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Dr Tim Harrower

Consultant Neurologist, Clinical Lead for Physiology Speciality Lead for neurology Research in the South West NIHR

01392 402457

College House

College House, University of Exeter, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK

Office hours:

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

Key publications | Publications by category | Publications by year

Publications by category

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, 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.

IMPORTANCE: Many people with Parkinson disease (PD) develop motor complications that are uncontrolled by levodopa dose adjustment. Among these patients, it is uncertain which drug class is more effective as adjuvant therapy. OBJECTIVE: to compare the long-term effects on patient-rated quality of life of adding a dopamine agonist vs a dopamine reuptake inhibitor (DRI), either a monoamine oxidase type B (MAO-B) inhibitor or a catechol-O-methyltransferase (COMT) inhibitor, to levodopa therapy for the treatment of patients with motor complications of PD. DESIGN, SETTING, AND PARTICIPANTS: This pragmatic semifactorial (2 × 1) randomized clinical trial recruited from 64 neurology and geriatric clinics (62 in the United Kingdom, 1 in the Czech Republic, and 1 in Russia) between February 23, 2001, and December 15, 2009. A total of 500 patients with idiopathic PD who developed uncontrolled motor complications and did not have dementia were randomly assigned on a 1:1:1 basis using a computerized minimization program. Data were analyzed between 2017 and 2020. INTERVENTIONS: Open-label dopamine agonist, MAO-B inhibitor, or COMT inhibitor. MAIN OUTCOMES AND MEASURES: Primary outcomes were scores on the 39-item Parkinson's Disease Questionnaire (PDQ-39) mobility domain and cost-effectiveness. Outcomes were assessed before study entry, at 6 and 12 months after randomization, and annually thereafter. Repeated-measures and log rank analyses were used in an intention-to-treat approach. RESULTS: Among 500 participants, the mean (SD) age was 73.0 (8.2) years; 314 participants (62.8%) were men. Over a median of 4.5 years (range, 0-13.3 years) of follow-up, the participants in the dopamine agonist group had a mean PDQ-39 mobility score that was 2.4 points (95% CI, -1.3 to 6.0 points) better than that of the combined MAO-B and COMT groups; however, this difference was not significant (P=.20). With regard to DRIs, participants in the MAO-B group had mean PDQ-39 mobility scores that were 4.2 points (95% CI, 0.4-7.9 points; P=.03) better than those of the COMT group and EuroQol 5-dimension 3-level (EQ-5D-3L) utility scores that were 0.05 points (95% CI, 0.003-0.09 points; P=.04) better than the COMT group. Nonsignificant improvements were found in the PDQ-39 summary index (mean difference, 2.2 points; 95% CI, -0.2 to 4.5 points; P=.07) along with nonsignificant reductions in dementia (rate ratio [RR], 0.70; 95% CI, 0.47-1.03; P =. 07) and mortality (RR, 0.76; 95% CI, 0.56-1.03; P=.07). When dopamine agonists were compared with MAO-B inhibitors only, the outcomes were similar. CONCLUSIONS AND RELEVANCE: in this study, patient-rated quality of life was inferior when COMT inhibitors were used as adjuvant treatment compared with MAO-B inhibitors or dopamine agonists among people with PD who experienced motor complications that were uncontrolled by levodopa therapy. The MAO-B inhibitors produced equivalent disease control, suggesting that these agents may be underused as adjuvant therapy. TRIAL REGISTRATION: isrctn.org Identifier: ISRCTN69812316; EU Clinical Trials Register Identifier: 2005-001813-16.

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.

