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759 results on '"Biessels, G.J."'

2. Big Data, Small Vessels

Author

Solinge, W.W. van, Biessels, G.J., Haitjema, S., Overmars, Lisa Malin, Solinge, W.W. van, Biessels, G.J., Haitjema, S., and Overmars, Lisa Malin

Published
2024

3. Risk factors for atherosclerotic and medial arterial calcification of the intracranial internal carotid artery

Author

Majoie, C.B., Roos, Y.B., Duijm, L.E., Keizer, K., van der Lugt, A., Dippel, D.W., Droogh-de Greve, K.E., Bienfait, H.P., van Walderveen, M.A., Wermer, M.J.H., Lycklama à Nijeholt, G.J., Boiten, J., Duyndam, D., Kwa, V.I., Meijer, F.J., van Dijk, E.J., Kesselring, F.O., Hofmeijer, J., Vos, J.A., Schonewille, W.J., van Rooij, W.J., de Kort, P.L., Pleiter, C.C., Bakker, S.L., Bot, J., Visser, M.C., Velthuis, B.K., van der Schaaf, I.C., Dankbaar, J.W., Mali, W.P., van Seeters, T., Horsch, A.D., Niesten, J.M., Biessels, G.J., Kappelle, L.J., Luitse, M.J., van der Graaf, Y., Vos, Annelotte, Kockelkoren, Remko, de Vis, Jill B., van der Schouw, Yvonne T., van der Schaaf, Irene C., Velthuis, Birgitta K., Mali, Willem P.T.M., and de Jong, Pim A.

Published
2018
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4. Progress toward standardized diagnosis of vascular cognitive impairment: Guidelines from the Vascular Impairment of Cognition Classification Consensus Study

Author

Taragano, F.E., Kril, J., Cavalieri, M., Jellinger, K.A., Kovacs, G.G., Engelborghs, S., Lafosse, C., Bertolucci, P.H., Brucki, S., Caramelli, P., de Toledo Ferraz Alves, T.C., Bocti, C., Fulop, T., Hogan, D.B., Hsiung, G.R., Kirk, A., Leach, L., Robillard, A., Sahlas, D.J., Guo, Q., Tian, J., Hokkanen, L., Jokinen, H., Benisty, S., Deramecourt, V., Hauw, J., Lenoir, H., Tsatali, M., Tsolaki, M., Sundar, U., Coen, R.F., Korczyn, A.D., Altieri, M., Baldereschi, M., Caltagirone, C., Caravaglios, G., Di Carlo, A., Di Piero, V., Gainotti, G., Galluzzi, S., Logroscino, G., Mecocci, P., Moretti, D.V., Padovani, A., Fukui, T., Ihara, M., Mizuno, T., Kim, S.Y., Akinyemi, R., Baiyewu, O., Ogunniyi, A., Szczudlik, A., Bastos-Leite, A.J., Firmino, H., Massano, J., Verdelho, A., Kruglov, L.S., Ikram, M.K., Kandiah, N., Arana, E., Barroso-Ribal, J., Calatayud, T., Cruz-Jentoft, A.J., López-Pousa, S., Martinez-Lage, P., Mataro, M., Börjesson-Hanson, A., Englund, E., Laukka, E.J., Qiu, C., Viitanen, M., Biessels, G.J., de Leeuw, F.-E., den Heijer, T., Exalto, L.G., Kappelle, L.J., Prins, N.D., Richard, E., Schmand, B., van den Berg, E., van der Flier, W.M., Bilgic, B., Allan, L.M., Archer, J., Attems, J., Bayer, A., Blackburn, D., Brayne, C., Bullock, R., Connelly, P.J., Farrant, A., Fish, M., Harkness, K., Ince, P.G., Langhorne, P., Mann, J., Matthews, F.E., Mayer, P., Pendlebury, S.T., Perneczky, R., Peters, R., Smithard, D., Stephan, B.C., Swartz, J.E., Todd, S., Werring, D.J., Wijayasiri, S.N., Wilcock, G., Zamboni, G., Au, R., Borson, S., Bozoki, A., Browndyke, J.N., Corrada, M.M., Crane, P.K., Diniz, B.S., Etcher, L., Fillit, H., Greenberg, S.M., Grinberg, L.T., Hurt, S.W., Lamar, M., Mielke, M., Ott, B.R., Perry, G., Powers, W.J., Ramos-Estebanez, C., Reed, B., Roberts, R.O., Romero, J.R., Saykin, A.J., Seshadri, S., Silbert, L., Stern, Y., Zarow, C., Skrobot, Olivia A., Black, Sandra E., Chen, Christopher, DeCarli, Charles, Erkinjuntti, Timo, Ford, Gary A., Kalaria, Rajesh N., O'Brien, John, Pantoni, Leonardo, Pasquier, Florence, Roman, Gustavo C., Wallin, Anders, Sachdev, Perminder, Skoog, Ingmar, Ben-Shlomo, Yoav, Passmore, Anthony P., Love, Seth, and Kehoe, Patrick G.

