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UCL Queen Square Institute of Neurology

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Cognitive Neurology

Professor Alex Leff

Research Team

Research Goals

  • To develop novel, evidence-based therapies for patients with cognitive impairment and to investigate how, at a neural network level, these therapies work.
  • To identify key brain and behaviour markers that will allow us to make individualized predictions of: i) recovery from brain injury; ii) response to therapies for brain injury
  • See also http://www.ucl.ac.uk/aphasialab/

Four brain regions in the left MCA territory, relative damage to which predict likely response to iReadMore therapy for patients with post-stroke central alexia.

 

     

    Funded Research Projects

    • Digital neuro-interventions to enhance re-learning in patients with acquired and degenerative brain diseases. Developing three separate digital neuro-interventions for: (1) patients with visuospatial neglect; (2) patients with dementia who forget familiar names; (3) aphasic patients who have word-finding difficulties. Funded by an NIHR (National Institute for Health Research) Research Professorship.
    • The ‘Listen-In’ project: developing, testing and rolling-out at a web-based therapy application for patients with impaired speech comprehension caused by stroke. Funded by the NIHR i4i programme.
    • The Read-Right and Eye-Search projects are for patients with hemianopia that causes, respectively, a reading problem and a problem with visual search. Both therapies work by retraining eye movements, to make them more efficient. Funded by the Stroke Association and NIHR.
    • Back of the brain project: a cross-sectional study with a new approach to cerebral localisation of visual perceptual functions. Funded by the Danish Research Council.
    Recent publications from Cognitive Neurology

    2021

    Roberts S, Bruce R, Lim L, Woodgate H, Ledingham K, Anderson S, Lorca-Puls DL, Gajardo-Vidal A, Leff AP, Hope TMH, Green DW, Crinion JT & Price CJ
    Better long-term outcomes in aphasic stroke survivors who received early clinical speech and language therapy: What’s driving recovery?
    Neuropsychological Rehabilitation (in press)

    Beare B.,  Doogan C.,  Douglass-Kirk P.,  Leff A. and Ward N.
    Neuro-Rehabilitation OnLine (N-ROL): Description and evaluation of a group based telerehabilitation programme for acquired brain injury (in press)

    Rice GE, Kerry SK, Robotham RJ, Leff AP, Lambon Ralph MA & Starrfelt R
    Category-selective deficits are the exception and not the rule: Evidence from a case-series of 64 patients with ventral occipito-temporal cortex damage Cortex 2021 (in press)

    Gajardo-Vidal A, Lorca-Puls DL, Ploras team, Warner H, Pshadry B, Crinion JT, Leff AP, Hope TMH, Geva S, Seghier ML, Green DW, Bowman H, & Price CJ
    Damage to Broca’s area does not contribute to long-term speech production outcome after stroke
    Brain 2021 https://doi.org/10.1093/brain/awaa460

    2020

    Geva S, Truneh T, Seghier ML, Hope TMH, Leff AP, Crinion JT, Gajardo-Vidal A, Lorca-Puls DL, Green DW, PLORAS team & Price CJ. Lesions that do and do not impair digit span: A study of 816 stroke survivorsBrain Communications 2020 [in press]

    Fleming V, Brownsett S, Krason A, Maegli MA, Coley-Fisher H, Ong Y, Nardo D, Leach R, Howard D, Robson H, Warburton E, Ashburner J, Price C, Crinion J, Leff A
    Efficacy of spoken word comprehension therapy in patients with chronic aphasia: A cross-over randomised controlled trial with structural imaging
    http://dx.doi.org/10.1136/jnnp-2020-324256

    Farrington-Douglas C and Leff A
    An expert opinion in speech and language therapy: The Queen Square Intensive Comprehensive Aphasia Programme Advances in Clinical Neuroscience & Rehabilitation 19(3):21-23 08 Sep 2020
    https://doi.org/10.47795/AEBQ6694

    Szalados R, Leff AP, Doogan CE. The clinical effectiveness of Eye-Search therapy for patients with hemianopia, neglect or hemianopia and neglect. Neuropsychological Rehabilitation.  Neuropsychol Rehabil 1-12 26 Apr 2020

    Thorudottir S, Sigurdardottir HM, Rice GE, Kerry SJ, Robotham RJ, Leff AP, Starrfelt R. The architect who lost the ability to imagine: the cerebral basis of visual imagery. Brain Sciences 2020; 10(2), online 1st February.

    2018

    Yao Y, Raman SS, Schiek, Leff A, Frassle S, Stephan KE. Variational Bayesian inversion for hierarchical unsupervised generative embedding (HUGE). NeuroImage 2018; 179:604-619 UCL Discovery

    Frassle S, Lomakina EI, Kasper LManjaly ZM, Leff A, Pruessmann KP, Buhmann JM, Stephan KE. A generative model of whole-brain effective connectivity. NeuroImage 2018; 179:505-529 UCL Discovery

    Aguilar OM, Kerry SJ, Crinion JT, Callaghan MF, Woodhead ZVJ, Leff AP. Dorsal and ventral visual stream contributions to preserved reading ability in patients with central alexia. Cortex 2018; 106:200-212 UCL Discovery

    Leff AP, Kempny AM, James L, Yelden K, Duport S, Farmer SF, Playford ED. Patients with a severe prolonged disorder of consciousness can show classical EEG responses to their own name compared with others' names. NeuroImage: Clinical 1st August 2018, in press UCL Discovery

    Lorca-Puls D, Gajardo-Vidal A, White J, Seghier M, Leff A, Green D, Crinion J, Ludersdorfer P, Hope T, Bowman H et al. The impact of sample size on the reproducibility of voxel-based lesion-deficit mappings. Neuropsychologia 2018; 115:101-111 UCL Discovery.