. Background
. Incorporating cognitive testing into routine clinical practice is a challenge in multiple sclerosis (MS), given the wide spectrum of both cognitive and physical impairments people can have and the time that testing requires. Shortened paper and verbal assessments predominate but still are not used routinely. Computer-based tests are becoming more widespread; however, changes in how a paper test is implemented can impact what exactly is being assessed in an individual. The Symbol Digit Modalities Test (SDMT) is one validated test that forms part of the cognitive batteries used in MS and has some computer-based versions. We developed a tablet-based SDMT variant that has the potential to be ultimately deployed to patients’ own devices.
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. Objective
. This paper aims to develop, validate, and deploy a computer-based SDMT variant, the Cognition Reaction (CoRe) test, that can reliably replicate the characteristics of the paper-based SDMT.
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. Methods
. We carried out analysis using Pearson and intraclass correlations, as well as a Bland-Altman comparison, to examine consistency between the SDMT and CoRe tests and for test-retest reliability. The SDMT and CoRe tests were evaluated for sensitivity to disability levels and age. A novel metric in CoRe was found: question answering velocity could be calculated. This was evaluated in relation to disability levels and age for people with MS and compared with a group of healthy control volunteers.
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. Results
. SDMT and CoRe test scores were highly correlated and consistent with 1-month retest values. Lower scores were seen in patients with higher age and some effect was seen with increasing disability. There was no learning effect evident. Question answering velocity demonstrated a small increase in speed over the 90-second duration of the test in people with MS and healthy controls.
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. Conclusions
. This study validates a computer-based alternative to the SDMT that can be used in clinics and beyond. It enables accurate recording of elements of cognition relevant in MS but offers additional metrics that may offer further value to clinicians and people with MS.
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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.

BACKGROUND: Huntington's Disease (HD) is a hereditary neurodegenerative disorder which affects individuals' ability to walk, talk, think, and reason. Onset is usually in the forties, there are no therapies currently available that alter disease course, and life expectancy is 10-20 years from diagnosis. The gene causing HD is fully penetrant, with a 50% probability of passing the disease to offspring. Although the impacts of HD are substantial, there has been little report of the quality of life of people with the condition in a manner that can be used in economic evaluations of treatments for HD. Health state utility values (HSUVs), used to calculate quality-adjusted life-years (QALYs), are the metric commonly used to inform such healthcare policy decision-making. OBJECTIVES: the aim was to report HSUVs for HD, with specific objectives to use European data to: (i) describe HSUVs by demographic and clinical characteristics; (ii) compare HSUVs of people with HD in the UK with population norms; (iii) identify the relative strength of demographic and clinical characteristics in predicting HSUVs. METHODS: European Huntington's Disease Network REGISTRY study data were used for analysis. This is a multi-centre, multi-national, observational, longitudinal study, which collects six-monthly demographic, clinical, and patient-reported outcome measures, including the SF-36. SF-36 scores were converted to SF-6D HSUVs and described by demographic and clinical characteristics. HSUVs from people with HD in the UK were compared with population norms. Regression analysis was used to estimate the relative strength of age, gender, time since diagnosis, and disease severity (according to the Total Function Capacity (TFC) score, and the UHDRS's Motor score, Behavioural score, and Cognition score) in predicting HSUVs. RESULTS: 11,328 questionnaires were completed by 5560 respondents with HD in 12 European countries. Women generally had lower HSUVs than men, and HSUVs were consistently lower than population norms for those with HD in the UK, and dropped with increasing disease severity. The regression model significantly accounted for the variance in SF-6D scores (n = 1939; F [7,1931] = 120.05; p

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).

Background: Evidence is conflicting about a causal role of inflammation in psychosis and, specifically, regarding antibodies binding to neuronal membrane targets, especially N-methyl-D-aspartate receptors. NMDAR, LGI1 and GABA-A antibodies were found more prevalent in people with psychosis than in healthy controls. We aim to test whether these antibodies are pathogenic and may cause isolated psychosis. The SINAPPS2 phase IIa double-blinded randomised controlled trial will test the efficacy and safety of immunoglobulin and rituximab treatment versus placebo for patients with acute psychosis symptoms as added to psychiatric standard of care. Methods: We will screen approximately 2500 adult patients with acute psychosis to identify 160 with antibody-positive psychosis without co-existing neurological disease and recruit about 80 eligible participants to the trial in the period from September 2017 to September 2021 across the UK. Eligible patients will be randomised 1:1 either to intravenous immunoglobulin (IVIG) followed by rituximab or to placebo infusions of 1% albumin followed by 0.9% sodium chloride, respectively. To detect a time-to-symptomatic-recovery hazard ratio of 0.322 with a power of 80%, 56 participants are needed to complete the trial, allowing for up to 12 participants to drop out of each group. Eligible patients will be randomised and assessed at baseline within 4 weeks of their eligibility confirmation. The treatment will start with IVIG or 1% albumin placebo infusions over 2-4 consecutive days no later than 7 days from baseline. It will continue 4-5 weeks later with a rituximab or sodium chloride placebo infusion and will end 2-3 weeks after this with another rituximab or placebo infusion. The primary outcome is the time to symptomatic recovery defined as symptomatic remission sustained for at least 6 months on the following Positive and Negative Syndrome Scale items: P1, P2, P3, N1, N4, N6, G5 and G9. Participants will be followed for 12 months from the first day of treatment or, where sustained remission begins after the first 6 months, for an additional minimum of 6 months to assess later response. Discussion: the SINAPPS2 trial aims to test whether immunotherapy is efficacious and safe in psychosis associated with anti-neuronal membrane antibodies. Trial registration: ISRCTN, 11177045. Registered on 2 May 2017. EudraCT, 2016-000118-31. Registered on 22 November 2016. ClinicalTrials.gov, NCT03194815. Registered on 21 June 2017.

