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Markostamou I, Morrissey S, Hornberger M. Imagery and Verbal Strategies in Spatial Memory for Route and Survey Descriptions. Brain Sci 2024; 14:403. [PMID: 38672053 PMCID: PMC11048460 DOI: 10.3390/brainsci14040403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 04/12/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024] Open
Abstract
Being able to represent and remember verbally-encoded information about spatial environments from different perspectives is important for numerous daily activities. The present study examined how frequently individuals spontaneously engage in visual mental imagery and verbal rehearsal strategies in memory recall of spatial descriptions, and whether using certain strategies is associated with better recall performance. Memory recall for route (person-centred) and survey (object-centred) spatial descriptions was examined in a sample of 105 neurotypical individuals, who also reported to what extent they used route- and survey-based mental imagery and verbal rehearsal strategies in each description. Results showed that participants favoured a path visualisation strategy to recall the route description and a map visualisation strategy to recall the survey description. Regression models further showed that employing both imagery and verbal strategies was associated with better recall for both route and survey descriptions, although imagery strategies held a higher predictive power. The present findings highlight the fact that the spontaneous use of internal strategies in the form of visual imagery and verbal rehearsal is ubiquitous when recalling spatial descriptions and a core part of efficient spatial memory functioning.
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Affiliation(s)
- Ioanna Markostamou
- Department of Psychology, Bournemouth University, Poole BH12 5BB, UK
- Division of Psychology, School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK
| | - Sol Morrissey
- Norwich Medical School, University of East Anglia, Norwich NR4 7UQ, UK
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2
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Clark IA, Maguire EA. Release of cognitive and multimodal MRI data including real-world tasks and hippocampal subfield segmentations. Sci Data 2023; 10:540. [PMID: 37587129 PMCID: PMC10432478 DOI: 10.1038/s41597-023-02449-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 08/07/2023] [Indexed: 08/18/2023] Open
Abstract
We share data from N = 217 healthy adults (mean age 29 years, range 20-41; 109 females, 108 males) who underwent extensive cognitive assessment and neuroimaging to examine the neural basis of individual differences, with a particular focus on a brain structure called the hippocampus. Cognitive data were collected using a wide array of questionnaires, naturalistic tests that examined imagination, autobiographical memory recall and spatial navigation, traditional laboratory-based tests such as recalling word pairs, and comprehensive characterisation of the strategies used to perform the cognitive tests. 3 Tesla MRI data were also acquired and include multi-parameter mapping to examine tissue microstructure, diffusion-weighted MRI, T2-weighted high-resolution partial volume structural MRI scans (with the masks of hippocampal subfields manually segmented from these scans), whole brain resting state functional MRI scans and partial volume high resolution resting state functional MRI scans. This rich dataset will be of value to cognitive and clinical neuroscientists researching individual differences, real-world cognition, brain-behaviour associations, hippocampal subfields and more. All data are freely available on Dryad.
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Affiliation(s)
- Ian A Clark
- Wellcome Centre for Human Neuroimaging, Department of Imaging Neuroscience, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Eleanor A Maguire
- Wellcome Centre for Human Neuroimaging, Department of Imaging Neuroscience, UCL Queen Square Institute of Neurology, University College London, London, UK.
