Podcast appearances and mentions of queen square

En este episodio, nos sumergimos en la vía motora más determinante del sistema nervioso humano: el tracto corticoespinal. A través de un recorrido detallado por su evolución, desarrollo, anatomía y función, analizamos por qué esta vía representa la gran apuesta evolutiva por la motricidad fina y por qué su lesión tiene consecuencias tan devastadoras. Hablamos de neurofisiología, de plasticidad, de evaluación con TMS y DTI, de terapias intensivas, neuromodulación, farmacología, robótica y de las posibilidades —y límites— reales de su regeneración tras un ictus. Si te interesa entender en profundidad cómo se ejecuta el movimiento voluntario y qué ocurre cuando esa vía falla, este episodio es para ti. Referencias del episodio: 1. Alawieh, A., Tomlinson, S., Adkins, D., Kautz, S., & Feng, W. (2017). Preclinical and Clinical Evidence on Ipsilateral Corticospinal Projections: Implication for Motor Recovery. Translational stroke research, 8(6), 529–540. https://doi.org/10.1007/s12975-017-0551-5 (https://pubmed.ncbi.nlm.nih.gov/28691140/). 2. Cho, M. J., Yeo, S. S., Lee, S. J., & Jang, S. H. (2023). Correlation between spasticity and corticospinal/corticoreticular tract status in stroke patients after early stage. Medicine, 102(17), e33604. https://doi.org/10.1097/MD.0000000000033604 (https://pubmed.ncbi.nlm.nih.gov/37115067/). 3. Dalamagkas, K., Tsintou, M., Rathi, Y., O'Donnell, L. J., Pasternak, O., Gong, X., Zhu, A., Savadjiev, P., Papadimitriou, G. M., Kubicki, M., Yeterian, E. H., & Makris, N. (2020). Individual variations of the human corticospinal tract and its hand-related motor fibers using diffusion MRI tractography. Brain imaging and behavior, 14(3), 696–714. https://doi.org/10.1007/s11682-018-0006-y (https://pubmed.ncbi.nlm.nih.gov/30617788/). 4. Duque-Parra, Jorge Eduardo, Mendoza-Zuluaga, Julián, & Barco-Ríos, John. (2020). El Tracto Cortico Espinal: Perspectiva Histórica. International Journal of Morphology, 38(6), 1614-1617. https://dx.doi.org/10.4067/S0717-95022020000601614 (https://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0717-95022020000601614). 5. Eyre, J. A., Miller, S., Clowry, G. J., Conway, E. A., & Watts, C. (2000). Functional corticospinal projections are established prenatally in the human foetus permitting involvement in the development of spinal motor centres. Brain : a journal of neurology, 123 ( Pt 1), 51–64. https://doi.org/10.1093/brain/123.1.51 (https://pubmed.ncbi.nlm.nih.gov/10611120/). 6. He, J., Zhang, F., Pan, Y., Feng, Y., Rushmore, J., Torio, E., Rathi, Y., Makris, N., Kikinis, R., Golby, A. J., & O'Donnell, L. J. (2023). Reconstructing the somatotopic organization of the corticospinal tract remains a challenge for modern tractography methods. Human brain mapping, 44(17), 6055–6073. https://doi.org/10.1002/hbm.26497 (https://pubmed.ncbi.nlm.nih.gov/37792280/). 7. Huang, L., Yi, L., Huang, H., Zhan, S., Chen, R., & Yue, Z. (2024). Corticospinal tract: a new hope for the treatment of post-stroke spasticity. Acta neurologica Belgica, 124(1), 25–36. https://doi.org/10.1007/s13760-023-02377-w (https://pubmed.ncbi.nlm.nih.gov/37704780/). 8. Kazim, S. F., Bowers, C. A., Cole, C. D., Varela, S., Karimov, Z., Martinez, E., Ogulnick, J. V., & Schmidt, M. H. (2021). Corticospinal Motor Circuit Plasticity After Spinal Cord Injury: Harnessing Neuroplasticity to Improve Functional Outcomes. Molecular neurobiology, 58(11), 5494–5516. https://doi.org/10.1007/s12035-021-02484-w (https://pubmed.ncbi.nlm.nih.gov/34341881/). 9. Kwon, Y. M., Kwon, H. G., Rose, J., & Son, S. M. (2016). The Change of Intra-cerebral CST Location during Childhood and Adolescence; Diffusion Tensor Tractography Study. Frontiers in human neuroscience, 10, 638. https://doi.org/10.3389/fnhum.2016.00638 (https://pubmed.ncbi.nlm.nih.gov/28066209/). 10. Lemon, R. N., Landau, W., Tutssel, D., & Lawrence, D. G. (2012). Lawrence and Kuypers (1968a, b) revisited: copies of the original filmed material from their classic papers in Brain. Brain : a journal of neurology, 135(Pt 7), 2290–2295. https://doi.org/10.1093/brain/aws037 (https://pubmed.ncbi.nlm.nih.gov/22374938/). 11. Li S. (2017). Spasticity, Motor Recovery, and Neural Plasticity after Stroke. Frontiers in neurology, 8, 120. https://doi.org/10.3389/fneur.2017.00120 (https://pubmed.ncbi.nlm.nih.gov/28421032/). 12. Liu, Z., Chopp, M., Ding, X., Cui, Y., & Li, Y. (2013). Axonal remodeling of the corticospinal tract in the spinal cord contributes to voluntary motor recovery after stroke in adult mice. Stroke, 44(7), 1951–1956. https://doi.org/10.1161/STROKEAHA.113.001162 (https://pubmed.ncbi.nlm.nih.gov/23696550/). 13. Liu, K., Lu, Y., Lee, J. K., Samara, R., Willenberg, R., Sears-Kraxberger, I., Tedeschi, A., Park, K. K., Jin, D., Cai, B., Xu, B., Connolly, L., Steward, O., Zheng, B., & He, Z. (2010). PTEN deletion enhances the regenerative ability of adult corticospinal neurons. Nature neuroscience, 13(9), 1075–1081. https://doi.org/10.1038/nn.2603 (https://pubmed.ncbi.nlm.nih.gov/20694004/). 14. Schieber M. H. (2007). Chapter 2 Comparative anatomy and physiology of the corticospinal system. Handbook of clinical neurology, 82, 15–37. https://doi.org/10.1016/S0072-9752(07)80005-4 (https://pubmed.ncbi.nlm.nih.gov/18808887/). 15. Stinear, C. M., Barber, P. A., Smale, P. R., Coxon, J. P., Fleming, M. K., & Byblow, W. D. (2007). Functional potential in chronic stroke patients depends on corticospinal tract integrity. Brain : a journal of neurology, 130(Pt 1), 170–180. https://doi.org/10.1093/brain/awl333 (https://pubmed.ncbi.nlm.nih.gov/17148468/). 16. Usuda, N., Sugawara, S. K., Fukuyama, H., Nakazawa, K., Amemiya, K., & Nishimura, Y. (2022). Quantitative comparison of corticospinal tracts arising from different cortical areas in humans. Neuroscience research, 183, 30–49. https://doi.org/10.1016/j.neures.2022.06.008 (https://pubmed.ncbi.nlm.nih.gov/35787428/). 17. Ward, N. S., Brander, F., & Kelly, K. (2019). Intensive upper limb neurorehabilitation in chronic stroke: outcomes from the Queen Square programme. Journal of neurology, neurosurgery, and psychiatry, 90(5), 498–506. https://doi.org/10.1136/jnnp-2018-319954 (https://pubmed.ncbi.nlm.nih.gov/30770457/). 18. Welniarz, Q., Dusart, I., & Roze, E. (2017). The corticospinal tract: Evolution, development, and human disorders. Developmental neurobiology, 77(7), 810–829. https://doi.org/10.1002/dneu.22455 (https://pubmed.ncbi.nlm.nih.gov/27706924/).

