Imperial College London

ProfessorAdamHampshire

Faculty of MedicineDepartment of Brain Sciences

Visiting Professor
 
 
 
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Contact

 

+44 (0)20 7594 7993a.hampshire

 
 
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Location

 

Burlington DanesHammersmith Campus

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Summary

 

Publications

Publication Type
Year
to

148 results found

Kurtin DL, Arana-Oiarbide G, Lorenz R, Violante IR, Hampshire Aet al., 2023, Planning ahead: Predictable switching recruits task-active and resting-state networks, HUMAN BRAIN MAPPING, Vol: 44, Pages: 5030-5046, ISSN: 1065-9471

Journal article

Taquet M, Skorniewska Z, Hampshire A, Chalmers JD, Ho L-P, Horsley A, Marks M, Poinasamy K, Raman B, Leavy OC, Richardson M, Elneima O, McAuley HJC, Shikotra A, Singapuri A, Sereno M, Saunders RM, Harris VC, Houchen-Wolloff L, Greening NJ, Mansoori P, Harrison EM, Docherty AB, Lone NI, Quint J, Sattar N, Brightling CE, Wain LV, Evans RE, Geddes JR, Harrison PJ, PHOSP-COVID Study Collaborative Groupet al., 2023, Acute blood biomarker profiles predict cognitive deficits 6 and 12 months after COVID-19 hospitalization., Nat Med, Vol: 29, Pages: 2498-2508

Post-COVID cognitive deficits, including 'brain fog', are clinically complex, with both objective and subjective components. They are common and debilitating, and can affect the ability to work, yet their biological underpinnings remain unknown. In this prospective cohort study of 1,837 adults hospitalized with COVID-19, we identified two distinct biomarker profiles measured during the acute admission, which predict cognitive outcomes 6 and 12 months after COVID-19. A first profile links elevated fibrinogen relative to C-reactive protein with both objective and subjective cognitive deficits. A second profile links elevated D-dimer relative to C-reactive protein with subjective cognitive deficits and occupational impact. This second profile was mediated by fatigue and shortness of breath. Neither profile was significantly mediated by depression or anxiety. Results were robust across secondary analyses. They were replicated, and their specificity to COVID-19 tested, in a large-scale electronic health records dataset. These findings provide insights into the heterogeneous biology of post-COVID cognitive deficits.

Journal article

Lerede A, Rodgers J, Middleton RM, Hampshire A, Nicholas Ret al., 2023, Patient-reported outcomes in multiple sclerosis: a prospective registry cohort study, Brain Communications, Vol: 5, Pages: 1-13, ISSN: 2632-1297

Registries have the potential to tackle some of the current limitations in determining the longterm impact of multiple sclerosis (MS). Online assessments using patient-reported outcomes(PROs) can streamline follow-up enabling large-scale, long-term, cost-effective, home-based,and patient-focused data collection. However, registry data are sparsely sampled and thesensitivity of PROs relative to clinician-reported scales is unknown, making it hard to fullyleverage their unique scope and scale to derive insights.This retrospective and prospective cohort study over 11 years involved 15,976 patients withmultiple sclerosis from the United Kingdom Multiples Sclerosis Register. Primary outcomeswere changes in two PROs: Multiple Sclerosis Impact Scale (MSIS-29) motor component, andMultiple Sclerosis Walking Scale (MSWS-12). First, we investigated their validity inmeasuring the impact of physical disability in multiple sclerosis, by looking at their sensitivityto disease subtype and duration. We grouped the available records (91,351 for MSIS-29 and68,092 for MSWS-12) by these two factors, and statistically compared the resulting groupsusing a novel approach based on Monte Carlo permutation analysis that was designed to copewith the intrinsic sparsity of registry data. Next, we used the PROs to draw novel insights intothe developmental time course of subtypes; in particular, the period preceding the transitionfrom relapsing to progressive forms.We report a robust main effect of disease subtype on the PROs and interactions of diseasesubtype with duration (all p<0.0001). Specifically, PROs worsen with disease duration for allsubtypes (all p<0.0001) apart from Benign MS (MSIS-29 motor: p=0.796; MSWS-12:p=0.983). Furthermore, the PROs of each subtype are statistically different from those of theother subtypes at all time bins (MSIS-29 motor: all p<0.05; MSWS-12: all p<0.01) exceptwhen comparing Relapsing Remitting MS with Benign MS and Primary Progressive MS withSecond

Journal article

Crook-Rumsey M, Daniels S, Abulikemu S, Lai H, Rapeaux A, Hadjipanayi C, Soreq E, Li L, Bashford J, Jeyasingh Jacob J, Gruia D-C, Lambert D, Weil R, Hampshire A, Sharp D, Haar Set al., 2023, Multicohort cross-sectional study of cognitive and behavioural digital biomarkers in neurodegeneration: the Living Lab study protocol, BMJ Open, Vol: 13, Pages: 1-9, ISSN: 2044-6055