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Latrèche C, Maeder J, Mancini V, Bortolin K, Schneider M, Eliez S. Altered developmental trajectories of verbal learning skills in 22q11.2DS: associations with hippocampal development and psychosis. Psychol Med 2023; 53:4923-4932. [PMID: 35775360 PMCID: PMC10476015 DOI: 10.1017/s0033291722001842] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 03/02/2022] [Accepted: 05/31/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND The cognitive profile in 22q11.2 deletion syndrome (22q11.2DS) is often characterized by a discrepancy between nonverbal vs. verbal reasoning skills, in favor of the latter skills. This dissociation has also been observed in memory, with verbal learning skills described as a relative strength. Yet the development of these skills is still to be investigated. We thus aimed to explore verbal learning longitudinally. Furthermore, we explored verbal learning and its respective associations with hippocampal alterations and psychosis, which remain largely unknown despite their high prevalence in 22q11.2DS. METHODS In total, 332 individuals (173 with 22q11.2DS) aged 5-30 years completed a verbal-paired associates task. Mixed-models regression analyses were conducted to explore developmental trajectories with threefold objectives. First, verbal learning and retention trajectories were compared between 22q11.2DS vs. HC. Second, we examined hippocampal volume development in 22q11.2DS participants with lower vs. higher verbal learning performance. Third, we explored verbal learning trajectories in 22q11.2DS participants with vs. without positive psychotic symptoms and with vs. without a psychotic spectrum disorder (PSD). RESULTS Our findings first reveal lower verbal learning performance in 22q11.2DS, with a developmental plateau emerging from adolescence. Second, participants with lower verbal learning scores displayed a reduced left hippocampal tail volume. Third, participants with PSD showed a deterioration of verbal learning performance, independently of verbal reasoning skills. CONCLUSION Our study challenges the current view of preserved verbal learning skills in 22q11.2DS and highlights associations with specific hippocampal alterations. We further identify verbal learning as a novel cognitive marker for psychosis in 22q11.2DS.
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Affiliation(s)
- Caren Latrèche
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
| | - Johanna Maeder
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
| | - Valentina Mancini
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
| | - Karin Bortolin
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
- Medical Image Processing Lab, Institute of Bioengineering, EPFL, Lausanne, Switzerland
| | - Maude Schneider
- Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
- Department of Neurosciences, KU Leuven, Center for Contextual Psychiatry, Leuven, Belgium
| | - Stephan Eliez
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
- Department of Genetic Medicine and Development, University of Geneva School of Medicine, Geneva, Switzerland
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Palombo DJ, Jones D, Strang C, Verfaellie M. Verbal recall in amnesia: Does scene construction matter? Neuropsychologia 2023; 184:108543. [PMID: 36931459 DOI: 10.1016/j.neuropsychologia.2023.108543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 03/02/2023] [Accepted: 03/14/2023] [Indexed: 03/17/2023]
Abstract
The hippocampus plays a critical role in episodic memory and imagination. One theoretical model posits that the hippocampus is important for scene construction, namely, the ability to conjure and maintain a scene-based representation in one's mind. To test one idea put forth by this view, we examined whether amnesia is associated with more severe impairment in memory when the to-be-remembered content places high demands on scene construction. To do so, we examined free recall performance for abstract (i.e., low scene imagery) and concrete, high scene-imagery single words in seven amnesic patients with hippocampal lesions and concomitant scene-construction deficits, and compared their performance to demographically matched healthy controls. As expected, amnesic patients were severely impaired in their free recall performance; however, their impairment did not differ as a function of word type. That is, their impairment was equally severe for words that evoke high versus low scene imagery. These findings suggest that the role of the hippocampus in verbal memory extends to content that does not place high demands on scene construction. Theoretical implications of these findings are discussed.
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Affiliation(s)
| | - Dominoe Jones
- Memory Disorders Research Center, VA Boston Healthcare System, USA
| | - Caroline Strang
- Memory Disorders Research Center, VA Boston Healthcare System, USA
| | - Mieke Verfaellie
- Memory Disorders Research Center, VA Boston Healthcare System, USA; Boston University School of Medicine, Department of Psychiatry, USA.
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Palermo L, Boccia M, Piccardi L, Nori R. Congenital lack and extraordinary ability in object and spatial imagery: An investigation on sub-types of aphantasia and hyperphantasia. Conscious Cogn 2022; 103:103360. [PMID: 35691243 DOI: 10.1016/j.concog.2022.103360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 05/26/2022] [Accepted: 05/27/2022] [Indexed: 11/26/2022]
Abstract
Studies that have shown a distinction between object and spatial imagery suggest more than one type of aphantasia and hyperphantasia, yet this has not been systematically investigated in studies on imagery ability extremes. Also, if the involuntary imagery is preserved in aphantasia and how this condition affects other skills is not fully clear. We collected data on spatial and object imagery, retrospective, and prospective memory, face recognition, and sense of direction (SOD), suggesting a distinction between two subtypes of aphantasia/hyperphantasia. Spatial aphantasia is associated with difficulties in visuo-spatial mental imagery and SOD. Instead, in object aphantasia there are difficulties in imaging single items and events - with no mental visualization of objects, out-of-focus, and black-and-white mental images more frequent than expected - in SOD and face recognition. Furthermore, associative involuntary imagery can be spared in aphantasia. The opposite pattern of performance was found in spatial and object hyperphantasia.
