Cognitive Neurology

Lead

Professor Alex Leff

Research Team

A regularly updated list of the Professor Leff's research team can be found here.

Collaborative Group

Research Goals

To develop novel, evidence-based therapies for patients with cognitive impairments and to investigate how, at a neural network level, these therapies work.
To identify key brain and behaviour markers that will allow us to make individualized predictions of: i) recovery from brain injury; ii) response to therapies for brain injury.
To develop, test and roll-out self-supporting therapy apps for people with visual or language impairments.听
To develop, deliver and assess a potentially very effective form of therapy for people with aphasia, namely, Intensive Comprehensive Aphasia Programmes.
To understand the mechanisms of disability and recovery in acquired brain injury.
To evaluate the effectiveness of neurorehabilitation and the use of outcome measures.
To develop collaborations between allied health professionals, recognizing the multi-faceted needs of the patient along the neurorehabilitative pathway.

Thirty-five participants completed, on average, 85 hours (IQR=70鈥�100) of Listen-In therapy. They showed large and significant improvements for trained spoken words over therapy versus standard care (11%, Cohen鈥檚 d=1.12). Gains were largely maintained at 12 and 24 weeks. Improvements on trained words were associated with brain tissue density changes in bilateral temporal lobes: 听

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Funded Research Projects

Digital neuro-interventions to enhance re-learning in patients with acquired and degenerative brain diseases. Developing three separate digital neuro-interventions for: (1) patients with visuospatial neglect, ATTEND; (2) patients with dementia who forget听familiar names, Gotcha!;听(3) aphasic patients who have word-finding difficulties. Funded by an NIHR (National Institute for Health Research) Research Professorship.

The 鈥楲isten-In鈥� project: developing, testing and rolling-out at a web-based therapy application for patients with impaired speech comprehension caused by stroke. Funded by the NIHR i4i programme.

The and projects are for patients with hemianopia that causes, respectively, a reading problem and a problem with visual search. Both therapies work by retraining eye movements, to make them more efficient.听Funded by the Stroke Association and NIHR.

: a cross-sectional study with a new approach to cerebral localisation of visual perceptual functions. Funded by the Danish Research Council.

Recent publications from Cognitive Neurology: 2021
Roberts S, Bruce R, Lim L, Woodgate H, Ledingham K, Anderson S, Lorca-Puls DL, Gajardo-Vidal A, Leff AP, Hope TMH, Green DW, Crinion JT & Price CJ
Better long-term outcomes in aphasic stroke survivors who received early clinical speech and language therapy: What鈥檚 driving recovery?
Neuropsychological Rehabilitation (in press)
Beare B.,听 Doogan C.,听 Douglass-Kirk P.,听 Leff A. and Ward N.
Neuro-Rehabilitation OnLine (N-ROL): Description and evaluation of a group based telerehabilitation programme for acquired brain injury (in press)
Rice GE, Kerry SK, Robotham RJ, Leff AP, Lambon Ralph MA & Starrfelt R
Category-selective deficits are the exception and not the rule: Evidence from a case-series of 64 patients with ventral occipito-temporal cortex damage Cortex 2021 (in press)
Gajardo-Vidal A, Lorca-Puls DL, Ploras team, Warner H, Pshadry B, Crinion JT, Leff AP, Hope TMH, Geva S, Seghier ML, Green DW, Bowman H, & Price CJ
Damage to Broca鈥檚 area does not contribute to long-term speech production outcome after stroke
Brain 2021
2020
Geva S, Truneh T, Seghier ML, Hope TMH, Leff AP, Crinion JT, Gajardo-Vidal A, Lorca-Puls DL, Green DW, PLORAS team & Price CJ. Lesions that do and do not impair digit span: A study of 816 stroke survivorsBrain Communications 2020 [in press]
Fleming V, Brownsett S, Krason A, Maegli MA, Coley-Fisher H, Ong Y, Nardo D, Leach R, Howard D, Robson H, Warburton E, Ashburner J, Price C, Crinion J, Leff A
Efficacy of spoken word comprehension therapy in patients with chronic aphasia: A cross-over randomised controlled trial with structural imaging
Farrington-Douglas C and Leff A
An expert opinion in speech and language therapy: The Queen Square Intensive Comprehensive Aphasia Programme Advances in Clinical Neuroscience & Rehabilitation 19(3):21-23 08 Sep 2020
Szalados R, Leff AP, Doogan CE. The clinical effectiveness of Eye-Search therapy for patients with hemianopia, neglect or hemianopia and neglect. Neuropsychological Rehabilitation.听 Neuropsychol Rehabil 1-12 26 Apr 2020

Thorudottir S, Sigurdardottir HM, Rice GE, Kerry SJ, Robotham RJ, Leff AP, Starrfelt R. The architect who lost the ability to imagine: the cerebral basis of visual imagery. Brain Sciences 2020; 10(2), online 1st February.
2018
Yao Y, Raman SS, Schiek, Leff A, Frassle S, Stephan KE. Variational Bayesian inversion for hierarchical unsupervised generative embedding (HUGE). NeuroImage 2018; 179:604-619

Frassle S, Lomakina EI, Kasper LManjaly ZM, Leff A, Pruessmann KP, Buhmann JM, Stephan KE. A generative model of whole-brain effective connectivity. NeuroImage 2018; 179:505-529

Aguilar OM, Kerry SJ, Crinion JT, Callaghan MF, Woodhead ZVJ, Leff AP. Dorsal and ventral visual stream contributions to preserved reading ability in patients with central alexia. Cortex 2018; 106:200-212

Leff AP, Kempny AM, James L, Yelden K, Duport S, Farmer SF, Playford ED. Patients with a severe prolonged disorder of consciousness can show classical EEG responses to their own name compared with others' names. NeuroImage: Clinical 1st August 2018, in press

Lorca-Puls D, Gajardo-Vidal A, White J, Seghier M, Leff A, Green D, Crinion J, Ludersdorfer P, Hope T, Bowman H et al. The impact of sample size on the reproducibility of voxel-based lesion-deficit mappings. Neuropsychologia 2018; 115:101-111 .

