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Contains fulltext : 293119.pdf (Publisher’s version ) (Open Access) Importance: Bariatric surgery-induced weight loss is often associated with improved cognitive function. However, improvement in cognitive function is not always exhibited by all patients, and the mechanisms behind cognitive improvement remain unknown. Objective: To investigate the association of changes in adipokines, inflammatory factors, mood, and physical activity with alterations in cognitive function after bariatric surgery among patients with severe obesity. Design, setting, and participants: This cohort study included 156 patients with severe obesity (body mass index [calculated as weight in kilograms divided by height in meters squared], >35) eligible for Roux-en-Y gastric bypass, aged between 35 and 55 years, who were enrolled in the BARICO (Bariatric Surgery Rijnstate and Radboudumc Neuroimaging and Cognition in Obesity) study between September 1, 2018, and December 31, 2020. Follow-up was completed July 31, 2021; 146 participants completed the 6-month follow-up and were included in the analysis. Intervention: Roux-en-Y gastric bypass. Main outcomes and measures: Overall cognitive performance (based on a 20% change index of the compound z score), inflammatory factors (eg, C-reactive protein and interleukin 6 levels), adipokines (eg, leptin and adiponectin levels), mood (assessed via the Beck Depression Inventory), and physical activity (assessed with the Baecke questionnaire). Results: A total of 146 patients (mean [SD] age, 46.1 [5.7] years; 124 women [84.9%]) completed the 6-month follow-up and were included. After bariatric surgery, all plasma levels of inflammatory markers, including C-reactive protein (median change, -0.32 mg/dL [IQR, -0.57 to -0.16 mg/dL]; P < .001) and leptin (median change, -51.5 pg/mL [IQR, -68.0 to -38.4 pg/mL]; P < .001), were lower, whereas adiponectin levels were higher (median change, 0.15 μg/mL [IQR, -0.20 to 0.62 µg/mL]; P < .001), depressive symptoms were (partly) resolved (median change in Beck Depression Inventory score, -3 [IQR, -6 to 0]; P < .001), and physical activity level was higher (mean [SD] change in Baecke score, 0.7 [1.1]; P < .001). Cognitive improvement was observed in 43.8% (57 of 130) of the participants overall. This group had lower C-reactive protein (0.11 vs 0.24 mg/dL; P = .04) and leptin levels (11.8 vs 14.5 pg/mL; P = .04) and fewer depressive symptoms at 6 months (4 vs 5; P = .045) compared with the group of participants who did not show cognitive improvement. Conclusions and relevance: This study suggests that lower C-reactive protein and leptin levels, as well as fewer depressive symptoms, might partly explain the mechanisms behind cognitive improvement after bariatric surgery. 13 p.

Contains fulltext : 292439.pdf (Publisher’s version ) (Closed access) Objective: Cerebral small vessel disease (SVD) is considered the most important vascular contributor to cognitive decline and dementia, although a causal relation between its MRI markers and dementia still needs to be established. The authors investigated the relation between baseline SVD severity as well as SVD progression on MRI markers and incident dementia, by subtype, in individuals with sporadic SVD over a follow-up period of 14 years. Methods: The study included 503 participants with sporadic SVD, and without dementia, from the prospective Radboud University Nijmegen Diffusion Tensor and Magnetic Resonance Cohort (RUN DMC) study, with screening for baseline inclusion conducted in 2006. Follow-ups in 2011, 2015, and 2020 included cognitive assessments and MRI scans. Dementia was diagnosed according to DSM-5 criteria and stratified into Alzheimer's dementia and vascular dementia. Results: Dementia as an endpoint was available for 498 participants (99.0%) and occurred in 108 participants (21.5%) (Alzheimer's dementia, N=38; vascular dementia, N=34; mixed-etiology Alzheimer’s dementia/vascular dementia, N=26), with a median follow-up time of 13.2 years (interquartile range, 8.8-13.8). Higher baseline white matter hyperintensity (WMH) volume (hazard ratio=1.31 per 1-SD increase, 95% CI=1.02-1.67), presence of diffusion-weighted-imaging-positive lesions (hazard ratio=2.03, 95% CI=1.01-4.04), and higher peak width of skeletonized mean diffusivity (hazard ratio=1.24 per 1-SD increase, 95% CI=1.02-1.51) were independently associated with all-cause dementia and vascular dementia. WMH progression predicted incident all-cause dementia (hazard ratio=1.76 per 1-SD increase, 95% CI=1.18-2.63). Conclusions: Both baseline SVD severity and SVD progression were independently associated with an increase in risk of all-cause dementia over a follow-up of 14 years. The results suggest that SVD progression precedes dementia and may causally contribute to its development. Slowing SVD progression may delay dementia onset. 11 p.

