Dr Tim Harrower
Consultant Neurologist, Clinical Lead for Physiology Speciality Lead for neurology Research in the South West NIHR
T.Harrower3@exeter.ac.uk
01392 402457
College House
College House, University of Exeter, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
Overview
Dr Timothy Harrower gained his medical degree at the University of Cape Town having graduated gained an intercalated B.Sc. in Medical Biochemistry and Human Physiology (cum laude). During training on the medical rotation in Cambridge membership of the Royal of College of Physicians was acquired and specialist neurology training completed. Having being awarded a Welcome Trust Clinical Research Grant he undertook research into neural stem cell biology and the mechanisms of neural transplant rejection at the Cambridge Centre for Brain Repair (University of Cambridge) where he read for a PhD in neuroscience. In addition, he was involved in managing all the patients with Huntington's Disease who had received neural transplants on the NEST neural transplant program.
In 2007 he was appointed Consultant Neurologist at the Royal Devon and Exeter NHS Foundation Trust and as a visiting neurologist at North Devon District Hospital. He continues to run a very active clinical program of clinics in general neurology but this is complemented running the Multiple Sclerosis, Huntington’s Disease, Motor Neuron Disease and Botulinum Toxin service.
Teaching at all levels from patients, scholars, students, nurses, trainees and peers is embedded in daily activities and has been recognised by being awarded a teaching excellence award by the University of Exeter Medical where he holds a Senior Clinical Lectureship post and is the Clinical Lead for Physiology.
Outside interests include trying to keep up with his teenage sons on the tennis court, training to maintain a reasonable bowling average for the Hospital cricket team, and ensuring he gets arthritis by running all manner running race or challenge.
But the new found skill of gardening in Devon provides balm for his soul and distracts from the more challenging aspects of modern NHS clinical service provision. Ultimately he still holds the dream of having a sublime and silky smooth tennis backhand….
Secretary: 01392 402455
NHS Email: timothy.harrower@nhs.net
Also based at: Department of Neurology, Royal Devon and Exeter NHS Foundation Hospital, Barrack Road, Exeter, EX2 5DW
Qualifications
B.Sc. (Medical Science) (University of Witwatersrand)
B.Sc. Honours (Medical Biochemistry) (University of Cape Town)
MBCHB (University of Cape Town)
MRCP (Royal College of Physicians London)
P.hD (Cambridge University)
FRCP (Royal College of Physicians London)
Research
Research interests
As Chief Investigator and Principle Investigator an extensive and balanced portfolio of research with both academic and commercial clinical trials has been developed by Tim. Clinical Trials have included Phase 1 through to Phase 5 and post licensing trials. Local, National and International Collaborations have allowed contributions to very large observational studies including Genome Wide Association Studies in Multiple Sclerosis and Comprehensive global longitudinal observational studies such as Enroll HD project. The main focus of current research is best described in the project list below.
Research projects
Current Projects:
Developing therapies for Motor Neuron Disease
- Developing Novel therapies for Huntington’s Disease
- Developing therapies for Multiple Sclerosis (including and especially for Progressive subtypes of MS)
- Developing Novel Botulinum Toxin Therapies
- Developing Migraine therapies
- Developing therapies for Tourette syndrome including Botulinum Toxin Therapies and Deep Brain stimulation
- Developing therapeutic pathways for managing autoimmune encephalitis
Grants
- Wellcome Trust Senior Clinical Fellow
Research grants
- 2000 Wellcome Trust
Full research Grant for for completetion of PhD
Publications
Journal articles
Rodgers WJ, Friede T, Vonberg FW, Constantinescu CS, Coles A, Chataway J, Duddy M, Emsley H, Ford H, Fisniku L, et al (In Press). The Impact of Smoking Cessation on Multiple Sclerosis Disease Progression.
Young CA, Rog DJ, Sharrack B, Tanasescu R, Kalra S, Harrower T, Tennant A, Mills RJ, Trajectories of Outcome in Neurological Conditions-MS Study Group (2024). Correlates and trajectories of relapses in relapsing-remitting multiple sclerosis. Neurol Sci, 45(5), 2181-2189. Abstract. Author URL.
