Dwij Mehta

University College London

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Manjit Matharu

National Hospital for Neurology and Neurosurgery

Sanjay Cheema

National Hospital for Neurology and Neurosurgery

Sunita Negi

GD Goenka University

Indran Davagnanam

National Hospital for Neurology and Neurosurgery

Lucy Simmonds

National Hospital for Neurology and Neurosurgery

Alan J. Hakim

University College London

Elspeth Hutton

Monash University

Pratik Narang

Birla Institute of Technology and Science, Pilani

Parag Sayal

National Hospital for Neurology and Neurosurgery

Aditya Mehta

Netaji Subhas University of Technology

Cooperative Institutions

University College London

National Hospital for Neurology and Neurosurgery

John Wiley & Sons (United States)

Hudson Institute

Johns Hopkins University

Oslo University Hospital

University College London Hospitals NHS Foundation Trust

Norwegian University of Science and Technology

Leiden University Medical Center

Johns Hopkins Medicine

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Bilateral Deep Brain Stimulation of the Globus Pallidus Pars Interna in a Patient with Variant Ataxia‐Telangiectasia

Movement Disorders Clinical Practice (2016)

Dejan Georgiev Dwij Mehta André Zacharia Saman Vinke Catherine Milabo

Ataxia-telangiectasia (A-T) is an autosomal-recessive disorder characterized by cerebellar ataxia, oculocutaneous telangiectasia, immunodeficiency, radiosensitivity, increased prevalence of malignancies, and increased level of alpha-fetoprotein (AFP). 1 The responsible gene A-T mutated (ATM), localized to chromosome 11q22-2, is a serine/threonine protein kinase that is involved in the cellular response to DNA damage.Whereas the classic form, genetically marked by truncating mutations of the ATM, is a severe, fast progressive disease with no residual ATM kinase activity, patients with variant A-T show a milder form of the disease, often presenting with a plethora of different extrapyramidal manifestations-choreoathetosis, resting tremor, and myoclonus-dystonia (M-D) and still have some residual ATM-kinase activity; they are usually carriers of at least one missense or leaky splice site mutation. 1,2We present a case of a variant A-T with mainly M-D presenting features and a favorable outcome after bilateral DBS of the globus pallidus pars interna (GPi-DBS).

Choreoathetosis

Paroxysmal dyskinesia

Movement Disorders

10.1002/mdc3.12287

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Citations (9)

Diagnosis and treatment evaluation in patients with spontaneous intracranial hypotension

Frontiers in Neurology (2023)

Dwij Mehta Sanjay Cheema Indran Davagnanam Manjit Matharu

Spontaneous intracranial hypotension is characterized by an orthostatic headache and audiovestibular symptoms alongside a myriad of other non-specific symptoms. It is caused by an unregulated loss of cerebrospinal fluid at the spinal level. Indirect features of CSF leaks are seen on brain imaging as signs of intracranial hypotension and/or CSF hypovolaemia as well as a low opening pressure on lumbar puncture. Direct evidence of CSF leaks can frequently, but not invariably, be observed on spinal imaging. The condition is frequently misdiagnosed due to its vague symptoms and a lack of awareness of the condition amongst the non-neurological specialities. There is also a distinct lack of consensus on which of the many investigative and treatment options available to use when managing suspected CSF leaks. The aim of this article is to review the current literature on spontaneous intracranial hypotension and its clinical presentation, preferred investigation modalities, and most efficacious treatment options. By doing so, we hope to provide a framework on how to approach a patient with suspected spontaneous intracranial hypotension and help minimize diagnostic and treatment delays in order to improve clinical outcomes.

Intracranial Hypotension

Spontaneous Intracranial Hypotension

Epidural Blood Patch

Signs and symptoms

10.3389/fneur.2023.1145949

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Citations (15)

Molecular dynamics simulations to study the interaction between carbon nanotube and calmodulin protein

Materials Today Proceedings (2020)

Dwij Mehta Sunita Negi R. Ganesh

Protein Dynamics

10.1016/j.matpr.2020.01.354

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Citations (5)

Cluster Headache Genomewide Association Study and Meta‐Analysis Identifies Eight Loci and Implicates Smoking as Causal Risk Factor

Annals of Neurology (2023)

Bendik S. Winsvold Aster V. E. Harder Caroline Ran Mona Ameri Chalmer Carolina Dalmasso

The objective of this study was to aggregate data for the first genomewide association study meta-analysis of cluster headache, to identify genetic risk variants, and gain biological insights.

Association (psychology)

Genome-wide Association Study

Cluster headache

Genetic Association

10.1002/ana.26743

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Citations (30)

Autonomic symptoms in migraine: Results of a prospective longitudinal study

Frontiers in Neurology (2022)

Jason C. Ray Sanjay Cheema Emma Foster Lakshini Gunasekera Dwij Mehta

To assess the prevalence and burden of autonomic symptoms in migraine, and determine the relationship with migraine frequency.Autonomic symptoms in migraine have been theorized to occur in the setting of inter-ictal sympathetic hypoactivity and hyper-sensitivity. There is limited data prospectively assessing cranial and extra-cranial autonomic symptoms with a validated instrument, or longitudinal data on the relationship between migraine disease activity and autonomic symptoms.Patients attending a single tertiary academic center were recruited into a prospective cohort study between September 2020 and June 2022. In addition to standard clinical care, they completed several surveys including the Composite Autonomic Symptom Scale (COMPASS-31) questionnaire, a validated survey of autonomic symptoms.A total of 43 patients (66.7% female, median age 42, IQR 17) were included in the final analysis. There was a baseline 20 monthly headache days (MHD) (IQR 21.7), and 65.1% of the population had chronic migraine by ICHD-3 criteria. A significantly elevated weighted COMPASS-31 score was reported in 60.5% of respondents (mean 30.3, SD 13.3) at baseline. After 12 months treatment, significant improvements were reported in migraine frequency (median MHD 20-8.7) and disability (median Migraine Disability Assessment Score 67-48), but not in autonomic symptoms (mean score 30.3, SD 11.2).Autonomic symptoms were frequently reported in patients with migraine. However, they did not correlate with headache frequency or reversion to episodic frequency. Further study is required to elucidate specific approaches and treatments for autonomic symptoms, and further evaluate the underlying pathophysiological mechanisms.