Item does not contain fulltext Histopathological alterations of the mamillary bodies are the most conspicuous and the most consistent neuropathological features of several disorders that occur after severe thiamine deficiency, such as Wernicke's encephalopathy and Korsakoff's syndrome. Moreover, they are among the few abnormalities that are visible to the naked eye in these disorders. With a lifetime prevalence of approximately 1.3%, Wernicke's encephalopathy is by far the most frequent cause of damage to the mamillary bodies in humans. Still, there is a persisting uncertainty with regard to the development and the clinical consequences of this damage, because it is virtually impossible to study in isolation. As a rule, it always occurs alongside neuropathology in other subcortical gray matter structures, notably the medial thalamus. Converging evidence from other pathologies and animal experiments is needed to assess the clinical impact of mamillary body damage and to determine which functions can be attributed to these structures in healthy subjects. In this chapter, we describe the history and the current state of knowledge with regard to thiamine deficiency disorders and the contribution of mamillary body damage to their clinical presentations.

IntroductionPost-stroke fatigue is frequently present in young adults, but its underlying mechanism is still unclear. The aim of the study was to investigate the association between lesion location, network efficiency and chronic post-stroke fatigue based on voxel-based lesion-symptom mapping and structural network connectivity analysis.Patients and MethodsOne hundred and thirty five young patients, aged 18–50 years, with a first-ever transient ischemic attack or cerebral infarction from the Follow-Up of Transient ischemic attack and stroke patients and Unelucidated Risk factor Evaluation (FUTURE) study, underwent 1.5T MRI and were assessed for fatigue using the self-report Checklist Individual Strength. Stroke lesions were manually segmented, and structural network efficiency was calculated using the diffusion MRI-based brain networks and graph theory for each patient. Univariate and multivariate analyses was performed to study the associations between MRI parameters and chronic post-stroke fatigue. In addition, we used voxel-based lesion-symptom mapping to analyze the relationship between the lesion location and chronic post-stroke fatigue.ResultsMean age at index event was 39.0 years (SD ± 8.2), and mean follow-up duration was 11.0 years (SD ± 8.0). 50 patients (37%) had post-stroke fatigue. Voxel-based lesion-symptom mapping showed no significant relation between stroke lesions and the presence of chronic post-stroke fatigue. Furthermore, there were no significant associations between the lesion size or network efficiency, and the presence of chronic post-stroke fatigue.DiscussionWe did not find any association between stroke characteristics (lesion location and size) and chronic post-stroke fatigue (CIS20-R), nor associations between structural brain network connectivity and post-stroke fatigue on the long term in young stroke patients.

Item does not contain fulltext Een van de belangrijkste onderzoeksmethoden in de multidisciplinaire diagnostiek van cognitieve stoornissen en dementie is het neuropsychologisch onderzoek (NPO). Uit de NPO-Monitor, een recente inventarisatie van de werkwijze bij een NPO onder psychologen betrokken bij de diagnostiek op Nederlandse geheugenpoli's, kwam veel variatie in de procedure en inhoud naar voren en bleek er behoefte te zijn aan een uniforme werkwijze. Naar aanleiding hiervan werd bij het Nederlands Instituut van Psychologen de Monodisciplinaire richtlijn Neuropsychologisch onderzoek bij lichte cognitieve stoornissen (MCI) en dementie opgesteld (https://www.psynip.nl/secties/neuropsychologie/). In deze richtlijn is een geharmoniseerde kernbatterij opgenomen die aanbevolen wordt als uitgangspunt voor het NPO. Deze geharmoniseerde kernbatterij dient te worden aangevuld met overige relevante tests om individuele vraagstellingen te beantwoorden. Door implementatie van deze richtlijn kan de kwaliteit van het NPO bij deze doelgroep worden gewaarborgd, onderlinge variatie worden verminderd, een betrouwbaardere vergelijking bij herhalingsonderzoek worden gemaakt en de communicatie tussen instellingen worden verbeterd. 15 p.