Young CA, Chaouch A, Mcdermott CJ, Al-Chalabi A, Chhetri SK, Talbot K, Harrower T, Orrell RW, Annadale J, Hanemann CO, et al (2024). Dyspnea (breathlessness) in amyotrophic lateral sclerosis/motor neuron disease: prevalence, progression, severity, and correlates. Amyotroph Lateral Scler Frontotemporal Degener, 1-11. Abstract. Author URL.
Young CA, Ealing J, McDermott CJ, Williams TL, Al-Chalabi A, Majeed T, Talbot K, Harrower T, Faull C, Malaspina A, et al (2023). Measuring disability in amyotrophic lateral sclerosis/motor neuron disease: the WHODAS 2.0-36, WHODAS 2.0-32, and WHODAS 2.0-12. AMYOTROPHIC LATERAL SCLEROSIS AND FRONTOTEMPORAL DEGENERATION, 24(1-2), 63-70. Author URL.
Young CA, Ealing J, McDermott CJ, Williams TL, Al-Chalabi A, Majeed T, Talbot K, Harrower T, Faull C, Malaspina A, et al (2023). Prevalence of depression in amyotrophic lateral sclerosis/motor neuron disease: multi-attribute ascertainment and trajectories over 30 months. Amyotroph Lateral Scler Frontotemporal Degener, 24(1-2), 82-90. Abstract. Author URL.
Nicholas R, Harrower T, Su R, Licata S, Vonsy J (2022). 014 Long-term effectiveness of natalizumab for RRMS: UK and global interim results from TYSABRI observational program. Journal of Neurology Neurosurgery & Psychiatry, 93(6), a18.1-a1a18.
Nicholas R, Harrower T, Liao S, Vonsy J (2022). 119 Long-term effectiveness of natalizumab for RRMS: UK and global interim results from TYSABRI observational program. Journal of Neurology Neurosurgery & Psychiatry, 93(6), a138.2-a1a138.
Gray R, Patel S, Ives N, Rick C, Woolley R, Muzerengi S, Gray A, Jenkinson C, McIntosh E, Wheatley K, et al (2022). Long-term Effectiveness of Adjuvant Treatment with Catechol-O-Methyltransferase or Monoamine Oxidase B Inhibitors Compared with Dopamine Agonists Among Patients with Parkinson Disease Uncontrolled by Levodopa Therapy: the PD MED Randomized Clinical Trial. JAMA Neurol, 79(2), 131-140. Abstract. Author URL.
Young CA, Mills RJ, Langdon D, Rog DJ, Sharrack B, Kalra S, Majeed T, Footit D, Harrower T, Nicholas RS, et al (2022). Measuring coping in multiple sclerosis: the Coping Index-MS. Mult Scler, 28(14), 2274-2284. Abstract. Author URL.
Young CA, McDermott CJ, Williams TL, Ealing J, Majeed T, Al-Chalabi A, Dick DJ, Talbot K, Harrower T, Pinto A, et al (2021). Measuring coping in people with amyotrophic lateral sclerosis using the Coping Index-ALS: a patient derived, Rasch compliant scale. J Neurol Sci, 421 Abstract. Author URL.
Young CA, Mills R, Rog D, Sharrack B, Majeed T, Constantinescu CS, Kalra S, Harrower T, Santander H, Courtald G, et al (2021). Quality of life in multiple sclerosis is dominated by fatigue, disability and self-efficacy. J Neurol Sci, 426 Abstract. Author URL.
Middleton RM, Pearson OR, Ingram G, Craig EM, Rodgers WJ, Downing-Wood H, Hill J, Tuite-Dalton K, Roberts C, Watson L, et al (2020). A Rapid Electronic Cognitive Assessment Measure for Multiple Sclerosis: Validation of Cognitive Reaction, an Electronic Version of the Symbol Digit Modalities Test. Journal of Medical Internet Research, 22(9), e18234-e18234. Abstract.
Lin S, Green HD, Hendy P, Heerasing NM, Chanchlani N, Hamilton B, Walker GJ, Heap GA, Hobart J, Martin RJ, et al (2020). Clinical Features and Genetic Risk of Demyelination Following Anti-TNF Treatment. J Crohns Colitis, 14(12), 1653-1661. Abstract. Author URL.
Edge R, Mills R, Tennant A, Diggle PJ, Young CA, Al-Chalabi A, Williams TL, Dick DJ, Talbot K, Burke G, et al (2020). Do pain, anxiety and depression influence quality of life for people with amyotrophic lateral sclerosis/motor neuron disease? a national study reconciling previous conflicting literature. JOURNAL OF NEUROLOGY, 267(3), 607-615. Author URL.
