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Del Giovane M, Trender WR, Bălăeţ M, Mallas EJ, Jolly AE, Bourke NJ, Zimmermann K, Graham NS, Lai H, Losty EJ, Oiarbide GA, Hellyer PJ, Faiman I, Daniels SJ, Batey P, Harrison M, Giunchiglia V, Kolanko MA, David MC, Li LM, Demarchi C, Friedland D, Sharp DJ, Hampshire A. Computerised cognitive assessment in patients with traumatic brain injury: an observational study of feasibility and sensitivity relative to established clinical scales. EClinicalMedicine 2023; 59:101980. [PMID: 37152359 PMCID: PMC10154960 DOI: 10.1016/j.eclinm.2023.101980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/28/2023] [Accepted: 04/12/2023] [Indexed: 05/09/2023] Open
Abstract
Background Online technology could potentially revolutionise how patients are cognitively assessed and monitored. However, it remains unclear whether assessments conducted remotely can match established pen-and-paper neuropsychological tests in terms of sensitivity and specificity. Methods This observational study aimed to optimise an online cognitive assessment for use in traumatic brain injury (TBI) clinics. The tertiary referral clinic in which this tool has been clinically implemented typically sees patients a minimum of 6 months post-injury in the chronic phase. Between March and August 2019, we conducted a cross-group, cross-device and factor analyses at the St. Mary's Hospital TBI clinic and major trauma wards at Imperial College NHS trust and St. George's Hospital in London (UK), to identify a battery of tasks that assess aspects of cognition affected by TBI. Between September 2019 and February 2020, we evaluated the online battery against standard face-to-face neuropsychological tests at the Imperial College London research centre. Canonical Correlation Analysis (CCA) determined the shared variance between the online battery and standard neuropsychological tests. Finally, between October 2020 and December 2021, the tests were integrated into a framework that automatically generates a results report where patients' performance is compared to a large normative dataset. We piloted this as a practical tool to be used under supervised and unsupervised conditions at the St. Mary's Hospital TBI clinic in London (UK). Findings The online assessment discriminated processing-speed, visual-attention, working-memory, and executive-function deficits in TBI. CCA identified two significant modes indicating shared variance with standard neuropsychological tests (r = 0.86, p < 0.001 and r = 0.81, p = 0.02). Sensitivity to cognitive deficits after TBI was evident in the TBI clinic setting under supervised and unsupervised conditions (F (15,555) = 3.99; p < 0.001). Interpretation Online cognitive assessment of TBI patients is feasible, sensitive, and efficient. When combined with normative sociodemographic models and autogenerated reports, it has the potential to transform cognitive assessment in the healthcare setting. Funding This work was funded by a National Institute for Health Research (NIHR) Invention for Innovation (i4i) grant awarded to DJS and AH (II-LB-0715-20006).
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Affiliation(s)
- Martina Del Giovane
- UK Dementia Research Institute, Care Research & Technology Centre, Imperial College and the University of Surrey, 9th Floor, Sir Michael Uren Hub, 86 Wood Ln, W12 0BZ, London, United Kingdom
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
| | - William R. Trender
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
| | - Maria Bălăeţ
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
| | - Emma-Jane Mallas
- UK Dementia Research Institute, Care Research & Technology Centre, Imperial College and the University of Surrey, 9th Floor, Sir Michael Uren Hub, 86 Wood Ln, W12 0BZ, London, United Kingdom
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
| | - Amy E. Jolly
- UK Dementia Research Institute, Care Research & Technology Centre, Imperial College and the University of Surrey, 9th Floor, Sir Michael Uren Hub, 86 Wood Ln, W12 0BZ, London, United Kingdom
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
- Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, Queen Square, WC1N 3BG, London, United Kingdom
| | - Niall J. Bourke
- UK Dementia Research Institute, Care Research & Technology Centre, Imperial College and the University of Surrey, 9th Floor, Sir Michael Uren Hub, 86 Wood Ln, W12 0BZ, London, United Kingdom
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 16 De Crespigny Park, SE5 8AB, London, United Kingdom
| | - Karl Zimmermann
- UK Dementia Research Institute, Care Research & Technology Centre, Imperial College and the University of Surrey, 9th Floor, Sir Michael Uren Hub, 86 Wood Ln, W12 0BZ, London, United Kingdom
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
| | - Neil S.N. Graham
- UK Dementia Research Institute, Care Research & Technology Centre, Imperial College and the University of Surrey, 9th Floor, Sir Michael Uren Hub, 86 Wood Ln, W12 0BZ, London, United Kingdom
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
| | - Helen Lai
- UK Dementia Research Institute, Care Research & Technology Centre, Imperial College and the University of Surrey, 9th Floor, Sir Michael Uren Hub, 86 Wood Ln, W12 0BZ, London, United Kingdom
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