Introduction and aimsDigital biomarkers can provide a cost-effective, objective, and robust measure forneurological disease progression, changes in care needs, and the effect of interventions.Motor function, physiology and behaviour can provide informative measures of neurologicalconditions and neurodegenerative decline. New digital technologies present an opportunityto provide remote, high-frequency monitoring of patients from within their homes. Thepurpose of the Living Lab study is to develop novel digital biomarkers of functionalimpairment in those living with neurodegenerative disease (NDD) and neurologicalconditions.Methods and analysisThe Living Lab Study is a cross-sectional observational study of cognition and behaviour inpeople living with NDDs and other, non-degenerative neurological conditions. Patients (n≥25for each patient group) with Dementia, Parkinson’s disease, Amyotrophic Lateral Sclerosis, Mild Cognitive Impairment, Traumatic Brain Injury, and Stroke along with controls (n≥60) willbe pragmatically recruited. Patients will carry out activities of daily living and functionalassessments within the living lab. The living lab is an apartment-laboratory containing afunctional kitchen, bathroom, bed and living area to provide a controlled environment todevelop novel digital biomarkers. The living lab provides an important intermediary stagebetween the conventional laboratory and the home. Multiple passive environmental sensors,internet-enabled medical devices, wearables, and EEG will be used to characterise functionalimpairments of NDDs and non-NDD conditions. We will also relate these digital technologymeasures to clinical and cognitive outcomes.Ethics and disseminationEthical approvals have been granted by the Imperial College Research Ethics Committee(reference number: 21IC6992). Results from the study will be disseminated at conferencesand within peer-reviewed journals.

Journal article

Stewart GR, Corbett A, Ballard C, Creese B, Aarsland D, Hampshire A, Charlton RA, Happé Fet al., 2023, Self-harm and Suicidality Experiences of Middle-Age and Older Adults With vs. Without High Autistic Traits., J Autism Dev Disord, Vol: 53, Pages: 3034-3046

Suicide has been identified as a leading cause of premature death in autistic populations. Elevated autistic traits have also been associated with higher rates of self-harm, suicidal ideation, and suicidal self-harm in the general population, but this has yet to be examined in older age. Using baseline cross-sectional data from the PROTECT study, middle-age and older adults with high autistic traits (n = 276) had significantly higher rates of suicidal ideation, deliberate self-harm, and suicidal self-harm than an age/sex-matched comparison group (n = 10,495). These differences represented a 5- to 6-fold increase in likelihood for self-harming and suicidality. These findings, which remained when controlling for depression symptoms, suggest that middle-age and older adults with high autistic traits may be particularly at risk of self-harm and suicidal behaviours.

Journal article

Cheetham NJ, Penfold R, Giunchiglia V, Bowyer V, Sudre CH, Canas LS, Deng J, Murray B, Kerfoot E, Antonelli M, Rjoob K, Molteni E, Osterdahl MF, Harvey NR, Trender WR, Malim MH, Doores KJ, Hellyer PJ, Modat M, Hammers A, Ourselin S, Duncan EL, Hampshire A, Steves CJet al., 2023, The effects of COVID-19 on cognitive performance in a community-based cohort: a COVID symptom study biobank prospective cohort study, ECLINICALMEDICINE, Vol: 62

Journal article

Balaet M, Kurtin D, Gruia D, Lerede A, Custovic D, Trender W, Jolly A, Hellyer P, Hampshire Aet al., 2023, Mapping the sociodemographic distribution and self-reported justifications for non-compliance with COVID-19 guidelines in the UK, Frontiers in Psychology, Vol: 14, Pages: 1-18, ISSN: 1664-1078

Which population factors have predisposed people to disregard government safetyguidelines during the COVID-19 pandemic and what justifications do they givefor this non-compliance? To address these questions, we analyse fixed-choiceand free-text responses to survey questions about compliance and governmenthandling of the pandemic, collected from tens of thousands of members ofthe UK public at three 6-monthly timepoints. We report that sceptical opinionsabout the government and mainstream-media narrative, especially as pertainingto justification for guidelines, significantly predict non-compliance. However,free text topic modelling shows that such opinions are diverse, spanning fromscepticism about government competence and self-interest to full-blownconspiracy theories, and covary in prevalence with sociodemographic variables.These results indicate that attempts to counter non-compliance throughargument should account for this diversity in peoples’ underlying opinions, andinform conversations aimed at bridging the gap between the general public andbodies of authority accordingly.