Published
2018
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5. The Vascular Impairment of Cognition Classification Consensus Study

Author

Taragano, F.E., Kril, J., Cavalieri, M., Jellinger, K.A., Kovacs, G.G., Engelborghs, S., Lafosse, C., Bertolucci, P.H., Brucki, S., Caramelli, P., de Toledo Ferraz Alves, T.C., Bocti, C., Fulop, T., Hogan, D.B., Hsiung, G.R., Kirk, A., Leach, L., Robillard, A., Sahlas, D.J., Guo, Q., Tian, J., Hokkanen, L., Jokinen, H., Benisty, S., Deramecourt, V., Hauw, J., Lenoir, H., Tsatali, M., Tsolaki, M., Sundar, U., Coen, R.F., Korczyn, A.D., Altieri, M., Baldereschi, M., Caltagirone, C., Caravaglios, G., Di Carlo, A., DI Piero, V., Gainotti, G., Galluzzi, S., Logroscino, G., Mecocci, P., Moretti, D.V., Padovani, A., Fukui, T., Ihara, M., Mizuno, T., Kim, S.Y., Akinyemi, R., Baiyewu, O., Ogunniyi, A., Szczudlik, A., Bastos-Leite, A.J., Firmino, H., Massano, J., Verdelho, A., Kruglov, L.S., Ikram, M.K., Kandiah, N., Arana, E., Barroso-Ribal, J., Calatayud, T., Cruz-Jentoft, A.J., López-Pousa, S., Martinez-Lage, P., Mataro, M., Börjesson-Hanson, A., Englund, E., Laukka, E.J., Qiu, C., Viitanen, M., Biessels, G.J., de Leeuw, F.-E., den Heijer, T., Exalto, L.G., Kappelle, L.J., Prins, N.D., Richard, E., Schmand, B., van den Berg, E., van der Flier, W.M., Bilgic, B., Allan, L.M., Archer, J., Attems, J., Bayer, A., Blackburn, D., Brayne, C., Bullock, R., Connelly, P.J., Farrant, A., Fish, M., Harkness, K., Ince, P.G., Langhorne, P., Mann, J., Matthews, F.E., Mayer, P., Pendlebury, S.T., Perneczky, R., Peters, R., Smithard, D., Stephan, B.C., Swartz, J.E., Todd, S., Werring, D.J., Wijayasiri, S.N., Wilcock, G., Zamboni, G., Au, R., Borson, S., Bozoki, A., Browndyke, J.N., Corrada, M.M., Crane, P.K., Diniz, B.S., Etcher, L., Fillit, H., Greenberg, S.M., Grinberg, L.T., Hurt, S.W., Lamar, M., Mielke, M., Ott, B.R., Perry, G., Powers, W.J., Ramos-Estebanez, C., Reed, B., Roberts, R.O., Romero, J.R., Saykin, A.J., Seshadri, S., Silbert, L., Stern, Y., Zarow, C., Skrobot, Olivia A., O'Brien, John, Black, Sandra, Chen, Christopher, DeCarli, Charles, Erkinjuntti, Timo, Ford, Gary A., Kalaria, Rajesh N., Pantoni, Leonardo, Pasquier, Florence, Roman, Gustavo C., Wallin, Anders, Sachdev, Perminder, Skoog, Ingmar, Ben-Shlomo, Yoav, Passmore, Anthony P., Love, Seth, and Kehoe, Patrick G.