In this episode, I review the pathological and clinical dimensions of migraine, the most common disabling neurological disorder. I tried to capture migraine's diverse disabling recurrent symptoms, from its risk factors, triggers and prodrome to the aura, the headache, and multiple heightened sensitivities.To illustrate the lived experience of migraine, its classical manifestations, and its curious variants, I refer to such vivid patient memoirs as those of Monica Nelson titled Mere Sense, and Abby Reed titled The Color of Pain. I also cited Oliver Sacks classical book titled 'Migraine'.I also flavour the podcast with historical migraine patient anecdotes, such as those of Ann Conway, the enlightenment writer who was treated by the great physicians William Harvey and Thomas Willis, of Annie, who was treated with an astounding number of therapies by the famous Queen Square neurologist William Gowers, and of Alexander Pope who treated his migraines in a most unconventional way.In this regard, I relied on Migraine: A History, Katherine Foxhall's magnificent historical account of the medieval ideas and treatments of the disorder, and Soul Made Flesh, Carl Zimmer's exhilarating biography of Thomas Willis.The podcast also explores and the evolution of migraine's acute and preventative treatments, and how a better understanding of its pathology is leading to treatments such as those that influence the CGRP pathway.

"Could this presenting syndrome be caused by a neurotoxin?" Oftentimes neurologists will pass over toxins when diagnosing. Yet disease caused by neurotoxins is widespread, with many having quite typical syndromes.  In the studio to discuss this is the first author of the October 2024 Editors' Choice paper, Dr. Frederick Vonberg¹. He draws attention to some hobbies and occupations to watch out for, the global prevalence of lead poisoning, presentations of botulism, and the origin of the infamous Mad Hatter syndrome.  Read the paper: Neurotoxicology: a clinical systems-based review 1. National Hospital for Neurology and Neurosurgery, Queen Square, London, UK Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest episodes. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback on social media - @PracticalNeurol. This episode was hosted by PN's podcast editor Dr. Amy Ross Russell. Production by Letícia Amorim, Brian O'Toole, and Amy Ross Russell. Editing by Brian O'Toole.

Harith Akram is the consultant neurosurgeon at the National Hospital for Neurology and Neurosurgery (UCLH) and the Unit of Functional Neurosurgery (UCL) at Queen Square. We discuss Dr. Akram's hobbies beyond the lab and OR and delve into his fascinating journey which culminated in him training in the UK, with many stops along the way. Harith shares insights into his illustrious career, highlighting the key mentors who shaped his path, including Drs. Marwan Hariz and Ludvic Zrinzo. With many anecdotes about these influential figures, he reveals the unique lessons each imparted on his training. We then explore Harith's research and clinical work, from the creation of the innovative 'Gilgamesh' to his highly cited STN symptom-specific sweetspots paper. He discusses the practical impacts of his research on surgical practices and his involvement in pivotal projects like the four-lead OCD trial and thalamic segmentations based on tractography. The conversation also touches on underutilized therapies, such as DBS for cluster headaches, and the exciting potential of a new MR sequence he designed (i.e., FAT1). Harith provides his perspective on the future of lesion-based therapies, particularly cingulotomies for OCD and pain. Harith shares his advice for young researchers, reflects on missed opportunities, and engages in rapid-fire questions that reveal his thoughts on the future of neuroscience and academia. Join us for an inspiring and informative episode that showcases Harith's remarkable journey and contributions.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021. Originally released: December 13, 2018 Want to make a name for yourself? Declare yourself chief of something. Or chief of many things, as Dr. S A Kinnier Wilson did. This week on the podcast, we commemorate his legacy and his commitment to neurology. Produced by James E Siegler. Music by Chris Zabriskie and Mystery Mammal. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast. REFERENCESCompston A. Progressive lenticular degeneration: a familial nervous disease associated with cirrhosis of the liver, by S. A. Kinnier Wilson, (From the National Hospital, and the Laboratory of the National Hospital, Queen Square, London) Brain 1912: 34; 295-509. Brain 2009;132(Pt 8):1997-2001. PMID 19634211S. A. Kinnier Wilson (1878-1937) Lenticular-hepatic degeneration. JAMA 1968;205(12):871-2. PMID 4877350Trocello JM, Broussolle E, Girardot-Tinant N, et al. Wilson's disease, 100 years later…. Rev Neurol (Paris) 2013;169(12):936-43. PMID 24119853Walshe JM. History of Wilson disease: a personal account. Handb Clin Neurol 2017;142:1-5. PMID 28433095 We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