Item does not contain fulltext De Mini-Mental State Examination (MMSE) werd in 1975 ontwikkeld door de Amerikaanse psychiater Marshal Folstein, zijn vrouw Susan en hun afdelingshoofd John McHugh als een instrument om op een snelle, gestandaardiseerde manier cognitieve symptomen te testen die kunnen wijzen op alzheimerdementie (Folstein e.a., 1975). Sindsdien is de MMSE een van de meest gebruikte cognitieve screeningsinstrumenten. Er is echter ook toenemende kritiek gekomen op dit instrument (Nieuwenhuis-Mark, 2010). De MMSE is bijvoorbeeld niet ontwikkeld voor andere vormen van dementie, niet sensitief voor milde cognitieve stoornissen (MCI), de psychometrische eigenschappen zijn matig, de standaardisatie van afname en scoring is niet optimaal en vertalingen zijn niet altijd uitgevoerd op de manier zoals wij psychologen dat geleerd hebben. Zo was er een tijd een Nederlandstalige versie van de MMSE in omloop waarin de opdracht was om het woord WERELD achterstevoren te spellen, als vertaling van het woord WORLD in de originele versie (terwijl het bij dit item cruciaal is dat het een eenlettergrepig woord betreft met drie medeklinkers achter elkaar). Kok en Verhey hebben in 2002 een gestandaardiseerde Nederlandse vertaling van de MMSE en de afnameprocedure gemaakt, waarin een aantal van deze knelpunten opgelost zijn (met WORST als te spellen woord). In diezelfde periode echter besloten de auteurs van de originele MMSE, die altijd het auteursrecht op de test hebben behouden, een exclusieve licentie aan te gaan met PAR Inc., een Amerikaanse testuitgever. Sindsdien bevindt de MMSE zich niet langer in het publieke domein, maar dient men per afname een bedrag af te dragen aan deze uitgever (Powsner & Powsner, 2005). De gestandaardiseerde Nederlandstalige MMSE is daarmee feitelijk een ongeautoriseerde uitgave geworden. De auteurs geven aan dat dit nodig was, om zo controle te kunnen uitoefenen op de kwaliteit van vertalingen en het gebruik van de MMSE voor commerciële doeleinden (Folstein & Folstein, 2010). 3 p.

Contains fulltext : 194837.pdf (Publisher’s version ) (Open Access) Autism spectrum disorder (ASD) and specific language impairment (SLI) are two neurodevelopmental disorders characterized by deficits in verbal and nonverbal communication skills. These skills are thought to develop largely through implicit - or automatic - learning mechanisms. The aim of the current paper was to investigate the role of implicit learning abilities in the atypical development of communication skills in ASD and SLI. In the current study, we investigated Response Times (RTs) and Event Related Potentials (ERPs) during implicit learning on a Serial Reaction Time (SRT) task in a group of typically developing (TD) children (n = 17), a group of autistic children (n = 16), and a group of children with SLI (n = 13). Findings suggest that learning in both ASD and SLI are similar to that in TD. However, electrophysiological findings suggest that autistic children seem to rely mainly on more automatic processes (as reflected by an N2b component), whereas the children with SLI seem to rely on more controlled processes (as reflected by a P3 component). The TD children appear to use a combination of both learning mechanisms. These findings suggest that clinical interventions should aim at compensating for an implicit learning deficit in children with SLI, but not in children with ASD. Future research should focus on developmental differences in implicit learning and related neural correlates in TD, ASD, and SLI. Lay Summary: Autism and Specific Language Impairment (SLI) are two disorders characterized by problems in social communication and language. Social communication and language are believed to be learned in an automatic way. This is called "implicit learning". We have found that implicit learning is intact in autism. However, in SLI there seems different brain activity during implicit learning. Maybe children with SLI learn differently, and maybe this different learning makes it more difficult for them to learn language. 12 p.

