Dr Amal Al Sayegh tells us about psychological therapies for treatment of post-concussion syndrome, and Dr Serena Hung describes patient’s perceptions of dyskinesia in Parkinson’s disease.
See also:
Psychological approaches to treatment of postconcussion syndrome: a systematic review http://tinyurl.com/bgcfkcl
Patient perception of dyskinesia in Parkinson’s disease http://tinyurl.com/bcqeav3
Tamara Matuz discusses her research looking for predictors for how well patients adjust to a diagnosis of ALS in southern Germany.
In this month’s podcast David Werring from University College London talks about his research into the link between brain microbleeds and intercerebral haemmorhage. Claudia Cooper explains her research looking at abusive behaviour by dementia patients towards their carers.
See also:
Abusive behaviour experienced by family carers from people with dementia http://tinyurl.com/bjw6n2e
Brain microbleeds as a potential risk factor for antiplatelet-related intracerebral haemorrhage http://tinyurl.com/bzso39e
In this month’s podcast Dawn Buse from the Montefiore Headache Center, New York, talks about her research into co-morbidities in chronic migrane sufferers.
See also: Sociodemographic and comorbidity profiles of chronic migraine and episodic migraine sufferers http://tinyurl.com/b3x44vm
Matthew Kiernan (editor of JNNP) interviews Caroline Lovelock about her paper: The SCAN rule: a clinical rule to reduce CT misdiagnosis of intracerebral haemorrhage in minor stroke. This paper was the editor’s choice in the March edition of JNNP.
In this second podcast Professor Matthew Kiernan talks to Dr Rhys Thomas about the law regarding sleep-related epilepsy and driving - this month’s editor’s choice paper.
Also Duncan Jarvies talks to Dr Howard Rosen about his research into self awareness in dementia patients - this month’s patient’s choice paper.
For more information please see:
Awake seizures after pure sleep-related epilepsy: a systematic review and implications for driving law http://tinyurl.com/a6jfzcr
Standardised measurement of self-awareness deficits in FTD and AD http://tinyurl.com/atkrdqe
We are delighted to offer you the inaugural podcast from JNNP. Recorded at BMA House London, our broadcast begins with a future vision for the journal from incoming Editor, Professor Matthew Kiernan based in Sydney. There then follows a discussion with Dr Marie D’hooghe from the National Multiple Sclerosis Centre in Belgium. Marie and Matthew discuss the long-term effects of childbirth in patients diagnosed with multiple sclerosis and uncover some interesting insights. They chat about:
How women with MS fare after childbirth
How hormonal effects may alter the clinical course of MS
How lifestyle factors contribute to these outcomes.
For more information please see the abstract of Long-term effects of childbirth in MS
Please email us your thoughts about this podcast (http://jnnp.bmj.com/) and suggestions for future ones.