Indomethacin-responsive headache disorders are rare conditions whose hallmark is an absolute response to the medicine and include paroxysmal hemicrania and hemicrania continua. In this episode, Gordon Smith, MD, FAAN, speaks with Peter Goadsby, MD, PhD, FRS, author of the article “Indomethacin-Responsive Headache Disorders,” in the Continuum® April 2024 Headache issue. Dr. Smith is a Continuum® Audio interviewer and professor and chair of neurology at Kenneth and Dianne Wright Distinguished Chair in Clinical and Translational Research at Virginia Commonwealth University in Richmond, Virginia. Dr. Goadsby is a professor of neurology at King's College London in London, United Kingdom and professor emeritus of neurology at the University of California, Los Angeles in Los Angeles, California. Additional Resources Read the article: Indomethacin-Responsive Headache Disorders Subscribe to Continuum: continpub.com/Spring2024 Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @gordonsmithMD Guest: @petergoadsby Transcript Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum, the premier topic-based neurology clinical review and CME journal from the American Academy of Neurology. Thank you for joining us on Continuum Audio, a companion podcast to the journal. Continuum Audio features conversations with the guest editors and authors of Continuum, who are the leading experts in their fields. Subscribers to the Continuum journal can read the full article or listen to verbatim recordings of the article by visiting the link in the Show Notes. Subscribers also have access to exclusive audio content not featured on the podcast. As an ad-free journal entirely supported by subscriptions, if you're not already a subscriber, we encourage you to become one. For more information on subscribing, please visit the link in the Show Notes. AAN members: Stay tuned after the episode to hear how you can get CME for listening. Dr Smith: This is Dr Gordon Smith. Today, I've got the great pleasure of interviewing Dr Peter Goadsby on indomethacin-responsive headache disorders, which is part of the April 2024 Continuum issue on headache. Dr. Goadsby is a Professor of Neurology at King's College London, in London, United Kingdom and a Professor Emeritus of Neurology at the University of California, Los Angeles, which is located in Los Angeles, California. Dr Goadsby, welcome to the podcast. Well Peter, I'm super excited to have the opportunity to talk to you. And I think, before we begin, we probably ought to expand on your introduction. I think there may be three or four neurologists who don't know who you are, and I think they should know who you are because you've got a really amazing story. These are exciting times in headache, right? And a lot of that's because of your work and you've been widely acknowledged for that; you received the appropriately named “Brain Prize,” which (if I'm correct) is the largest neuroscience award in the world; got to meet Danish royalty; you're - more recently, the ABF Scientific Breakthrough Award, which is super excited. So, particularly interested in hearing about your Continuum article. But before we get there, I think it would be really great to hear your story. How did you get into this in the beginning, and what's inspired you along the way to the many achievements you've had? Dr Goadsby: Why, it's a very kind introduction. People have been nice to me. It has to be said, Danish royalty were very nice, I have to say, and the very jolly chap, the Prince of Denmark. I got into neurology - I guess it's all about mentoring for me. I got into neurology because I got into medical school pretty much by accident. I really wasn't that interested and heard a lecture by James Lance, who was Professor of Neurology, University of New South Wales, at the time. He was talking about a nondominant parietal lobe. I'd seen the case as a medical student; it sort of just seemed weird to me and I wasn't that interested. But he set out this way of thinking about things to try and understand why a clinical presentation is what it is - what he described as a physiological approach to clinical neurology. He described a number of things, but he described that in this lecture and then gave a reference to some work that Mountcastle did on nondominant parietal recordings from awake behaving monkeys in the Journal of Neurophysiology. And I thought to myself, “Wow, this is really interesting - you could really get to the bottom of something,” and had that sort of “puzzle-y” thing going on. And I thought Lance was just wonderful, so I became interested in that. And then eventually I asked him about research - actually, I asked him about research after a lecture he gave on migraine, and the explanation of the time was some circulating substance - probably just as silly now. I went up to him afterwards and said to him, I thought the explanation he was giving was wrong. Like, here was a global person - he described Lance-Adams syndrome; this was someone who trained at Mass General, trained at Queen Square; was the first professor of neurology in Australia. I was just – like, it was a stupid thing to do. But I couldn't resist myself - I told him I thought it was wrong. And he's very polite, and he said, “Well, perhaps you could come and help us by doing some research.” And I thought, “Okay, that's a very nice response.” Interestingly, his daughter described him as unfailingly polite at his funeral. Of the many things you'd say about him, he was a kind person. Whether it's science or just the way you practice - that word (kind) - you can know as much about a subject as you like, but if you're not kind to patients, you're probably in the wrong game. He taught me to be curious about a problem and got me interested in headache, and to be kind in clinical practice - just kind – and I think they were very important lessons. So, I got into it because of excellent mentoring, and I'd like to think I've helped some others along the way. Dr Smith: Well, you certainly have helped a lot of people, Peter, and what a great story. I'm reflecting - I think the first vignette in The Man Who Mistook His Wife for a Hat was a right parietal syndrome - wasn't it? You've read that book? Dr Goadsby: Yes, I have. And I've met Sacks. When Sacks came to Australia, he wanted to see Lance, and Lance said, “Fine, but you have to meet me between the morning round and the afternoon clinical meeting.” And he got him to come and have lunch with him in the hospital cafeteria at the Prince Henry Hospital and invited me to this lunch. And I sat there and watched them chat. But it was a measure of Lance and how people were interested in him that Oliver Sacks had to get in a taxi and come out to a hospital cafeteria to have lunch if you wanted to have a chat. Because it was - it was a privilege to train with the person. You know, I've done okay, but I only do okay if you've got – you know, you can work with patients, you've got great collaborators, and you've got someone you can get advice from (a great mentor). Dr Smith: Yeah, that's actually really great words of wisdom for the residents and fellows and junior faculty listening to this. Maybe we should actually talk about your article, which was really great. Your article was on indomethacin-responsive headaches - and we can maybe talk about some specific questions - but what's the main take-home point? If our listeners needed to take or were to take home one point from your article, what would it be, other than it's indomethacin-responsive (that's in the title)? Dr Goadsby: Yeah, it's what it says on the jar. Well, I think the one thing to take home is that there are forms of headache that seem relatively pedestrian, like one-sided headache that feels like it ought to be migraine that's strictly one-sided, and a small percentage of them respond almost like switching a light off to indomethacin. So, I think you have to have a high index of suspicion. And I'm sure I give indomethacin to ten, twenty times as many people - or thirty - who end up (or even more, probably) who end up having a response. But we do it for a short period of time. For those who get the response - I can tell you, when they come back, they're crying, their partners crying, or the other day I saw one, their child's crying, because all of a sudden, you've basically fixed the problem up. So, the message would be, if you've heard about something and it feels a bit “maybe, could be” - you've heard this indomethacin thing - just do it for a couple of weeks. The worst thing that can happen is nothing (nothing happens). For a couple of weeks, they're not going to have a problem with the tummy (and I'm not advocating taking people with a active gastric ulcer, trying to bump them off). But you cover them properly, you give them a short trial, and occasionally in your practice, you will be so rewarded by that - you will dance home. Dr Smith: Well, this is going to be my next question. There are very specific criteria, right, for defining cluster, SUNCT, SUNA (and there was a really great Continuum Audio conversation I had with Mark Burish I'll refer our listeners to about cluster, SUNCT, and SUNA), but the indomethacin-responsive headaches - and even migraine - that sounds to me, as someone who's not a headache person, like, that could be challenging to sort out. If you see someone who has consistent, unilateral headache, do you just do an indomethacin trial, or do you select based on other criteria from the classification system? Dr Goadsby: I'd like to think I was aware of the criteria, and I am. But the longer I practice, the more I'm inclined simply to give the indomethacin and get the question off the table because I don't think there's a sine qua non; there's nothing that will - apart from the indomethacin effect - there's nothing that will convince me 100% to be able to not do it. I've seen enough people who haven't clearly read the classification in detail (patients, I mean) and took indomethacin, and got a response where you wouldn't have predicted it, and they're very happy and the story ends well. So, I would advise people not to worry too much about whether it ought to or not respond, but find out if it does. Dr Smith: So, the obvious next question is, how does this work? It's pretty unusual in medicine, certainly in neurology, to have something that's so dramatically effective. What's the mechanism? Dr Goadsby: Well, that's the easiest question - we don't understand it. It is particular to indomethacin - it's weird. Some patients will say, “We'll give you a little bit of a hint by telling you (maybe) that ibuprofen was useful,” but most don't give you that much of a hint (some will even say aspirin is useful). But we haven't really gotten to the bottom of it. What are the current thoughts? It must be something that's not simply cyclo-oxygenase because other cyclo-oxygenase inhibitors don't do that – so, that's helpful. The other broad things people think about are whether there's a nitrergic aspect to it. We've got some basic science work that can show that nitrergically induced changes in experimental animal model of these trigeminal autonomic cephalalgias can be modified by indomethacin in one part of the model, where naproxen (for example) can't. So, we think there may be a nitrergic component to it. The other thing is the structure of the molecule makes you think about melatonin, if you put the two up – it's a work in progress. Of the things I would like to do in my life, I'd really like to get to the bottom of it, I have to tell you, because if we could work out what it is that's great about indomethacin and then get rid of the GI thing . . . Then, if you talk about cure - because when people get a response to this (you know, the oldest reported case with a response took it for thirty-seven years; they died of something else) - and continue to respond. It's one of the sort of upsides and downsides when you diagnose it - you can tell a person that they're going to continue to respond (take a breath) until they die basically, because unfortunately, the problem doesn't tend to settle down - at least the treatment stays consistent. If we could get rid of the tummy problem, that would be real progress. Dr Smith: So, what do you do with the patient who has the tummy problem? Is there another approach? Dr Goadsby: Well, there's a range of things you try and do; you use PPIs (proton pump inhibitors) and H2 blockers pretty liberally; you try to get the lowest dose, and that's usually best done by the patient. I give them the ordinary-release indomethacin; it's an impression that I have, over the years, that the slow-release indomethacin is not as efficient (just as a recommendation). I let patients - they take it three times a day, or twice - I let them work out what the littlest amount is that they need, having given them a regime to iron it out, because they can work it out for themselves. It's a partnership. It'll be very individual. If someone wants to take two in the morning and one at night and feels happy, have at it. If they want to take one three times a day, if they want to take one at lunchtime - whatever they - let them work out the minimal amount. And the other thing that we found useful - small percentage (maybe one in five) will find the coxibs useful (like celecoxib), but that's not universal at all; it generally takes the edge off. A palpable percentage will find adding melatonin in can be indomethacin sparing. Then the other (probably most important) thing is that the noninvasive vagal nerve stimulator can be very useful in reducing indomethacin dosing or even getting patients entirely off indomethacin dosing. How that works, of course, is as mysterious in the sense of these problems as is indomethacin. But that's something really worth thinking about - can be very, very useful in getting the doses down. Dr Smith: You've been doing this for a while, right? And you've seen a lot of – Dr Goadsby: Let's not emphasize that “for a while” side, right, okay? Dr Smith: For a while – just a little while, Peter. Dr Goadsby: A little while. Dr Smith: I'm just thinking - and I'm a neuromuscular guy, so give me a little latitude - but when I was a resident, our concept of headache was pretty simple; it was migraine, classic or common, and we knew a little bit about cluster. And no one talked about SUNCT or SUNA or all these other things, and wow, what an amazing several decades it's been. What's the future look like? And - maybe think big – so, is a cure for migraine in the foreseeable future? What's coming next? Dr Goadsby: If you think really big (and I'll think really big), if “cure” means that we could control it sufficiently that you wouldn't notice it, I think that's very much - it's almost here, for some. Now, I think of it like cholesterol - someone's got high cholesterol; they take a statin, and if they don't get any problems, the cholesterol normalizes. I'm simplifying things (I'm not a cardiologist), but you take your cholesterol tablet - you take it once a day; everything's fine and dandy. You never get “cured,” as such, but the effect is an effective cure from manifestations of the problem - and I am simplifying things a little bit. If I look at it like that, then I think we're getting to a place where some patients, we can treat them so well, and the problem is so suppressed, and they have so few problems with side effects (and some have none), that we're really getting there. We saw a study of the promontory phase of migraine using a gepant (ubrogepant), and we saw the ability (if you recognize the attack early enough) to treat and never have pain. Never have pain. Well, that's pretty close. It might sound crazy to think about it as a cure because someone will say, “Well, they've still got their genes,” and so on. Fine. But migraine is about disability, and if you can stop the disability and give a person full function in their life, well, you're pretty much there. And we're getting there, as we understand the disease. Dr Smith: Really amazing. I have another question that I've actually been really dying to ask you. I'm a peripheral nerve guy, and you may not be aware of this, but those of us who are interested in therapeutic development in peripheral neuropathy, or advocacy, or recognition of neuropathy as a substantive, meaningful entity, are inspired by the work of you and your colleagues in headache. Examples might be advocacy for federal funding or having CDMRP funding - things like this. But an area where - I'm just curious - we spent a lot of effort (and it seems like it's been really transformational for you guys) is having taxonomy, which isn't a particularly sexy topic. But maybe you can talk about the power of having a taxonomic classification and getting towards a cure. Because looking through this Continuum issue - it's really remarkable – it's just all sorts of things that I never would have thought of twenty years ago, and each of them is treated a bit differently. Dr Goadsby: Yes. As with all things in medicine, if you don't get the diagnosis, you can't get to the base - you've got to be able to get a diagnosis. And our taxonomy, the International Classification of Headache Disorders, has gone through three editions. We're working on the fourth. I have the privilege of being the chairman for the fourth edition (the first three were chaired by Jes Olesen). I do think it's one of the absolute achievements of our field (and Olesen needs to be really feted for doing this) that we have a definition system - it's operational; it's reasonably straightforward; it's been translated into, like, forty languages; that every government on the planet that I know of - and I'm talking about (I think I'd better mention no governments) but every big government you can think of, without exception, has adopted (‘cause I'll just get in trouble with the ones I've mentioned) have all adopted this classification; all the health technology assessments (the FDA, for example; the European Medicine, for another example), the Chinese government (People's Republic), Taiwan. Just, all over the world, people use one thing. So, if we do a randomized control trial - there's one recently came out; it doesn't really matter which gepant it is - but you look at the results in North America, and then you look at the results that were done by the Chinese and the South Koreans in a study, and the placebo rates and the active rates are more or less identical. Because what we've been able to do is homogenize who gets into clinical trials and understand what's happening. So, if I get up and talk about whatever we're going to talk about now, like, in rural India, people will know what we're talking about; all the neurologists will be on the same page and so we can make progress. And when we make progress, it's global progress because we sing from the same hymn sheets. I think the taxonomy has been really important for this. And, of course, if you get the diagnosis right, then you can start to begin to get the treatments right and you can bring all the knowledge from randomized controlled trials. There's no point having a whole lot of data if you can't apply it, and what's great about our taxonomy is we can apply it everywhere in the world. Dr Smith: Wow, what a cool answer. So, I have a follow up question for you, Peter, which has to do with reproducibility. This is a huge issue, right? In reproducibility and clinical trial evidence and in many fields, this has been a big issue - in psychiatry and other areas of neurology, where trials are nonreproducible. To what extent do you think this problem in other fields is a taxonomic problem, or a internal validity problem, in terms of the populations being recruited? I'm really impressed to hear that you don't have that problem in headache. Dr Goadsby: I do think one of the advantages that the International Classification of Headache Disorders has given us (International Headache Society being the proponent of that) is that there's clinical homogeneity, relatively speaking, in our clinical trial populations. This comes back to the clinic; good clinical trials are as much about the clinicians who are involved and the care they take in recruiting patients, and so on. Which is not to say that psychiatrists are not careful - not at all. But I do think that if you want to just test a question, everyone in the laboratory will tell you that you need to have - say you're doing work with rodents, for example; you want about the same weight, you want the same strain, they're eating about the same, they're up and down at night - everything is about the same. If you want to do good clinical trial work, you have to tidy up as much as you can so the only thing that's really impacting upon the question is the medicine, or the placebo, or whatever that you're testing. So, I think you're right. I think sometimes the pain people struggle with this because, as you say, a painful neuropathy can come from a lot of places. Well, if you just take all of those etiologies, you throw them into one study, and you test it against something, it doesn't surprise me that that's not so useful, compared to taking an individual thing that's really well defined - where you've understood the clinical side, you've understood the pathophysiology as much as you could - and just test that, one at a time. I think that's been a good lesson for us. And that's why there's nothing that's ever failed in a migraine clinical trial (a properly designed one) that ever was useful, and nothing that was ever successful that didn't continue to be successful. Now, some things were successful, and they produced, like, liver enzyme problems - so, that's “no win-no foul” situation. But the homogeneity's been quite important, I think. And it comes back to good clinical practice. Dr Smith: Well, thank you for the roadmap - that's really, really interesting. I'd like to finish up with another shift in gears, and to talk about workforce. Obviously, we have a national shortage of neurologists in the United States. We're never going to be able to train enough headache neurologists to take care of all headache patients, and we need to think about systems of care, which I guess we could talk about. But my question for you is, what would you say - a lot of residents listen to Continuum Audio, and hopefully, more medical students in the future and now - what do you say to them about a career in headache? Listening to this, I kind of feel like I want to go do a headache fellowship - it's pretty exciting. What's your pitch to them? Dr Goadsby: I'll tell you one small thing first before I say that; I did do twelve months in clinical neurophysiology, doing nerve conduction, muscle biopsies, evoked potentials. I actually did over ninety muscle biopsies (needle muscle biopsies) when I was training, so I understand your feeling. But I just got the feeling many years earlier than you've had it. What do I say to residents? Well, headache is an area where you can make a diagnosis, you can manage the patient, and you can make them better. I'd say to the resident, “Ask - just look in the mirror and ask yourself, why did you get into medicine?” You got into medicine to help people, and headache is an area where you can really help them. Plus, there's tens of millions of people with the problem, so you will always be in demand. And one of the great things about headache (I think it's probably true of neuromuscular) is it's also a very good lifestyle choice because our problems are generally with primary headache disorders - are not emergent (people don't tend to ring you up at night), and it's not really an on-call issue. You can have a proper balanced existence (work-life balance), and you can do it in a way that's really enjoyable. And then there's an extra bonus: there's all the wonderful neuroscience and neuropharmacology that's going on in headache. I just think if a resident looks in the mirror and says, “Why am I doing this?” most of them are going to look back at themselves and say, “Because I want to do good.” And they also want to do good in a way that they can have a proper life themselves. And if they're the two answers you got back when you look in the mirror (“I want to do good” and “I want to have some life myself”) - headache - that's the place to go, because there's plenty of room and you can do both. Dr Smith: Well Peter, that's great - sign me up. And I think people know where to find you to call for a recommendation. What a great conversation and a really great article. And again, I'll refer our listeners to Mark Burish's article on cluster, which is a really great companion to your article ‘cause it gives you the full spectrum of trigeminal autonomic cephalgias (which is pretty cool), and the rest of the issue is equally amazing. Peter, you don't disappoint. The next time you see the Danish Crown Prince, say “Hi” from me (I love Denmark - it's a lovely place to be). And thanks again for doing this. Dr Goadsby: Well, thank you, and thanks for the Academy for organizing. And the other thing about residents - if you want to stay in touch with neurology, stay in touch with the Academy; they're a pretty good bunch. Dr Smith: Couldn't agree more, couldn't agree more. Again, today we've been interviewing Dr. Peter Goadsby. His article on indomethacin-responsive headache disorders appears in the most recent issue of Continuum, on headache. Be sure to check out our Continuum Audio podcasts from this and other issues. And listeners, thank you very much for joining us today.   Dr. Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practice. Right now, during our Spring Special, all subscriptions are 15% off. Go to Continpub.com/Spring2024, or use the link in the episode notes to learn more and take advantage of this great discount. This offer ends June 30, 2024. AAN members: go to the link in the episode notes and complete the evaluation to get CME. Thank you for listening to Continuum Audio.