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.

BACKGROUND: Cervical dystonia (CD) involves painful involuntary contraction of the neck and shoulder muscles and abnormal posture in middle-aged adults. Botulinum neurotoxin type a (BoNT-A) is effective in treating CD but little is known about its associated cost-effectiveness. OBJECTIVE: to evaluate the cost-effectiveness of abobotulinumtoxinA for treating CD from the UK payer perspective. METHODS: a Markov model was developed to evaluate the cost-effectiveness of abobotulinum-toxinA versus best supportive care (BSC) in CD, with a lifetime horizon and health states for response, nonresponse, secondary nonresponse, and BSC in patients with CD (mean age: 53 years; 37% male). Clinical improvement measured using Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) was mapped to utility using data from a randomized trial of abobotulinumtoxinA. Health care resource use, costs, and other inputs were from the British National Formulary, Personal Social Services Research Unit, published literature, or expert opinion. Costs and outcomes were discounted at 3.5% per annum. RESULTS: in the base case, the incremental lifetime quality-adjusted life-years (QALYs) gained from abobotulinumtoxinA arm versus BSC was 0.253 per patient, whereas the incremental cost was £7,160, leading to an incremental cost-effectiveness ratio (ICER) of £30,468 per QALY. One-way sensitivity analyses showed that these results were sensitive to the proportion of responders to abobotulinumtoxinA at first injection, duration between injections, the number of reinjections allowed among primary nonresponders, and any difference in baseline TWSTRS value between the BSC and abobotulinumtoxinA arms. Probabilistic sensitivity analysis showed that abobotulinumtoxinA was cost-effective 46% and 49% of times at thresholds of £20,000 and £30,000 per QALY, respectively. Scenarios are considered including vial-sharing, productivity losses, secondary response/nonresponse at subsequent injections, 5-year time horizon, and alternative reinjection intervals for BoNT-As produced ICERs ranging from cost-saving to £40,777 per QALY, versus BSC. CONCLUSION: AbobotulinumtoxinA was found to be cost-effective in treating adults with CD, at acceptable willingness-to-pay thresholds in the UK.

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.

BACKGROUND: Whether initial treatment for Parkinson's disease should consist of levodopa, dopamine agonists, or monoamine oxidase type B inhibitors (MAOBI) is uncertain. We aimed to establish which of these three classes of drug, as initial treatment, provides the most effective long-term control of symptoms and best quality of life for people with early Parkinson's disease. METHODS: in this pragmatic, open-label randomised trial, patients newly diagnosed with Parkinson's disease were randomly assigned (by telephone call to a central office; 1:1:1) between levodopa-sparing therapy (dopamine agonists or MAOBI) and levodopa alone. Patients and investigators were not masked to group assignment. Primary outcomes were the mobility dimension on the 39-item patient-rated Parkinson's disease questionnaire (PDQ-39) quality-of-life scale (range 0-100 with six points defined as the minimally important difference) and cost-effectiveness. Analysis was intention to treat. This trial is registered, number ISRCTN69812316. FINDINGS: Between Nov 9, 2000, and Dec 22, 2009, 1620 patients were assigned to study groups (528 to levodopa, 632 to dopamine agonist, 460 to MAOBI). With 3-year median follow-up, PDQ-39 mobility scores averaged 1·8 points (95% CI 0·5-3·0, p=0·005) better in patients randomly assigned to levodopa than those assigned to levodopa-sparing therapy, with no increase or attrition of benefit during 7 years' observation. PDQ-39 mobility scores were 1·4 points (95% CI 0·0-2·9, p=0·05) better in patients allocated MAOBI than in those allocated dopamine agonists. EQ-5D utility scores averaged 0·03 (95% CI 0·01-0·05; p=0·0002) better with levodopa than with levodopa-sparing therapy; rates of dementia (hazard ratio [HR] 0·81, 95% CI 0·61-1·08, p=0·14), admissions to institutions (0·86, 0·63-1·18; p=0·4), and death (0·85, 0·69-1·06, p=0·17) were not significantly different, but the upper CIs precluded any substantial increase with levodopa compared with levodopa-sparing therapy. 179 (28%) of 632 patients allocated dopamine agonists and 104 (23%) of 460 patients allocated MAOBI discontinued allocated treatment because of side-effects compared with 11 (2%) of 528 patients allocated levodopa (p

