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UCL Queen Square Institute of Neurology

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Dr Mahinda Yogarajah

Mahinda Yogarajah PhD FRCP

Our research group uses advanced neuroimaging (structural MRI, diffusion MRI and fMRI), EEG, psychophysics and phenomenological approaches to transform our understanding and treatment of epilepsy and functional seizures. We are particularly interested in the brain’s predictive processes, interoception (the body’s representation in the brain), and the interplay between perception, consciousness and agency. Using this framework, we seek to better understand how disruptions in the brain, together with psycho-social factors, contribute to the behavioural and neuropsychiatric symptoms experienced by individuals with epilepsy and/or functional seizures. 

Our group was the first to describe the multidimensional nature of interoceptive changes in individuals with functional seizures. We were also the first group to demonstrate how changes in brain-heart communication (indexed by the heartbeat evoked potential) precede functional seizures. In work funded by the NIH, we are currently exploring the therapeutic implications of these findings, and extending our mechanistic work with funding from the Association of British Neurologists.

We collaborate with cognitive neuroscientists (Prof S Garfinkel, Institute of Cognitive Neuroscience), biomedical engineers (Dr D Abasolo, University of Surrey), clinical academic neuropsychiatrists (Prof H Critchley, Brighton and Sussex Medical School) and philosophers (Dr Eleanor Byrne, University of Birmingham).

thalamus
 
Figure legend: Example of thalamic segmentation in a group of individuals with functional seizures.

heartbeat potentials
Figure legend: The heartbeat evoked potential changes before functional seizures but not epileptic seizures.

 

Selected Recent Publications

  • Edwards MJ, Yogarajah M, Stone J. Why functional neurological disorder is not feigning or malingering. Nat Rev Neurol. 2023 Apr;19(4):246-256. doi: 10.1038/s41582-022-00765-z.
  • Elkommos S, Martin-Lopez D, Koreki A, Jolliffe C, Kandasamy R, Mula M, Critchley HD, Edwards MJ, Garfinkel S, Richardson MP, Yogarajah M. Changes in the heartbeat-evoked potential are associated with functional seizures. J Neurol Neurosurg Psychiatry. 2023 Sep;94(9):769-775. doi: 10.1136/jnnp-2022-330167.
  • Hinchliffe CHL, Yogarajah M, Elkommos S, Tang H, Abasolo D. Nonictal electroencephalographic measures for the diagnosis of functional seizures. Epilepsia. 2024 Nov;65(11):3293-3302. doi: 10.1111/epi.18110. 
  • O'Mahony B, Nielsen G, Baxendale S, Edwards MJ, Yogarajah M. Economic Cost of Functional Neurologic Disorders: A Systematic Review. Neurology. 2023 Jul 11;101(2):e202-e214. doi: 10.1212/WNL.0000000000207388. 
  • Yogarajah M. Dissociative seizures in the emergency department: how to solve the problem of diagnostic confusion leading to iatrogenic harm? J Neurol Neurosurg Psychiatry. 2024 Mar 13;95(4):293. doi: 10.1136/jnnp-2023-332617.