Dr Aida Suárez-Gonzalez narrates her blog written for Dementia Researcher. In this blog Aida discusses the process of senior academic promotions (grade 9 and 10) in UK higher education institutions, focusing on the underrepresentation of women in such positions. She shares tips and learnings from her own experience, advising readers to prepare in advance, organise their merits according to the framework, attend workshops, download official forms, seek examples of successful applications, be aware of gender bias, craft a strong personal statement, aim for the minimum requirements rather than perfection, seek support from experienced colleagues, and be mindful of internal deadlines to increase their chances of success in the promotions process. Find the original text, and narration here on our website. https://www.dementiaresearcher.nihr.ac.uk/guest-blog-getting-yourself-a-senior-academic-promotion/ -- Dr Aida Suarez-Gonzalez is a Clinical Neuropsychologist and Senior Research Fellow at the Dementia Research Centre, UCL Institute of Neurology at Queen Square. With many years clinical experience working in Spain, Aida now investigating non-pharmacological interventions, services and assistive technologies to support people living well with dementia. -- This podcast is brought to you in association with Alzheimer's Association, Alzheimer's Research UK, Alzheimer's Society and Race Against Dementia, who we thank for their ongoing support. Enjoy listening? We're always looking for new bloggers, drop us a line dementiaresearcher@ucl.ac.uk  