Edge R, Mills R, Tennant A, Diggle PJ, Young CA, Al-Chalabi A, Williams TL, Dick DJ, Talbot K, Burke G, et al (2020). Do pain, anxiety and depression influence quality of life for people with amyotrophic lateral sclerosis/motor neuron disease? a national study reconciling previous conflicting literature (vol 267, pg 607, 2020). JOURNAL OF NEUROLOGY, 267(3), 616-617. Author URL.
Butzkueven H, Kappos L, Wiendl H, Trojano M, Spelman T, Chang I, Kasliwal R, Jaitly S, Campbell N, Ho P-R, et al (2020). Long-term safety and effectiveness of natalizumab treatment in clinical practice: 10 years of real-world data from the Tysabri Observational Program (TOP). Journal of Neurology, Neurosurgery & Psychiatry, 91(6), 660-668. Abstract.
Young CA, Mills R, Al-Chalabi A, Burke G, Chandran S, Dick DJ, Ealing J, Hanemann CO, Harrower T, Mcdermott CJ, et al (2020). Measuring quality of life in ALS/MND: validation of the WHOQOL-BREF. Amyotroph Lateral Scler Frontotemporal Degener, 1-9. Abstract. Author URL.
Hawton A, Green C, Goodwin E, Harrower T (2019). Health state utility values (QALY weights) for Huntington's disease: an analysis of data from the European Huntington's Disease Network (EHDN). Eur J Health Econ, 20(9), 1335-1347. Abstract. Author URL.
Lennox B, Yeeles K, Jones PB, Zandi M, Joyce E, Yu LM, Tomei G, Pollard R, Vincent SA, Shimazaki M, et al (2019). Intravenous immunoglobulin and rituximab versus placebo treatment of antibody-associated psychosis: Study protocol of a randomised phase IIa double-blinded placebo-controlled trial (SINAPPS2). Trials, 20(1). Abstract.
Young CA, Ealing J, McDermott C, Williams T, Al-Chalabi A, Majeed T, Burke G, Pinto A, Dick D, Talbot K, et al (2019). The relationships between symptoms, disability, perceived health and quality of life in amyotrophic lateral sclerosis/motor neuron disease. Amyotroph Lateral Scler Frontotemporal Degener, 20(5-6), 317-327. Abstract. Author URL.
Milinis K, Tennant A, Mills RJ, Al-Chalabi A, Burke G, Dick DJ, Ealing J, Hanemann CO, Harrower T, McDermott CJ, et al (2018). Development and validation of Spasticity Index-Amyotrophic Lateral Sclerosis. Acta Neurol Scand, 138(1), 47-54. Abstract. Author URL.
Kapoor R, Ho P-R, Campbell N, Chang I, Deykin A, Forrestal F, Lucas N, Yu B, Arnold DL, Freedman MS, et al (2018). Effect of natalizumab on disease progression in secondary progressive multiple sclerosis (ASCEND): a phase 3, randomised, double-blind, placebo-controlled trial with an open-label extension. The Lancet Neurology, 17(5), 405-415.
Maxan A, Mason S, Saint-Pierre M, Smith E, Ho A, Harrower T, Watts C, Tai Y, Pavese N, Savage JC, et al (2018). Outcome of cell suspension allografts in a patient with Huntington's disease. Ann Neurol, 84(6), 950-956. Abstract. Author URL.
Middleton RM, Rodgers WJ, Chataway J, Schmierer K, Rog D, Galea I, Akbari A, Tuite-Dalton K, Lockhart-Jones H, Griffiths D, et al (2018). Validating the portal population of the United Kingdom Multiple Sclerosis Register. Mult Scler Relat Disord, 24, 3-10. Abstract. Author URL.
McGeachan AJ, Hobson EV, Al-Chalabi A, Stephenson J, Chandran S, Crawley F, Dick D, Donaghy C, Ellis CM, Gorrie G, et al (2017). A multicentre evaluation of oropharyngeal secretion management practices in amyotrophic lateral sclerosis. Amyotroph Lateral Scler Frontotemporal Degener, 18(1-2), 1-9. Abstract. Author URL.