Chronic Migraine

10.3389/fneur.2022.1036798

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Citations (8)

Migraine

Elsevier eBooks (2024)

Dwij Mehta Sanjay Cheema Manjit Matharu

Joint hypermobility

Hypermobility (travel)

Phonophobia

10.1016/b978-0-323-95082-4.00057-8

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Headache disorders in patients with Ehlers-Danlos syndromes and hypermobility spectrum disorders

Frontiers in Neurology (2024)

Dwij Mehta Lucy Simmonds Alan J. Hakim Manjit Matharu

Extra-articular symptoms, including headaches, are frequently encountered in patients with Ehlers-Danlos syndrome (EDS) and hypermobility spectrum disorders (HSD), and may be the presenting complaint. Migraine is reported in up to three quarters of patients with symptomatic joint hypermobility, have a higher headache frequency, and an earlier age of onset compared to the general population. Orthostatic headache is an important presentation, and should raise suspicion of an underlying spinal cerebrospinal fluid leak, dysautonomia, and craniocervical pathology, which are all associated with heritable connective tissue disorders (HCTD) including EDS. Any proposed invasive procedure should be scrupulously balanced against its potential risks, taking into account the type of EDS (e.g., vascular EDS) and its systemic manifestations. This is particularly pertinent when suspecting craniocervical instability since it remains a controversial diagnosis with a limited treatment evidence-base. This article reviews the commonly encountered headache disorders in patients with joint hypermobility-related conditions with a focus on EDS and HSD, describes their diverse presentations, and an overview of the recommended management strategies. It also emphasises the need for increased awareness of comorbid conditions in EDS and HSD among clinicians treating headaches to ensure a patient-tailored approach and facilitate a multidisciplinary approach in managing often complex cases.

Joint hypermobility

Ehlers–Danlos syndrome

Dysautonomia

Orthostatic intolerance

Hypermobility (travel)

10.3389/fneur.2024.1460352

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Surgical Management Of Spinal Cerebrospinal Fluid-Venous Fistula

Brain and Spine (2023)

David Rowland Dwij Mehta Sanjay Cheema Indran Davagnanam Ayman Qureshi

10.1016/j.bas.2023.101802

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LDFaceNet: Latent Diffusion-based Network for High-Fidelity Deepfake Generation

arXiv (Cornell University) (2024)

Dwij Mehta Aditya Mehta Pratik Narang

Over the past decade, there has been tremendous progress in the domain of synthetic media generation. This is mainly due to the powerful methods based on generative adversarial networks (GANs). Very recently, diffusion probabilistic models, which are inspired by non-equilibrium thermodynamics, have taken the spotlight. In the realm of image generation, diffusion models (DMs) have exhibited remarkable proficiency in producing both realistic and heterogeneous imagery through their stochastic sampling procedure. This paper proposes a novel facial swapping module, termed as LDFaceNet (Latent Diffusion based Face Swapping Network), which is based on a guided latent diffusion model that utilizes facial segmentation and facial recognition modules for a conditioned denoising process. The model employs a unique loss function to offer directional guidance to the diffusion process. Notably, LDFaceNet can incorporate supplementary facial guidance for desired outcomes without any retraining. To the best of our knowledge, this represents the first application of the latent diffusion model in the face-swapping task without prior training. The results of this study demonstrate that the proposed method can generate extremely realistic and coherent images by leveraging the potential of the diffusion model for facial swapping, thereby yielding superior visual outcomes and greater diversity.

High fidelity

10.48550/arxiv.2408.02078

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Exploring Thermal Annealing to Study Interaction of Calmodulin Protein with Carbon Nanotube:A Molecular Dynamics Simulation Approach

Research Square (Research Square) (2023)

Dwij Mehta Sunita Negi Ganesh Rajaraman

Abstract Carbon nanotubes have shown their importance from their vast applications in all different fields such as electronics, sensors, drug delivery, air-water filtration and catalyst support this research aimed to investigate the potential application of an armchair single-walled carbon nanotube in the field of biomedicine by studying its interaction with calmodulin protein (3CLN). Through Molecular Dynamics simulations, it was found that the interaction only takes place at elevated temperatures, such as 500 K. Our research involved examining the interaction between Calmodulin protein and carbon nanotube through a thermal annealing process that entailed increasing the temperature from 300 K to 500 K, then cooling back to room temperature. We conducted molecular dynamics simulations using NAMD and VMD to study this process. Although we intended to investigate whether any significant interaction occurs at 300 K, we observed something unexpected during the experiment. Specifically, at the end of the simulation, we observed some fascinating dynamics during the annealing process, where the protein wrapped around the carbon nanotube, forming a stable corona-like structure. This was different from what we had initially set out to investigate. This structure remains intact even after cooling the structure to room temperature as well. The observed structure is important from the point of view of application of the carbon nanotube in the drug delivery applications.

10.21203/rs.3.rs-2842413/v1

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