In another episode in this series, we talk to one of the NAKEDHEALTH Founding Partners, Lee Williams, about his journey to NAKEDHEALTH.   Before setting up NAKEDHEALTH with Max and Raj, Lee began his post-graduation career in pharmacy manufacturing and research neurogenetics in Queen Square, London. After initially aiming to make the leap into mainstream consumer advertising, as a copywriter, Lee then discovered this now less hidden world of healthcare advertising - and the rest is history! Check out Lee's journey, from the Rhondda valleys to some of London's biggest agencies and then co-founding his own - which may be interesting for those considering a move into the agency world or for those of you reflecting on how on earth you ended up in this industry we love!

Brain surgery? “It's not rocket science”. Harith Akram is a world renowned consultant neurosurgeon at the National Hospital for Neurology and Neurosurgery (UCLH) and the Unit of Functional Neurosurgery (UCL) in Queen Square, London, who has recently pioneered a world-first: the cure for chronic pain.Don't forget you can watch these interviews, fully extended, exclusively on Global Player. Download it from the App Store, head to globalplayer.com, or follow this link to watch the full interview with Harith Akram:https://www.globalplayer.com/videos/2JsSZFgZjuU/ You can get in touch with Dan Schreiber on Twitter and Instagram (@Schreiberland). In his bio, you'll find the link to our Discord channel - a global community of likeminded weirdos!

Dr Aida Suárez-Gonzalez narrates her blog written for Dementia Researcher. In this blog Aida shares valuable tips for researchers who are planning to undertake research on non-pharmacological interventions in dementia. From identifying the right intervention to selecting appropriate outcome measures, and provide practical advice to help you design high-quality studies, that are deliverable and that can have a meaningful impact on the lives of people with dementia. Join us as we explore the unique challenges and opportunities in this exciting area of research. Find the original text, and narration here on our website. https://www.dementiaresearcher.nihr.ac.uk/guest-blog-non-pharmacological-interventions/ -- Dr Aida Suarez-Gonzalez is a Clinical Neuropsychologist and Senior Research Fellow at the Dementia Research Centre, UCL Institute of Neurology at Queen Square. With many years clinical experience working in Spain, Aida now investigating non-pharmacological interventions, services and assistive technologies to support people living well with dementia. -- This podcast is brought to you in association with Alzheimer's Association, Alzheimer's Research UK, Alzheimer's Society and Race Against Dementia, who we thank for their ongoing support. Enjoy listening? We're always looking for new bloggers, drop us a line dementiaresearcher@ucl.ac.uk  

Dr Aida Suárez-Gonzalez narrates her blog written for Dementia Researcher. There are many ways in which you can use your research and your knowledge to advocate. Aida encourages everyone to get better at public engagement. With your advocacy, you can contribute to fight discrimination and join a global movement to protect the human rights of people with dementia. Find the original text, and narration here on our website. https://www.dementiaresearcher.nihr.ac.uk/guest-blog-dementia-research-and-advocacy/ -- Dr Aida Suarez-Gonzalez is a Clinical Neuropsychologist and Senior Research Fellow at the Dementia Research Centre, UCL Institute of Neurology at Queen Square. With many years clinical experience working in Spain, Aida now investigating non-pharmacological interventions, services and assistive technologies to support people living well with dementia. -- This podcast is brought to you in association with Alzheimer's Association, Alzheimer's Research UK, Alzheimer's Society and Race Against Dementia, who we thank for their ongoing support. Enjoy listening? We're always looking for new bloggers, drop us a line dementiaresearcher@ucl.ac.uk  

Dr Aida Suárez-Gonzalez narrates her blog written for Dementia Researcher. Aida has just been awarded UCL Global Engagement Funds (GEF) for a project to co-produce positive narratives about dementia. The GEF are an exciting seed funding scheme for all sorts of global engagement ideas. In Aida's project, she plans to partne with collaborators at Princeton University and the University of South Carolina. The aim being to co-create an Oliver Sack's style book about people with posterior cortical atrophy (PCA), primary progressive aphasia (PPA) and dementia with lewy bodies (DLB). And publish it - in this blog Aida shares her journey of selling the idea and applying for the UCL Global Engagement funds. Find the original text, and narration here on our website. https://www.dementiaresearcher.nihr.ac.uk/guest-blog-building-positive-narratives-about-dementia/ --   Dr Aida Suarez-Gonzalez is a Clinical Neuropsychologist and Senior Research Fellow at the Dementia Research Centre, UCL Institute of Neurology at Queen Square. With many years clinical experience working in Spain, Aida now investigating non-pharmacological interventions, services and assistive technologies to support people living well with dementia. -- This podcast is brought to you in association with Alzheimer's Association, Alzheimer's Research UK, Alzheimer's Society and Race Against Dementia, who we thank for their ongoing support. Enjoy listening? We're always looking for new bloggers, drop us a line dementiaresearcher@ucl.ac.uk 