| | - Ethan J.F. Losty
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
| | - Garazi Araña Oiarbide
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
| | - Peter J. Hellyer
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 16 De Crespigny Park, SE5 8AF, London, United Kingdom
| | - Irene Faiman
- Clinical Neuropsychology Service, St George's University Hospital NHS Foundation Trust, Blackshaw Road, SW17 0QT, London, United Kingdom
| | - Sarah J.C. Daniels
- UK Dementia Research Institute, Care Research & Technology Centre, Imperial College and the University of Surrey, 9th Floor, Sir Michael Uren Hub, 86 Wood Ln, W12 0BZ, London, United Kingdom
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
| | - Philippa Batey
- UK Dementia Research Institute, Care Research & Technology Centre, Imperial College and the University of Surrey, 9th Floor, Sir Michael Uren Hub, 86 Wood Ln, W12 0BZ, London, United Kingdom
- The Helix Centre, Imperial College London, and the Royal College of Arts, St. Mary’s Hospital, 3rd Floor Paterson Building, 20 South Wharf Road, Paddington, W2 1PE, London, United Kingdom
| | - Matthew Harrison
- UK Dementia Research Institute, Care Research & Technology Centre, Imperial College and the University of Surrey, 9th Floor, Sir Michael Uren Hub, 86 Wood Ln, W12 0BZ, London, United Kingdom
- The Helix Centre, Imperial College London, and the Royal College of Arts, St. Mary’s Hospital, 3rd Floor Paterson Building, 20 South Wharf Road, Paddington, W2 1PE, London, United Kingdom
| | - Valentina Giunchiglia
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
| | - Magdalena A. Kolanko
- UK Dementia Research Institute, Care Research & Technology Centre, Imperial College and the University of Surrey, 9th Floor, Sir Michael Uren Hub, 86 Wood Ln, W12 0BZ, London, United Kingdom
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
| | - Michael C.B. David
- UK Dementia Research Institute, Care Research & Technology Centre, Imperial College and the University of Surrey, 9th Floor, Sir Michael Uren Hub, 86 Wood Ln, W12 0BZ, London, United Kingdom
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
| | - Lucia M. Li
- UK Dementia Research Institute, Care Research & Technology Centre, Imperial College and the University of Surrey, 9th Floor, Sir Michael Uren Hub, 86 Wood Ln, W12 0BZ, London, United Kingdom
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
| | - Célia Demarchi
- UK Dementia Research Institute, Care Research & Technology Centre, Imperial College and the University of Surrey, 9th Floor, Sir Michael Uren Hub, 86 Wood Ln, W12 0BZ, London, United Kingdom
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
| | - Daniel Friedland
- UK Dementia Research Institute, Care Research & Technology Centre, Imperial College and the University of Surrey, 9th Floor, Sir Michael Uren Hub, 86 Wood Ln, W12 0BZ, London, United Kingdom
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
| | - David J. Sharp
- UK Dementia Research Institute, Care Research & Technology Centre, Imperial College and the University of Surrey, 9th Floor, Sir Michael Uren Hub, 86 Wood Ln, W12 0BZ, London, United Kingdom
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
| | - Adam Hampshire
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
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David MCB, Kolanko M, Del Giovane M, Lai H, True J, Beal E, Li LM, Nilforooshan R, Barnaghi P, Malhotra PA, Rostill H, Wingfield D, Wilson D, Daniels S, Sharp DJ, Scott G. Remote Monitoring of Physiology in People Living With Dementia: An Observational Cohort Study. JMIR Aging 2023; 6:e43777. [PMID: 36892931 PMCID: PMC10037178 DOI: 10.2196/43777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 01/09/2023] [Accepted: 01/31/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Internet of Things (IoT) technology enables physiological measurements to be recorded at home from people living with dementia and monitored remotely. However, measurements from people with dementia in this context have not been previously studied. We report on the distribution of physiological measurements from 82 people with dementia over approximately 2 years. OBJECTIVE Our objective was to characterize the physiology of people with dementia when measured in the context of their own homes. We also wanted to explore the possible use of an alerts-based system for detecting health deterioration and discuss the potential applications and limitations of this kind of system. METHODS We performed a longitudinal community-based cohort study of people with dementia using "Minder," our IoT remote monitoring platform. All people with dementia received a blood pressure machine for systolic and diastolic blood pressure, a pulse oximeter measuring oxygen saturation and heart rate, body weight scales, and a thermometer, and were asked to use each device once a day at any time. Timings, distributions, and abnormalities in measurements were examined, including the rate of significant abnormalities ("alerts") defined by various standardized criteria. We used our own study criteria for alerts and compared them with the National Early Warning Score 2 criteria. RESULTS A total of 82 people with dementia, with a mean age of 80.4 (SD 7.8) years, recorded 147,203 measurements over 958,000 participant-hours. The median percentage of days when any participant