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Journal articleDatta G, Violante IR, Scott G, et al., 2016,
Translocator positron-emission tomography and magnetic resonance spectroscopic imaging of brain glial cell activation in multiple sclerosis.
, Multiple Sclerosis, Vol: 23, Pages: 1469-1478, ISSN: 1352-4585BACKGROUND: Multiple sclerosis (MS) is characterised by a diffuse inflammatory response mediated by microglia and astrocytes. Brain translocator protein (TSPO) positron-emission tomography (PET) and [myo-inositol] magnetic resonance spectroscopy (MRS) were used together to assess this. OBJECTIVE: To explore the in vivo relationships between MRS and PET [(11)C]PBR28 in MS over a range of brain inflammatory burden. METHODS: A total of 23 patients were studied. TSPO PET imaging with [(11)C]PBR28, single voxel MRS and conventional magnetic resonance imaging (MRI) sequences were undertaken. Disability was assessed by Expanded Disability Status Scale (EDSS) and Multiple Sclerosis Functional Composite (MSFC). RESULTS: [(11)C]PBR28 uptake and [ myo-inositol] were not associated. When the whole cohort was stratified by higher [(11)C]PBR28 inflammatory burden, [ myo-inositol] was positively correlated to [(11)C]PBR28 uptake (Spearman's ρ = 0.685, p = 0.014). Moderate correlations were found between [(11)C]PBR28 uptake and both MRS creatine normalised N-acetyl aspartate (NAA) concentration and grey matter volume. MSFC was correlated with grey matter volume (ρ = 0.535, p = 0.009). There were no associations between other imaging or clinical measures. CONCLUSION: MRS [ myo-inositol] and PET [(11)C]PBR28 measure independent inflammatory processes which may be more commonly found together with more severe inflammatory disease. Microglial activation measured by [(11)C]PBR28 uptake was associated with loss of neuronal integrity and grey matter atrophy.
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Conference paperJenkins PO, De Simoni S, Fleminger J, et al., 2016,
Disruption to the dopaminergic system after traumatic brain injury
, Annual Meeting of the Association-of-British-Neurologists (ABN), Publisher: BMJ Publishing Group, ISSN: 1468-330X -
Journal articleIbitoye RT, Renowden SA, Faulkner HJ, et al., 2016,
Ovarioleukodystrophy due to EIF2B5 mutations.
, Pract Neurol, Vol: 16, Pages: 496-499Ovarioleukodystrophy-the co-occurrence of leukodystrophy and premature ovarian failure-is a rare presentation now recognised to be part of the clinical spectrum of vanishing white matter disease. We describe a woman with epilepsy and neuroimaging changes consistent with leukoencephalopathy who presented with non-convulsive status epilepticus after starting hormone replacement therapy in the context of premature ovarian failure. Genetic testing confirmed her to be a compound heterozygote for EIF2B5 mutations; the gene encodes a subunit of eukaryotic translation initiation factor 2B. Mutations in EIF2B1-5 result in vanishing white matter disease. We highlight the importance of ovarian failure as a diagnostic pointer to eukaryotic translation initiation factor 2B (eIF2B)-related ovarioleukodystrophy and present a brief literature review of ovarioleukodystrophy.
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Journal articleIbitoye RT, Wilkins A, Scolding NJ, 2016,
Neurosarcoidosis: a clinical approach to diagnosis and management
, Journal of Neurology, Vol: 264, Pages: 1023-1028, ISSN: 0340-5354Sarcoidosis is a rare but important cause ofneurological morbidity, and neurological symptoms oftenherald the diagnosis. Our understanding of neurosarcoidosishas evolved from early descriptions of a uveoparotidfever to include presentations involving every part of theneural axis. The diagnosis should be suspected in patientswith sarcoidosis who develop new neurological symptoms,those presenting with syndromes highly suggestive ofneurosarcoidosis, or neuro-inflammatory disease wheremore common causes have been excluded. Investigationshould look for evidence of neuro-inflammation, bestachieved by contrast-enhanced brain magnetic resonanceimaging and cerebrospinal fluid analysis. Evidence ofsarcoidosis outside the nervous system should be sought insearch of tissue for biopsy. Skin lesions should be identi-fied and biopsies taken. Chest radiography including highresolutioncomputed tomography is often informative. Indifficult cases, fluorodeoxyglucose positron emissiontomography and gallium-67 imaging may identify subclinicaldisease and a target for biopsy. Symptomaticpatients should be treated with corticosteroids, and ifclinically indicated other immunosuppressants such ashydroxychloroquine, azathioprine, cyclophosphamide ormethotrexate should be added. Anti-tumour necrosis factoralpha therapies may be considered in refractory disease butcaution should be exercised as there is evidence to suggestthey may unmask disease.
