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Harry Costello

@drharrycostello.bsky.social
1.2K followers 314 following 58 posts

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

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Harry Costello @drharrycostello.bsky.social · 07/07/2026
Our new review in Molecular Psychiatry: www.nature.com/articles/s41... #Depression affects a third of people with #Alzheimer's or #Parkinson's disease, yet current #antidepressants have little benefit. We review disease-specific mechanisms and emerging treatments.
nature.com
Depression in neurodegenerative disease: neurobiological mechanisms and emerging treatments - Molecular Psychiatry
Molecular Psychiatry - Depression in neurodegenerative disease: neurobiological mechanisms and emerging treatments
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Kevin Mitchell @wiringthebrain.bsky.social · 23/06/2026
This is the kind of almost magic-like payoff we get from decades of basic and applied research by thousands of scientists across the globe. This is why we do it.
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Prof Rick Adams @drrickadams.bsky.social · 08/06/2026
Closing in two days!
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Taraz Lee @tarazlee.bsky.social · 28/05/2026
Super excited by this manuscript led by the amazing @brissend.bsky.social By combining fMRI, TMS, and modeling, we finally have causal evidence that the cerebellum is contributing to brain-wide working memory representations and recall performance! 1/n
Plot showing that the read-out of visual working memory information from cerebellum is degraded following stimulation to cerebellum, IPS, or FEF
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Harry Costello @drharrycostello.bsky.social · 12/05/2026
Real privilege to play a small part in this project (led by Jennifer Foley & Alison Cartier) and collaborate with such brilliant clinicians, artists, and patients living with young-onset #Parkinsons. Hopefully demonstrates the potential power of creative interdisciplinary collaboration.
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Ignacio Saez, PhD @ignaciosaezphd.bsky.social · 04/05/2026
Excited to share new work now published in @cp-iscience.bsky.social Using single-neuron recordings in humans, we show that dopamine neurons encode reward expectations derived from past experience––giving us a new look into how reward learning unfolds in the human brain 🧵👇
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Patrick Mineault @patrickmineault.bsky.social · 04/05/2026
Do you think that the canonical cortical circuit is complicated? It's so much worse than that! Overlayed on top of the wired connectome, there are *18* different signal-carrying peptides in cortex! Their range is ~similar to the size of a cortical column elifesciences.org/articles/47889 1/
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Huw Jarvis @huwjarvis.net · 27/04/2026
📄NEW PAPER📄 Dopamine underpins both effort💪 and reward learning⭐. Here, we show it also supports their interaction! w A Huynh, D Obawede, J Coxon @coxon.bsky.social, M Bellgrove, and T Chong @trevorchong.bsky.social #dopamine #learning #effort @plosbiology.org journals.plos.org/plosbiology/... 1/5
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Cameron Blevins @cblevins.bsky.social · 03/04/2026
This is so, so well-articulated.
People call this friction "grunt work." Schwartz uses exactly that phrase, and he's right that LLMs can remove it. What he doesn't say, because he already has decades of hard-won intuition and doesn't need the grunt work anymore, is that for someone who doesn't yet have that intuition, the grunt work is the work. The boring parts and the important parts are tangled together in a way that you can't separate in advance. You don't know which afternoon of debugging was the one that taught you something fundamental about your data until three years later, when you're working on a completely different problem and the insight surfaces. Serendipity doesn't come from efficiency. It comes from spending time in the space where the problem lives, getting your hands dirty, making mistakes that nobody asked you to make and learning things nobody assigned you to learn.
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David Juurlink @davidjuurlink.bsky.social · 26/01/2026
I’ve spent 15 years challenging a flawed explanation for an infant’s death. Credit to The New Yorker for patient investigative journalism that corrected the record when institutions did not.
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Michael Okun @michaelokun.bsky.social · 17/01/2026
Does early autonomic burden in prodromal Parkinson’s disease predict later cognitive (thinking) impairment? Martinez Nunez and colleagues describe in a new paper in Movement Disorders how early autonomic symptoms in prodromal Parkinson’s disease may be linked to later cognitive (thinking) decline.
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Dylan Williams @dylwil.bsky.social · 06/01/2026
I'm starting a thread on misunderstandings about the role of APOE in Alzheimer's disease / dementia, from the POV of epidemiology / statistical genetics. I will add to this sporadically over time... #endalz #episky #medsky
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NY Times Pitchbot @nytpitchbot.bsky.social · 08/01/2026
I lost my job, my kids have measles, and Trump's personal Gestapo is randomly executing American citizens. But at least now there won't be any non-binary characters on the new Paw Patrol spin-off.