Published
2017
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6. The global burden of cerebral small vessel disease in low- and middle-income countries: A systematic review and meta-analysis.

Author

Lam, B.Y.K., Cai, Y., Akinyemi, R., Biessels, G.J., Brink, H. van den, Chen, C, Cheung, C.W., Chow, K.N., Chung, H.K.H., Duering, M., Fu, S.T., Gustafson, D., Hilal, S., Hui, V.M.H., Kalaria, R., Kim, S., Lam, M.L.M., Leeuw, F.E. de, Li, A.S.M., Markus, H.S., Marseglia, A., Zheng, H., O'Brien, J., Pantoni, L., Sachdev, P.S., Smith, E.E., Wardlaw, J., Mok, V.C.T., Lam, B.Y.K., Cai, Y., Akinyemi, R., Biessels, G.J., Brink, H. van den, Chen, C, Cheung, C.W., Chow, K.N., Chung, H.K.H., Duering, M., Fu, S.T., Gustafson, D., Hilal, S., Hui, V.M.H., Kalaria, R., Kim, S., Lam, M.L.M., Leeuw, F.E. de, Li, A.S.M., Markus, H.S., Marseglia, A., Zheng, H., O'Brien, J., Pantoni, L., Sachdev, P.S., Smith, E.E., Wardlaw, J., and Mok, V.C.T.

Abstract

01 januari 2023, Item does not contain fulltext, BACKGROUND: Cerebral small vessel disease (cSVD) is a major cause of stroke and dementia. Previous studies on the prevalence of cSVD are mostly based on single geographically defined cohorts in high-income countries. Studies investigating the prevalence of cSVD in low- and middle-income countries (LMICs) are expanding but have not been systematically assessed. AIM: This study aims to systematically review the prevalence of cSVD in LMICs. RESULTS: Articles were searched from the Ovid MEDLINE and EMBASE databases from 1 January 2000 to 31 March 2022, without language restrictions. Title/abstract screening, full-text review, and data extraction were performed by two to seven independent reviewers. The prevalence of cSVD and study sample size were extracted by pre-defined world regions and health status. The Risk of Bias for Non-randomized Studies tool was used. The protocol was registered on PROSPERO (CRD42022311133). A meta-analysis of proportion was performed to assess the prevalence of different magnetic resonance imaging markers of cSVD, and a meta-regression was performed to investigate associations between cSVD prevalence and type of study, age, and male: female ratio. Of 2743 studies identified, 42 studies spanning 12 global regions were included in the systematic review. Most of the identified studies were from China (n = 23). The median prevalence of moderate-to-severe white matter hyperintensities (WMHs) was 20.5%, 40.5%, and 58.4% in the community, stroke, and dementia groups, respectively. The median prevalence of lacunes was 0.8% and 33.5% in the community and stroke groups. The median prevalence of cerebral microbleeds (CMBs) was 10.7% and 22.4% in the community and stroke groups. The median prevalence of moderate-to-severe perivascular spaces was 25.0% in the community. Meta-regression analyses showed that the weighted median age (51.4 ± 0.0 years old; range: 36.3-80.2) was a significant predictor of the prevalence of moderate-to-severe WMH and lacunes

