JNNP podcast

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. Follow JNNP on twitter: @JNNP_BMJ

The effectiveness of endovascular treatment (EVT) in cases of acute ischaemic stroke caused by distal medium vessel occlusion (DMVO) is still unclear. A study in the JNNP assessed the safety and effectiveness of EVT in comparison to the best medical management for DMVO. Podcast host Dr. Saima Chaudhry¹ spoke to some of the paper's authors, Dr. Adam Dmytriw², Dr. Vivek Yedavalli³ and Dr. Hamza Salim³.   Read the paper: Endovascular therapy versus best medical management in distal medium middle cerebral artery acute ischaemic stroke: a multinational multicentre propensity score-matched study   1. Warren Alpert Medical School, Brown University, Rhode Island, USA 2. Neuroendovascular Program, Massachusetts General Hospital, Boston, Massachusetts, USA 3. Radiology, Johns Hopkins Medicine, Baltimore, Maryland, USA 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

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 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  

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 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

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 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

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. Follow JNNP on twitter: @JNNP_BMJ

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. Follow JNNP on twitter: @JNNP_BMJ

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. Follow JNNP on twitter: https://twitter.com/jnnp_bmj

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