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Dr Nick @nmwilkinson.eurosky.social · 30/11/2025
Chinese whispers, genetic edition. This is a fascinating reminder that "genetic determination", at the level of organism behaviour, is not just about the genome inherited in the zygote, but about millions/billions of cells, each with a prob unique take on that foundational genome, working together.
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Harry Costello @drharrycostello.bsky.social · 24/11/2025
Evoke trial of @novonordisk’s #semaglutide for AD fails to slow progression: www.sciencemediacentre.org/expert-react... A second large #GLP1 agonist trial in neurodegeneration with another disappointing result. Why isn’t the promise (& hype) of observational data translating to trials?
sciencemediacentre.org
expert reaction to news from Novo Nordisk that semaglutide does not reduce Alzheimer’s Disease progression | Science Media Centre
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James Ball @jamesrball.com · 20/11/2025
This does feel like a major crossing of the Rubicon – the world's best-funded and in many ways most powerful public health agency is now actively pushing disinformation. I know there's a *lot* going on to care about at the moment, but this one really is significant, and matters well beyond the US.
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Dr Selena Wisnom @lswisnom.bsky.social · 03/11/2025
Academics in Assyria in the 7th c BC complain that admin is preventing them from doing research and teaching
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Calum Guinea @calumguinea.bsky.social · 01/08/2025
My first post into the bsky void, the first preprint of my PhD! A novel task to bridge learning and effort decision-making. Of course, we find that effort choice is sensitive to prior learning, but this integration of beliefs into action is affected by anhedonia. doi.org/10.1101/2025...
doi.org
Effort choices are sensitive to prior learning
Motivated behaviour relies on both learning and effort-based decision-making, yet these processes are often studied in isolation. We developed a novel paradigm combining probabilistic associative lear...
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Harry Costello @drharrycostello.bsky.social · 22/10/2025
Fascinating and clinically important new paper. It highlights both reassuring and concerning findings on the cardiometabolic effects of #antidepressants. Should post-initiation monitoring focus more on #metabolic changes than QTc? www.thelancet.com/journals/lan...
thelancet.com
The effects of antidepressants on cardiometabolic and other physiological parameters: a systematic review and network meta-analysis
We found strong evidence that antidepressants differ markedly in their physiological effects, particularly for cardiometabolic parameters. Treatment guidelines should be updated to reflect differences...
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Kevin Mitchell @wiringthebrain.bsky.social · 16/10/2025
Great review on The Genetics of Human Handedness: Microtubules and Beyond www.cell.com/trends/genet... - handedness is such an interesting phenotype!
cell.com
Genetics of human handedness: microtubules and beyond
Handedness (i.e., the preference to use either the left or the right hand for fine motor tasks) is a widely investigated trait. Handedness heritability is consistently estimated to be 25%. After decad...
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Armin Lak @laklab.bsky.social · 16/10/2025
Out today at Neuron, our experiments show that frontal cortical representation of economic variables is jointly determined by spatial organization and downstream connectivity of neurons, revealing a structured, multi-scale code for economic variables. www.cell.com/neuron/fullt...
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Ashley Tyrer @ashleytyrer.bsky.social · 15/10/2025
1/ To explore or to exploit? I’m excited to share my new preprint with @tobiasuhauser.bsky.social and @micahgallen.com, correlating variations in cortical microstructures with individual differences in exploration-exploitation behaviours, using a gamified task! 🧵 www.biorxiv.org/content/10.1...
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Sam Gershman @gershbrain.bsky.social · 14/10/2025
Really interesting work by Bakhurin and colleagues challenging the reward prediction error hypothesis of dopamine: www.nature.com/articles/s41... I love this figure which both echoes and undermines the famous figure from Schultz et al. (1997).
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Mehdi Hasan @mehdirhasan.bsky.social · 29/09/2025
“Israeli Forces Kill 198 Palestinians in Gaza Over Three Days” It’s a genocide. Daily endless massacres, largely ignored in the West.
news.antiwar.com
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...
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Kevin Mitchell @wiringthebrain.bsky.social · 24/09/2025
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
nature.com
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.
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Robert Howard @profrobhoward.bsky.social · 21/09/2025
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.com
ProfRobHoward
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Harry Costello @drharrycostello.bsky.social · 22/09/2025
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/...
journals.sagepub.com
Sage Journals: Discover world-class research
Subscription and open access journals from Sage, the world's leading independent academic publisher.