Journal article

Lennon MJ, Brooker H, Creese B, Thayanandan T, Rigney G, Aarsland D, Hampshire A, Ballard C, Corbett A, Raymont Vet al., 2023, Lifetime Traumatic Brain Injury and Cognitive Domain Deficits in Late Life: The PROTECT-TBI Cohort Study., J Neurotrauma, Vol: 40, Pages: 1423-1435

Traumatic brain injury (TBI) causes cognitive impairment but it remains contested regarding which cognitive domains are most affected. Further, moderate-severe TBI is known to be deleterious, but studies of mild TBI (mTBI) show a greater mix of negative and positive findings. This study examines the longer-term cognitive effects of TBI severity and number of mTBIs in later life. We examined a subset (n = 15,764) of the PROTECT study, a cohort assessing risk factors for cognitive decline (ages between 50 and 90 years). Participants completed cognitive assessments annually for 4 years. Cognitive tests were grouped using a principal components analysis (PCA) into working memory, episodic memory, attention, processing speed, and executive function. Lifetime TBI severity and number were retrospectively recalled by participants using the Brain Injury Screening Questionnaire (BISQ). Linear mixed models (LMMs) examined the effect of severity of head injury (non-TBI head strike, mTBI, and moderate-severe TBI) and number of mTBI at baseline and over time. mTBI was considered as a continuous and categorical variable (groups: 0 mTBI, 1 mTBI, 2 mTBIs, 3 mTBIs, and 4+ mTBIs). Of the participants 5725 (36.3%) reported at least one mTBI and 510 (3.2%) at least one moderate-severe TBI, whereas 3711 (23.5%) had suffered at worst a non-TBI head strike and 5818 (32.9%) reported no head injuries. The participants had suffered their last reported head injury an average (standard deviation, SD) of 29.6 (20.0) years prior to the study. Regarding outcomes, there was no worsening in longitudinal cognitive trajectories over the study duration but at baseline there were significant cognitive deficits associated with TBI. At baseline, compared with those without head injury, individuals reporting at least one moderate-severe TBI had significantly poorer attention (B = -0.163, p < 0.001), executive scores (B = -0.151, p = 0.004), and pro

Journal article

Balaet M, Trender W, Hellyer P, Hampshire Aet al., 2023, Associations between the use of psychedelics and other recreational drugs with mental health and resilience during the COVID-19 pandemic, Frontiers in Psychiatry, Vol: 14, Pages: 1-14, ISSN: 1664-0640

The large-scale disruption to peoples’ daily lives during the COVID-19 pandemic provides a context for examining whether use of substances such as psychedelics in a naturalistic (outside of a controlled environment) setting, is associated with better mental wellbeing and resilience relative to those who use other drugs, or who do not use drugs at all. We interrogate data from the Great British Intelligence Test and identify that 7.8% out of N=30,598 unique respondents used recreational drugs inclusive of psychedelics, cannabis, cocaine, and MDMA during the COVID-19 pandemic. Recruitment materials did not mention drug use would be surveyed, thereby enabling us to model the relationship with mood and resilience in people who had not specifically self-selected themselves for a ‘drug’ study. We report that people form clusters, characterised by different real-world patterns of drug use, and the majority of psychedelics users also use cannabis. However, a subset of cannabis users do not use psychedelics, enabling a subtractive comparison. Those who primarily used psychedelics and cannabis during the COVID-19 pandemic had worse mood self-assessment and resilience scores compared to those who never used drugs or primarily used cannabis. This pattern was also evident for other recreational drug use clusters, except for those who primarily used MDMA and cannabis,who had better mood but were of too low incidence to have confidence in this estimate. These findings cast light on the significant differences in mental wellbeing between users of different drugs and the non-user population during a global-crisis and call for future research to explore the pharmacological, contextual and cultural variables associated with these differences, their generalisability and causal links with greater precision.

Journal article

Del Giovane M, Trender WR, Bălăeţ M, Mallas E-J, Jolly AE, Bourke NJ, Zimmermann K, Graham NSN, Lai H, Losty EJF, Oiarbide GA, Hellyer PJ, Faiman I, Daniels SJC, Batey P, Harrison M, Giunchiglia V, Kolanko MA, David MCB, Li LM, Demarchi C, Friedland D, Sharp DJ, Hampshire Aet al., 2023, Computerised cognitive assessment in patients with traumatic brain injury: an observational study of feasibility and sensitivity relative to established clinical scales, EClinicalMedicine, Vol: 59, ISSN: 2589-5370

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) = 3.9

Journal article

Bourke N, Trender W, Hampshire A, Lai H, Demarchi C, David M, Hellyer P, Sharp D, Friedland Det al., 2023, Assessing prospective and retrospective metacognitive accuracy following traumatic brain injury remotely across cognitive domains, Neuropsychological Rehabilitation, Vol: 33, Pages: 574-591, ISSN: 0960-2011