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.

Publications by year

In Press

2023

2022

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.

Abstract. Author URL.

2021

2020

Abstract.

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.

2019

Abstract. Author URL.

Abstract.

Nicholas R, Harrower T, Jiang X, Licata S, Vonsy J (2019). NATALIZUMAB TREATMENT FOR MS: UK AND GLOBAL RESULTS FROM TOP. Author URL.

2018

2017

Shivane A, Edwards P, Hilton D, Cunningham R, Nabarro L, Harrower T (2017). A case of meningo-encephalitis with unusual neuropathology. Author URL.

Abstract. Author URL.

2015

Dharia S, Harrower T (2015). CNS RELAPSE OF NHL MASQUERADING AS MILLER FISHER SYNDROME. Author URL.

2014

Abstract. Author URL.

2013

2012

Lashley D, Gormley K, Harrower T (2012). Natal Natalizumab. Author URL.

2011

2008

2006

2005

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.

2004

Harrower TP, Barker RA (2004). Is There a Future for Neural Transplantation?. BioDrugs, 18(3), 141-153.

2002

2001

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.

Refresh publications

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

Teaching sessions academic year 2019/2020

Session Title	Activity dates	Venue

Intracranial pressure and cerebral blood flow	06/12/2019	NC12
Physiological changes in pregnancy	08/01/2020	NC12
The placenta	10/01/2020	NC12
Respiratory Physiology 2: gas transport/haemoglobin	21/02/2020	NC12
Electricity and the heart	13/03/2020	NC12
Assesssing Cardiac Function	18/03/2020	NC12
Atheroma formation - cell,molecular and histology of this and calcification	18/03/2020	NC12
Brain Lesions and control of behaviour	24/04/2020	NC12
Dementia	24/04/2020	NC12
The kidney as producer, excreter and regulator	04/05/2020	NC12
Control, composition and volume of ECF	04/05/2020	NC12
Diuretics	13/05/2020	NC12
Gastroeneterology Lecture	27/05/2020	NC12
Liver and Pancreas	03/06/2020	NC12

LSRC year 1 (Tuesdays)
Temperature regulation	05/11/2019	LSRC
Motor Pathways	10/12/2019	LSRC
Autonomic Nervous System	17/12/2019	LSRC
Birth and the First Breath	14/01/2020	LSRC
Thyroid Function and Dysfunction	21/01/2020	LSRC
Cardiac Cycle	10/03/2020	LSRC
Anaemia	17/03/2020	LSRC
Interpretation of ABG2	12/05/2020	LSRC
The Stomach, Acid vomiting etc	26/05/2020	LSRC
Liver Function Tests	02/06/2020	LSRC
Biliary Tree Disease	09/06/2020	LSRC

Year 2
Movement Dysorders	23/10/2019	NC12
Living with a Movement Disorder	01/11/2019	NC12
Multiple Sclerosis	25/10/2019	NC12
Epilepsy	30/10/2019	NC12
Causes, Prevention & Consequences of DVT/VTE	18/12/2019	NC12
Haemoglobinopathies	18/12/2019	NC12
Brain Lesions	24/04/2020

LRSC Year 2 (Thursdays)

Oedema, features, aetiology & treatment	19/03/2020	LSRC

Are they dead and what killed them	02/04/2020	LSRC

Brain Phantoms	23/04/2020	LSRC

Smell and Taste	14/05/2020	LSRC

Year 4 and 5
Neurological Emergencies (4 session per year)		RILD
Pattern Recognition in Neurology (4 sessions per year)		RILD
Headache CPC (4 sessions per year		RILD


