markparamlall

693 posts

markparamlall

markparamlall

@markparamlall

Consultant Neuropsychiatrist Neurorehab Prev@activecare@QueenSq @Cygnet@northbristolNHS Ex SpR @SLAM Interests: Neuro, TBI, Tourette & Neurodevelopmental Psych

Beigetreten Eylül 2019
193 Folgt281 Follower
Himanshu Tyagi
Himanshu Tyagi@himanshutyagi·
Like many other important issues, you championed the cause of #OCD as Dean - now, as President, we are fortunate to have you amplify the voice of this often silent epidemic even further. Honoured that your first event as President-elect will be our OCD webinar on this very topic at 16:00hrs today :-) Those who missed the earlier notification can still register here: rcpsych.ac.uk/events/confere… @OrchardOCD @chrisha_jay @Marghe_Zenoni @reachdrdeepa @subodhdave1
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Michael Fox
Michael Fox@foxmdphd·
Should doctors be certified to deliver brain stimulation? @shansiddiqi @Brain_Circuits says yes - kicking off the brain stimulation subspecialty summit (BraSS).
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Himanshu Tyagi
Himanshu Tyagi@himanshutyagi·
This call for a “Share Once” support register in mental health is sensible and humane. Important report from @MoneyMHT moneyandmentalhealth.org/press-release/…
Martin Lewis@MartinSLewis

Why do people with mental (or physical) health vulnerabilities need call essential firm after firm and govt departments too to declare it, needing repeat the same painful, possibly embarrassing explanations. Today @MMHPI is calling for a 'tell us once' system. Here's my quote on why..... "The government has a Tell Us Once system for when someone dies, yet we lack the same for those who are alive and struggling. That makes no sense. We need a single simple system that can work across essential services like banks, energy and water firms, and government systems too – whichever people choose. “Right now, a vulnerable person in the middle of a mental (or physical) health crisis may have to call firm after firm, and government agencies on top, repeating the same painful, possibly embarrassing or triggering explanation again and again. In a digital age where data sharing is simple, that feels almost cruel. “Of course safeguards and informed consent are essential, people must have control of their data. But it is time we stopped focusing on using data to just drive profit and started using it to drive compassion.” Read full info and get details about the underlying research here... moneyandmentalhealth.org/press-release/…

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Michael Fox
Michael Fox@foxmdphd·
What’s the difference between a neurological vs psychiatric disorder? @Brain_Circuits, it’s only the circuit impacted. Honored to become one of the first full Professors of both Psychiatry and Neurology @harvardmed. Excited to help bridge this divide.
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Himanshu Tyagi
Himanshu Tyagi@himanshutyagi·
When perception detaches from reality in AI, is it noise… or circuitry? LLMs may have “hallucination neurons” (H Neurons) as this preprint from China is claiming: arxiv.org/abs/2512.01797 <0.1% of units predicting false beliefs, causally drive over-compliance, and emerge during pre-training - suggesting #LLM hallucinations aren’t just data noise but a microscopic circuit problem. As a #neuropsychiatrist treating circuit disorders in human brain, the parallel is hard to ignore. Different brains, similar mysteries. #HNeurons #AI
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Himanshu Tyagi
Himanshu Tyagi@himanshutyagi·
How many doctors realise that high serum B12 can coexist with functional B12 deficiency? This simple question from a medical student two years ago led to the paper below - and sparked quite a conversation on Twitter. It was fascinating to see practitioners and patients from across the world chip in with their thoughts and experiences. I’m delighted that the main author of this paper - @HamzaAMahmood21 - a bright @uclmedsci alum and now a doctor at @FrimleyHealth, has joined X/Twitter. Hopefully he’ll take this important conversation further with his upcoming systematic review on elevated #B12. @dr_pratimasingh
Himanshu Tyagi@himanshutyagi

Elevated serum #B12 can be a sign of B12 deficiency! Pseudo-hypercobalaminaemia occurs because circulating B12 is bound to inactive proteins or immune complexes (e.g. macro-B12), leaving intracellular delivery via transcobalamin impaired, so functional deficiency persists despite high total B12. This matters because clinicians may falsely reassure themselves, missing deficiency & underlying disease while neuropsychiatric symptoms continue. In our preliminary UK survey of 46 GPs examining responses to raised B12, not a single respondent identified pseudo-hypercobalaminaemia, revealing a major blind spot in clinical reasoning. Survey was led by Hamza Mahmood @FrimleyHealth & co-supervised by @dr_pratimasingh @HPFT_NHS Read it in full here: cureus.com/articles/44530… #openaccess @neuropsych_ucl @uclh @UCLIoN

