Vanessa Raymont

University of Oxford | OX · Department of Psychiatry

Abstract Introduction Endometriosis impacts 1 in 10 women and can be a debilitating disease. Late diagnosis is a major challenge with Endometriosis, contributing further to the exacerbation of symptoms and suboptimal clinical management. Regardless of the commonality of the condition, public awareness and research around endometriosis is severely...

Aims: This study reports a new workforce preparedness framework for use during pandemics, specifically within clinical trials units. Methods: An evidence-based framework was developed using qualitative and quantitative data, as reported by the EPIC observational study. A framework methodology was used to analyse qualitative and quantitative data to...

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...

The Oxford Brain Health Centre (BHC) provides real‐world research data, aligned with the UK Biobank imaging study (UKB), routinely captured in a clinical service from patients under‐represented in dementia research. In this work we present how we 1) adapted the UKB MRI acquisition protocol to be suitable for memory clinic patients, 2) modified the...

Introduction With the pressing need to develop treatments that slow or stop the progression of Alzheimer’s disease, new tools are needed to reduce clinical trial duration and validate new targets for human therapeutics. Such tools could be derived from neurophysiological measurements of disease. Methods and analysis The New Therapeutics in Alzheim...

Importance: Pain is a silent global epidemic impacting approximately a third of the population. Pharmacological and surgical interventions are primary modes of treatment. Cognitive/behavioural management approaches and interventional pain management strategies are approaches that have been used to assist with the management of chronic pain. Accurat...

The Oxford Brain Health Clinic (BHC) is a joint clinical-research service that provides memory clinic patients and clinicians access to high-quality assessments not routinely available, including brain MRI aligned with the UK Biobank imaging study (UKB). In this work we present how we 1) adapted the UKB MRI acquisition protocol to be suitable for m...

Background: Preterm birth (PTB) is one of the main causes of neonatal deaths globally, with approximately 15 million infants are born preterm. Women from the Black, Asian, and Minority Ethnic (BAME) populations maybe at higher risk of PTB, therefore, the mental health impact on mothers experiencing a PTB is particularly important, within the BAME...

The Oxford Brain Health Clinic (BHC) is a joint clinical-research service that provides memory clinic patients and clinicians access to high-quality assessments not routinely available, including brain MRI aligned with the UK Biobank imaging study (UKB). In this work we present how we 1) adapted the UKB MRI acquisition protocol to be suitable for m...

Introduction Clinical Trials Units (CTUs) are a key component of delivering non-commercial and commercial clinical research globally. Within the UK, CTUs are seen as a specialist and independent entity available to all researchers requiring support to setup, conduct and deliver clinical trials. Therefore, an involvement of a CTU is highly recommend...

Objective: The clinical trial unit (CTU) workforce in the UK have been delivering COVID-19 research since the inception of the pandemic. Challenges associated with COVID-19 research have impacted the global healthcare communities differently. Thus, the overall objective of the study was to determine the mental health impact among CTU staff working...

Introduction Despite major advances in the field of neuroscience over the last three decades, the quality of assessments available to patients with memory problems in later life has barely changed. At the same time, a large proportion of dementia biomarker research is conducted in selected research samples that often poorly reflect the demographics...

BACKGROUND Over the last few decades, 3 pathogenic pandemics have impacted the global population; severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV) and SARS-CoV-2. The global disease burden has attributed to millions of deaths and morbidities, with the majority being attributed to SARS...

Background People with dementia (PWD) are vulnerable to abrupt changes to daily routines. The lockdown enforced on the 23rd of March 2020 in the UK to contain the expansion of the COVID-19 pandemic limited opportunities for PWD to access healthcare services and socialise. The SOLITUDE study explored the potential long-term effects of lockdown on PW...

Objective Social distancing to limit COVID-19 transmission has led to extensive lifestyle changes, including for people with dementia (PWD). The aim of this study, therefore, was to assess the impact of lockdown on the mental health of PWD and their carers. Methods Forty-five carers of PWD completed a telephone interview during the baseline assess...