ARENA sessions
MND session	16/03/2020	TBC
Huntington's Disease session	24/03/2020	TBC

Other Teaching

MS One disease? Regional MS Academy	18/06/2019	Jurys Inn
Managing Movement Disorders Dept of Medicine Lunchtime)		RILD
What's new in Neurology	05/11/2019	RILD
Weakness not due to stroke		RILD
Psychiatric Neuroinflammation (Liason Psychiatry Course)	13/06/2019	Mecure Hotel
Management of Sialhorrhea	21/09/2020	Exeter Race Course
Tremor and Siallhorrhea Management (British Geriatric Meeting)	03/10/2019	Mercure Hotel
Hyperkinetic Movement Disorders (GIM Traing Day )	18/11/2019	RILD
Brain Stem Bother (Dept Medicine Lunchtime)	19/11/2019	RILD
MND Symposia (MND Diagnosis and Management)	20/11/2019
Other cuases of Back Pain	22/11/2019	Sandy Park
PACES course (all day Saturday)	25/01/2020
ABC of modern epilepsy management	04/02/2020	Nuffield
MND Spire session (10:00 - 2 hours)	16/03/2020	G18
Immunomudulation in MS: Implications for Multiple Sclerosis	26/03/2020	Bristol
SINAPPS 2 (Psychiatry MAC - Edgemoor hotel, Bovey tracey, haytor road, Newton Abbot TQ13 9LE	20/04/2020	Okehampton

Other teaching Commitments
Angof session	11/12/2019
Inspire Clinical Research Lecture	05/11/2019

Supervision / Group

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Profile

Dr Tim Harrower

Consultant Neurologist, Clinical Lead for Physiology Speciality Lead for neurology Research in the South West NIHR

Overview

Qualifications

Research

Research interests

Research projects

Research grants

Publications

Publications by category

Journal articles

Abstract:Prevalence of depression in amyotrophic lateral sclerosis/motor neuron disease: multi-attribute ascertainment and trajectories over 30 months.

Abstract: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.

Abstract:Measuring coping in multiple sclerosis: the Coping Index-MS.

Abstract:Measuring coping in people with amyotrophic lateral sclerosis using the Coping Index-ALS: a patient derived, Rasch compliant scale.

Abstract:Quality of life in multiple sclerosis is dominated by fatigue, disability and self-efficacy.

Abstract:A Rapid Electronic Cognitive Assessment Measure for Multiple Sclerosis: Validation of Cognitive Reaction, an Electronic Version of the Symbol Digit Modalities Test

Abstract:Clinical Features and Genetic Risk of Demyelination Following Anti-TNF Treatment.

Abstract:Long-term safety and effectiveness of natalizumab treatment in clinical practice: 10 years of real-world data from the Tysabri Observational Program (TOP)

Abstract:Measuring quality of life in ALS/MND: validation of the WHOQOL-BREF.

Abstract:Health state utility values (QALY weights) for Huntington's disease: an analysis of data from the European Huntington's Disease Network (EHDN).

Abstract:Intravenous immunoglobulin and rituximab versus placebo treatment of antibody-associated psychosis: Study protocol of a randomised phase IIa double-blinded placebo-controlled trial (SINAPPS2)

Abstract:The relationships between symptoms, disability, perceived health and quality of life in amyotrophic lateral sclerosis/motor neuron disease.

Abstract:Development and validation of Spasticity Index-Amyotrophic Lateral Sclerosis.

Abstract:Outcome of cell suspension allografts in a patient with Huntington's disease.

Abstract:Validating the portal population of the United Kingdom Multiple Sclerosis Register.

Abstract:A multicentre evaluation of oropharyngeal secretion management practices in amyotrophic lateral sclerosis.

Abstract:Cost-effectiveness analysis of abobotulinumtoxinA for the treatment of cervical dystonia in the United Kingdom.

Abstract:AbobotulinumtoxinA in the management of cervical dystonia in the United Kingdom: a budget impact analysis.

Abstract:Laboratory medicine best practice guideline: Vitamins A, E and the carotenoids in blood

Abstract: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.

Abstract:Analysis of immune-related loci identifies 48 new susceptibility variants for multiple sclerosis

Abstract:Management of sialorrhoea in motor neuron disease: a survey of current UK practice

Abstract:Stent placement for management of a small parasagittal meningioma. Technical note.