Item does not contain fulltext Om meer inzicht te krijgen in de ervaringen van patiënten en naasten met het neuropsychologisch onderzoek (NPO) en het medische uitslaggesprek op de geheugenpoli werden vier focusgroepen met veertien patiënten en dertien naasten georganiseerd. De gegevens werden zowel inductief als deductief geanalyseerd. Uit de groepsinterviews kwamen drie thema's naar voren: onzekerheid, vroege diagnostische paradox en informatieretentie. Tijdens het NPO en uitslaggesprek bestond er een hoge mate van onzekerheid. De vroege diagnostische paradox verwijst naar het tegelijk aanwezig zijn van negatieve (confrontatie met cognitieve klachten tijdens het NPO) en positieve ervaringen (opluchting of bevestiging door resultaten van het NPO en medische diagnose). Informatieretentie verwijst naar de geringe mate waarin medische informatie beklijft. In de klinische praktijk kunnen clinici onzekerheid verminderen door duidelijk te communiceren en onderbrekingen tijdens het NPO te voorkomen. Het onthouden van informatie kan worden verbeterd door een naaste erbij te betrekken of de informatie ook visueel of geschreven aan te bieden. 16 p.

Item does not contain fulltext Het beschrijven van kwantitatief bepaalde testscores is een essentieel aspect van het neuropsychologisch onderzoek. Het gebruik van uniforme, kwalitatieve beschrijvingen van de scores op (cognitieve) tests zorgt voor een heldere, ondubbelzinnige communicatie binnen de beroepsgroep en verbetert het maatschappelijk belang van de klinisch-neuropsychologische diagnostiek. Hoewel de noodzaak hiervan breed onderschreven wordt, was er tot nu toe geen (inter)nationaal geaccepteerde overeenstemming over de wijze waarop scores worden geclassificeerd en beschreven. In 2018 heeft een consensusbijeenkomst van de American Academy of Clinical Neuropsychology (AACN) plaatsgevonden, met twee doelen: (1) het formuleren van een voorstel voor het classificeren van testscores die normaal en niet-normaal verdeeld zijn, en (2) het definiëren van 'stoornis' en de toepassing bij individuele cases (Guilmette e.a., 2020). In dit artikel hebben we de conclusies en aanbevelingen getracht te vertalen in een voorstel voor de Nederlandse praktijk. 8 p.

Contains fulltext : 179660.pdf (Publisher’s version ) (Open Access) In this review, we present a survey on Korsakoff's syndrome (KS), a residual syndrome in patients who suffered from a Wernicke encephalopathy (WE) that is predominantly characterized by global amnesia, and in more severe cases also by cognitive and behavioral dysfunction. We describe the history of KS and its definition, its epidemiology, and the lack of consensus criteria for its diagnosis. The cognitive and behavioral symptoms of KS, which include anterograde and retrograde amnesia, executive dysfunction, confabulation, apathy, as well as affective and social-cognitive impairments, are discussed. Moreover, recent insights into the underlying neurocognitive mechanisms of these symptoms are presented. In addition, the evidence so far on the etiology of KS is examined, highlighting the role of thiamine and alcohol and discussing the continuity hypothesis. Furthermore, the neuropathology of KS is reviewed, focusing on abnormalities in the diencephalon, including the mammillary bodies and thalamic nuclei. Pharmacological treatment options and nonpharmacological interventions, such as those based on cognitive rehabilitation, are discussed. Our review shows that thiamine deficiency (TD) is a crucial factor in the etiology of KS. Although alcohol abuse is by far the most important context in which TD occurs, there is no convincing evidence for an essential contribution of ethanol neurotoxicity (EN) to the development of WE or to the progression of WE to KS. Future research on the postmortem histopathological analysis of brain tissues of KS patients is crucial for the advancement of our knowledge of KS, especially for associating its symptoms with lesions in various thalamic nuclei. A necessary requirement for the advancement of studies on KS is the broad acceptance of a comprehensive definition and definite diagnostic criteria. Therefore, in this review, we propose such a definition of KS and draft outlines for prospective diagnostic criteria. 16 p.