took any measurements (ie, any device) was 56.2% (IQR 33.2%-83.7%, range 2.3%-100%). Reassuringly, engagement of people with dementia with the system did not wane with time, reflected in there being no change in the weekly number of measurements with respect to time (1-sample t-test on slopes of linear fit, P=.45). A total of 45% of people with dementia met criteria for hypertension. People with dementia with α-synuclein-related dementia had lower systolic blood pressure; 30% had clinically significant weight loss. Depending on the criteria used, 3.03%-9.46% of measurements generated alerts, at 0.066-0.233 per day per person with dementia. We also report 4 case studies, highlighting the potential benefits and challenges of remote physiological monitoring in people with dementia. These include case studies of people with dementia developing acute infections and one of a person with dementia developing symptomatic bradycardia while taking donepezil. CONCLUSIONS We present findings from a study of the physiology of people with dementia recorded remotely on a large scale. People with dementia and their carers showed acceptable compliance throughout, supporting the feasibility of the system. Our findings inform the development of technologies, care pathways, and policies for IoT-based remote monitoring. We show how IoT-based monitoring could improve the management of acute and chronic comorbidities in this clinically vulnerable group. Future randomized trials are required to establish if a system like this has measurable long-term benefits on health and quality of life outcomes.
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Affiliation(s)
- Michael C B David
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Magdalena Kolanko
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Martina Del Giovane
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Helen Lai
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Jessica True
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Emily Beal
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Lucia M Li
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Ramin Nilforooshan
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Payam Barnaghi
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Paresh A Malhotra
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
- Imperial College London, Brain Sciences, South Kensington, London, United Kingdom
| | - Helen Rostill
- Surrey and Borders Partnership NHS Foundation Trust, Leatherhead, Surrey, United Kingdom
| | - David Wingfield
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Danielle Wilson
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Sarah Daniels
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - David J Sharp
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Gregory Scott
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
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David MCB, Del Giovane M, Liu KY, Gostick B, Rowe JB, Oboh I, Howard R, Malhotra PA. Cognitive and neuropsychiatric effects of noradrenergic treatment in Alzheimer's disease: systematic review and meta-analysis. J Neurol Neurosurg Psychiatry 2022; 93:jnnp-2022-329136. [PMID: 35790417 PMCID: PMC9484390 DOI: 10.1136/jnnp-2022-329136] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 05/19/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Dysfunction of the locus coeruleus-noradrenergic system occurs early in Alzheimer's disease, contributing to cognitive and neuropsychiatric symptoms in some patients. This system offers a potential therapeutic target, although noradrenergic treatments are not currently used in clinical practice. OBJECTIVE To assess the efficacy of drugs with principally noradrenergic action in improving cognitive and neuropsychiatric symptoms in Alzheimer's disease. METHODS The MEDLINE, Embase and ClinicalTrials.gov databases were searched from 1980 to December 2021. We generated pooled estimates using random effects meta-analyses. RESULTS We included 19 randomised controlled trials (1811 patients), of which six were judged as 'good' quality, seven as 'fair' and six 'poor'. Meta-analysis of 10 of these studies (1300 patients) showed a significant small positive effect of noradrenergic drugs on global cognition, measured using the Mini-Mental State Examination or Alzheimer's Disease Assessment Scale-Cognitive Subscale (standardised mean difference (SMD): 0.14, 95% CI: 0.03 to 0.25, p=0.01; I2=0%). No significant effect was seen on measures of attention (SMD: 0.01, 95% CI: -0.17 to 0.19, p=0.91; I2=0). The apathy meta-analysis included eight trials (425 patients) and detected a large positive effect of noradrenergic drugs (SMD: 0.45, 95% CI: 0.16 to 0.73, p=0.002; I2=58%). This positive effect was still present following removal of outliers to account for heterogeneity across studies. DISCUSSION Repurposing of established noradrenergic drugs is most likely to offer effective treatment in Alzheimer's disease for general cognition and apathy. However, several factors should be considered before designing future clinical trials. These include targeting of appropriate patient subgroups and understanding the dose effects of individual drugs and their interactions with other treatments to minimise risks and maximise therapeutic effects. PROSPERO REGISTERATION NUMBER CRD42021277500.