John, Kelly and Good Morning Callum steer the sleigh this week!We talk through a week of training which includes the Weston Prom 5 Mile Race and Ashton Court parkrun.We talk through race results - local and worldwide!Kelly takes us into her corner and reviews some Strava stats!The final Patron Prize Winner is Catie O'Donoghue! AND - we have an interview with Charlotte Hogan who started the Queen Square Run Cub!Have a great week and Merry Christmas everyone :-)Cheers,The SMM Team

Dr Aida Suárez-Gonzalez narrates her blog written for Dementia Researcher. ReadClear is an app to support reading in posterior cortical atrophy (PCA). Aida and her team co-produced the service with a group of people living with PCA, and then went on to test it in a randomised clinical trial. Aida has blogged about the value of this PPI process in the past but has never written about how she supported participants to engage with the app during the trial and how co-production continued during the trial itself. Dr Ivanna Pavisic and Dr Dilek Ocal were the colleagues who conducted the ReadClear home-based trial with her. They travelled around England training participants on how to use the app and facilitating a context that led to new rounds of priceless feedback. In this blog Aida chats to both of them as they share their learnings and personal experience. Find the original text, and narration here on our website. https://www.dementiaresearcher.nihr.ac.uk/guest-blog-embedding-ppi-in-our-readclear-tech-trial/ We're always on the look out for new contributors, if you would like to write and narrate your own blog - drop us a line to dementiaresearcher@nihr.ac.uk Don't forget to also listen to our fortnightly - published fortnightly, just look for Dementia Researcher in your podcast app. -- Dr Aida Suarez-Gonzalez is a Clinical Neuropsychologist and Senior Research Fellow at the Dementia Research Centre, UCL Institute of Neurology at Queen Square. With many years clinical experience working in Spain, Aida now investigating non-pharmacological interventions, services and assistive technologies to support people living well with dementia. -- This podcast is brought to you from University College London in association with the National Institute for Health Research, Alzheimer's Research UK and Alzheimer's Society, who we thank for their ongoing support. Enjoy listening? We're always looking for new bloggers, drop us a line dementiaresearcher@ucl.ac.uk  

In episode 32 of the Know Stroke Podcast, we were joined by Professor Nick Ward. About our Guest: Professor Ward is a consultant neurologist at National Hospital for Neurology and Neurosurgery and a professor of clinical neurology and neurorehabilitaion at Queen Square UCL Institute of Neurology. His special clinical interest is in stroke and neurorehabilitation, focusing in particular on recovery of arm and hand function through the Queen Square upper limb neurorehabilitation programme. He is the founder of the Neurorehabilitation Online N-ROL project. He is co-founder of the UCLP Centre for Neurorehabilitation, co-editor Oxford Textbook of Neurorehabilitation and associate editor of the journals Neurorehabilitation and Neural Repair and Journal of Neurology, Neurosurgery and Psychiatry. Professor Ward leads a research program to help understand the mechanisms of upper limb impairment and treatment after stroke. In particular, he uses structural and functional brain imaging to study the relationship between brain network reorganisation and recovery of movement after stroke. Special mentions: Emilia Clark's charity SameYou for Brain injury and stroke recovery Gripable training platform for upper arm rehabilitation Catherine Doogan, Post Doc and Clinical Psychologist who is working on developing Digital Interventions in Neuro-Rehabilitation (DINR) In the news: A call for architect students to help design the Next Generation of Stroke Rehabilitation Centers  Show Info: Music intro jingle credit to Jake Dansereau, connect at JAKEEZo on Soundcloud @user-257386777. Once Jake gets settled in to college life at university we'll be glad to have him back at the helm producing our podcast again! You'll be missed here Jake on so many levels, thank you! Our intro welcome is the voice of Caroline Goggin, a stroke survivor and our first podcast guest! Please listen to her inspiring story on this episode Thank you Caroline! Until next time, be sure to give the show a like and share, +follow and connect with us on social or contact us to be a guest on the Know Stroke Podcast

Dr Aida Suárez-Gonzalez narrates her blog written for Dementia Researcher. Systematic reviews are powerful ways to assess the state of knowledge on a particular research topic. They appraise and collate all relevant empirical evidence and their impact can be enormous: from informing clinical decision-making to global policy. That is why it is critical that we conduct them with rigour. In this blog Aida provides a brief starter guide with 5 steps and practical tips to ease the way for those of you embarking on your first systematic review - essential reading for PhD and Masters Students. Find the original text, and narration here on our website. https://www.dementiaresearcher.nihr.ac.uk/guest-blog-how-to-prepare-a-search-strategy-for-your-systematic-review/ We're always on the look out for new contributors, if you would like to write and narrate your own blog - drop us a line to dementiaresearcher@nihr.ac.uk Don't forget to also listen to our fortnightly - published fortnightly, just look for Dementia Researcher in your podcast app. -- Dr Aida Suarez-Gonzalez is a Clinical Neuropsychologist and Senior Research Fellow at the Dementia Research Centre, UCL Institute of Neurology at Queen Square. With many years clinical experience working in Spain, Aida now investigating non-pharmacological interventions, services and assistive technologies to support people living well with dementia. -- This podcast is brought to you from University College London in association with the National Institute for Health Research, Alzheimer's Research UK and Alzheimer's Society, who we thank for their ongoing support. Enjoy listening? We're always looking for new bloggers, drop us a line dementiaresearcher@ucl.ac.uk  

Dr Aida Suárez-Gonzalez narrates her blog written for Dementia Researcher. One of the types of dementia I investigate in my research is Posterior Cortical Atrophy (PCA). PCA is also called the visual variant of Alzheimer´s disease (AD) because the syndrome is characterised by early and disabling visual difficulties and most (although not all) cases show underlying AD pathology. PCA is a young onset dementia, meaning most people with the condition present symptoms before the age of 65, typical in the 50s or early 60s. Age at onset (AAO) is an important variable to study for dementia researchers because it is known to influence the clinical expression of AD. However, this important driving factor is currently under investigated in atypical forms of AD. In this blog Aida discusses her own research on the topic, and why this is important. Find the original text, and narration here on our website. https://www.dementiaresearcher.nihr.ac.uk/guest-blog-age-at-onset-in-atypical-alzheimers-why-it-matters/ We're always on the look out for new contributors, if you would like to write and narrate your own blog - drop us a line to dementiaresearcher@nihr.ac.uk Don't forget to also listen to our fortnightly - published fortnightly, just look for Dementia Researcher in your podcast app. -- Dr Aida Suarez-Gonzalez is a Clinical Neuropsychologist and Senior Research Fellow at the Dementia Research Centre, UCL Institute of Neurology at Queen Square. With many years clinical experience working in Spain, Aida now investigating non-pharmacological interventions, services and assistive technologies to support people living well with dementia. -- This podcast is brought to you from University College London in association with the National Institute for Health Research, Alzheimer's Research UK and Alzheimer's Society, who we thank for their ongoing support. Enjoy listening? We're always looking for new bloggers, drop us a line dementiaresearcher@ucl.ac.uk  