Gajardo-Vidal A, Lorca-Puls DL, Crinion JT, White J, Seghier ML, Leff A, Hope TMH, Ludersdorfer P, Green DW, Bowman H et al. How distributed processing produces false negatives in voxel-based lesion-deficit analyses. Neuropsychologia 2018; 115:124-133

Woodhead SVJ, Kerry SJ, Aguilar OM, Ong YH, Hogan JS, Pappa K, Leff AP, Crinion JT. Randomized trial of iReadMore word reading training and brain stimulation in central alexia. Brain, online 4 June 2018

Dalmaijer ES, Li KMS, Gorgoraptis N, Leff AP, Cohen DL, Parton A, Husain M, Malhotra P. Randomised, double-blind, placebo-controlled crossover study of single-dose guanfacine in unilateral neglect following stroke. Journal of Neurology, Neurosurgery and Psychiatry 2018; 89(6):593-598
Aguilar OM, Kerry SJ, Ong Y-H, Callaghan MF, Crinion听 JT, Woodhead ZVJ, Price CJ, Leff AP and Hope TMH.听 Lesion site dependent treatment responses to therapy after aphasic stroke. J Neurol Neurosurg Psychiatry, in press, 2018.
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Hope TMH, Leff AP, Price CJ. Predicting language outcomes after stroke: is structural disconnection a useful predictor? NeuroImage: Clinical, in press, 2018.
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Kempny A, James L, Yelden K, Duport S, Farmer S, Playford ED, Leff AP.听 Patients with a severe prolonged disorder of consciousness can show classical EEG responses to their own name compared with others' names.听 NeuroImage: Clinical, in press, 2018.
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Lorca-Puls DL, Gajardo-Vidal A, White J, Seghier ML, Leff AP, Green DW, Crinion听 JT, Ludersdorfer P, Hope TMH, Bowman H & Price CJ. How distributed processing produces false negatives in voxel-based lesion-deficit analyses. Neuropsychologia, in press, 2018.
2017
Nardo D, Holland R, Leff A, Price C, Crinion J. Less is more: Brain, online 1 December 2017 doi.org/10.1093/brain/awx234
Fleming V, Krason A, Leach R, Leff A, Brownsett S.听 Listen-In:听 high-dose home-based auditory comprehension therapy is achievable and effective.听 Int J Stroke 2017; 12:24, online 1 November 2017
Dalmaijer ES, Li KMS, Gorgoraptis N, Leff AP, Cohen DL, Parton A, Husain M, Malhotra PA.听 A randomised double-blind, placebo-controlled crossover study of single-dose guanfacine in unilateral neglect following stroke.听 Journal of Neurology, Neurosurgery, and Psychiatry, accepted for publication
Leff AP, Boyd LA, Hayward KS, Ward NS, Stinear CM, Rosso C, Fisher RJ, Carter AR, Copland DA, Carey LM et al.
2017 Jul;12(5):480-493. doi: 10.1177/1747493017714176.
Yelden K, Duport S, James LM, Kempny A, Farmer SF, Leff AP, Playford ED. Disability and Rehabilitation 2017 Jun 21:1-6. doi: 10.1080/09638288.2017.1339209. [Epub ahead of print]
Gajardo-Vidal A, Lorca-Puls DL, Hope TMH, Parker Jones O, Seghier ML, Oberhuber M, Prejawa S, Crinion JC,听 Leff AP, Green DW, Price CJ. Brain 2017; 140(6):1729-1742 doi: 10.1093/brain/awx087.
Hope TMH, Leff AP, Prejawa S, Bruce R, Haigh Z, Lim L, Ramsden S, Oberhuber M, Ludersdorfer P, Crinion JC, Seghier ML, Price CJ. . Brain 2017; 140(6):1718-1728 doi: 10.1093/brain/awx086.
Woodhead ZVJ, Crinion J, Penny W, Teki S, Price CJ, Leff AP. Journal of Neurology, Neurosurgery and Psychiatry, online 4 March 2017 doi: 10.1136/jnnp-2016-314621. Epub 2017 Mar 4.
2016
Holland R, Leff AP, Penny WD, Rothwell JC, Crinion J. Neuroimage. 2016 Oct 15;140:126-33. doi: 10.1016/j.neuroimage.2016.01.037. Epub 2016 Jan 26.
Kempny AM, James L, Yelden K, Duport S, Farmer S, Playford ED, Leff AP.s. Neuroimage: Clinical 2016; 12:312-319 doi: 10.1016/j.nicl.2016.07.013. eCollection 2016.

Further information

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听*听 Hope et al. Right hemisphere structural adaptation and changing language听听听 skills years after left hemisphere stroke. Brain 2017; 140(6):1718-1728

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