UCL Institute of Neurology


Neurorehabilitation Group

Dr Alex Leff

My main clinical and academic interest is in cognitive rehabilitation, especially in the field of acquired language disorders. I have developed two web-based rehabilitation tools that can be used to by therapists and patients with hemianopia.

Description of work

The focus of this Group is clinical research with a strong translational element facilitated by excellent collaborations within the Institute of Neurology, UCL (Department of Neuroinflammation [MS NMR Unit], Department of Motor Neuroscience and Movement Disorders), and externally.

Studies of the mechanisms, measurement and management of neurological disability are carried out within the MS NMR Unit, with Professors David Miller, Maria Ron and Tarek Yousry. Activities of this section are being supported by a programme grant from the MS Society, and other funding from the MS Society, Wellcome Trust and De Laszlo Foundation. The Group has been strengthened by the award of a Wellcome Trust Advanced Clinical Fellowship to Dr Olga Ciccarelli and a new lectureship, in collaboration with the Peninsula Medical School, in Neurological Outcome Measurement: the first such lectureship in the UK.

Studies of the mechanisms underlying disability are focused mainly on MS, stroke and motor neurone disease and utilize both structural and fMRI. Within MS, Dr Olga Ciccarelli is leading the studies looking at the mechanisms of damage in acute lesions affecting the motor tracts and, in particular, the effect they have on the axons that traverse them. Dr Tom Jenkins is studying the structural/functional relationship following optic neuritis, continuing the studies of Dr Ahmed Toosy. In addition, our Group’s particular interest in the early primary progressive phase has entered its most interesting stage with the three-year follow-up of a unique cohort of patients with early disease. This study, led by Drs Jaume Sastre-Garriga and Zhaleh Khaleeli, provides new insights into the mechanisms underlying disease progression in MS. Collaborative studies in the imaging of stroke recovery are being lead by Dr Nick Ward (Wellcome Trust Advanced Fellow). Drs Nick Ward, Diane Playford and Richard Greenwood have established an Institute for Restorative and Rehabilitation Neuroscience (http://www.irrn.ucl.ac.uk), which is a cross-departmental group linking researchers with an interest in the mechanisms of functional recovery in neurological disease.

The Neurological Outcome Measures Unit has now established a network of centres including the NHNN at Queen Square, the Peninsula Medical School and the Free University in Amsterdam (Professor Chris Polman and Dr Bernard Uitdehaag). This allows us to combine measurement expertise with large clinical populations and will ensure a healthy future for the Unit, strengthened by its multiple international collaborations in Europe, the Americas, and Australasia. In particular, collaboration with a worldleading measurement group from Murdoch University in Perth, Australia (Professors David Andrich and Irene Styles, Dr Barry Sheridan) ensures that our work and training in measurement is of the highest standard. Amongst its recent achievements are the validation of a generic walking scale and the development of scales measuring the impact of spasticity (Dr Jeremy Hobart) and cervical dystonia (Dr Stefan Cano). The MS Impact Scale, which was developed by the Unit in 2001, and the MS Walking Scale, are now being used to good effect in clinical trials and epidemiological studies world-wide. The Unit is championing the use of more advanced measurement techniques such as Rasch analysis, item banking, and computer adaptive measurement.

In the management of neurological disability, the Unit has been closely involved in the development of the National Framework for Long-Term Neurological
Conditions (Professor Alan Thompson) and in the development of competencies for those involved in the management of these conditions (Professor Alan Thompson, Dr Diane Playford and Ms Bernie Porter, MS Nurse Consultant). The Group has completed a study of goal-setting used during in-patient rehabilitation (Dr Diane Playford) and a study of the treatment of relapses in MS (home or hospital), which involved the development of a new measurement tool evaluating the service (Dr Jeremy Chataway, Dr Afsane Riazi, Ms Bernie Porter. Studies of spasticity (Dr Val Stevenson) and vocational rehabilitation (Dr Diane Playford and Ms Jo Sweetland) continue.


Professor Alan Thompson FRCP, FRCPI
Garfield Weston Professor of Clinical Neurology and Neurorehabilitation
Department of Brain Repair and Rehabilitation
Institute of Neurology, UCL
Queen Square
Tel: 020 7679 6924