The ability to monitor one's behaviour is frequently impaired following TBI, impacting on patients’ rehabilitation. Inaccuracies in judgement or self-reflection of one’s performance provides a useful marker of metacognition. However, metacognition is rarely measured during routine neuropsychology assessments and how it varies across cognitive domains is unclear. A cohort of participants consisting of 111 TBI patients [mean age = 45.32(14.15), female = 29] and 84 controls [mean age = 31.51(12.27), female = 43] was studied. Participants completed cognitive assessments via a bespoke digital platform on their smartphones. Included in the assessment were a prospective evaluation of memory and attention, and retrospective confidence judgements of task performance. Metacognitive accuracy was calculated from the difference between confidence judgement of task performance and actual performance. Prospective judgment of attention and memory was correlated with task performance in these domains for controls but not patients. TBI patients had lower task performance in processing speed, executive functioning and working memory compared to controls, maintaining high confidence, resulting in overestimation of cognitive performance compared to controls. Additional judgments of task performance complement neuropsychological assessments with little additional time–cost. These results have important theoretical and practical implications for evaluation of metacognitive impairment in TBI patients and neurorehabilitation.

Journal article

Sabatini S, Ukoumunne OC, Ballard C, Collins R, Kim S, Corbett A, Aarsland D, Hampshire A, Brooker H, Clare Let al., 2023, What does feeling younger or older than one's chronological age mean to men and women? Qualitative and quantitative findings from the PROTECT study, PSYCHOLOGY & HEALTH, Vol: 38, Pages: 324-347, ISSN: 0887-0446

Journal article

Peers PV, Punton SF, Murphy FC, Watson P, Bateman A, Duncan J, Astle DE, Hampshire A, Manly Tet al., 2022, A randomized control trial of the effects of home-based online attention training and working memory training on cognition and everyday function in a community stroke sample., Neuropsychol Rehabil, Vol: 32, Pages: 2603-2627

Cognitive difficulties are common following stroke and can have widespread impacts on everyday functioning. Technological advances offer the possibility of individualized cognitive training for patients at home, potentially providing a low-cost, low-intensity adjunct to rehabilitation services. Using this approach, we have previously demonstrated post-training improvements in attention and everyday functioning in fronto-parietal stroke patients. Here we examine whether these benefits are observed more broadly in a community stroke sample. Eighty patients were randomized to either 4 weeks of online adaptive attention training (SAT), working memory training (WMT) or waitlist (WL). Cognitive and everyday function measures were collected before and after the intervention, and after 3 months. During training, weekly measures of patients' subjective functioning were collected. The training was well received and compliance good. No differences in our primary end-point, spatial bias, or other cognitive functions were observed. However, on patient-reported outcomes, SAT participants showed greater levels of improvement in everyday functioning than WMT or WL participants. In line with our previous work, everyday functioning improvements were greatest for patients with spatial impairments and those who received SAT training. Whether attention training can be recommended for stroke survivors depends on whether cognitive test performance or everyday functioning is considered more relevant.

Journal article

Hampshire A, Menon DK, 2022, Response to “Understanding chronic Covid-19”, eClinicalMedicine, Vol: 51

Journal article

Singham T, Saunders R, Brooker H, Creese B, Aarsland D, Hampshire A, Ballard C, Corbett A, Desai R, Stott Jet al., 2022, Are subtypes of affective symptoms differentially associated with change in cognition over time: A latent class analysis, JOURNAL OF AFFECTIVE DISORDERS, Vol: 309, Pages: 437-445, ISSN: 0165-0327

Journal article

Hampshire A, Chatfield DA, Manktelow A, Jolly A, Trender W, Hellyer P, Del Giovane M, Newcombe VFJ, Outtrim JG, Warne B, Bhatti J, Pointin L, Elmer A, Sithole N, Bradley J, Kingston N, Saweer SJ, Bullmore ET, Rowe JB, Menon DK, Cambridge NeuroCOVID Group, NIHR COVID-19 BioResource, Cambridge NIHR Clinical Research Facilityet al., 2022, Multivariate profile and acute-phase correlates of cognitive deficits in a COVID-19 hospitalised cohort, EClinicalMedicine, Vol: 47, Pages: 1-10, ISSN: 2589-5370

Background. Preliminary evidence has highlighted a likely association between severe COVID-19 and persistent cognitive deficits. Further research is required to confirm this association, determine whethercognitive 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 (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 an N=66,008 normative datasets. Global accuracy and response time composites were calculated (G_SScore & G_RT). Linear modelling predicted composite score deficitsfrom 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) than expected given the 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. 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

Journal article

Stewart GR, Corbett A, Ballard C, Creese B, Aarsland D, Hampshire A, Charlton RA, Happé Fet al., 2022, Traumatic life experiences and post-traumatic stress symptoms in middle-aged and older adults with and without autistic traits., Int J Geriatr Psychiatry, Vol: 37