Contains fulltext : 201491.pdf (Publisher’s version ) (Open Access) Purpose: Noonan syndrome (NS) is a genetic disorder that is associated with social cognitive problems. While treatment aimed at the improvement of social cognition is available for other neuropsychiatric disorders, no such interventions yet exist for NS patients. In this study, the development of the first social cognitive training for NS patients is described and its applicability and feasibility evaluated. Methods: Eleven adult patients with NS participated in this controlled proof-of-principle study. Six patients were included in the treatment group and five in the control group. Neuropsychological testing was performed in both groups at baseline and posttreatment. Social cognition was a primary outcome measure and nonsocial cognition and psychopathology secondary outcome measures. Differences between pre- and posttest were investigated with Wilcoxon signed-rank tests, and a process evaluation was performed to aid interpretation of the results. Results: Both groups were comparable with regard to age, estimated intelligence, and baseline performance. Although no significant differences were found between pre- and posttest scores on primary and secondary outcome measures in either group, a medium-large effect size was found on emotion recognition in the treatment group. Also, the process evaluation demonstrated the feasibility of the training. Conclusion: This first social cognitive training for adult patients with NS has proven to be feasible for this population and showed some encouraging results regarding emotion recognition, although the training protocol could be optimized. Further investigation is required using a randomized controlled design in a larger sample, in order to substantiate the overall effectiveness of the training. 16 p.

Item does not contain fulltext Autismespectrumstoornis (ASS) en taalontwikkelingsstoornis (TOS) zijn twee ontwikkelingsstoornissen die gekenmerkt worden door tekortkomingen in communicatieve vaardigheden. Normaal ontwikkelende kinderen verwerven deze vaardigheden grotendeels via impliciete leerprocessen, ofwel een automatische manier van leren die leidt tot onbewuste kennis. Voor zowel ASS als TOS is daarom geopperd dat een probleem in het impliciet leren ten grondslag ligt aan de moeizame ontwikkeling van communicatieve vaardigheden en dat hier mogelijk voor wordt gecompenseerd door het expliciete leersysteem. In dit artikel bespreken wij hoe impliciet leren wordt onderzocht en wat de bevindingen zijn bij ASS en TOS. Wij concluderen dat bij ASS het impliciete leersysteem intact lijkt, maar dat er desalniettemin een neiging lijkt te zijn om het expliciete leersysteem te gebruiken. Bij TOS lijkt het impliciete leersysteem echter niet intact, en dit maakt een gebruik van het expliciete leersysteem noodzakelijk. 13 p.

Contains fulltext : 183247.pdf (Publisher’s version ) (Open Access) Aim: People with autism spectrum disorder (ASD) typically have deficits in the working memory (WM) system. Working memory is found to be an essential chain in successfully navigating in the social world. We hypothesize that brain networks for WM have an altered network integrity in ASD compared to controls. Methods: 13 adolescents (1 female) with autistic disorder (n = 1), Asperger's disorder (n = 7), and pervasive developmental disorder not otherwise specified (n = 5), and 13 typically developing control adolescents (1 female) participated in this study. Functional MRI was performed using an n-back task and in resting state. Results: The analysis of the behavioral data revealed deficits in working memory performance in ASD, but only when tested to the limit. Adolescents with ASD showed lower binary global efficiency in the working memory network than the control group with n-back and resting state data. This correlated with diagnostic scores for total problems, reciprocity, and language. Conclusion: Adolescent with higher functioning autism have difficulty with the working memory system, which is typically compensated. Functional MRI markers of brain network organization in ASD are related to characteristics of autism as represented in diagnostic scores. Therefore, functional MRI provides neuronal correlates for memory difficulties in adolescents with ASD. 11 p.

