markparamlall

Consultant Neuropsychiatrist Neurorehab Prev@activecare@QueenSq @Cygnet@northbristolNHS Ex SpR @SLAM Interests: Neuro, TBI, Tourette & Neurodevelopmental Psych

[Himanshu Tyagi @himanshutyagi]

Just a reminder that this is scheduled for tomorrow. Open to all.

[Himanshu Tyagi @himanshutyagi]

Like many other important issues, you championed the cause of #OCD as Dean - now, as President, we are fortunate to have you amplify the voice of this often silent epidemic even further.

Honoured that your first event as President-elect will be our OCD webinar on this very topic at 16:00hrs today :-)

Those who missed the earlier notification can still register here: https://t.co/QMyt3SNgTM @OrchardOCD @chrisha_jay @Marghe_Zenoni @reachdrdeepa @subodhdave1

[markparamlall @markparamlall]

@himanshutyagi Congratulations 👏🎉

[markparamlall @markparamlall]

"The wheel is come full circle, I am here." — William Shakespeare (King Lear)

https://t.co/NpkM6s7Nth

[markparamlall @markparamlall]

@foxmdphd @shansiddiqi @Brain_Circuits Definitely, yes!

[Jing Jiang @jingjiang_psy]

📢 Can noninvasive TMS reach & modulate the human hippocampus? 🧠⚡🧲 Multimodal evidence (TMS-iEEG + TMS-fMRI) from our new @NatureComms paper says YES: https://t.co/tDGpm8Tvil
Here’s what we did and why it matters. 👇
#TMS #iEEG #fMRI #Hippocampus #Memory #Emotion

[Himanshu Tyagi @himanshutyagi]

This call for a “Share Once” support register in mental health is sensible and humane.

Important report from @MoneyMHT
https://t.co/BWqDqcclgx

[Michael Fox @foxmdphd]

What’s the difference between a neurological vs psychiatric disorder? @Brain_Circuits, it’s only the circuit impacted. Honored to become one of the first full Professors of both Psychiatry and Neurology @harvardmed. Excited to help bridge this divide.

[Himanshu Tyagi @himanshutyagi]

When perception detaches from reality in AI, is it noise… or circuitry?

LLMs may have “hallucination neurons” (H Neurons) as this preprint from China is claiming:

https://t.co/uFcwIYrgvT

<0.1% of units predicting false beliefs, causally drive over-compliance, and emerge during pre-training - suggesting #LLM hallucinations aren’t just data noise but a microscopic circuit problem.

As a #neuropsychiatrist treating circuit disorders in human brain, the parallel is hard to ignore.

Different brains, similar mysteries. #HNeurons #AI

[Himanshu Tyagi @himanshutyagi]

How many doctors realise that high serum B12 can coexist with functional B12 deficiency?

This simple question from a medical student two years ago led to the paper below - and sparked quite a conversation on Twitter. It was fascinating to see practitioners and patients from across the world chip in with their thoughts and experiences.

I’m delighted that the main author of this paper - @HamzaAMahmood21 - a bright @uclmedsci alum and now a doctor at @FrimleyHealth, has joined X/Twitter. Hopefully he’ll take this important conversation further with his upcoming systematic review on elevated #B12. @dr_pratimasingh

[Himanshu Tyagi @himanshutyagi]

Moments like the Sunday night’s #BAFTA incident remind us that although certain neuropsychiatric symptoms can be involuntary, yet their impact remains real.

https://t.co/eI50KaenEX

Public understanding must hold both compassion for an illness like #Tourettes & sensitivity to societal prejudices. The path forward is neither denial nor blame. Education remains the best antidote.

Below is a short thread on the essentials of #coprolalia in Tourette syndrome, based on observations made over ten years while running a specialist Tourette clinic at #NHNN @uclh

(1/10)

[Dr Sudhir Kumar MD DM @hyderabaddoctor]

Sleep is not a luxury; it is neuroprotection.

This is not just a graphic, it is based on PET scan data showing what happens to your brain’s "fuel" (glucose metabolism) after just one night of missed sleep.

