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Harry Costello

@drharrycostello.bsky.social

1.2K followers 310 following 54 posts

Academic neuropsychiatrist | MD PhD | Clinical Lecturer @UCLPsychiatry | Mood, Motivation & Neurodegeneration | Aspiring apiarist

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Harry Costello @drharrycostello.bsky.social · Mar 19

Delighted our ( @jonroiser.bsky.social @profrobhoward.bsky.social) paper is now out in @brain1878.bsky.social ! 🎉🧠

We show that #Parkinson's #depression may stem from a reduction in reward sensitivity that is unresponsive to dopaminergic medication:

🔗 doi.org/10.1093/brai...
🧵⬇️

Impaired reward sensitivity in Parkinson's depression is unresponsive to dopamine treatment

Depression in Parkinson’s disease is common and disabling, and often includes motivational symptoms such as apathy and anhedonia. Costello et al. show that

doi.org

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Reposted by Harry Costello

Mehdi Hasan @mehdirhasan.bsky.social · 9d

“Israeli Forces Kill 198 Palestinians in Gaza Over Three Days”

It’s a genocide. Daily endless massacres, largely ignored in the West.

Israeli Forces Kill 198 Palestinians in Gaza Over Three Days - News From Antiwar.com

Israeli attacks have killed at least 198 Palestinians and wounded 786 in the Gaza Strip over 72 hours, according to death toll updates released by Gaza's Health Ministry, as Israel continues its US-ba...

news.antiwar.com

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Reposted by Harry Costello

Kevin Mitchell @wiringthebrain.bsky.social · 14d

Familial confounding in the associations between maternal health and autism www.nature.com/articles/s41... - drawing causal conclusions from observational studies is not a good idea

Familial confounding in the associations between maternal health and autism - Nature Medicine

Using national registry data from Denmark, 30 maternal diagnoses linked to offspring autism were identified with most associations attributable to family-level factors rather than direct causal effects of maternal diagnoses.

www.nature.com

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Reposted by Harry Costello

Robert Howard @profrobhoward.bsky.social · 17d

BlueSky friends, forgive me for not posting much on here. I'm standing for President of the RCPsych in the elections next March. I'm still speaking and listening to friends and colleagues about what is important, but you can learn about what I would do if successful here: www.profrobhoward.com

ProfRobHoward

www.profrobhoward.com

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Harry Costello @drharrycostello.bsky.social · 16d

Implications for the field:
🔹 We found no evidence that mAb therapies increase depression risk in AD/PD.
🔹 Neuropsychiatric outcomes are rarely included in disease-modifying therapy trials.
🔹 Without proper measurement, we risk missing both potential benefits and harms.

Harry Costello @drharrycostello.bsky.social · 16d

Our meta-analysis found no significant difference in risk of depression with mAb therapy vs placebo (log risk ratio −0.24, 95% CI −0.52 to 0.04, p=0.09).

However, most trials excluded participants with depression at baseline and included no depression measures.

Harry Costello @drharrycostello.bsky.social · 16d

From 3000 studies we identified 13 RCTs (👥 8,603 participants: 4,690 treatment, 3,913 placebo)

All reported depression incidence as an adverse event.
‼️ *But* NONE assessed change in depressive symptom severity with mood scales.

Harry Costello @drharrycostello.bsky.social · 16d

Why does this matter?
#Depression is common (40% of pts), disabling & tough to treat in AD/PD.

Monoclonal antibodies (like lecanemab, donanemab etc) target pathological proteins (eg amyloid) but also trigger inflammatory & vascular changes—all mechanisms linked to depression.

Harry Costello @drharrycostello.bsky.social · 16d

New paper out in @journal_ad (led by Guy Gitlin-Leigh). @profrobhoward.bsky.social

We conducted the first systematic review + meta-analysis on whether monoclonal antibody therapies for #Alzheimer’s (AD) & #Parkinson’s (PD) affect risk of depression.
Link:

journals.sagepub.com/doi/10.1177/...