OBJECTIVES: Research with younger adults has begun to explore associations between autism/autistic traits and vulnerability to Post Traumatic Stress Disorder (PTSD). Large scale studies and/or examination of age-effects have not been conducted. METHODS: Adults aged 50 years+ from the PROTECT study (n = 20,220) completed items about current and childhood socio-communicative difficulties characteristic of autism. Approximately 1% (n = 251) endorsed high autistic traits, henceforth the Autism Spectrum Traits (AST) group. Differences between the AST and an age-and sex-matched "Comparison Older Adults" (COA; n = 9179) group were explored for lifetime traumatic experiences and current symptoms of PTSD, depression, and anxiety. RESULTS: Almost 30% of the AST group, compared to less than 8% of the COA, reported severe trauma in childhood/adulthood, including emotional, physical or sexual abuse. Elevated current PTSD symptoms were reported by AST compared to COA. An interaction was observed between autistic traits and trauma severity; the effect of level of trauma on PTSD symptoms was significantly greater for AST versus COA participants. This interaction remained significant when controlling for current depression and anxiety symptoms. CONCLUSIONS: The findings suggest that high autistic traits may increase the likelihood of experiencing trauma across the lifespan, and the impact of severe trauma on PTSD symptoms. Older adults with high (vs. low) autistic traits may be at greater risk of experiencing PTSD symptoms in latter life. Future research should test whether the pattern of results is similar for diagnosed autistic adults.

Journal article

Zhao S, Shibata K, Hellyer PJ, Trender W, Manohar S, Hampshire A, Husain Met al., 2022, Rapid vigilance and episodic memory decrements in COVID-19 survivors, Brain Communications, Vol: 4

Recent studies indicate that COVID-19 infection can lead to serious neurological consequences in a small percentage of individuals. However, in the months following acute illness, many more suffer from fatigue, low motivation, disturbed mood, poor sleep and cognitive symptoms, colloquially referred to as 'brain fog'. But what about individuals who had asymptomatic to moderate COVID-19 and reported no concerns after recovering from COVID-19? Here, we examined a wide range of cognitive functions critical for daily life (including sustained attention, memory, motor control, planning, semantic reasoning, mental rotation and spatial-visual attention) in people who had previously suffered from COVID-19 but were not significantly different from a control group on self-reported fatigue, forgetfulness, sleep abnormality, motivation, depression, anxiety and personality profile. Reassuringly, COVID-19 survivors performed well in most abilities tested, including working memory, executive function, planning and mental rotation. However, they displayed significantly worse episodic memory (up to 6 months post-infection) and greater decline in vigilance with time on task (for up to 9 months). Overall, the results show that specific chronic cognitive changes following COVID-19 are evident on objective testing even amongst those who do not report a greater symptom burden. Importantly, in the sample tested here, these were not significantly different from normal after 6-9 months, demonstrating evidence of recovery over time.

Journal article

Hampshire A, Trender W, Grant JE, Mirza MB, Moran R, Hellyer PJ, Chamberlain SRet al., 2022, Item-level analysis of mental health symptom trajectories during the COVID-19 pandemic in the UK: Associations with age, sex and pre-existing psychiatric conditions, Comprehensive Psychiatry, Vol: 114, Pages: 1-18, ISSN: 0010-440X

BackgroundThere is widespread concern regarding how the COVID-19 pandemic has affected mental health. Emerging meta-analyses suggest that the impact on anxiety/depression may have been transient, but much of the included literature has major methodological limitations. Addressing this topic rigorously requires longitudinal data of sufficient scope and scale, controlling for contextual variables, with baseline data immediately pre-pandemic.AimsTo analyse self-report of symptom frequency from two largely UK-based longitudinal cohorts: Cohort 1 (N = 10,475, two time-points: winter pre-pandemic to UK first winter resurgence), and Cohort 2 (N = 10,391, two time-points, peak first wave to UK first winter resurgence).MethodMultinomial logistic regression applied at the item level identified sub-populations with greater probability of change in mental health symptoms. Permutation analyses characterised changes in symptom frequency distributions. Cross group differences in symptom stability were evaluated via entropy of response transitions.ResultsAnxiety was the most affected aspect of mental health. The profiles of change in mood symptoms was less favourable for females and older adults. Those with pre-existing psychiatric diagnoses showed substantially higher probability of very frequent symptoms pre-pandemic and elevated risk of transitioning to the highest levels of symptoms during the pandemic. Elevated mental health symptoms were evident across intra-COVID timepoints in Cohort 2.ConclusionsThese findings suggest that mental health has been negatively affected by the pandemic, including in a sustained fashion beyond the first UK lockdown into the first winter resurgence. Women, and older adults, were more affected relative to their own baselines. Those with diagnoses of psychiatric conditions were more likely to experience transition to the highest levels of symptom frequency.