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Contains fulltext : 176255.pdf (Publisher’s version ) (Closed access) It has been suggested that people with autism spectrum disorder (ASD) have an increased tendency to use explicit (or intentional) learning strategies. This altered learning may play a role in the development of the social communication difficulties characterizing ASD. In the current study, we investigated incidental and intentional sequence learning using a Serial Reaction Time (SRT) task in an adult ASD population. Response times and event related potentials (ERP) components (N2b and P3) were assessed as indicators of learning and knowledge. Findings showed that behaviorally, sequence learning and ensuing explicit knowledge were similar in ASD and typically developing (TD) controls. However, ERP findings showed that learning in the TD group was characterized by an enhanced N2b, while learning in the ASD group was characterized by an enhanced P3. These findings suggest that learning in the TD group might be more incidental in nature, whereas learning in the ASD group is more intentional or effortful. Increased intentional learning might serve as a strategy for individuals with ASD to control an overwhelming environment. Although this led to similar behavioral performances on the SRT task, it is very plausible that this intentional learning has adverse effects in more complex social situations, and hence contributes to the social impairments found in ASD. 11 p.

Contains fulltext : 174222.pdf (Publisher’s version ) (Open Access) BACKGROUND: Exercise interventions to prevent dementia and delay cognitive decline have gained considerable attention in recent years. Human and animal studies have demonstrated that regular physical activity targets brain function by increasing cognitive reserve. There is also evidence of structural changes caused by exercise in preventing or delaying the genesis of neurodegeneration. Although initial studies indicate enhanced cognitive performance in patients with mild cognitive impairment (MCI) following an exercise intervention, little is known about the effect of an extensive, controlled and regular exercise regimen on the neuropathology of patients with MCI. This study aims to determine the effects of an extensive exercise programme on the progression of MCI. METHODS/DESIGN: This randomised controlled clinical intervention study will take place across three European sites. Seventy-five previously sedentary patients with a clinical diagnosis of MCI will be recruited at each site. Participants will be randomised to one of three groups. One group will receive a standardised 1-year extensive aerobic exercise intervention (3 units of 45 min/week). The second group will complete stretching and toning (non-aerobic) exercise (3 units of 45 min/week) and the third group will act as the control group. Change in all outcomes will be measured at baseline (T0), after six months (T1) and after 12 months (T2). The primary outcome, cognitive performance, will be determined by a neuropsychological test battery (CogState battery, Trail Making Test and Verbal fluency). Secondary outcomes include Montreal Cognitive Assessment (MoCA), cardiovascular fitness, physical activity, structural changes of the brain, quality of life measures and measures of frailty. Furthermore, outcome variables will be related to genetic variations on genes related to neurogenesis and epigenetic changes in these genes caused by the exercise intervention programme. DISCUSSION: The results will add new insights into the prevailing notion that exercise may slow the rate of cognitive decline in MCI. TRIAL REGISTRATION: ClinicalTrials.gov NCT02913053. 10 p.

Contains fulltext : 179155.pdf (Publisher’s version ) (Open Access) Background: Errorless learning (EL) is a promising rehabilitation principle for (re)learning instrumental activities in patients with amnesia, including patients with Korsakoff's syndrome (KS). Successfully (re)learning tasks might improve the sense of competence and independence, and subsequently the quality of life. Quality of life in patients with KS has received limited attention, and no studies have been conducted to experimentally examine the effect of EL on quality of life in patients in this patient group. Materials and methods: The QUALIDEM, an observation scale for quality of life, was completed by professional nurses before and after EL training in a group of fifty-one patients with KS. This scale was also completed for a group of thirty-one control patients receiving care as usual but no EL training. Results: Quality of life was significantly increased on eight of the nine subscales in the Korsakoff group who participated in an EL training. There was a trend toward a significant increase in "positive affect" (ie, the ninth subscale). In contrast, no changes over time were found on any of the subscales in the control group that did not participate in any EL training. Conclusion: Despite severe memory impairments, patients with KS still have the potential to (partially) (re)learn tasks using EL. This potential should be exploited, as the successes of (re)-learning might improve the quality of life of Korsakoff patients in nursing homes. 7 p.