Sage Journals: Discover world-class research

Subscription and open access journals from Sage, the world's leading independent academic publisher.

journals.sagepub.com

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Reposted by Harry Costello

Malcolm Campbell @malcolmgcampbell.bsky.social · 19d

🚨Our preprint is online!🚨

www.biorxiv.org/content/10.1...

How do #dopamine neurons perform the key calculations in reinforcement #learning?

Read on to find out more! 🧵

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Reposted by Harry Costello

Sarah Katharina Buehler @sarahkathbuehler.bsky.social · 19d

Excited to share this new preprint on the Predictive Modelling of Depression Treatment Response using Individual Symptoms and Latent Factors with @clairegillan.bsky.social fresh up on @medrxivpreprint.bsky.social www.medrxiv.org/content/10.1...

Predictive Modelling of Depression Treatment Response using Individual Symptoms and Latent Factors

Machine learning models have increasingly been used to identify predictors of treatment response in depression, and it is hoped that they may eventually help with clinical decision making. However, th...

www.medrxiv.org

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Reposted by Harry Costello

Thomas Luo @thomas-zhihao-luo.bsky.social · 21d

How does the brain decide? 🧠

Our new @nature.com paper shows that neural activity switches from an 'evidence gathering' to a 'commitment' state at a precise moment we call nTc.

After nTc, new evidence is ignored, revealing a neural marker for the instant when the mind is made up.

rdcu.be/eGUrv

Transitions in dynamical regime and neural mode during perceptual decisions - Nature

Simultaneous recordings were made of hundreds of neurons in the rat frontal cortex and striatum, showing that decision commitment involves a rapid, coordinated transition in dynamical regime and neura...

www.nature.com

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Harry Costello @drharrycostello.bsky.social · 25d

The studies I’m thinking of ⬇️. Any others?

jamanetwork.com/journals/jam...

www.thelancet.com/journals/lan...

Harry Costello @drharrycostello.bsky.social · 25d

Pretty sure the only large blinded RCTs of #GLP-1 agonists in psychiatry/neurology have been in #schizophrenia and #Parkinson’s disease—both found no core symptomatic benefit.

Fantastic drugs for metabolic health, but current trial evidence for broader neuro/psych use sadly isn’t promising.

Eric Topol @erictopol.bsky.social · 25d

We know GLP-1 drugs reduce brain inflammation. But I didn't anticipate bipolar disorder as a possible indication in the future
www.nature.com/articles/s41...

Glucagon-like Peptide-1 receptor agonists as emerging therapeutics in bipolar disorder: a narrative review of preclinical and clinical evidence - Molecular Psychiatry

Molecular Psychiatry - Glucagon-like Peptide-1 receptor agonists as emerging therapeutics in bipolar disorder: a narrative review of preclinical and clinical evidence

www.nature.com

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Harry Costello @drharrycostello.bsky.social · 26d

‘Maintaining share of #NHS spend on mental health, will be critical although it fell last year and will again this year. It likely will continue to do so over the next 3years. I hope I am wrong.’

Worrying times for NHS #mentalhealth care which barely featured in the 10yr plan…

Shaun Lintern @shaunlintern.bsky.social · 26d

National mental health director Claire Murdoch resigns with immediate effect claiming political pressure for a new person...her resignation letter....👀

Reposted by Harry Costello

Andreas Horn @andreashorn.org · Sep 3

In #DeepBrainStimulation

the two major developments across the last decade have been

1. Adaptive DBS and
2. Connectomic DBS

In a @natrevneurol.nature.com article with @julianneumann.bsky.social, we ask:

Could the two be united into a common framework?

www.nature.com/articles/s41...

A 🧵

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Reposted by Harry Costello

Marcelo Mattar @marcelomattar.bsky.social · Jul 2

Thrilled to see our TinyRNN paper in @nature! We show how tiny RNNs predict choices of individual subjects accurately while staying fully interpretable. This approach can transform how we model cognitive processes in both healthy and disordered decisions. doi.org/10.1038/s415...