    Gajardo-Vidal A, Lorca-Puls DL, Crinion JT, White J, Seghier ML, Leff A, Hope TMH, Ludersdorfer P, Green DW, Bowman H et al. How distributed processing produces false negatives in voxel-based lesion-deficit analyses. Neuropsychologia 2018; 115:124-133 UCL Discovery

    Woodhead SVJ, Kerry SJ, Aguilar OM, Ong YH, Hogan JS, Pappa K, Leff AP, Crinion JT. Randomized trial of iReadMore word reading training and brain stimulation in central alexia. Brain, online 4 June 2018 UCL Discovery

    Dalmaijer ES, Li KMS, Gorgoraptis N, Leff AP, Cohen DL, Parton A, Husain M, Malhotra P. Randomised, double-blind, placebo-controlled crossover study of single-dose guanfacine in unilateral neglect following stroke. Journal of Neurology, Neurosurgery and Psychiatry 2018; 89(6):593-598 UCL Discovery

    Aguilar OM, Kerry SJ, Ong Y-H, Callaghan MF, Crinion  JT, Woodhead ZVJ, Price CJ, Leff AP and Hope TMH.  Lesion site dependent treatment responses to therapy after aphasic stroke. J Neurol Neurosurg Psychiatry, in press, 2018.
     
    Hope TMH, Leff AP, Price CJ. Predicting language outcomes after stroke: is structural disconnection a useful predictor? NeuroImage: Clinical, in press, 2018.
     
    Kempny A, James L, Yelden K, Duport S, Farmer S, Playford ED, Leff AP.  Patients with a severe prolonged disorder of consciousness can show classical EEG responses to their own name compared with others' names.  NeuroImage: Clinical, in press, 2018.
     
    Lorca-Puls DL, Gajardo-Vidal A, White J, Seghier ML, Leff AP, Green DW, Crinion  JT, Ludersdorfer P, Hope TMH, Bowman H & Price CJ. How distributed processing produces false negatives in voxel-based lesion-deficit analyses. Neuropsychologia, in press, 2018.

    2017

    Nardo D, Holland R, Leff A, Price C, Crinion J. Less is more: Neural mechanisms underlying anomia treatment in chronic aphasic patients. Brain, online 1 December 2017 doi.org/10.1093/brain/awx234

    Fleming V, Krason A, Leach R, Leff A, Brownsett S.  Listen-In:  high-dose home-based auditory comprehension therapy is achievable and effective.  Int J Stroke 2017; 12:24, online 1 November 2017

    Dalmaijer ES, Li KMS, Gorgoraptis N, Leff AP, Cohen DL, Parton A, Husain M, Malhotra PA.  A randomised double-blind, placebo-controlled crossover study of single-dose guanfacine in unilateral neglect following stroke.  Journal of Neurology, Neurosurgery, and Psychiatry, accepted for publication

    Leff AP, Boyd LA, Hayward KS, Ward NS, Stinear CM, Rosso C, Fisher RJ, Carter AR, Copland DA, Carey LM et al. Biomarkers of stroke recovery: Consensus-based core recommendations from the Stroke Recovery and Rehabilitation Roundtable (SRRR). International Journal of Stroke,
    2017 Jul;12(5):480-493. doi: 10.1177/1747493017714176.

    Yelden K, Duport S, James LM, Kempny A, Farmer SF, Leff AP, Playford ED. Late recovery of awareness in prolonged disorders of consciousness – a cross-sectional cohort study. Disability and Rehabilitation 2017 Jun 21:1-6. doi: 10.1080/09638288.2017.1339209. [Epub ahead of print]

    Gajardo-Vidal A, Lorca-Puls DL, Hope TMH, Parker Jones O, Seghier ML, Oberhuber M, Prejawa S, Crinion JC,  Leff AP, Green DW, Price CJ. Using TMS of the undamaged brain to identify lesion sites that predict language outcome after stroke. Brain 2017; 140(6):1729-1742 doi: 10.1093/brain/awx087.

    Hope TMH, Leff AP, Prejawa S, Bruce R, Haigh Z, Lim L, Ramsden S, Oberhuber M, Ludersdorfer P, Crinion JC, Seghier ML, Price CJ. Right hemisphere structural adaptation and changing language skills years after left hemisphere stroke. Brain 2017; 140(6):1718-1728 doi: 10.1093/brain/awx086.

    Woodhead ZVJ, Crinion J, Penny W, Teki S, Price CJ, Leff AP. Auditory training changes temporal lobe connectivity in ‘Wernicke’s aphasia’: a randomised trial. Journal of Neurology, Neurosurgery and Psychiatry, online 4 March 2017 doi: 10.1136/jnnp-2016-314621. Epub 2017 Mar 4.

    2016

    Holland R, Leff AP, Penny WD, Rothwell JC, Crinion J. Modulation of frontal effective connectivity during speech. Neuroimage. 2016 Oct 15;140:126-33. doi: 10.1016/j.neuroimage.2016.01.037. Epub 2016 Jan 26.

    Kempny AM, James L, Yelden K, Duport S, Farmer S, Playford ED, Leff AP. Functional near infrared spectroscopy as a probe of brain function in people with prolonged disorders of consciousness. Neuroimage: Clinical 2016; 12:312-319 doi: 10.1016/j.nicl.2016.07.013. eCollection 2016.

    Further information

     

     

     *  Hope et al. Right hemisphere structural adaptation and changing language    skills years after left hemisphere stroke. Brain 2017; 140(6):1718-1728 10.1093/brain/awx086