Contains fulltext : 167726.pdf (Publisher’s version ) (Closed access) INTRODUCTION: Cerebral small vessel disease is one of the most important risk factors for dementia, and has been related to hippocampal atrophy, which is among the first observed changes on conventional MRI in patients with dementia. However, these volumetric changes might be preceded by loss of microstructural integrity of the hippocampus for which conventional MRI is not sensitive enough. Therefore, we investigated the relation between the hippocampal diffusion parameters and the risk of incident dementia, using diffusion tensor imaging, independent of hippocampal volume. METHODS: The RUNDMC study is a prospective study among 503 elderly with small vessel disease, without dementia, with 5 years follow-up in 2012 (99.6% response-rate). Cox regression analysis was performed to calculate hazard ratios for dementia, of fractional anisotropy and mean diffusivity within the hippocampus, adjusted for demographics, hippocampal volume, and white matter. This was repeated in participants without evident hippocampal volume loss, because in these participants the visible damage might not yet have already started, whereas damage might have started on a microstructural level. RESULTS: 43 participants developed dementia (8.6%), resulting in a 5.5-year cumulative risk of 11.1% (95%CI 7.7-14.6). Higher mean diffusivity was associated with an increased 5-year risk of dementia. In the subgroup of participants with the upper half hippocampal volume, higher hippocampal mean diffusivity, more than doubled the 5-year risk of dementia. CONCLUSION: This is the first prospective study showing a relation between a higher baseline hippocampal mean diffusivity and the risk of incident dementia in elderly with small vessel disease at 5-year follow-up, independent of hippocampal volume and white matter volume. Hum Brain Mapp 37:327-337, 2016. (c) 2015 Wiley Periodicals, Inc. 11 p.

Contains fulltext : 157611.pdf (Publisher’s version ) (Open Access) Achtergrond: Binnen de dsm-iv-tr zijn alcoholgerelateerde cognitieve stoornissen moeilijk onder te brengen, met als gevolg dat deze neurocognitieve stoornissen vaak over het hoofd worden gezien. De komst van de dsm-5 zou hierin uitkomst kunnen bieden. Doel: De dsm-5 vergelijken met de dsm-iv-tr voor de classificatie van alcoholgerelateerde cognitieve stoornissen en de klinische relevantie bespreken. Methode: Het vergelijken van de hoofdstukken uit de dsm-iv-tr en de dsm-5 voor alcoholgerelateerde cognitieve stoornissen. Resultaten: In de dsm-5 is er meer aandacht gekomen voor alcoholgerelateerde neurocognitieve stoornissen. Naast een onderscheid in ernst (beperkt en uitgebreid) wordt er onderscheid gemaakt in type (niet-amnestisch-confabulerende type versus amnestisch-confabulerende type) en specificatie van de duur (gedragsstoornissen en/of persisterend). Conclusie: In de dsm-5 krijgen alcoholgerelateerde neurocognitieve stoornissen meer aandacht, waarbij neuropsychologisch onderzoek een essentieel onderdeel vormt in de classificatie, diagnostiek en behandeling van neurocognitieve stoornissen. ENGLISH: BACKGROUND: It is evident from the dsm-iv-tr that alcohol-related impairment is extremely difficult to classify accurately. As a result, cognitive deficits can easily be overlooked. The dsm-5, however, incorporates a new category, namely 'neurocognitive disorders', which may lead to significant improvements in clinical practice. AIM: To compare the classification of alcohol-related cognitive dysfunction in dsm-iv-tr and dsm-5 and to discuss the clinical relevance of the revised classification in the dsm-5. METHOD: We compare the chapters of the dsm-iv-tr and the dsm-5 concerning alcohol-related cognitive impairment and describe the changes that have been made. RESULTS: The dsm-5 puts greater emphasis on alcohol-related neurocognitive impairment. Not only does dsm-5 distinguish between the degree of severity (major or minor neurocognitive disorder), it also distinguishes between the type of impairment (non-amnestic-type versus confabulating-amnestic type). It also makes a distinction between the durations of impairment (behavioural and/or persistent disorders). CONCLUSION: The dsm-5 gives a clearer description of alcohol-related neurocognitive dysfunction than does dsm-iv-tr and it stresses the essential role of neuropsychological assessment in the classification, diagnosis, and treatment of neurocognitive disorders. 5 p.