Muthukumar M, Desai K, Abogunrin S, Harrower T, Gabriel S, Dinet J (2017). Cost-effectiveness analysis of abobotulinumtoxinA for the treatment of cervical dystonia in the United Kingdom. Clinicoecon Outcomes Res, 9, 211-229. Abstract. Author URL.
Hauser SL, Bar-Or A, Comi G, Giovannoni G, Hartung H-P, Hemmer B, Lublin F, Montalban X, Rammohan KW, Selmaj K, et al (2017). Ocrelizumab versus Interferon Beta-1a in Relapsing Multiple Sclerosis. New England Journal of Medicine, 376(3), 221-234.
Dinet J, Desai K, Brand S, Abogunrin S, Gabriel S, Harrower T (2015). 61. AbobotulinumtoxinA in the management of cervical dystonia (CD) in the United Kingdom (UK): a budget impact analysis (BIA). Toxicon, 93
Abogunrin S, Brand S, Desai K, Dinet J, Gabriel S, Harrower T (2015). AbobotulinumtoxinA in the management of cervical dystonia in the United Kingdom: a budget impact analysis. Clinicoecon Outcomes Res, 7, 441-449. Abstract. Author URL.
Greaves RF, Woollard GA, Hoad KE, Walmsley TA, Johnson LA, Briscoe S, Koetsier S, Harrower T, Gill JP (2014). Laboratory medicine best practice guideline: Vitamins A, E and the carotenoids in blood. Clinical Biochemist Reviews, 35(2), 81-113. Abstract.
PD Med Collaborative Group, Gray R, Ives N, Rick C, Patel S, Gray A, Jenkinson C, McIntosh E, Wheatley K, Williams A, et al (2014). Long-term effectiveness of dopamine agonists and monoamine oxidase B inhibitors compared with levodopa as initial treatment for Parkinson's disease (PD MED): a large, open-label, pragmatic randomised trial. Lancet, 384(9949), 1196-1205. Abstract. Author URL.
Beecham AH, Patsopoulos NA, Xifara DK, Davis MF, Kemppinen A, Cotsapas C, Shah TS, Spencer C, Booth D, Goris A, et al (2013). Analysis of immune-related loci identifies 48 new susceptibility variants for multiple sclerosis. Nature Genetics, 45(11), 1353-1362. Abstract.
Hobson EV, McGeachan A, Al-Chalabi A, Chandran S, Crawley F, Dick D, Donaghy C, Ealing J, Ellis CM, Gorrie G, et al (2013). Management of sialorrhoea in motor neuron disease: a survey of current UK practice. Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 14(7-8), 521-527. Abstract.
Alkufri F, Harrower T, Rahman Y, Hughes E, Mundy H, Knibb JA, Moriarty J, Connor S, Samuel M (2013). Molybdenum cofactor deficiency presenting with a parkinsonism-dystonia syndrome. MOVEMENT DISORDERS, 28(3), 399-400. Author URL.
Barker RA, Mason SL, Harrower TP, Swain RA, Ho AK, Sahakian BJ, Mathur R, Elneil S, Thornton S, Hurrelbrink C, et al (2013). The long-term safety and efficacy of bilateral transplantation of human fetal striatal tissue in patients with mild to moderate Huntington's disease. JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 84(6), 657-665. Author URL.
Orth M, Handley OJ, Schwenke C, Dunnett S, Wild EJ, Tabrizi SJ, Landwehrmeyer GB, Bachoud-Levi A-C, Bentivoglio AR, Biunno I, et al (2011). Observing Huntington's disease: the European Huntington's Disease Network's REGISTRY. JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 82(12), 1409-+. Author URL.
Ganesan D, Higgins JNP, Harrower T, Burnet NG, Sarkies NJC, Manford M, Pickard JD (2008). Stent placement for management of a small parasagittal meningioma. Technical note. J Neurosurg, 108(2), 377-381. Abstract. Author URL.
Harrower TP, Tyers P, Hooks Y, Barker RA (2006). Long-term survival and integration of porcine expanded neural precursor cell grafts in a rat model of Parkinson's disease. Experimental Neurology, 197(1), 56-69.
Harrower T, Barker RA (2005). Cell therapies for neurological disease--from bench to clinic to bench. Expert Opin Biol Ther, 5(3), 289-291. Abstract. Author URL.