Journal article

Wolfova K, Creese B, Aarsland D, Ismail Z, Corbett A, Ballard C, Hampshire A, Cermakova Pet al., 2022, Gender/Sex Differences in the Association of Mild Behavioral Impairment with Cognitive Aging., J Alzheimers Dis, Vol: 88, Pages: 345-355

BACKGROUND: While the gender/sex differences in neuropsychiatric symptoms in dementia population are well described, gender/sex differences in mild behavioral impairment (MBI) in dementia-free populations and the relationship to cognitive performance and to subsequent cognitive decline have not been studied. OBJECTIVE: We aimed to explore gender/sex differences in the association of MBI with the level of cognitive performance and its rate of decline in a dementia-free cohort. METHODS: We studied 8,181 older adults enrolled in the online PROTECT UK Study. MBI was assessed using the MBI Checklist and cognition was measured by digit span, paired associate learning, spatial working memory, and verbal reasoning. Statistical analysis was conducted using linear regression models and linear mixed-effects models. RESULTS: Out of 8,181 individuals (median age 63 years, 73% females), 11% of females and 14% of males had MBI syndrome. Females exhibited less often symptoms of decreased motivation (45% versus 36% in males), impulse dyscontrol (40% versus 44% in males; p = 0.001) and social inappropriateness (12% versus 15%; p < 0.001), while they showed more often symptoms of emotional dysregulation (45% versus 36%; p < 0.001). The associations of MBI domains with some measures of cognitive performance and decline were stronger in males than females, with the exception of the association of emotional dysregulation with the rate of cognitive decline in verbal reasoning, which was present exclusively in females. CONCLUSION: MBI may influence cognition to a greater extent in males than in females. We propose that predictors and biomarkers of dementia should consider gender/sex as an effect modifier.

Journal article

Usher I, Hellyer P, Lee KS, Leech R, Hampshire A, Alamri A, Chari Aet al., 2021, "It's not rocket science" and "It's not brain surgery"-"It's a walk in the park": prospective comparative study, BMJ: British Medical Journal, Vol: 375, Pages: 1-7, ISSN: 0959-535X

Objective To compare cognitive testing scores in neurosurgeons and aerospace engineers to help settle the age old argument of which phrase—“It’s not brain surgery” or “It’s not rocket science”—is most deserved.Design International prospective comparative study.Setting United Kingdom, Europe, the United States, and Canada.Participants 748 people (600 aerospace engineers and 148 neurosurgeons). After data cleaning, 401 complete datasets were included in the final analysis (329 aerospace engineers and 72 neurosurgeons).Main outcome measures Validated online test (Cognitron’s Great British Intelligence Test) measuring distinct aspects of cognition, spanning planning and reasoning, working memory, attention, and emotion processing abilities.Results The neurosurgeons showed significantly higher scores than the aerospace engineers in semantic problem solving (difference 0.33, 95% confidence interval 0.13 to 0.52). Aerospace engineers showed significantly higher scores in mental manipulation and attention (−0.29, −0.48 to −0.09). No difference was found between groups in domain scores for memory (−0.18, −0.40 to 0.03), spatial problem solving (−0.19, −0.39 to 0.01), problem solving speed (0.03, −0.20 to 0.25), and memory recall speed (0.12, −0.10 to 0.35). When each group’s scores for the six domains were compared with those in the general population, only two differences were significant: the neurosurgeons’ problem solving speed was quicker (mean z score 0.24, 95% confidence interval 0.07 to 0.41) and their memory recall speed was slower (−0.19, −0.34 to −0.04).Conclusions In situations that do not require rapid problem solving, it might be more correct to use the phrase “It’s not brain surgery.” It is possible that both neurosurgeons and aerospace engineers are unnecessarily placed on a pedestal and that “It&rsqu

Journal article

Stewart GR, Corbett A, Ballard C, Creese B, Aarsland D, Hampshire A, Charlton RA, Happé Fet al., 2021, The Mental and Physical Health Profiles of Older Adults Who Endorse Elevated Autistic Traits., J Gerontol B Psychol Sci Soc Sci, Vol: 76, Pages: 1726-1737

OBJECTIVES: The mental and physical health profile of autistic people has been studied in adolescence and adulthood, with elevated rates of most conditions being reported. However, this has been little studied taking a dimensional approach to autistic traits and in older age. METHODS: A total of 20,220 adults aged 50-81 years from the PROTECT study reported whether they experienced persistent sociocommunicative traits characteristic of autism. Approximately 1%, 276 individuals, were identified as endorsing elevated autistic traits in childhood and currently, henceforth the "Autism Spectrum Trait" (AST) group. An age- and gender-matched comparison group was formed of 10,495 individuals who did not endorse any autistic behavioral traits, henceforth the "Control Older Adults" (COA) group. Differences between AST and COA groups were explored in self-reported psychiatric diagnoses, self-reported symptoms of current depression and anxiety, and self-reported physical health diagnoses. Associations were also examined between autistic traits and health across the whole sample. RESULTS: The AST group reported significantly elevated rates of psychiatric diagnoses compared to the COA group. Additionally, the AST group showed significantly higher self-reported symptoms of current depression and anxiety than the COA group. However, few differences were observed in individual physical health conditions, and no differences in total co-occurring physical diagnoses between groups. Similar associations between autistic traits and health were also found taking a dimensional approach across the whole sample. DISCUSSION: These findings suggest that older adults with elevated autistic traits may be at greater risk of poorer mental, but not physical, health in later life. Future studies should incorporate polygenic scores to elucidate the possible genetic links between the propensity to autism/high autistic traits and to psychiatric conditions, and to explore whether th