Background: Preterm birth (PTB) is one of the main causes of neonatal deaths globally, with approximately 15 million infants are born preterm. Therefore, the mental health (MH) impact experienced by mothers experiencing a PTB is important, especially within the Black, Asian and Minority Ethnic (BAME) populations. Aim The aims of the study were to...

Background Ongoing symptoms or the development of new symptoms following a SARS-CoV-2 diagnosis has caused a complex clinical problem known as “:Long COVID”: (LC). This has introduced further pressure on global healthcare systems as there appears to be a need for ongoing clinical management of these patients. LC personifies heterogeneous symptoms a...

Background Polycystic Ovary Syndrome (PCOS) is a chronic and a common gynaecological condition impacting women of reproductive age. Women with PCOS have hormonal, ovulatory and metabolic dysfunction resulting in multiple symptoms. The correlation between hormonal disbalance and the impact on women’s mental health (MH) has been researched for decade...

Introduction: Alwyn Lishman appreciated that if we are to understand the psychological consequences of cerebral disorder we must study the interaction between organic disease and psychological processes. Methods: We have reviewed Lishman's two major publications on the neuropsychiatry of head injury, published in 1968 and 1988, and considered th...

Importance Pain is a silent global epidemic impacting approximately a third of the population. Pharmacological and surgical interventions are primary modes of treatment. Cognitive/behavioural management approaches and interventional pain management strategies are approaches that have been used to assist with the management of chronic pain. Accurate...

Launched in August 2020, the Oxford Brain Health Centre (BHC) is the UK's first psychiatry‐led joint clinical‐research service providing high‐quality assessments and increasing research opportunities for patients with memory problems. By embedding research in the NHS service, the BHC aims to address gaps between clinical practice and research advan...

Background: Due to demand on UK memory clinic services, most patients have limited consultant interaction before diagnosis/discharge. Technology offers an opportunity for remote assessment, from telephone/video-based consultations to fully digitised cognitive assessments with potential to track disease progression. Whilst many acute services utili...

Approximately 5% of all dementia diagnoses may be attributable to traumatic brain injuries (TBI), but the precise pathway and required thresholds for increased dementia risk remain unclear. TBI can cause disparate degrees of damage to parts of the brain and thus may affect different subdomains of cognitive function differently. This study examined...

Background: Social isolation and loneliness are both known to exert detrimental effects on mental health and cognitive functioning, as well as on medial temporal lobe volume in older adults. Reduced social interactions have also been found to increase the risk of cognitive decline and dementia in older people. Since restrictions to social contacts...

The Oxford Brain Health Centre (BHC) is a pioneering psychiatry‐led joint clinical‐research service launched in 2020. It provides NHS patients with existing memory problems access to high‐quality assessments not routinely available in clinical practice, including MRI rather than CT. This abstract describes the MRI protocol of the BHC, designed to t...

New Therapeutics in Alzheimer’s Disease (NTAD) is a multi‐centre, longitudinal study to develop reliable and sensitive biomarkers for patients in the early stage of Mild Cognitive Impairment (MCI) and Alzheimer’s Disease (AD). The hallmark of E/MEG abnormalities in AD patients is changes to the power and frequency of the alpha rhythm. Here, we expl...

Machine Learning (ML) is a common Artificial Intelligence (AI) method. The use of ML offers the opportunity to develop better data mining techniques in order to analyse complex clinical interactions with a large number of variables. ML models should provide “real-time” clinical support reducing clinical risk to patients with model-agnostic interpre...

Effective, disease modifying therapies for Alzheimer’s disease (AD) remain a quandary, following a panoply of expensive failures in human clinical trials. Given the stagnation in therapeutics, alternative approaches are needed. Recent successes of genetic therapies in other neurodegenerative diseases may highlight the way forward. This scoping revi...