Aims It has been suggested that in patients with type 2 diabetes mellitus (T2DM), brain atrophy is most pronounced in the hippocampus, but this has not been investigated systematically. The present pooled analysis of three studies examined if hippocampal atrophy is more prominent than global brain atrophy in patients with T2DM relative to controls. Methods Data were derived from a cohort study of patients with vascular disease (SMART-Medea (T2DM = 120; no T2DM = 502)), and from two case–control studies (UDES1 (T2DM = 61; controls = 30) and UDES2 (T2DM = 54; controls = 53)). In SMART-Medea and UDES1, hippocampal volume was obtained by manual tracing on 1.5 Tesla (T) MRI scans. Total brain and intracranial volume (ICV) were determined by an automated segmentation method. In UDES2, hippocampal and total brain volume were determined by FreeSurfer and ICV by manual segmentation on 3 T MRI scans. Results The pooled analyses, adjusted for age and sex, showed a significant negative relation between T2DM and total brain-to-ICV ratio (standardized mean difference = − 1.24%, 95% CI: − 1.63; − 0.86), but not between T2DM and hippocampal-to-ICV ratio (0.00%, 95% CI: − 0.01; 0.00) or between T2DM and hippocampal-to-total brain volume ratio (0.01%, 95% CI: − 0.01; 0.02). In patients with T2DM no associations were found between brain volume measures and HbA1c or memory. Conclusion Patients with T2DM had greater brain atrophy but not hippocampal atrophy, compared to controls. These findings do not support specific vulnerability of the hippocampus in patients with T2DM.

Contains fulltext : 220333.pdf (Publisher’s version ) (Open Access) Radboud University, 18 september 2020 Promotores : Olde Rikkert, M.G.M., Kessels, R.P.C. Co-promotores : Claassen, J.A.H.R., Aaronson, J.A.

Contains fulltext : 203516.pdf (Publisher’s version ) (Open Access) Radboud University, 06 juni 2019 Promotores : Olde Rikkert, M.G.M., Kessels, R.P.C. Co-promotores : Aaronson, J.A., Bossers, W.J.R.

Contains fulltext : 169272.pdf (Publisher’s version ) (Open Access) Radboud University, 22 mei 2017 Promotor : Kessels, R.P.C. Co-promotor : Koopmans †, P.P.

Contains fulltext : 173273.pdf (Publisher’s version ) (Open Access) Radboud University, 01 juni 2017 Promotores : Kessels, R.P.C., Olderikkert, M.G.M. Co-promotor : Boelen, D.H.E.

Contains fulltext : 157686.pdf (Publisher’s version ) (Open Access) Based on this thesis, it can be concluded that using eHealth interventions on modifiable lifestyle risk factors for neurodegenerative diseases, specifically Alzheimer’s disease, appears to be a viable option. I describe the validation of a new online, fast-to-play self-monitor instrument aimed at four cognitive functions crucial for optimal wellbeing and independent living. In my next studies I describe the 1-year outcome on modifiable lifestyle risk factors in participants who actively used the Brain Aging Monitor. After one year participants showed an overall lifestyle improvement in follow-up measurements that was mainly caused by improvements in exercise, dietary, and sleep outcomes. Added to the positive lifestyle outcomes, I describe the cognitive outcomes from the BAM-COG. This showed a positive change in working memory performance, which was correlated with the overall improvement in lifestyle score and slightly decreased body weight. Overall, the study described in this thesis provided interesting and relevant data on the feasibility of this type of eHealth field trials that allows dissemination and evaluation of innovations to large populations at lower costs and in a shorter time than more strictly controlled designs. The BAM and BAM-COG results are sufficiently promising to conclude that it is worthwhile to further develop public health interventions to stimulate healthy brain aging by means of eHealth and mHealth innovations. RU Radboud Universiteit, 09 juni 2016 Promotores : Olde Rikkert, M.G.M., Kessels, R.P.C. Co-promotores : Qin, L., Lange, A.H. de 221 p.

Contains fulltext : 155624.pdf (Publisher’s version ) (Open Access) Radboud Universiteit Nijmegen, 18 maart 2016 Promotores : Kessels, R.P.C., Olderikkert, M.G.M. Co-promotor : Claassen, J.A.H.R.