Abstract:Cell therapies for neurological disease--from bench to clinic to bench.

Abstract:Unilateral transplantation of human primary fetal tissue in four patients with Huntington's disease: NEST-UK safety report ISRCTN no 36485475.

Conferences

Publications by year

In Press

2023

Abstract:Prevalence of depression in amyotrophic lateral sclerosis/motor neuron disease: multi-attribute ascertainment and trajectories over 30 months.

2022

Abstract: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.

Abstract:Measuring coping in multiple sclerosis: the Coping Index-MS.

2021

Abstract:Measuring coping in people with amyotrophic lateral sclerosis using the Coping Index-ALS: a patient derived, Rasch compliant scale.

Abstract:Quality of life in multiple sclerosis is dominated by fatigue, disability and self-efficacy.

2020

Abstract:A Rapid Electronic Cognitive Assessment Measure for Multiple Sclerosis: Validation of Cognitive Reaction, an Electronic Version of the Symbol Digit Modalities Test

Abstract:Clinical Features and Genetic Risk of Demyelination Following Anti-TNF Treatment.

Abstract:Long-term safety and effectiveness of natalizumab treatment in clinical practice: 10 years of real-world data from the Tysabri Observational Program (TOP)

Abstract:Measuring quality of life in ALS/MND: validation of the WHOQOL-BREF.

2019

Abstract:Health state utility values (QALY weights) for Huntington's disease: an analysis of data from the European Huntington's Disease Network (EHDN).

Abstract:Intravenous immunoglobulin and rituximab versus placebo treatment of antibody-associated psychosis: Study protocol of a randomised phase IIa double-blinded placebo-controlled trial (SINAPPS2)

Abstract:The relationships between symptoms, disability, perceived health and quality of life in amyotrophic lateral sclerosis/motor neuron disease.

2018

Abstract:Development and validation of Spasticity Index-Amyotrophic Lateral Sclerosis.

Abstract:Outcome of cell suspension allografts in a patient with Huntington's disease.

Abstract:Validating the portal population of the United Kingdom Multiple Sclerosis Register.

2017

Abstract:A multicentre evaluation of oropharyngeal secretion management practices in amyotrophic lateral sclerosis.

Abstract:Cost-effectiveness analysis of abobotulinumtoxinA for the treatment of cervical dystonia in the United Kingdom.

2015

Abstract:AbobotulinumtoxinA in the management of cervical dystonia in the United Kingdom: a budget impact analysis.

2014

Abstract:Laboratory medicine best practice guideline: Vitamins A, E and the carotenoids in blood

Abstract: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.

2013

Abstract:Analysis of immune-related loci identifies 48 new susceptibility variants for multiple sclerosis

Abstract:Management of sialorrhoea in motor neuron disease: a survey of current UK practice

2012

2011

2008

Abstract:Stent placement for management of a small parasagittal meningioma. Technical note.

2006

2005

Abstract:Cell therapies for neurological disease--from bench to clinic to bench.

2004

Abstract:
Prevalence of depression in amyotrophic lateral sclerosis/motor neuron disease: multi-attribute ascertainment and trajectories over 30 months.

Abstract:
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.

Abstract:
Measuring coping in multiple sclerosis: the Coping Index-MS.

Abstract:
Measuring coping in people with amyotrophic lateral sclerosis using the Coping Index-ALS: a patient derived, Rasch compliant scale.

Abstract:
Quality of life in multiple sclerosis is dominated by fatigue, disability and self-efficacy.

Abstract:
A Rapid Electronic Cognitive Assessment Measure for Multiple Sclerosis: Validation of Cognitive Reaction, an Electronic Version of the Symbol Digit Modalities Test

Abstract:
Clinical Features and Genetic Risk of Demyelination Following Anti-TNF Treatment.

Abstract:
Long-term safety and effectiveness of natalizumab treatment in clinical practice: 10 years of real-world data from the Tysabri Observational Program (TOP)

Abstract:
Measuring quality of life in ALS/MND: validation of the WHOQOL-BREF.

Abstract:
Health state utility values (QALY weights) for Huntington's disease: an analysis of data from the European Huntington's Disease Network (EHDN).