Background Gestational diabetes mellitus (GDM) is a common complication of pregnancy and is associated with an increased risk of mental health (MH) disorders including antenatal and postnatal depression (PND), anxiety and post-traumatic-stress-disorder (PTSD). We hypothesized GDM and MH disorders will disproportionately affect individuals from Blac...

Background The identification of people at risk of cognitive impairment is essential for improving recruitment in secondary prevention trials of Alzheimer's disease. We aimed to test and qualify a biomarker risk assignment algorithm (BRAA) to identify participants at risk of developing mild cognitive impairment due to Alzheimer's disease within 5 y...

Evidence before this study Research into exploring the mental health sequalae in endometriosis is limited. Therefore, to our knowledge, this is the first evidence synthesis conducted to determine the prevalence of the endometriosis, mental health (MH) and associated presentations, including chronic pelvic pain. The evidence demonstrated limited dat...

Introduction With the pressing need to develop treatments that slow or stop the progression of Alzheimer's disease, new tools are needed to reduce clinical trial duration and validate new targets for human therapeutics. Such tools could be derived from neurophysiological measurements of disease. Methods and Analysis The New Therapeutics in Alzheime...

To evaluate and holistically treat the mental health sequelae and potential psychiatric comorbidities associated with obstetric and gynaecological conditions, it is important to optimize patient care, ensure efficient use of limited resources and improve health-economic models. Artificial intelligence applications could assist in achieving the abov...

Background The aims of this systematic review and meta-analysis are to examine the prevalence of adverse mental health outcomes, both short-term and long-term, among SARS patients, healthcare workers and the general public of SARS-affected regions, and to examine the protective and risk factors associated with these mental health outcomes. Methods...

Background: The global impact of COVID-19 pandemic continues to affect the lives of billions of people with recurrent waves. Healthcare systems are struggling to manage pre-existing patient care and recurring covid-19 demands. As a result, we evaluated the mental health impact using systematic review and meta-analysis. Methods: A comprehensive sear...

Dementia is a global public health priority which cost global societies $818 billion in 2015 and is disproportionately impacting low and middle-income countries (LMICs). With limited availability of disease modifying drugs to treat Alzheimer's disease (AD), researchers have increasingly focused on preventative strategies which may promote healthy c...

Pandemics disrupt clinical trials worldwide, with lasting effects on research. It can severely impact clinical trialists ability to conduct safe and ethically uncompromised trials. Hence, the mounting pressure results in ethically and morally distressing decisions faced by clinical trial professionals during pandemic situations. Whilst clinical tri...

The hippocampus, through its mediation of fear responses is thought to play a central role in the onset and maintenance of anxiety disorders. Prevalence of anxiety disorders remains high in older populations; however, little is known about their association with hippocampal changes in this age group. Due to differing levels of cortisol as adults ag...

Background Three decades after the amyloid cascade hypothesis was first proposed, research into discovery of effective treatments for Alzheimer's disease has not yet produced any disease-modifying treatments. Aims This review outlines the progress made by dementia research thus far, and provides a brief overview of the therapeutic approaches resul...

International Women's Day will be celebrated on 8 March 2021. Much has changed in the modern world, but it is still a fact that women are underrepresented in many sectors; this is especially true in science and research. Colleagues from the Oxford Brain Health Clinical Trials Unit reflect on the historical contribution of women in STEM and what fut...

Introduction/Background Endometriosis is a complex, chronic gynaecological condition impacting approximately 176 million women globally. It is associated with symptoms such as chronic pelvic pain (CPP), dysmenorrhoea, menorrhagia, sexual dysfunction and infertility. During several points in the lifecycle of this chronic disease, women bear the cons...

The Oxford Brain Health Centre (BHC) is an ambitious and innovative joint clinical‐research service that aims to bring UK NHS memory services into the 21st century by addressing gaps between clinical practice and research advances into dementia. This NIHR‐funded partnership between Oxford Health NHS Foundation Trust and the University of Oxford wil...