Dr Aida Suárez-Gonzalez narrates her blog written for Dementia Researcher. Lately Aida has been involved in many interview panels and, coincidentally, also in helping a substantial number of colleagues to prepare for grant and research job interviews. Her repeated exposure to the person specification assessment process in a short window of time has made Aida acutely aware of a few behaviours that she greatly appreciate in candidates - so to help you nail your next research job interview Aida is sharing her top 5 tips in her first contribution as a staff blogger for Dementia Researcher. Find the original text, and narration here on our website. https://www.dementiaresearcher.nihr.ac.uk/guest-blog-top-tips-to-nail-your-research-job-interview/ We're always on the look out for new contributors, if you would like to write and narrate your own blog - drop us a line to dementiaresearcher@nihr.ac.uk Don't forget to also listen to our fortnightly - published fortnightly, just look for Dementia Researcher in your podcast app. -- Dr Aida Suarez-Gonzalez is a Clinical Neuropsychologist and Senior Research Fellow at the Dementia Research Centre, UCL Institute of Neurology at Queen Square. With many years clinical experience working in Spain, Aida now investigating non-pharmacological interventions, services and assistive technologies to support people living well with dementia. -- This podcast is brought to you from University College London in association with the National Institute for Health Research, Alzheimer's Research UK and Alzheimer's Society, who we thank for their ongoing support. Enjoy listening? We're always looking for new bloggers, drop us a line dementiaresearcher@ucl.ac.uk  

Dr Stephen Reeders founded MVM Partners in 1997. They invest in high growth businesses with bases in London and Boston. He's had three different lives— Firstly he obtained a BA in Natural Sciences from Cambridge, before getting his Medical Degree from Oxford and then training as a Doctor in some of the UK's premier institutes such as John Radcliffe, Guys and Queen Square. In part II, he became a Clinical Researcher across both Oxford and some of the US's greatest research houses. For example, just in the infancy of his career, he discovered PKD1 — a gene linked to Polycystic Kidney Disease. The seminal paper was published in Nature in 1985. Finally — in the third act, he moved into the world of business and investment — in which he tackled how to translate some of these discoveries into great businesses that could benefit people at scale. He was also the first investor and acting CEO of UpToDate. In this interview, I try and unpack what made him able to excel in all three acts — and also, why a flourishing Doctor and Clinical Academic would move into the world of investment. I hope you enjoy. You can find me on Twitter @MustafaSultan and subscribe to my newsletter on www.musty.io

Dr. Wild is a Professor of Neurology at University College London, a Consultant Neurologist at the National Hospital for Neurology and Neurosurgery in London's Queen Square, and Associate Director of UCL Huntington's Disease Centre. He runs clinics in general neurology, neurogenetic movement disorders and Huntington's disease. He leads a team of researchers aiming to accelerate the development of new therapies to make a real difference for people impacted by Huntington's disease. Dr. Wild believes that “Scientists have a duty to make their work accessible and understandable to the people who need it most.” So in 2010, I co-founded HDBuzz, an online source of reliable, impartial, easy-to-understand information about HD research. HDBuzz is now the world's foremost HD research news source. In recognition of this, he was awarded the 2012 Michael Wright Community Leadership Award by the Huntington Society of Canada and the 2014 Research Award by the Huntington's Disease Society of America (which is where I first met Dr. Wild). He has authored 7 book chapters and over 80 peer-reviewed publications. He serves on the Medical Advisory Panel of the Huntington's Disease Association, the Association of British Neurologists Neurogenetics Advisory Panel, and the Translational Neurology Panel of the European Academy of Neurology. He is the Associate Editor of the Journal of Huntington's Disease and advises the steering committee to the UK All-Party Parliamentary Group on Huntington's disease. He is the co-Lead Facilitator of the European Huntington's Disease Network‘s Biomarkers Working Group. For more information about HDClarity, please visit www.hdclarity.net

Dr Chiara Pizzamiglio of the Department of Neuromuscular Diseases at Queen Square discusses her recent publication looking at a huge cohort of 197 patients with McArdle disease. Dr Pizzamiglio hi-lights the diagnostic challenges in this GSD and shows new insights into the spectrum of extra-muscular manifestations seen in the condition. Phenotype and genotype of 197 British patients with McArdle disease: An observational single-centre study Chiara Pizzamiglio et al https://doi.org/10.1002/jimd.12438

Meet Professor Ley Sander, a consultant neurologist at the National Hospital for Neurology and Neurosurgery, London, with a special interest in epilepsy.Ley is Head of the Department of Clinical and Experimental Epilepsy at UCL Queen Square and works across the continents to empower those in LMICs (Low-Middle Income Countries) regarding epilepsy prevention, treatment, and seizure control. Ley also has a talent for photography!We talk about how Ley got into his passion for helping people affected by epilepsy, his work today, and some of the clear obstacles when it comes to minimising epilepsy cases - such as clean water. **CONNECT WITH LEY**• LinkedIn: https://www.linkedin.com/in/ley-sander-223645b • Twitter: https://twitter.com/leysander• Instagram: https://instagram.com/ley.sander**READ ABOUT LEY'S WORK**• UCLH: https://www.uclh.nhs.uk/our-services/find-consultant/professor-ley-sander • Epilepsy Pathway Innovation in Africa: https://epina.web.ox.ac.uk • ResearchGate: https://www.researchgate.net/profile/Ley-Sander • Epilepsy Society: https://epilepsysociety.org.uk/latest/news/top-epilepsy-expert-nine-years & https://epilepsysociety.org.uk/what-we-do/research/our-researchers/ley-sander  • The Lancet Neurology: https://www.thelancet.com/laneur/editorial-advisory-board **CHECK OUT THE YOUTUBE VIDEO WITH LEY**• YouTube: https://youtu.be/G-UD2SvUcvo**CONNECT WITH TORIE**• Website: https://www.torierobinson.com• Twitter: https://twitter.com/torierobinson10• LinkedIn: https://www.linkedin.com/torierobinson• Facebook: https://www.facebook.com/TorieRobinsonSpeaker **CHECK OUT TORIE'S YOUTUBE & BLOG**• YouTube: https://www.youtube.com/c/TorieRobinson• Blog: https://www.torierobinson.com/blog**HIRE TORIE AS A SPEAKER ON EPILEPSY, MENTAL HEALTH, DISABILITY, & DIVERSITY**https://www.torierobinson.com/contact

In the first of a two part episode learn about the history of the iconic Queen's Square in Galt.  The plan to make it Galt's Town Centre, it's amazing Churches, the Cenotaph and more!

Meet Asst. Prof. Gabriele Lignani: the Principal Investigator, Senior Research Fellow, & Biotechnologist at the University for Neurology and Neurosurgery, Queen Square, London, and recent winner of the Harinarayan Young Neuroscientist Award 2021 for his research into Activity-dependent Gene Therapy for Intractable Epilepsy! Gabriele speaks with Torie about researching gene therapy for epilepsy and his journey into epilepsy research.CONNECT WITH GABRIELELinkedIn: https://www.linkedin.com/in/gabriele-lignani-288b9023Twitter: https://twitter.com/LignaniLab_UCL & https://twitter.com/gabrilignani READ ABOUT GABRIELE'S WORKWebsite: https://www.lignanilab.comResearchGate: https://www.researchgate.net/profile/Gabriele-Lignani Rare Revolution interview: https://bit.ly/3reUJacREAD THE INTERVIEW WITH GABRIELEhttps://www.torierobinson.com/blog/gabriele-lignani-gene-therapy CONNECT WITH TORIEWebsite: https://www.torierobinson.comTwitter: https://twitter.com/torierobinson10LinkedIn: https://www.linkedin.com/torierobinsonFacebook: https://www.facebook.com/TorieRobinsonSpeaker CHECK OUT TORIE'S YOUTUBE & BLOGYouTube: https://youtube.com/c/TorieRobinsonBlog: https://www.torierobinson.com/blog