Journal article

Hampshire A, Hellyer PJ, Trender W, Chamberlain SRet al., 2021, Insights into the impact on daily life of the COVID-19 pandemic and effective coping strategies from free-text analysis of people's collective experiences, Interface Focus, Vol: 11, Pages: 1-11, ISSN: 2042-8901

There has been considerable speculation regarding how people cope during the COVID-19 pandemic; however, surveys requiring selection from prespecified answers are limited by researcher views and may overlook the most effective measures. Here, we apply an unbiased approach that learns from people's collective lived experiences through the application of natural-language processing of their free-text reports. At the peak of the first lockdown in the United Kingdom, 51 113 individuals provided free-text responses regarding self-perceived positive and negative impact of the pandemic, as well as the practical measures they had found helpful during this period. Latent Dirichlet Allocation identified, in an unconstrained data-driven manner, the most common impact and advice topics. We report that six negative topics and seven positive topics are optimal for capturing the different ways people reported being affected by the pandemic. Forty-five topics were required to optimally summarize the practical coping strategies that they recommended. General linear modelling showed that the prevalence of these topics covaried substantially with age. We propose that a wealth of coping measures may be distilled from the lived experiences of the general population. These may inform feasible individually tailored digital interventions that have relevance during and beyond the pandemic.

Journal article

Parkin B, Daws R, Das Neves I, Violante I, Soreq E, Faisal A, Sandrone S, Lao-Kaim N, Martin-Bastida A, Roussakis A-A, Piccini P, Hampshire Aet al., 2021, Dissociable effects of age and Parkinson's disease on instruction based learning, Brain Communications, Vol: 3, ISSN: 2632-1297

The cognitive deficits associated with Parkinson’s disease vary across individuals and change across time, with implications for prognosis and treatment. Key outstanding challenges are to define the distinct behavioural characteristics of this disorder and develop diagnostic paradigms that can assess these sensitively in individuals. In a previous study, we measured different aspects of attentional control in Parkinson’s disease using an established fMRI switching paradigm. We observed no deficits for the aspects of attention the task was designed to examine; instead those with Parkinson’s disease learnt the operational requirements of the task more slowly. We hypothesized that a subset of people with early-to-mid stage Parkinson’s might be impaired when encoding rules for performing new tasks. Here, we directly test this hypothesis and investigate whether deficits in instruction-based learning represent a characteristic of Parkinson’s Disease. Seventeen participants with Parkinson’s disease (8 male; mean age: 61.2 years), 18 older adults (8 male; mean age: 61.3 years) and 20 younger adults (10 males; mean age: 26.7 years) undertook a simple instruction-based learning paradigm in the MRI scanner. They sorted sequences of coloured shapes according to binary discrimination rules that were updated at two-minute intervals. Unlike common reinforcement learning tasks, the rules were unambiguous, being explicitly presented; consequently, there was no requirement to monitor feedback or estimate contingencies. Despite its simplicity, a third of the Parkinson’s group, but only one older adult, showed marked increases in errors, 4 SD greater than the worst performing young adult. The pattern of errors was consistent, reflecting a tendency to misbind discrimination rules. The misbinding behaviour was coupled with reduced frontal, parietal and anterior caudate activity when rules were being encoded, but not when attention was initially o

Journal article

Palmer EOC, Trender W, Tyacke RJ, Hampshire A, Lingford-Hughes Aet al., 2021, Impact of COVID-19 restrictions on alcohol consumption behaviours, BJPsych Open, Vol: 7, Pages: 1-7, ISSN: 2056-4724

BackgroundWe aimed to evaluate how coronavirus (COVID-19) restrictions had altered individual's drinking behaviours, including consumption, hangover experiences, and motivations to drink, and changing levels of depression and anxiety.MethodWe conducted an online cross-sectional self-report survey. Whole group analysis compared pre- versus post-COVID restrictions. A correlation coefficient matrix evaluated the associations between all outcome scores. Self-report data was compared with Alcohol Use Disorders Identification Test (AUDIT) scores from the 2014 Adult Psychiatric Morbidity Survey. Multiple linear modelling (MLM) was calculated to identify factors associated with increasing AUDIT scores and post-restriction AUDIT scores.ResultsIn total, 346 individuals completed the survey, of which 336 reported drinking and were therefore analysed. After COVID-19 restrictions 23.2% of respondents reported an increased AUDIT score, and 60.1% a decreased score. AUDIT score change was positively correlated with change in depression (P < 0.01, r = 0.15), anxiety (P < 0.01, r = 0.15) and drinking to cope scores (P < 0.0001, r = 0.35). MLM revealed that higher AUDIT scores were associated with age, mental illness, lack of a garden, self-employed or furloughed individuals, a confirmed COVID-19 diagnosis and smoking status.ConclusionsCOVID-19 restrictions decreased alcohol consumption for the majority of individuals in this study. However, a small proportion increased their consumption; this related to drinking to cope and increased depression and anxiety.