Traumatic brain injury (TBI) has been associated with an increased risk of dementia, but the link between mild TBI across the life‐course remains unclear. The PREVENT Dementia study is recruiting healthy volunteers in middle age (aged 40 – 59) to identify factors that may increase their risk of dementia. This analysis assessed white matter integrit...

The Amyloid/Tau/Neurodegeneration (ATN) framework has been proposed as means of evidencing the biological state of Alzheimer’s disease (AD). Predicting ATN status in pre‐dementia individuals therefore provides an important opportunity for targeted recruitment into AD interventional studies. We investigated the extent to which ATN phenotype can be p...

Background The Amyloid/Tau/Neurodegeneration (ATN) framework has been proposed as a means of evidencing the biological state of Alzheimer’s disease (AD). Predicting ATN status in pre-dementia individuals therefore provides an important opportunity for targeted recruitment into AD interventional studies. We investigated the extent to which ATN-defin...

Traumatic brain injury (TBI) is considered to be a risk factor for the later development of dementia, but although the evidence dates back to the early 20th century, the nature of any association and its mechanistic pathways remain unclear. There has been greater focus on this subject over recent years, in part because of increasing reports around...

Clinical trials are conducted to find better ways to prevent, screen for, diagnose or treat human disease. The development of clinical trials throughout history has built the foundation for ethically and scientifically robust research. As our healthcare needs have evolved, so have clinical trials and the standards by which they are run. Vanessa Ray...

The endocannabinoid system consists of cannabinoid receptors (which mediate the actions of cannabis), their endogenous ligands (endocannabinoids), and the enzymes and proteins associated with their regulation. In brain, the endocannabinoid system, in part, functions to modulate the release of other neurotransmitters via the subtype 1 (CB1) receptor...

The effect of prior beliefs on reasoning and decision-making is a robust, poorly understood phenomenon, exhibiting considerable individual variation. Neuroimaging studies widely show the involvement of the left prefrontal cortex (pFC) in reasoning involving beliefs. However, little patient data exist to speak to the necessity and role of the left p...

Objective: To investigate dopamine D2/D3 receptor availability following traumatic brain injury (TBI) and their relationship to the presence of DSM-IV Major Depressive Disorder (MDD) and patterns of axonal injury. Methods: Twelve moderate-severe TBI patients and 26 controls were imaged using [11C]PHNO positron emission tomography (PET) and struc...

Objectives The objective of this study is to evaluate the relationship between suicidal ideation (SI), structural brain damage, and cognitive deficits in patients with penetrating traumatic brain injury (pTBI). Methods Vietnam War veterans ( n = 142) with pTBI to the prefrontal cortex (PFC) underwent combination of neuropsychological and psychiatr...

Introduction: Recent failures of potential novel therapeutics for Alzheimer's disease (AD) have prompted a drive towards clinical studies in prodromal or preclinical states. However, carrying out clinical trials in early disease stages is extremely challenging-a key reason being the unfeasibility of using classical outcome measures of dementia tri...

To answer the question of how brain pathology affects reasoning about negative emotional content, we administered a disjunctive logical reasoning task involving arguments with neutral content (e.g. Either there are tigers or women in NYC, but not both; There are no tigers in NYC; There are women in NYC) and emotionally laden content (e.g. Either th...

Background/Aims: The aim of this study was to identify effective psychosocial interventions to enhance coping in people who have experienced a traumatic brain injury, in order to inform clinical practice and articulate future research directions. Methods: Five electronic databases (CINAHL, Medline, EMBASE, PsycINFO, and Cochrane Library) were sear...

Heat has been reported to exert variable effects on people with Gilles de la Tourette syndrome (TS). At age 24 years, a 32-year-old right-handed man with TS experienced a marked reduction in tics for two years after undergoing dehydration by entering a hot tub at 103°F (39.4°C) to 104°F (40.0°C) for 3 to 4 hours. On the Yale Global Tic Severity Sca...