Abstract:
Intravenous immunoglobulin and rituximab versus placebo treatment of antibody-associated psychosis: Study protocol of a randomised phase IIa double-blinded placebo-controlled trial (SINAPPS2)

Abstract:
The relationships between symptoms, disability, perceived health and quality of life in amyotrophic lateral sclerosis/motor neuron disease.

Abstract:
Development and validation of Spasticity Index-Amyotrophic Lateral Sclerosis.

Abstract:
Outcome of cell suspension allografts in a patient with Huntington's disease.

Abstract:
Validating the portal population of the United Kingdom Multiple Sclerosis Register.

Abstract:
A multicentre evaluation of oropharyngeal secretion management practices in amyotrophic lateral sclerosis.

Abstract:
Cost-effectiveness analysis of abobotulinumtoxinA for the treatment of cervical dystonia in the United Kingdom.

Abstract:
AbobotulinumtoxinA in the management of cervical dystonia in the United Kingdom: a budget impact analysis.

Abstract:
Laboratory medicine best practice guideline: Vitamins A, E and the carotenoids in blood

Abstract:
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.

Abstract:
Analysis of immune-related loci identifies 48 new susceptibility variants for multiple sclerosis

Abstract:
Management of sialorrhoea in motor neuron disease: a survey of current UK practice

Abstract:
Stent placement for management of a small parasagittal meningioma. Technical note.

Abstract:
Cell therapies for neurological disease--from bench to clinic to bench.

Abstract:
Unilateral transplantation of human primary fetal tissue in four patients with Huntington's disease: NEST-UK safety report ISRCTN no 36485475.

Abstract:
Prevalence of depression in amyotrophic lateral sclerosis/motor neuron disease: multi-attribute ascertainment and trajectories over 30 months.

Abstract:
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.

Abstract:
Measuring coping in multiple sclerosis: the Coping Index-MS.

Abstract:
Measuring coping in people with amyotrophic lateral sclerosis using the Coping Index-ALS: a patient derived, Rasch compliant scale.

Abstract:
Quality of life in multiple sclerosis is dominated by fatigue, disability and self-efficacy.

Abstract:
A Rapid Electronic Cognitive Assessment Measure for Multiple Sclerosis: Validation of Cognitive Reaction, an Electronic Version of the Symbol Digit Modalities Test

Abstract:
Clinical Features and Genetic Risk of Demyelination Following Anti-TNF Treatment.

Abstract:
Long-term safety and effectiveness of natalizumab treatment in clinical practice: 10 years of real-world data from the Tysabri Observational Program (TOP)

Abstract:
Measuring quality of life in ALS/MND: validation of the WHOQOL-BREF.

Abstract:
Health state utility values (QALY weights) for Huntington's disease: an analysis of data from the European Huntington's Disease Network (EHDN).

Abstract:
Intravenous immunoglobulin and rituximab versus placebo treatment of antibody-associated psychosis: Study protocol of a randomised phase IIa double-blinded placebo-controlled trial (SINAPPS2)

Abstract:
The relationships between symptoms, disability, perceived health and quality of life in amyotrophic lateral sclerosis/motor neuron disease.

Abstract:
Development and validation of Spasticity Index-Amyotrophic Lateral Sclerosis.

Abstract:
Outcome of cell suspension allografts in a patient with Huntington's disease.

Abstract:
Validating the portal population of the United Kingdom Multiple Sclerosis Register.

Abstract:
A multicentre evaluation of oropharyngeal secretion management practices in amyotrophic lateral sclerosis.

Abstract:
Cost-effectiveness analysis of abobotulinumtoxinA for the treatment of cervical dystonia in the United Kingdom.

Abstract:
AbobotulinumtoxinA in the management of cervical dystonia in the United Kingdom: a budget impact analysis.

Abstract:
Laboratory medicine best practice guideline: Vitamins A, E and the carotenoids in blood

Abstract:
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.

Abstract:
Analysis of immune-related loci identifies 48 new susceptibility variants for multiple sclerosis

Abstract:
Management of sialorrhoea in motor neuron disease: a survey of current UK practice

Abstract:
Stent placement for management of a small parasagittal meningioma. Technical note.

Abstract:
Cell therapies for neurological disease--from bench to clinic to bench.

Abstract:
Unilateral transplantation of human primary fetal tissue in four patients with Huntington's disease: NEST-UK safety report ISRCTN no 36485475.