The aims of this study were to evaluate the literature regarding the use of ultra-low-field magnetic resonance imaging (ULF-MRI) and its potential use in dementia diagnosis.

Access to neuroimaging causes bottlenecks in dementia diagnostic pathways and limits overall capacity; there is wide variation across the UK. At present, dementia diagnosis rates in the UK remain below 65% and significant improvements in efficiency and accessibility of assessment services are needed to meet growing demand.

Modern MRI scanners use high strength magnetic fields (typically 1.5–3T), are expensive to install and operate, and usually require patients to travel to a general hospital. ULF-MRI systems (typically < 0.1T) are portable, relatively inexpensive, and do not require specialist staff to operate. They do not require shielding and are powered via a standard electrical socket. The use of ULF-MRI has historically been limited by multiple factors including poor image quality. Advances in software and hardware now mean that there is realistic potential to use ULF-MRI across a range of clinical applications.

The study followed the PRISMA 2020 guidelines and was registered on PROSPERO. Five electronic databases were searched for studies related to ULF-MRI using pre-developed terms. Studies comparing high field and ULF-MRI neuroimaging in adults were included. Studies of acute presentations (e.g. traumatic brain injury or acute cerebrovascular accident) were excluded. A data extraction template was used to synthesise study characteristics and outcomes. Two reviewers completed the selection process and data extraction independently.

2357 citations were identified, from which 101 studies were selected for further review based on title and abstract, of which eight met criteria for inclusion. Further studies were identified by forward and backward citation searching and through contact with active researchers in the field. The selected publications included both single and multi-centre studies. The Hyperfine Swoop system was used in almost all studies. Mean participant age range was 31 to 63. Qualitative and quantitative comparisons demonstrated good correspondence between high field and ULF-MRI across a range of measures studied, including volumetric measures and moderate to severe white matter hyperintensities.

The limited available evidence suggests that there is potential for ULF-MRI to transform the approach to neuroimaging in the assessment of dementia. Dedicated research into the use of ULF-MRI in this specific application will determine if it will be one of the much-needed disruptors to our current processes of dementia assessment.

Non epileptic attacks (also referred to as psychogenic non-epileptic seizures, functional seizures or dissociative seizures) are similar in appearance to epileptic seizures but are not accompanied by ictal electroencephalographic (EEG) discharges. NEAD is classified as either a conversion or dissociative disorder in DSM-V and ICD11 respectively, and is often associated with significant long-term disability. People with NEAD often access care across many different specialties and healthcare settings. Their experiences of doing so are frequently negative, based both on interactions with clinicians and integration of care.

The aims of this study were to review the existing literature on the attitudes of clinicians towards non-epileptic attack disorder (NEAD), and any differences that exist between professional groups.

The study followed PRISMA 2020 guidelines and was registered on the international prospective register of systematic reviews (PROSPERO). Three electronic databases (MEDLINE, EMBASE and PsycInfo) were searched for studies of clinician attitudes towards NEAD using pre-developed terms. These terms were optimised following familiarisation with the literature. Specific inclusion and exclusion criteria were applied, and studies were selected if they included data regarding the attitudes of healthcare professionals from any group towards NEAD. A data extraction template was used to synthesise study characteristics and outcomes. The Mixed Methods Appraisal Tool was used to appraise methodological quality of the included studies. Two reviewers independently completed the selection process and data extraction.

The search strategy yielded 2885 citations, of which 76 were selected for review of the full publication based on the title and abstract. Inclusion/exclusion criteria were applied to full texts. The literature mainly included clinicians from general practice, neurology, emergency department and psychiatry. There was general negative stereotyping of people with NEAD and a lack of confidence in management. Attitudes differed between professions, particularly with respect to aetiology.

The literature highlighted that many clinicians held a negative attitude towards people with NEAD, and there was evidence of a general lack in confidence towards NEAD across all healthcare professional groups. There was a difference between healthcare professional groups, mostly related to views on aetiology. The review highlights the need for greater education related to NEAD with a focus on understanding aetiology and greater transparency in interdisciplinary working.