Primary objective: This qualitative study aimed to gain a better understanding of how medical and social services in the UK currently support patients with Traumatic Brain Injury (TBI) in the community. Furthermore, we explored patients' wishes and expectations of a newly established TBI clinic. Methods and procedures: We conducted semi-structur...

While it is widely accepted that lesions to orbital prefrontal cortex lead to emotion related disruptions and poor decision-making, there is very little patient data on this issue involving actual logical reasoning tasks. We tested patients with circumscribed, focal lesions largely confined to polar/orbital prefrontal cortex (BA 10 & 11) (N=17) on...

Background: During deployment and upon returning home, veterans experience emotional challenges that test their social and psychological adaptation and place them at risk for suicidal thinking. Individual variability in skill-based capacity to adaptively perceive, understand, correctly use, and manage emotions (called emotional competence) may pla...

A factor structure underlying DSM-IV diagnoses has been previously reported in neurologically intact patients. The authors determined the brain regions associated with factors underlying DSM-IV diagnoses and compared the ability of DSM-IV diagnoses, factor scores, and self-report measures to account for the neuroanatomical findings in patients with...

Anhedonia is a common symptom following traumatic brain injury. The neural basis of anhedonia is poorly understood, but believed to involve disturbed reward processing, rather than the loss of sense of pleasure. This analysis was undertaken to determine if injury to specific regions of prefrontal cortex (PFC) result in anhedonia. A CT-based lesion...

Disinhibition, the inability to inhibit inappropriate behavior, is seen in frontal-temporal degeneration, Alzheimer's disease, and stroke. Behavioral disinhibition leads to social and emotional impairments, including impulsive behavior and disregard for social conventions. The authors investigated the effects of lesions on behavioral disinhibition...

Central modulation of serotonin and dopamine underlies efficacy for a variety of psychiatric therapeutics. ITI-007 is an investigational new drug in development for treatment of schizophrenia, mood disorders, and other neuropsychiatric disorders. The purpose of this study was to determine brain occupancy of ITI-007 at serotonin 5-HT2A receptors, do...

Neuropsychopharmacology, the official publication of the American College of Neuropsychopharmacology, publishing the highest quality original research and advancing our understanding of the brain and behavior.

To evaluate the hypothesis that educational attainment, a marker of cognitive reserve, is a predictor of disability-free recovery (DFR) after moderate to severe traumatic brain injury (TBI). Retrospective study of the TBI Model Systems Database, a prospective multicenter cohort funded by the National Institute on Disability and Rehabilitation Resea...

This study evaluated whether structural brain lesions modulate the relationship between pathological aggression and the dopaminergic system in traumatic brain injury (TBI). While converging evidence suggests that different areas of the prefrontal cortex modulate dopaminergic activity, to date no evidence exists of a modulation of endogenous dopamin...

Apathy, common in neurological disorders, is defined as disinterest and loss of motivation, with a reduction in self-initiated activity. Research in diseased populations has shown that apathy is associated with variations in the volume of brain regions such as the anterior cingulate and the frontal lobes. The goal of this study was to determine the...

The endocannabinoid system consists of cannabinoid receptors (which mediate the actions of cannabis), their endogenous ligands (endocannabinoids), and the enzymes and proteins associated with their regulation. In brain, the endocannabinoid system functions to modulate the release of other neurotransmitters via the subtype 1 (CB1) receptor. Abnormal...

Is the nature of decision-making capacity (DMC) for treatment significantly different in medical and psychiatric patients? To compare the abilities relevant to DMC for treatment in medical and psychiatric patients who are able to communicate a treatment choice. A secondary analysis of two cross-sectional studies of consecutive admissions: 125 to a...

To examine the association between regional brain uptake of a novel amyloid positron emission tomography (PET) tracer florbetapir F 18 ([(18)F]-AV-45) and cognitive performance in a pilot study. Cross-sectional comparison of [(18)F]-AV-45 in AD patients versus controls. Three specialty memory clinics. Eleven participants with probable Alzheimer dis...