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Himanshu Tyagi
Himanshu Tyagi@himanshutyagi·
Moments like the Sunday night’s #BAFTA incident remind us that although certain neuropsychiatric symptoms can be involuntary, yet their impact remains real. rollingstone.co.uk/film/news/tour… Public understanding must hold both compassion for an illness like #Tourettes & sensitivity to societal prejudices. The path forward is neither denial nor blame. Education remains the best antidote. Below is a short thread on the essentials of #coprolalia in Tourette syndrome, based on observations made over ten years while running a specialist Tourette clinic at #NHNN @uclh (1/10)
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Dr Sudhir Kumar MD DM
Dr Sudhir Kumar MD DM@hyderabaddoctor·
Sleep is not a luxury; it is neuroprotection. This is not just a graphic, it is based on PET scan data showing what happens to your brain’s "fuel" (glucose metabolism) after just one night of missed sleep. The drop in activity in the prefrontal cortex and thalamus is staggering. In fact: 👉 17 hours without sleep = Mental performance of someone with 0.05% blood alcohol concentration (BAC). 👉 24 hours without sleep = Equivalent to 0.10% BAC (higher than the legal driving limit). When you skip sleep, your brain doesn't just "feel" tired, it functionally slows down. You are not being "productive" by staying up; you are operating a compromised machine. Prioritize rest. Your brain will thank you with better focus, better mood, and faster processing tomorrow. Dr Sudhir Kumar @hyderabaddoctor
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markparamlall
markparamlall@markparamlall·
@himanshutyagi This is very important as it is one of the recommended blood tests in primary care to identify organic reversible causes of cognitive impairment.
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Himanshu Tyagi
Himanshu Tyagi@himanshutyagi·
Elevated serum #B12 can be a sign of B12 deficiency! Pseudo-hypercobalaminaemia occurs because circulating B12 is bound to inactive proteins or immune complexes (e.g. macro-B12), leaving intracellular delivery via transcobalamin impaired, so functional deficiency persists despite high total B12. This matters because clinicians may falsely reassure themselves, missing deficiency & underlying disease while neuropsychiatric symptoms continue. In our preliminary UK survey of 46 GPs examining responses to raised B12, not a single respondent identified pseudo-hypercobalaminaemia, revealing a major blind spot in clinical reasoning. Survey was led by Hamza Mahmood @FrimleyHealth & co-supervised by @dr_pratimasingh @HPFT_NHS Read it in full here: cureus.com/articles/44530… #openaccess @neuropsych_ucl @uclh @UCLIoN
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Himanshu Tyagi
Himanshu Tyagi@himanshutyagi·
Our new paper in Biological Psychiatry Open @SOBP presents converging neurobiological evidence that Body Dysmorphic Disorder (#BDD) is a unified Occipital–Fronto–Limbic (OFL) circuit disorder, not merely isolated visual or #OCD like deficits. This important meta-analysis of neuroimaging studies was led by Yihui Cheng @UofGMedicine, in collaboration with Emalee Burrows @UCL, @twr2twr @Cambridge_Uni, @HarithAkram @UCLIoN, Ludvic Zrinzo @UCLBrainScience Mapping the interconnections between visual processing, temporal-limbic, and frontostriatal networks provides a clearer framework - the OFL circuit - for developing neurobiologically informed treatment approaches in this complex disorder characterised by variable treatment response. Read the full article here doi.org/10.1016/j.bpsg… #OpenAccess @BDDFoundation @LABDDclinic #BodyDysmorphicDisorder #BDDAwareness @neuropsych_ucl
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Anthony David
Anthony David@ProfTonyDavid·
Inflammatory markers (IL-6 and CRP) in childhood and their association with brain structure and psychotic experiences in adulthood - CRP at age 9 related to inc sup frontal gyrus vols in those with psychotic experiences age 18. doi.org/10.1016/j.bbi.… @SecretaryINA @The_BNPA
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Jon Stone
Jon Stone@jonstoneneuro·
New @AANmember guidelines for management of functional seizures - led by @btolchin - are another important landmark for people with FND around the world. ✅Rigorous evidence-based process ✅Consensus practical recommendations ✅Endorsed by @FNDSociety neurology.org/doi/10.1212/WN…
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UCL Brain Sciences
UCL Brain Sciences@UCLBrainScience·
Parkinson’s is now the fastest growing neurological condition in the world. In this podcast, Dr Sonia Gandhi (@UCLIoN) shares more about her work to reverse that trend. 🎧 Listen now: bbc.co.uk/sounds/play/m0…
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KimH
KimH@KH118118·
🔥 Hot off the press! NICE has published NG252, a brand-new guideline on rehabilitation for chronic neurological disorders, including Functional Neurological Disorder. Another big step after #FND became a core neurology subspecialty in NHS England! 🧠 nice.org.uk/guidance/ng252
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Jonathan Rogers
Jonathan Rogers@drjprogers·
Fantastic morning spent on @The_BNPA's new course on neuropsychology for physicians, led by the brilliant @vaughanbell! Basic science to clinical applications, including requesting and interpreting reports. Highly recommended!
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Jonathan Rogers
Jonathan Rogers@drjprogers·
Here's an idea I've been thinking about for years: is the dopaminergic deficit in Parkinson's disease common to other conditions with psychomotor slowing? However, it took 3 students on their summer project to collect the evidence for @Brain1878. doi.org/10.1093/brain/… 🧵...
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