Published
2023

7. Neuroimaging standards for research into small vessel disease-advances since 2013.

Author

Duering, M., Biessels, G.J., Brodtmann, A., Chen, C, Cordonnier, C., Leeuw, F.E. de, Debette, S., Frayne, R., Jouvent, E., Rost, N.S., Telgte, A. ter, Al-Shahi Salman, R., Backes, W.H., Bae, H.J., Brown, R., Chabriat, H., Luca, A. De, DeCarli, C., Dewenter, A., Doubal, F.N., Ewers, M., Field, T.S., Ganesh, A., Greenberg, S., Helmer, K.G., Hilal, S., Jochems, A.C.C., Jokinen, H., Kuijf, H., Lam, B.Y.K., Lebenberg, J., MacIntosh, B.J., Maillard, P., Mok, V.C.T., Pantoni, L., Rudilosso, S., Satizabal, C.L., Schirmer, M.D., Schmidt, R., Smith, C., Staals, J., Thrippleton, M.J., Veluw, S.J. van, Vemuri, P., Wang, Yilong, Werring, D., Zedde, M., Akinyemi, R.O., Brutto, O.H. Del, Markus, H.S., Zhu, Y.C., Smith, E.E., Dichgans, M., Wardlaw, J.M., Duering, M., Biessels, G.J., Brodtmann, A., Chen, C, Cordonnier, C., Leeuw, F.E. de, Debette, S., Frayne, R., Jouvent, E., Rost, N.S., Telgte, A. ter, Al-Shahi Salman, R., Backes, W.H., Bae, H.J., Brown, R., Chabriat, H., Luca, A. De, DeCarli, C., Dewenter, A., Doubal, F.N., Ewers, M., Field, T.S., Ganesh, A., Greenberg, S., Helmer, K.G., Hilal, S., Jochems, A.C.C., Jokinen, H., Kuijf, H., Lam, B.Y.K., Lebenberg, J., MacIntosh, B.J., Maillard, P., Mok, V.C.T., Pantoni, L., Rudilosso, S., Satizabal, C.L., Schirmer, M.D., Schmidt, R., Smith, C., Staals, J., Thrippleton, M.J., Veluw, S.J. van, Vemuri, P., Wang, Yilong, Werring, D., Zedde, M., Akinyemi, R.O., Brutto, O.H. Del, Markus, H.S., Zhu, Y.C., Smith, E.E., Dichgans, M., and Wardlaw, J.M.

Abstract

01 juli 2023, Item does not contain fulltext, Cerebral small vessel disease (SVD) is common during ageing and can present as stroke, cognitive decline, neurobehavioural symptoms, or functional impairment. SVD frequently coexists with neurodegenerative disease, and can exacerbate cognitive and other symptoms and affect activities of daily living. Standards for Reporting Vascular Changes on Neuroimaging 1 (STRIVE-1) categorised and standardised the diverse features of SVD that are visible on structural MRI. Since then, new information on these established SVD markers and novel MRI sequences and imaging features have emerged. As the effect of combined SVD imaging features becomes clearer, a key role for quantitative imaging biomarkers to determine sub-visible tissue damage, subtle abnormalities visible at high-field strength MRI, and lesion-symptom patterns, is also apparent. Together with rapidly emerging machine learning methods, these metrics can more comprehensively capture the effect of SVD on the brain than the structural MRI features alone and serve as intermediary outcomes in clinical trials and future routine practice. Using a similar approach to that adopted in STRIVE-1, we updated the guidance on neuroimaging of vascular changes in studies of ageing and neurodegeneration to create STRIVE-2.