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Affiliation(s)
- Liana Palermo
- Department of Medical and Surgical Sciences, 'Magna Graecia' University of Catanzaro, Catanzaro, Italy.
| | - Maddalena Boccia
- Department of Psychology, 'Sapienza' University of Rome, Rome, Italy; I.R.C.C.S. Santa Lucia Foundation, Rome, Italy
| | - Laura Piccardi
- Department of Psychology, 'Sapienza' University of Rome, Rome, Italy; I.R.C.C.S. Santa Lucia Foundation, Rome, Italy
| | - Raffaella Nori
- Department of Psychology, University of Bologna, Bologna, Italy
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McCormick C, Maguire EA. The distinct and overlapping brain networks supporting semantic and spatial constructive scene processing. Neuropsychologia 2021; 158:107912. [PMID: 34116069 PMCID: PMC8287593 DOI: 10.1016/j.neuropsychologia.2021.107912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/20/2021] [Accepted: 06/04/2021] [Indexed: 11/17/2022]
Abstract
Scene imagery features prominently when we recall autobiographical memories, imagine the future and navigate around in the world. Consequently, in this study we sought to better understand how scene representations are supported by the brain. Processing scenes involves a variety of cognitive processes that in the real world are highly interactive. Here, however, our goal was to separate semantic and spatial constructive scene processes in order to identify the brain areas that were distinct to each process, those they had in common, and the connectivity between regions. To this end, participants searched for either semantic or spatial constructive impossibilities in scenes during functional MRI. We focussed our analyses on only those scenes that were possible, thus removing any error detection that would evoke reactions such as surprise or novelty. Importantly, we also counterbalanced possible scenes across participants, enabling us to examine brain activity and connectivity for the same possible scene images under two different conditions. We found that participants adopted different cognitive strategies, which were reflected in distinct oculomotor behaviour, for each condition. These were in turn associated with increased engagement of lateral temporal and parietal cortices for semantic scene processing, the hippocampus for spatial constructive scene processing, and increased activation of the ventromedial prefrontal cortex (vmPFC) that was common to both. Connectivity analyses showed that the vmPFC switched between semantic and spatial constructive brain networks depending on the task at hand. These findings further highlight the well-known semantic functions of lateral temporal areas, while providing additional support for the previously-asserted contribution of the hippocampus to scene construction, and recent suggestions that the vmPFC may play a key role in orchestrating scene processing.
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Affiliation(s)
- Cornelia McCormick
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, WC1N 3AR, UK; Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Eleanor A Maguire
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, WC1N 3AR, UK.
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Watching Movies Unfold, a Frame-by-Frame Analysis of the Associated Neural Dynamics. eNeuro 2021; 8:ENEURO.0099-21.2021. [PMID: 34193513 PMCID: PMC8272404 DOI: 10.1523/eneuro.0099-21.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 05/21/2021] [Accepted: 06/02/2021] [Indexed: 12/02/2022] Open
Abstract
Our lives unfold as sequences of events. We experience these events as seamless, although they are composed of individual images captured in between the interruptions imposed by eye blinks and saccades. Events typically involve visual imagery from the real world (scenes), and the hippocampus is frequently engaged in this context. It is unclear, however, whether the hippocampus would be similarly responsive to unfolding events that involve abstract imagery. Addressing this issue could provide insights into the nature of its contribution to event processing, with relevance for theories of hippocampal function. Consequently, during magnetoencephalography (MEG), we had female and male humans watch highly matched unfolding movie events composed of either scene image frames that reflected the real world, or frames depicting abstract patterns. We examined the evoked neuronal responses to each image frame along the time course of the movie events. Only one difference between the two conditions was evident, and that was during the viewing of the first image frame of events, detectable across frontotemporal sensors. Further probing of this difference using source reconstruction revealed greater engagement of a set of brain regions across parietal, frontal, premotor, and cerebellar cortices, with the largest change in broadband (1–30 Hz) power in the hippocampus during scene-based movie events. Hippocampal engagement during the first image frame of scene-based events could reflect its role in registering a recognizable context perhaps based on templates or schemas. The hippocampus, therefore, may help to set the scene for events very early on.