Harrower TP, Barker RA (2004). Is There a Future for Neural Transplantation?. BioDrugs, 18(3), 141-153.
Harrower T, Ratcliffe E, Richards A, Dunnett S, Bark R (2002). Long-Term Survival of Porcine Expanded Neural Precursors in the Rat Model of Parkinson's Disease. Clinical Science, 103(s47), 67p-67p.
Rosser AE, Barker RA, Harrower T, Watts C, Farrington M, Ho AK, Burnstein RM, Menon DK, Gillard JH, Pickard J, et al (2002). Unilateral transplantation of human primary fetal tissue in four patients with Huntington's disease: NEST-UK safety report ISRCTN no 36485475. J Neurol Neurosurg Psychiatry, 73(6), 678-685. Abstract. Author URL.
Harrower T, Cruz G, Copeman L, Richards A, Dunnett S, Barker R (2001). MHC and α Gal Expression in Porcine Fetal Neural Tissue. Clinical Science, 100(s44), 13p-13p.
Conferences
Nicholas R, Harrower T, Sun Z, Vonsy J (2022). LONG-TERM EFFECTIVENESS OF NATALIZUMAB FOR RRMS: UK AND GLOBAL INTERIM RESULTS FROM TYSABRI OBSERVATIONAL PROGRAM. Author URL.
Nicholas R, Harrower T, Jiang X, Licata S, Vonsy J (2019). NATALIZUMAB TREATMENT FOR MS: UK AND GLOBAL RESULTS FROM TOP. Author URL.
Shivane A, Edwards P, Hilton D, Cunningham R, Nabarro L, Harrower T (2017). A case of meningo-encephalitis with unusual neuropathology. Author URL.
Desai K, Muthukumar M, Abogunrin S, Harrower T, Dinet J, Gabriel S (2015). ABOBOTULINUMTOXIN a IN THE MANAGEMENT OF CERVICAL DYSTONIA IN THE UNITED KINGDOM: a COST-EFFECTIVENESS ANALYSIS. Author URL.
Dharia S, Harrower T (2015). CNS RELAPSE OF NHL MASQUERADING AS MILLER FISHER SYNDROME. Author URL.
Lashley D, Gormley K, Harrower T (2012). Natal Natalizumab. Author URL.
External Engagement and Impact
Awards
- QUDOS Highly Commended in the Physician Category (National)
- Staff Aureus Teaching Award (UEMS)
- Ciba-Geigy Gold Medal Best Medical Science Student (University of Witwatersrand (Wits))
- Sackler Foundation Scholarship (Cambridge University)
- D.R. Macintosh Foundation Scholarship (Wits and University of Cape Town (UCT))
- Dr H.J. Van der Bijl Scholarship (Wits and UCT)
- Convocation Merit Award (Wits)
Committee/panel activities
- British Neurotoxin Network (Founding Director)
- Clinical Research Speciality Lead for Neurology (Clinical Research Network South West Peninsula)
- Clinical Research Sub-Speciality Lead for Motor Neuron disease (Clinical Research Network South West Peninsula)
- President of the MND association in Devon
Editorial responsibilities
- Invited to provide peer review for submitted Journal of Neurology, Practical Neurology, Brain and ACNR (Advances in Clinical Neurology and Rehabilitation)
Invited lectures
- International Transplant Congress (Plenary Lecture) “Neural Transplantation”
- Royal College of Physician Regional Lecture “Hyperkinetic Movement Disorders”
Media Coverage
- Sky news and BBC news when trial results of Opera were published
- BBC news when trial of Deep Brain Therapy was announced
- ECTRIMS Highlights package Program
- Toxins Highlights package Program
Teaching
Undergraduate:- General Human Physiology for Medical Students (Years 1 and 2)
- Clinical Neurology (Clinical Years)
Post Graduate:
- General Neurology for doctors in training including:
- Foundation year Trainees
- Core Medical Trainees
- Specialist Registrars
- Neurological principles for General Practioners across the region
- Neurological perspectives for other specialities including:
- Ophthalmology
- Psychiatry
- Orthopaedic surgeons
- Elderly Care Physicians
- Training Programs for Spasticity Management
- eg Continuum of Learning to Improve Management with Botulinum Toxin Project (CLIMB) in spasticity
- Training Programs for Dystonia
- eg CLIMB project for Cervical Dystonia
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