Published
2023

16. Cognitive recovery after stroke

Author

Biessels, G.J., Kort, P.L.M. de, Aben, Hugo Paul, Biessels, G.J., Kort, P.L.M. de, and Aben, Hugo Paul

Published
2022

17. Framework for Clinical Trials in Cerebral Small Vessel Disease (FINESSE): A Review

Author

Markus, H.S., Flier, W.M. van der, Smith, E.E., Bath, P., Biessels, G.J., Briceno, E., Brodtman, A., Chabriat, H., Chen, C, Leeuw, F.E. de, Egle, M., Ganesh, A., Georgakis, M.K., Gottesman, R.F., Kwon, S., Launer, L., Mok, V., O'Brien, J., Ottenhoff, L., Pendlebury, S., Richard, E., Sachdev, P., Schmidt, R., Springer, M., Tiedt, S., Wardlaw, J.M., Verdelho, A., Webb, A., Werring, D., Duering, M., Levine, D., Dichgans, M., Markus, H.S., Flier, W.M. van der, Smith, E.E., Bath, P., Biessels, G.J., Briceno, E., Brodtman, A., Chabriat, H., Chen, C, Leeuw, F.E. de, Egle, M., Ganesh, A., Georgakis, M.K., Gottesman, R.F., Kwon, S., Launer, L., Mok, V., O'Brien, J., Ottenhoff, L., Pendlebury, S., Richard, E., Sachdev, P., Schmidt, R., Springer, M., Tiedt, S., Wardlaw, J.M., Verdelho, A., Webb, A., Werring, D., Duering, M., Levine, D., and Dichgans, M.

Abstract

Item does not contain fulltext, IMPORTANCE: Cerebral small vessel disease (SVD) causes a quarter of strokes and is the most common pathology underlying vascular cognitive impairment and dementia. An important step to developing new treatments is better trial methodology. Disease mechanisms in SVD differ from other stroke etiologies; therefore, treatments need to be evaluated in cohorts in which SVD has been well characterized. Furthermore, SVD itself can be caused by a number of different pathologies, the most common of which are arteriosclerosis and cerebral amyloid angiopathy. To date, there have been few sufficiently powered high-quality randomized clinical trials in SVD, and inconsistent trial methodology has made interpretation of some findings difficult. OBSERVATIONS: To address these issues and develop guidelines for optimizing design of clinical trials in SVD, the Framework for Clinical Trials in Cerebral Small Vessel Disease (FINESSE) was created under the auspices of the International Society of Vascular Behavioral and Cognitive Disorders. Experts in relevant aspects of SVD trial methodology were convened, and a structured Delphi consensus process was used to develop recommendations. Areas in which recommendations were developed included optimal choice of study populations, choice of clinical end points, use of brain imaging as a surrogate outcome measure, use of circulating biomarkers for participant selection and as surrogate markers, novel trial designs, and prioritization of therapeutic agents using genetic data via Mendelian randomization. CONCLUSIONS AND RELEVANCE: The FINESSE provides recommendations for trial design in SVD for which there are currently few effective treatments. However, new insights into understanding disease pathogenesis, particularly from recent genetic studies, provide novel pathways that could be therapeutically targeted. In addition, whether other currently available cardiovascular interventions are specifically effective in SVD, as opposed to other subtypes