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Conference paperAhmad H, Arshad Q, Roberts R, et al., 2016,
CHRONIC DIZZINESS POST TRAUMATIC BRAIN INJURY: A CROSS-SECTIONAL STUDY
, Annual Meeting of the Association-of-British-Neurologists (ABN), Publisher: BMJ PUBLISHING GROUP, ISSN: 0022-3050 -
Conference paperLi L, Violante I, Ross E, et al., 2016,
BRAIN NETWORK MODULATION WITH NON-INVASIVE BRAIN STIMULATION
, Annual Meeting of the Association-of-British-Neurologists (ABN), Publisher: BMJ PUBLISHING GROUP, ISSN: 0022-3050 -
Conference paperScott G, Jolly A, Jenkins PO, et al., 2016,
THE EFFECT OF MINOCYCLINE ON NEUROINFLAMMATION AFTER BRAIN TRAUMA
, Annual Meeting of the Association-of-British-Neurologists (ABN), Publisher: BMJ PUBLISHING GROUP, ISSN: 0022-3050 -
Journal articleScott G, Mahmud M, Owen DR, et al., 2016,
Microglial positron emission tomography (PET) imaging in epilepsy: applications, opportunities and pitfalls
, Seizure-European Journal of Epilepsy, Vol: 44, Pages: 42-47, ISSN: 1059-1311Neuroinflammation is increasingly implicated in epileptogenesis and epilepsy. Microglia are an important mediator of central nervous system inflammation, and the development of positron emission tomography (PET) radioligands which bind the Translocator Protein (TSPO), an outer mitochondrial membrane protein expressed by microglia, has enabled in vivo measurement of neuroinflammation. Here, we outline the principles and potential pitfalls of TSPO PET imaging in relation to epilepsy, and opportunities for using TSPO imaging as a biomarker for future anti-inflammatory based therapeutics in epilepsy.
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Journal articleRajchl M, Lee MCH, Oktay O, et al., 2016,
DeepCut: object segmentation from bounding box annotations using convolutional neural networks
, IEEE Transactions on Medical Imaging, Vol: 36, Pages: 674-683, ISSN: 0278-0062In this paper, we propose DeepCut, a method to obtain pixelwise object segmentations given an image dataset labelled weak annotations, in our case bounding boxes. It extends the approach of the well-known GrabCut[1] method to include machine learning by training a neural network classifier from bounding box annotations. We formulate the problem as an energy minimisation problem over a densely-connected conditional random field and iteratively update the training targets to obtain pixelwise object segmentations. Additionally, we propose variants of the DeepCut method and compare those to a naìˆve approach to CNN training under weak supervision. We test its applicability to solve brain and lung segmentation problems on a challenging fetal magnetic resonance dataset and obtain encouraging results in terms of accuracy.
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Journal articlevon Rosenberg W, Chanwimalueang T, Goverdovsky V, et al., 2016,
Smart helmet: wearable multichannel ECG & EEG
, IEEE Journal of Translational Engineering in Health and Medicine, Vol: 4, ISSN: 2168-2372Modern wearable technologies have enabled continuous recording of vital signs, however, for activities such as cycling, motor-racing, or military engagement, a helmet with embedded sensors would provide maximum convenience and the opportunity to monitor simultaneously both the vital signs and the electroencephalogram (EEG). To this end, we investigate the feasibility of recording the electrocardiogram (ECG), respiration, and EEG from face-lead locations, by embedding multiple electrodes within a standard helmet. The electrode positions are at the lower jaw, mastoids, and forehead, while for validation purposes a respiration belt around the thorax and a reference ECG from the chest serve as ground truth to assess the performance. The within-helmet EEG is verified by exposing the subjects to periodic visual and auditory stimuli and screening the recordings for the steady-state evoked potentials in response to these stimuli. Cycling and walking are chosen as real-world activities to illustrate how to deal with the so-induced irregular motion artifacts, which contaminate the recordings. We also propose a multivariate R-peak detection algorithm suitable for such noisy environments. Recordings in real-world scenarios support a proof of concept of the feasibility of recording vital signs and EEG from the proposed smart helmet.
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