Journal article

Kurtin DL, Violante IR, Zimmerman K, Leech R, Hampshire A, Patel MC, Carmichael DW, Sharp DJ, Li LMet al., 2021, Investigating the interaction between white matter and brain state on tDCS-induced changes in brain network activity, Brain Stimulation, Vol: 14, Pages: 1261-1270, ISSN: 1876-4754

BACKGROUND: Transcranial direct current stimulation (tDCS) is a form of noninvasive brain stimulation whose potential as a cognitive therapy is hindered by our limited understanding of how participant and experimental factors influence its effects. Using functional MRI to study brain networks, we have previously shown in healthy controls that the physiological effects of tDCS are strongly influenced by brain state. We have additionally shown, in both healthy and traumatic brain injury (TBI) populations, that the behavioral effects of tDCS are positively correlated with white matter (WM) structure. OBJECTIVES: In this study we investigate how these two factors, WM structure and brain state, interact to shape the effect of tDCS on brain network activity. METHODS: We applied anodal, cathodal and sham tDCS to the right inferior frontal gyrus (rIFG) of healthy (n = 22) and TBI participants (n = 34). We used the Choice Reaction Task (CRT) performance to manipulate brain state during tDCS. We acquired simultaneous fMRI to assess activity of cognitive brain networks and used Fractional Anisotropy (FA) as a measure of WM structure. RESULTS: We find that the effects of tDCS on brain network activity in TBI participants are highly dependent on brain state, replicating findings from our previous healthy control study in a separate, patient cohort. We then show that WM structure further modulates the brain-state dependent effects of tDCS on brain network activity. These effects are not unidirectional - in the absence of task with anodal and cathodal tDCS, FA is positively correlated with brain activity in several regions of the default mode network. Conversely, with cathodal tDCS during CRT performance, FA is negatively correlated with brain activity in a salience network region. CONCLUSIONS: Our results show that experimental and participant factors interact to have unexpected effects on brain network activity, and that these effects are not fully predictable by studying the fa

Journal article

Hampshire A, Trender W, Chamberlain SR, Jolly AE, Grant JE, Patrick F, Mazibuko N, Williams SCR, Barnby JM, Hellyer P, Mehta MAet al., 2021, Cognitive deficits in people who have recovered from COVID-19, ECLINICALMEDICINE, Vol: 39

Journal article

Hampshire A, Hellyer PJ, Soreq E, Mehta MA, Ioannidis K, Trender W, Grant JE, Chamberlain SRet al., 2021, Associations between dimensions of behaviour, personality traits, and mental-health during the COVID-19 pandemic in the United Kingdom (vol 12, 4111, 2021), NATURE COMMUNICATIONS, Vol: 12

Journal article

Hampshire A, Hellyer P, Soreq E, Mehta M, Ioannidis K, Trender W, Grant J, Chamberlain Set al., 2021, Associations between dimensions of behaviour, personality traits, and mental-health during the COVID-19 pandemic in the United Kingdom, Nature Communications, ISSN: 2041-1723

Journal article

Zhao S, Shibata K, Hellyer PJ, Trender W, Manohar S, Hampshire A, Husain Met al., 2021, Rapid vigilance and episodic memory decrements in COVID-19 survivors

<jats:title>Abstract</jats:title><jats:p>Recent studies indicate that COVID-19 infection can lead to serious neurological consequences in a small percentage of individuals. However, in the months following acute illness, many more suffer from fatigue, low motivation, disturbed mood, poor sleep and cognitive symptoms, colloquially referred to as ‘brain fog’. But what about individuals who had asymptomatic to moderate COVID-19 and report no concerns after recovering from COVID-19? Here we examined a wide range of cognitive functions critical for daily life (including sustained attention, memory, motor control, planning, semantic reasoning, mental rotation and spatial-visual attention) in people who had previously suffered from COVID-19 but were not significantly different from a control group on self-reported fatigue, forgetfulness, sleep abnormality, motivation, depression, anxiety and personality profile. Reassuringly, COVID-19 survivors performed well in most abilities tested, including working memory, executive function, planning and mental rotation. However, they displayed significantly worse episodic memory (up to 6 months post-infection) and greater decline in vigilance with time on task (for up to 9 months). Overall, the results show that specific chronic cognitive changes following COVID-19 are evident on objective testing even amongst those who do not report a greater symptom burden. Importantly, in the sample tested here, these were not significantly different from normal after six-nine months, demonstrating evidence of recovery over time.</jats:p>

Journal article

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