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Affiliation(s)
- Michael C B David
- Imperial College London and the University of Surrey, UK Dementia Research Institute Care Research and Technology Centre, London, UK
- Brain Sciences, Imperial College London, London, UK
- Imperial College Healthcare NHS Trust, Clinical Neurosciences, Charing Cross Hospital, London, UK
| | - Martina Del Giovane
- Imperial College London and the University of Surrey, UK Dementia Research Institute Care Research and Technology Centre, London, UK
- Brain Sciences, Imperial College London, London, UK
| | - Kathy Y Liu
- Division of Psychiatry, University College London, London, UK
| | | | - James Benedict Rowe
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Imafidon Oboh
- South West London and St George's Mental Health NHS Trust, London, UK
| | - Robert Howard
- Division of Psychiatry, University College London, London, UK
| | - Paresh A Malhotra
- Imperial College London and the University of Surrey, UK Dementia Research Institute Care Research and Technology Centre, London, UK
- Brain Sciences, Imperial College London, London, UK
- Imperial College Healthcare NHS Trust, Clinical Neurosciences, Charing Cross Hospital, London, UK
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Hampshire A, Chatfield DA, MPhil AM, Jolly A, Trender W, Hellyer PJ, Giovane MD, Newcombe VF, Outtrim JG, Warne B, Bhatti J, Pointon L, Elmer A, Sithole N, Bradley J, Kingston N, Sawcer SJ, Bullmore ET, Rowe JB, Menon DK. Multivariate profile and acute-phase correlates of cognitive deficits in a COVID-19 hospitalised cohort. EClinicalMedicine 2022; 47:101417. [PMID: 35505938 PMCID: PMC9048584 DOI: 10.1016/j.eclinm.2022.101417] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 03/29/2022] [Accepted: 04/07/2022] [Indexed: 02/02/2023] Open
Abstract
Background Preliminary evidence has highlighted a possible association between severe COVID-19 and persistent cognitive deficits. Further research is required to confirm this association, determine whether cognitive deficits relate to clinical features from the acute phase or to mental health status at the point of assessment, and quantify rate of recovery. Methods 46 individuals who received critical care for COVID-19 at Addenbrooke's hospital between 10th March 2020 and 31st July 2020 (16 mechanically ventilated) underwent detailed computerised cognitive assessment alongside scales measuring anxiety, depression and post-traumatic stress disorder under supervised conditions at a mean follow up of 6.0 (± 2.1) months following acute illness. Patient and matched control (N = 460) performances were transformed into standard deviation from expected scores, accounting for age and demographic factors using N = 66,008 normative datasets. Global accuracy and response time composites were calculated (G_SScore & G_RT). Linear modelling predicted composite score deficits from acute severity, mental-health status at assessment, and time from hospital admission. The pattern of deficits across tasks was qualitatively compared with normal age-related decline, and early-stage dementia. Findings COVID-19 survivors were less accurate (G_SScore=-0.53SDs) and slower (G_RT=+0.89SDs) in their responses than expected compared to their matched controls. Acute illness, but not chronic mental health, significantly predicted cognitive deviation from expected scores (G_SScore (p=0.0037) and G_RT (p = 0.0366)). The most prominent task associations with COVID-19 were for higher cognition and processing speed, which was qualitatively distinct from the profiles of normal ageing and dementia and similar in magnitude to the effects of ageing between 50 and 70 years of age. A trend towards reduced deficits with time from illness (r∼=0.15) did not reach statistical significance. Interpretation Cognitive deficits after severe COVID-19 relate most strongly to acute illness severity, persist long into the chronic phase, and recover slowly if at all, with a characteristic profile highlighting higher cognitive functions and processing speed. Funding This work was funded by the National Institute for Health Research (NIHR) Cambridge Biomedical Research Centre (BRC), NIHR Cambridge Clinical Research Facility (BRC-1215-20014), the Addenbrooke's Charities Trust and NIHR COVID-19 BioResource RG9402. AH is funded by the UK Dementia Research Institute Care Research and Technology Centre and Imperial College London Biomedical Research Centre. ETB and DKM are supported by NIHR Senior Investigator awards. JBR is supported by the Wellcome Trust (220258) and Medical Research Council (SUAG/051 G101400). VFJN is funded by an Academy of Medical Sciences/ The Health Foundation Clinician Scientist Fellowship. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.