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Malcolm Campbell @malcolmgcampbell.bsky.social · 19/09/2025
🚨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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Sarah Katharina Buehler @sarahkathbuehler.bsky.social · 19/09/2025
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...
medrxiv.org
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...
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Thomas Luo @thomas-zhihao-luo.bsky.social · 17/09/2025
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
nature.com
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...
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Harry Costello @drharrycostello.bsky.social · 13/09/2025
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.
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Harry Costello @drharrycostello.bsky.social · 12/09/2025
‘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…
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Andreas Horn @andreashorn.org · 03/09/2025
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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Marcelo Mattar @marcelomattar.bsky.social · 02/07/2025
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...
doi.org
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...
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Joar Øveraas Halvorsen @joarhalvorsen.bsky.social · 29/08/2025
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...
sciencedirect.com
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…
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Harry Costello @drharrycostello.bsky.social · 29/08/2025
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...
bbc.co.uk
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.
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tal boger @talboger.bsky.social · 19/08/2025
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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Robert Howard @profrobhoward.bsky.social · 19/08/2025
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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Frank Harrell @f2harrell.bsky.social · 18/08/2025
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.
fharrell.com
Incorporating Historical Control Data Into an RCT – Statistical Thinking
Historical data (HD) are being used increasingly in Bayesian analyses when it is difficult to randomize enough patients to study effectiveness of a treatment. Such analyses summarize observational stu...
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Harry Costello @drharrycostello.bsky.social · 06/08/2025
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.
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Sam Gershman @gershbrain.bsky.social · 04/08/2025
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.
sciencedirect.com
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
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Stephen Bush @stephenkb.bsky.social · 02/08/2025
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.
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JAMA @jama.com · 02/08/2025
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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Prasad Jallepalli, MD, PhD @prasad.bsky.social · 29/07/2025
few outcomes, except for 99% of FDA-approved drugs, 174 recipients of 104 Nobel Prizes, training ~30K MDs and ~10K PhDs per year to enter the workforce, and a 34% reduction in age-adjusted cancer deaths since 1990 -- the largest decrease in history
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Kevin Mitchell @wiringthebrain.bsky.social · 27/07/2025
Identifying reproducible biomarkers for microbiome association studies requires sample sizes of thousands www.sciencedirect.com/science/arti...
sciencedirect.com
Identifying reproducible biomarkers for microbiome association studies requires thousands of sample sizes
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Andreas Brandmaier @brandmaier.bsky.social · 28/07/2025
New study out in Nature Medicine: Education does not protect against age-related decline of memory. Read more here: Reevaluating the role of education on cognitive decline and brain aging in longitudinal cohorts across 33 Western countries www.nature.com/articles/s41...
nature.com
Reevaluating the role of education on cognitive decline and brain aging in longitudinal cohorts across 33 Western countries - Nature Medicine
In a large cross-national study, education was linked to better memory and larger brain volumes but not to slower cognitive or brain decline with age, suggesting that the association reflects early-li...
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Nature Reviews Psychology @natrevpsychol.nature.com · 25/07/2025
How insights from posttraumatic stress disorder can inform treatment of functional neurological disorder Perspective by Andrea Putica (@andreaputica.bsky.social), James Agathos (@agathosj.bsky.social) & Kim Felmingham (@drkimfelm.bsky.social) Web: go.nature.com/4kWkhmq PDF: rdcu.be/exKpC
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Nature @nature.com · 22/07/2025
Nature research paper: Mitochondrial origins of the pressure to sleep go.nature.com/40oC7Y4
go.nature.com
Mitochondrial origins of the pressure to sleep - Nature
Research on Drosophila neurons shows links between the need to sleep and aerobic metabolism, indicating that the pressure to sleep may have a mitochondrial origin.
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Adam Kucharski @adamjkucharski.bsky.social · 14/07/2025
On the same weekend a child dies of measles in the UK, with 16 others hospitalised in recent weeks, the Telegraph decide to profile someone who has repeatedly made misleading and debunked claims about vaccines...
Measles outbreak: child dies in Liverpool as vaccine rate plunges
The death in a city where one in four young children are unprotected is fuelling warnings that the virus could spread like ‘wildfire’ Aseem Malhotra: ‘The harm caused by the Covid vaccine has been catastrophic’

The British cardiologist on biased drug trials, his role advising RFK Jr and why all vaccines should be reassessed for safety
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Science Magazine @science.org · 11/07/2025
In a new #ScienceReview, researchers provide a critical evaluation of research linking glymphatic dysfunction with Alzheimer’s disease. scim.ag/4lG54a0
Figure showing a schematic of the glymphatic system in health and Alzheimer's disease.
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