Discovering cognitive strategies with tiny recurrent neural networks - Nature

Modelling biological decision-making with tiny recurrent neural networks enables more accurate predictions of animal choices than classical cognitive models and offers insights into the underlying cog...

doi.org

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Reposted by Harry Costello

Joar Øveraas Halvorsen @joarhalvorsen.bsky.social · Aug 29

Comparing a treatment to waitlist is an extremely low bar. Essentially it isn't even a bar as objectively ineffective treatments (e.g. homeopathy) outperforms waitlist.
www.sciencedirect.com/science/arti...

Effects of EMDR vs. waiting list for adults with post-traumatic stress disorder: A systematic review and meta-analysis of randomized controlled trials

Posttraumatic Stress Disorder (PTSD) is a prevalent mental health condition that can significantly impair quality of life. Eye Movement Desensitizatio…

www.sciencedirect.com

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Harry Costello @drharrycostello.bsky.social · Aug 29

At last! Why did this take decades to introduce when most of Europe & the US rolled it out long ago?

Especially important given emerging evidence linking VZV vaccination with protection against neurodegenerative disorders. #chickenpox

www.bbc.co.uk/news/article...

Children offered chickenpox vaccine on NHS

All young children in England and Wales will be offered a free chickenpox vaccine by the NHS from January 2026.

www.bbc.co.uk

Reposted by Harry Costello

tal boger @talboger.bsky.social · Aug 19

On the left is a rabbit. On the right is an elephant. But guess what: They’re the *same image*, rotated 90°!

In @currentbiology.bsky.social, @chazfirestone.bsky.social & I show how these images—known as “visual anagrams”—can help solve a longstanding problem in cognitive science. bit.ly/45BVnCZ

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Reposted by Harry Costello

Robert Howard @profrobhoward.bsky.social · Aug 19

What's not to like about this image, presented at AAIC and touted as showing lasting and expanding (maybe, even clinically important) efficacy of lecanemab treatment through 48 months of treatment - but only if you start treatment early and don't stop?

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Reposted by Harry Costello

Frank Harrell @f2harrell.bsky.social · Aug 18

Wonderful information about SEVERE limitations of "real world data". Telling in the RWD sphere is unwillingness of its practitioners to add a model parameter to represent unknown bias as exemplified in fharrell.com/post/hxcontrol => uncertainty intervals for treatment effects properly wider.

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Harry Costello @drharrycostello.bsky.social · Aug 6

Obviously ridiculous from a ridiculous person — but this seems to reflect the consensus on social care across all major UK parties.

AI has become the opium of a political class that is out of ideas and too fearful to face the real challenges of our time.

Farrukh @implausibleblog.bsky.social · Aug 6

Boris Johnson tells an audience in Taiwan,

"We will solve the problem of a shortage of social care workers which we have in the UK"

"Not with more immigrants but with ChatGPT"

Reposted by Harry Costello

Sam Gershman @gershbrain.bsky.social · Aug 4

A landmark volume, The Handbook of Dopamine, is now online:
www.sciencedirect.com/handbook/han...

Big kudos to the editors, Stephanie Cragg and Mark Walton, for putting this together.

Handbook of Behavioral Neuroscience | Volume 32: The Handbook of Dopamine | ScienceDirect.com by Elsevier

Read the latest chapters of Handbook of Behavioral Neuroscience at ScienceDirect.com, Elsevier’s leading platform of peer-reviewed scholarly literature

www.sciencedirect.com

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Reposted by Harry Costello

Stephen Bush @stephenkb.bsky.social · Aug 2

The replies to this post, even on here, even moreso on X, are so depressing to me. We live in a world where cities have never been safer and a minority of people are denying themselves a lot of delightful experiences because they’ve gone mad online.

John Rentoul @rentouljohn.bsky.social · Aug 1

Crime and the perception of crime: @jburnmurdoch.ft.com via @stephenkb.bsky.social www.ft.com/content/9623...

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Reposted by Harry Costello

JAMA @jama.com · Aug 2

US children's health has worsened from 2007 to 2023 across various indicators, including mortality, chronic conditions, and mental health.

ja.ma/4lZnRxG #MedSky #PedSky

Figure 1. All-Cause Mortality Rates per 100 000 in the US vs OECD18 for <1-Year-Old Infants and 1- to 19-Year-Old Individuals, 2007-2022

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