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McCormick C, Dalton MA, Zeidman P, Maguire EA. Characterising the hippocampal response to perception, construction and complexity. Cortex 2021; 137:1-17. [PMID: 33571913 PMCID: PMC8048772 DOI: 10.1016/j.cortex.2020.12.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 11/25/2020] [Accepted: 12/04/2020] [Indexed: 12/31/2022]
Abstract
The precise role played by the hippocampus in supporting cognitive functions such as episodic memory and future thinking is debated, but there is general agreement that it involves constructing representations comprised of numerous elements. Visual scenes have been deployed extensively in cognitive neuroscience because they are paradigmatic multi-element stimuli. However, questions remain about the specificity and nature of the hippocampal response to scenes. Here, we devised a paradigm in which we had participants search pairs of images for either colour or layout differences, thought to be associated with perceptual or spatial constructive processes respectively. Importantly, images depicted either naturalistic scenes or phase-scrambled versions of the same scenes, and were either simple or complex. Using this paradigm during functional MRI scanning, we addressed three questions: 1. Is the hippocampus recruited specifically during scene processing? 2. If the hippocampus is more active in response to scenes, does searching for colour or layout differences influence its activation? 3. Does the complexity of the scenes affect its response? We found that, compared to phase-scrambled versions of the scenes, the hippocampus was more responsive to scene stimuli. Moreover, a clear anatomical distinction was evident, with colour detection in scenes engaging the posterior hippocampus whereas layout detection in scenes recruited the anterior hippocampus. The complexity of the scenes did not influence hippocampal activity. These findings seem to align with perspectives that propose the hippocampus is especially attuned to scenes, and its involvement occurs irrespective of the cognitive process or the complexity of the scenes.
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Affiliation(s)
- Cornelia McCormick
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, WC1N 3AR, UK
| | - Marshall A Dalton
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, WC1N 3AR, UK
| | - Peter Zeidman
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, WC1N 3AR, UK
| | - Eleanor A Maguire
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, WC1N 3AR, UK.
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Monk AM, Dalton MA, Barnes GR, Maguire EA. The Role of Hippocampal-Ventromedial Prefrontal Cortex Neural Dynamics in Building Mental Representations. J Cogn Neurosci 2021; 33:89-103. [PMID: 32985945 PMCID: PMC7116437 DOI: 10.1162/jocn_a_01634] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The hippocampus and ventromedial prefrontal cortex (vmPFC) play key roles in numerous cognitive domains including mind-wandering, episodic memory, and imagining the future. Perspectives differ on precisely how they support these diverse functions, but there is general agreement that it involves constructing representations composed of numerous elements. Visual scenes have been deployed extensively in cognitive neuroscience because they are paradigmatic multielement stimuli. However, it remains unclear whether scenes, rather than other types of multifeature stimuli, preferentially engage hippocampus and vmPFC. Here, we leveraged the high temporal resolution of magnetoencephalography to test participants as they gradually built scene imagery from three successive auditorily presented object descriptions and an imagined 3-D space. This was contrasted with constructing mental images of nonscene arrays that were composed of three objects and an imagined 2-D space. The scene and array stimuli were, therefore, highly matched, and this paradigm permitted a closer examination of step-by-step mental construction than has been undertaken previously. We observed modulation of theta power in our two regions of interest-anterior hippocampus during the initial stage and vmPFC during the first two stages, of scene relative to array construction. Moreover, the scene-specific anterior hippocampal activity during the first construction stage was driven by the vmPFC, with mutual entrainment between the two brain regions thereafter. These findings suggest that hippocampal and vmPFC neural activity is especially tuned to scene representations during the earliest stage of their formation, with implications for theories of how these brain areas enable cognitive functions such as episodic memory.