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Affiliation(s)
- Adam Hampshire
- UK DRI Care Research and Technology Centre, Department of Brain Sciences, Imperial College London, United Kingdom
| | - Doris A. Chatfield
- Cambridge University Hospitals National Health Service Foundation Trust, United Kingdom
| | - Anne Manktelow MPhil
- Cambridge University Hospitals National Health Service Foundation Trust, United Kingdom
| | - Amy Jolly
- UK DRI Care Research and Technology Centre, Department of Brain Sciences, Imperial College London, United Kingdom
| | - William Trender
- UK DRI Care Research and Technology Centre, Department of Brain Sciences, Imperial College London, United Kingdom
| | - Peter J. Hellyer
- UK DRI Care Research and Technology Centre, Department of Brain Sciences, Imperial College London, United Kingdom
| | - Martina Del Giovane
- UK DRI Care Research and Technology Centre, Department of Brain Sciences, Imperial College London, United Kingdom
| | | | - Joanne G. Outtrim
- Cambridge University Hospitals National Health Service Foundation Trust, United Kingdom
| | - Ben Warne
- Cambridge University Hospitals National Health Service Foundation Trust, United Kingdom
| | - Junaid Bhatti
- Department of Psychiatry, University of Cambridge, United Kingdom
| | - Linda Pointon
- Department of Psychiatry, University of Cambridge, United Kingdom
| | - Anne Elmer
- National Institute for Health Research Cambridge Clinical Research Facility, Cambridge University Hospitals National Health Service Foundation Trust, United Kingdom
| | - Nyarie Sithole
- Cambridge University Hospitals National Health Service Foundation Trust, United Kingdom
- Division of Infectious Diseases, Department of Medicine, University of Cambridge, United Kingdom
| | - John Bradley
- Cambridge University Hospitals National Health Service Foundation Trust, United Kingdom
- Department of Medicine, University of Cambridge, United Kingdom
- National Institute for Health Research Cambridge BioResource, United Kingdom
| | - Nathalie Kingston
- National Institute for Health Research COVID-19 BioResource, United Kingdom
| | - Stephen J. Sawcer
- Department of Clinical Neurosciences, and Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom
| | - Edward T. Bullmore
- Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, United Kingdom
- Department of Psychiatry, University of Cambridge, United Kingdom
- Cambridgeshire and Peterborough National Health Service Foundation Trust, United Kingdom
| | - James B. Rowe
- Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, United Kingdom
- Department of Psychiatry, University of Cambridge, United Kingdom
- Department of Clinical Neurosciences, and Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom
| | - David K. Menon
- Cambridge University Hospitals National Health Service Foundation Trust, United Kingdom
- Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, United Kingdom
- Division of Anaesthesia, Department of Medicine, University of Cambridge
| | - the Cambridge NeuroCOVID Group, the NIHR COVID-19 BioResource, and Cambridge NIHR Clinical Research Facility
- UK DRI Care Research and Technology Centre, Department of Brain Sciences, Imperial College London, United Kingdom
- Cambridge University Hospitals National Health Service Foundation Trust, United Kingdom
- Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, United Kingdom
- Department of Psychiatry, University of Cambridge, United Kingdom
- National Institute for Health Research Cambridge Clinical Research Facility, Cambridge University Hospitals National Health Service Foundation Trust, United Kingdom
- Division of Infectious Diseases, Department of Medicine, University of Cambridge, United Kingdom
- Department of Medicine, University of Cambridge, United Kingdom
- National Institute for Health Research Cambridge BioResource, United Kingdom
- Department of Clinical Neurosciences, and Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom
- Cambridgeshire and Peterborough National Health Service Foundation Trust, United Kingdom
- Division of Anaesthesia, Department of Medicine, University of Cambridge
- National Institute for Health Research COVID-19 BioResource, United Kingdom
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