The drop in activity in the prefrontal cortex and thalamus is staggering.
In fact:
👉 17 hours without sleep = Mental performance of someone with 0.05% blood alcohol concentration (BAC).
👉 24 hours without sleep = Equivalent to 0.10% BAC (higher than the legal driving limit).

When you skip sleep, your brain doesn't just "feel" tired, it functionally slows down. You are not being "productive" by staying up; you are operating a compromised machine.

Prioritize rest. Your brain will thank you with better focus, better mood, and faster processing tomorrow.

Dr Sudhir Kumar
@hyderabaddoctor

[markparamlall @markparamlall]

@himanshutyagi This is very important as it is one of the recommended blood tests in primary care to identify organic reversible causes of cognitive impairment.

[Himanshu Tyagi @himanshutyagi]

Elevated serum #B12 can be a sign of B12 deficiency!

Pseudo-hypercobalaminaemia occurs because circulating B12 is bound to inactive proteins or immune complexes (e.g. macro-B12), leaving intracellular delivery via transcobalamin impaired, so functional deficiency persists despite high total B12. This matters because clinicians may falsely reassure themselves, missing deficiency & underlying disease while neuropsychiatric symptoms continue.

In our preliminary UK survey of 46 GPs examining responses to raised B12, not a single respondent identified pseudo-hypercobalaminaemia, revealing a major blind spot in clinical reasoning. Survey was led by Hamza Mahmood @FrimleyHealth & co-supervised by @dr_pratimasingh @HPFT_NHS

Read it in full here: https://t.co/eQD3PNS0ZX #openaccess @neuropsych_ucl @uclh @UCLIoN

[Himanshu Tyagi @himanshutyagi]

Our new paper in Biological Psychiatry Open @SOBP presents converging neurobiological evidence that Body Dysmorphic Disorder (#BDD) is a unified Occipital–Fronto–Limbic (OFL) circuit disorder, not merely isolated visual or #OCD like deficits. This important meta-analysis of neuroimaging studies was led by Yihui Cheng @UofGMedicine, in collaboration with Emalee Burrows @UCL, @twr2twr @Cambridge_Uni, @HarithAkram @UCLIoN, Ludvic Zrinzo @UCLBrainScience

Mapping the interconnections between visual processing, temporal-limbic, and frontostriatal networks provides a clearer framework - the OFL circuit - for developing neurobiologically informed treatment approaches in this complex disorder characterised by variable treatment response.

Read the full article here https://t.co/iFNkSKECX4 #OpenAccess

@BDDFoundation @LABDDclinic #BodyDysmorphicDisorder #BDDAwareness @neuropsych_ucl

[Anthony David @ProfTonyDavid]

Inflammatory markers (IL-6 and CRP) in childhood and their association with brain structure and psychotic experiences in adulthood - CRP at age 9 related to inc sup frontal gyrus vols in those with psychotic experiences age 18.
https://t.co/KMZw3mJfUp
@SecretaryINA @The_BNPA

[Jon Stone @jonstoneneuro]

New @AANmember guidelines for management of functional seizures - led by @btolchin - are another important landmark for people with FND around the world.

✅Rigorous evidence-based process
✅Consensus practical recommendations
✅Endorsed by @FNDSociety

https://t.co/B9GIuJrnPA

[UCL Brain Sciences @UCLBrainScience]

Parkinson’s is now the fastest growing neurological condition in the world.
In this podcast, Dr Sonia Gandhi (@UCLIoN) shares more about her work to reverse that trend.
🎧 Listen now: https://t.co/XWPQBQXBEQ

[KimH @KH118118]

🔥 Hot off the press! NICE has published NG252, a brand-new guideline on rehabilitation for chronic neurological disorders, including Functional Neurological Disorder. Another big step after #FND became a core neurology subspecialty in NHS England! 🧠 https://t.co/Qz27MBnaOj

[Jonathan Rogers @drjprogers]

Fantastic morning spent on @The_BNPA's new course on neuropsychology for physicians, led by the brilliant @vaughanbell!

Basic science to clinical applications, including requesting and interpreting reports. Highly recommended!