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Barry DN, Clark IA, Maguire EA. The relationship between hippocampal subfield volumes and autobiographical memory persistence. Hippocampus 2020; 31:362-374. [PMID: 33320970 PMCID: PMC8048905 DOI: 10.1002/hipo.23293] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 11/30/2020] [Accepted: 12/06/2020] [Indexed: 12/11/2022]
Abstract
Structural integrity of the human hippocampus is widely acknowledged to be necessary for the successful encoding and retrieval of autobiographical memories. However, evidence for an association between hippocampal volume and the ability to recall such memories in healthy individuals is mixed. Here we examined this issue further by combining two approaches. First, we focused on the anatomically distinct subregions of the hippocampus where more nuanced associations may be expressed compared to considering the whole hippocampal volume. A manual segmentation protocol of hippocampal subregions allowed us to separately calculate the volumes of the dentate gyrus/CA4, CA3/2, CA1, subiculum, pre/parasubiculum and uncus. Second, a critical feature of autobiographical memories is that they can span long time periods, and so we sought to consider how memory details persist over time by conducting a longitudinal study whereby participants had to recall the same autobiographical memories on two visits spaced 8 months apart. Overall, we found that there was no difference in the total number of internal (episodic) details produced at Visits 1 and 2. However, further probing of detail subcategories revealed that specifically the amount of subjective thoughts and emotions included during recall had declined significantly by the second visit. We also observed a strong correlation between left pre/parasubiculum volume and the amount of autobiographical memory internal details produced over time. This positive relationship was evident for particular facets of the memories, with remembered events, perceptual observations and thoughts and emotions benefitting from greater volume of the left pre/parasubiculum. These preliminary findings expand upon existing functional neuroimaging evidence by highlighting a potential link between left pre/parasubiculum volume and autobiographical memory. A larger pre/parasubiculum appears not only to protect against memory decay, but may possibly enhance memory persistence, inviting further scrutiny of the role of this brain region in remote autobiographical memory retrieval.
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Affiliation(s)
- Daniel N Barry
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Ian A Clark
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Eleanor A Maguire
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, UK
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Monk AM, Barnes GR, Maguire EA. The Effect of Object Type on Building Scene Imagery-an MEG Study. Front Hum Neurosci 2020; 14:592175. [PMID: 33240069 PMCID: PMC7683518 DOI: 10.3389/fnhum.2020.592175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 10/09/2020] [Indexed: 12/28/2022] Open
Abstract
Previous studies have reported that some objects evoke a sense of local three-dimensional space (space-defining; SD), while others do not (space-ambiguous; SA), despite being imagined or viewed in isolation devoid of a background context. Moreover, people show a strong preference for SD objects when given a choice of objects with which to mentally construct scene imagery. When deconstructing scenes, people retain significantly more SD objects than SA objects. It, therefore, seems that SD objects might enjoy a privileged role in scene construction. In the current study, we leveraged the high temporal resolution of magnetoencephalography (MEG) to compare the neural responses to SD and SA objects while they were being used to build imagined scene representations, as this has not been examined before using neuroimaging. On each trial, participants gradually built a scene image from three successive auditorily-presented object descriptions and an imagined 3D space. We then examined the neural dynamics associated with the points during scene construction when either SD or SA objects were being imagined. We found that SD objects elicited theta changes relative to SA objects in two brain regions, the right ventromedial prefrontal cortex (vmPFC) and the right superior temporal gyrus (STG). Furthermore, using dynamic causal modeling, we observed that the vmPFC drove STG activity. These findings may indicate that SD objects serve to activate schematic and conceptual knowledge in vmPFC and STG upon which scene representations are then built.
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Affiliation(s)
- Anna M Monk
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Gareth R Barnes
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Eleanor A Maguire
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
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