Fran Brander is a Consultant Physiotherapist at the renowned National Hospital for Neurology and Neurosurgery. She is the lead physiotherapist in the Upper Limb Program and chats about research into clinical practice, being ambitious in our treatment of the upper limb post brain injury and philosophy of upper limb treatment.3.23 - Introduction4.33 - Career pathway6.42 - Consult Physiotherapists (UK)10.13 - National Hospital for Neurology & Neurosurgery – Queen Square London12.00 - Rehabilitation Units in the UK – Levels14.44 - UCL Upper Limb Service18.18 - Arguing for funding21.42 - Patient selection24.37 - Being a national health service26.55 - Program structure32.44 - Hands on or hands off35.47 - Tech in the program40.28 - What is the most important component?44.15 - Application of the model to other services

Welcome back to the Healthcare Hub! On this episode we meet Neil Shah, the Executive Director at Queen Square Family Health. Neil has experience in a vast range of public health organizations since his completion of the DeGroote MBA program and shared some great insights with us in this interview. We discuss his progression between project management roles in differing clinical areas, working with a board of directors, how to continue learning after graduation, and much more! Abhinav also brings us an update on the deal between Canada and the USA to acquire more AstraZeneca vaccine doses, while Tyler takes a look at Raziel Health, the smart home device for remote patient monitoring. --- Send in a voice message: https://anchor.fm/healthcarehubpodcast/message

Dr. Paul Pender, a board certified Ophthalmologist and author of Rebuilding Trust in Healthcare: A Doctor’s Prescription for a Post-Pandemic America joins Dr. Elaina George on this week’s episode of Living in the Solution to discuss how the doctor and patient relationship is the foundation of fixing the American healthcare system most especially after the COVID tumult of the past year. Dr. Paul Pender is an honors graduate of Harvard College and of the University of Michigan Medical Center in Ophthalmology and Neurology. He attended a neurology rotation at The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.   Dr Pender's Bio - https://paulpendermd.com/about-dr-paul-pender-bedford/   Connect with Dr Pender on LinkedIn - https://www.linkedin.com/in/paul-pender-md-a9a031156/

Liam Freill is one of the organizers of the Queen Square Farmers Market. Its opening day is Sunday, June 7th, rain or shine, from 9 a.m. to 2 p.m.

Episode 38: We visit Queen Square, England and listen to the sounds of footsteps, people chatting, and general urban ambiance. Sit back, relax, and enjoy! --- Sleep & Study Soundscapes is a weekly podcast curating and uploading the best tracks to help you study or sleep. --- Contact Us: SleepandStudySoundScapes@gmail.com --- Sound profile: England, Europe, Outdoors, Downtown, City --- Send in a voice message: https://anchor.fm/sleep-and-study-soundscapes/message Support this podcast: https://anchor.fm/sleep-and-study-soundscapes/support

In this episode, we a had an amazing conversation with Dr. Mithu Storoni, the author of Stress-Proof. Mithu received her medical degree from the University Cambridge and has published papers across the fields of neuroscience, neurology and neuro-ophthalmology. She is a brilliant scientist trained in eye surgery, has a PhD in Neuro-ophthalmology, and was previously a Clinical Research Fellow at the National Hospital of Neurology and Neurosurgery in Queen Square, London where she studies pupillometry looking at the relationship between the pupillary response and stress! Mithu spent a few years trawling through all the scientific research she could find on stress before writing Stress-Proof, a science-based guide based on data from over 500 published studies. We hope you enjoy this conversation and will share it with loved ones who will benefit from her knowledge and experience. Link to Stress Proof: https://amzn.to/2VzWrTK Dr. Storoni's social media:  Instagram  Twitter You can follow us on: Instagram: @teamsherzai Facebook: Team Sherzai Twitter: @teamsherzai YouTube: Team Sherzai

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

Want to make a name for yourself? Declare yourself chief of something. Or chief of many things, as Dr. S. A. Kinnier Wilson did. This week on the podcast, we commemorate his legacy and his commitment to neurology. Produced by James E. Siegler. Music by Chris Zabriskie and Mystery Mammal. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast. REFERENCES S. A. Kinnier Wilson (1878-1937) Lenticular-hepatic degeneration. JAMA : the journal of the American Medical Association. 1968;205:871-2. Compston A. Progressive lenticular degeneration: a familial nervous disease associated with cirrhosis of the liver, by S. A. Kinnier Wilson, (From the National Hospital, and the Laboratory of the National Hospital, Queen Square, London) Brain 1912: 34; 295-509. Brain. 2009;132:1997-2001. Trocello JM, Broussolle E, Girardot-Tinant N, Pelosse M, Lachaux A, Lloyd C and Woimant F. Wilson's disease, 100 years later. Rev Neurol (Paris). 2013;169:936-43. Walshe JM. History of Wilson disease: a personal account. Handbook of clinical neurology. 2017;142:1-5.

In this interview, I speak with my friend, Ian Frizell, who has early onset Parkinson’s Disease. He was formally diagnosed, allegedly, in 2011 when his neurologist said “if I were a betting man, I’d bet that you have Parkinson’s,” however an official diagnosis came from his GP when Ian asked her for a sick note in 2013. “What’s wrong with you?” she asked, as she skimmed through his notes on her computer, “ah yes, you’ve got Parkinson’s”. So… diagnosed 2011/2013, Ian had been suffering from symptoms of Parkinson's Disease since about 1995. In 2015, a (different) neurologist referred him to the Deep Brain Stimulation (DBS) team at the National Hospital for Neurology and Neurosurgery (NHNN) in Queen Square, London, to assess his suitability for this operation. On the 19th of April 2016, he underwent surgery to have electrodes placed in his brain (bilateral deep brain stimulation of the sub-thalamic nucleus) and a neurostimulator in his chest. Watch and learn from Ian about his experience and fighting back against PD. Be sure to visit his website and follow his blog at: http://www.dbsacompletenobrainer.co.uk

Professor Michael Hanna, Senior Consultant Neurologist at Queen Square, UCL, London, discusses the developments in genetics in neuromuscular diseases with Eric Hoffman, Gordon Holmes lecturer at the ABN meeting 2017, in Liverpool. Professor Eric Hoffman (Binghampton University, USA) describes in this conversation his extensive work on the rare condition of Duchenne’s muscular dystrophy. This is the last of a series of podcasts recorded at the 2017 ABN meeting, held in May, in Liverpool, UK. More on this subject on the Practical Neurology website: http://pn.bmj.com/, where you can find these particular articles as well: "Muscle disease" - http://pn.bmj.com/content/9/1/54; "Muscle diseases: mimics and chameleons" - http://pn.bmj.com/content/14/5/288.

Queen Square

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

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

Peter Gautier-Smith, now retired from neurological consulting at Queen Square, and crime fiction writer, describes how he made the leap from clinician to novelist.This interview is part of a Practical Neurology package on neurology and detective writing. For more information, and the other interviews in the set, see bit.ly/19YiaEM

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 Practical Neurology bit.ly/1dqReQq.In this podcast Andrew Lees, director of the Queen Square Brain Bank, discusses with PN editor Phil Smith how neurologists draw upon detective skills (and how this is changing as the specialty changes), those who have turned these skills to crime fiction writing, and the use of narrative in clinical case histories.The expert witnesses called upon are Oliver Sacks, best selling author and professor of neurology at NYU School of Medicine, Peter Gautier Smith, now retired from consulting at Queen Square and who wrote 31 detective novels, and 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/1cPaoxMPeter Gautier-Smith bit.ly/1d5HhKjHarold Klawans bit.ly/19cXRGCOliver Sacks bit.ly/1hBsbgz

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/a32m868Movement disorders: what lies beneath? http://tinyurl.com/a32m868A 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/as9dq32Comparison of patient rated treatment response with measured improvement in Parkinson’s disease http://tinyurl.com/bj57hu2