Queen's Hospital is a hospital in Romford in the London Borough of Havering. It was built on the site of the former Oldchurch Park, a short distance south of the town centre. It is run by Barking, Havering and Redbridge University Hospitals NHS Trust.
BACKGROUND:Common and rare genetic variants in leucine-rich repeat kinase 2 (LRRK2) have been linked with sporadic and familial Parkinson's disease (PD). Recently, we discovered that common genetic variation near the LRRK2 locus determined survival in progressive supranuclear palsy (PSP). Our study aimed to explore biomarkers of LRRK2 and lysosomal dysfunction in PSP. METHODS:Immunoblotting was used to measure total LRRK2 and LRRK2-dependent Rab10 phosphorylation at the threonine 73 residue (pRab10Thr73) in neutrophil and monocyte samples from PSP and control participants. Urine samples were applied to a multiplexed assay to quantitate bis(monoacylglycerol)phosphate (BMP) species as markers of lysosomal dysfunction. Cerebrospinal fluid (CSF) samples from a wider cohort of PSP and control participants were applied to a stable isotope standards and capture by anti-peptide antibodies assay to measure total LRRK2 and pRab10Thr73 levels. LRRK2 genotypes (rs76904798 and rs2242367) and 1-year change in Progressive Supranuclear Palsy Rating Scale (PSPRS) scores were obtained. RESULTS:A total of 61 PSP and 34 control participants were included. Total urine 22:6-BMP levels were higher in PSP versus control samples (P = 0.04) and correlated with CSF total LRRK2 levels (r = 0.49, P = 0.04). There were no group-level differences in monocyte and CSF levels of total LRRK2 and pRab10Thr73. In PSP, carriers of the alternate allele (CT and TT genotypes) at the LRRK2 PD risk variant, rs76904798, had higher levels of CSF total LRRK2 versus CC genotype (P = 0.02). Baseline monocyte total LRRK2 levels predicted 1-year change in the PSPRS score (P = 0.008). CONCLUSIONS:Biochemically defined lysosomal dysfunction is evident in PSP. Genetic and biochemical stratification may identify PSP patients that would benefit from LRRK2-targeting therapies. © 2026 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
Automated radiology report generation remains a key challenge in clinical AI, requiring alignment between visual, anatomical, and linguistic representations. This study introduces SPINE - a Segmentation-guided Processing and Integration framework for spinal MRI report generation - designed to integrate multimodal (T1-, T2-weighted, and segmentation) inputs for anatomically informed narrative synthesis. Using axial and sagittal MRI datasets comprising 515 and 190 patients, respectively, SPINE was evaluated across multiple multimodal and segmentation-aware configurations. Results show that incorporating segmentation maps substantially improves report accuracy, coherence, and clinical relevance, with the T1 + T2 + Seg model achieving the most balanced performance across all metrics. Models trained on LLM-standardized reports outperformed those trained on human-written text, demonstrating the importance of linguistic consistency. Comparative analysis also revealed that GPT-4o generated more fluent and clinically detailed reports than Grok-3. These findings highlight the potential of combining multimodal imaging with language-model-driven structuring to enhance both the factual accuracy and clinical reliability of automated radiology reporting, paving the way for more interpretable and trustworthy AI-assisted diagnostics.
Intrasaccular flow disruption has become established for the treatment of wide necked and bifurcation aneurysms. The most successful current devices are the WEB (Microvention) and Contour (Stryker). The Artisse (Medtronic) is a novel intrasaccular device designed to treat a variety of aneurysm morphologies. The first generation Artisse device was used in clinical trials in 2016.1 This device has now been significantly modified, and this video discusses the second generation (video 1). The current device features a dual layer, 72 wire mesh basket. It includes an atraumatic, off-center distal tip to prevent aneurysm dome damage during deployment, and proximal and distal marker bands for improved visibility. There are currently limited sizes of the device compared with the WEB. Deployment is via a 0.021 inch microcatheter. This technical video discusses the device with the aid of an illustrative case of an middle cerebral artery aneurysm. neurintsurg;18/8/1839/V1F1V1Video 1 The Artisse device.
Abstract Objective To review current evidence and guideline recommendations on the use of antiepileptic drugs (AEDs), particularly levetiracetam, for seizure prophylaxis in neurosurgical patients, and to highlight their overuse in clinical practice. Methods A narrative review was conducted using international and Chinese literature, including guidelines from the American Heart Association (AHA), American Academy of Neurology (AAN), Neurocritical care society (NCS), Brain Trauma Foundation (BTF), European Association of Neuro-Oncology (EANO), European Stroke Organization (ESO), and Chinese Neurosurgical Society. Results Evidence indicates limited benefit of prophylactic AEDs in seizure-naïve patients. In major neurosurgical conditions—traumatic brain injury (TBI), subarachnoid hemorrhage (SAH), intracerebral hemorrhage (ICH), brain tumors, and elective craniotomy—routine or prolonged levetiracetam prophylaxis is not supported. Short-term administration (≤ 7 days) is justified only for TBI and select perioperative SAH cases. Surveys show widespread over-prescription of levetiracetam beyond guideline recommendations. Conclusion Levetiracetam is frequently overused for seizure prophylaxis in neurosurgery. Strict adherence to guideline-directed indications and duration is essential to improve outcomes and avoid unnecessary adverse effects. Increased education and dissemination of consensus statements are needed globally.