Published
2022

20. New insights into the genetic etiology of Alzheimer's disease and related dementias

Author

Bellenguez, C. Küçükali, F. Jansen, I.E. Kleineidam, L. Moreno-Grau, S. Amin, N. Naj, A.C. Campos-Martin, R. Grenier-Boley, B. Andrade, V. Holmans, P.A. Boland, A. Damotte, V. van der Lee, S.J. Costa, M.R. Kuulasmaa, T. Yang, Q. de Rojas, I. Bis, J.C. Yaqub, A. Prokic, I. Chapuis, J. Ahmad, S. Giedraitis, V. Aarsland, D. Garcia-Gonzalez, P. Abdelnour, C. Alarcón-Martín, E. Alcolea, D. Alegret, M. Alvarez, I. Álvarez, V. Armstrong, N.J. Tsolaki, A. Antúnez, C. Appollonio, I. Arcaro, M. Archetti, S. Pastor, A.A. Arosio, B. Athanasiu, L. Bailly, H. Banaj, N. Baquero, M. Barral, S. Beiser, A. Pastor, A.B. Below, J.E. Benchek, P. Benussi, L. Berr, C. Besse, C. Bessi, V. Binetti, G. Bizarro, A. Blesa, R. Boada, M. Boerwinkle, E. Borroni, B. Boschi, S. Bossù, P. Bråthen, G. Bressler, J. Bresner, C. Brodaty, H. Brookes, K.J. Brusco, L.I. Buiza-Rueda, D. Bûrger, K. Burholt, V. Bush, W.S. Calero, M. Cantwell, L.B. Chene, G. Chung, J. Cuccaro, M.L. Carracedo, Á. Cecchetti, R. Cervera-Carles, L. Charbonnier, C. Chen, H.-H. Chillotti, C. Ciccone, S. Claassen, J.A.H.R. Clark, C. Conti, E. Corma-Gómez, A. Costantini, E. Custodero, C. Daian, D. Dalmasso, M.C. Daniele, A. Dardiotis, E. Dartigues, J.-F. de Deyn, P.P. de Paiva Lopes, K. de Witte, L.D. Debette, S. Deckert, J. Del Ser, T. Denning, N. DeStefano, A. Dichgans, M. Diehl-Schmid, J. Diez-Fairen, M. Rossi, P.D. Djurovic, S. Duron, E. Düzel, E. Dufouil, C. Eiriksdottir, G. Engelborghs, S. Escott-Price, V. Espinosa, A. Ewers, M. Faber, K.M. Fabrizio, T. Nielsen, S.F. Fardo, D.W. Farotti, L. Fenoglio, C. Fernández-Fuertes, M. Ferrari, R. Ferreira, C.B. Ferri, E. Fin, B. Fischer, P. Fladby, T. Fließbach, K. Fongang, B. Fornage, M. Fortea, J. Foroud, T.M. Fostinelli, S. Fox, N.C. Franco-Macías, E. Bullido, M.J. Frank-García, A. Froelich, L. Fulton-Howard, B. Galimberti, D. García-Alberca, J.M. García-González, P. Garcia-Madrona, S. Garcia-Ribas, G. Ghidoni, R. Giegling, I. Giorgio, G. Goate, A.M. Goldhardt, O. Gomez-Fonseca, D. González-Pérez, A. Graff, C. Grande, G. Green, E. Grimmer, T. Grünblatt, E. Grunin, M. Gudnason, V. Guetta-Baranes, T. Haapasalo, A. Hadjigeorgiou, G. Haines, J.L. Hamilton-Nelson, K.L. Hampel, H. Hanon, O. Hardy, J. Hartmann, A.M. Hausner, L. Harwood, J. Heilmann-Heimbach, S. Helisalmi, S. Heneka, M.T. Hernández, I. Herrmann, M.J. Hoffmann, P. Holmes, C. Holstege, H. Vilas, R.H. Hulsman, M. Humphrey, J. Biessels, G.J. Jian, X. Johansson, C. Jun, G.R. Kastumata, Y. Kauwe, J. Kehoe, P.G. Kilander, L. Ståhlbom, A.K. Kivipelto, M. Koivisto, A. Kornhuber, J. Kosmidis, M.H. Kukull, W.A. Kuksa, P.P. Kunkle, B.W. Kuzma, A.B. Lage, C. Laukka, E.J. Launer, L. Lauria, A. Lee, C.-Y. Lehtisalo, J. Lerch, O. Lleó, A. Longstreth, W., Jr Lopez, O. de Munain, A.L. Love, S. Löwemark, M. Luckcuck, L. Lunetta, K.L. Ma, Y. Macías, J. MacLeod, C.A. Maier, W. Mangialasche, F. Spallazzi, M. Marquié, M. Marshall, R. Martin, E.R. Montes, A.M. Rodríguez, C.M. Masullo, C. Mayeux, R. Mead, S. Mecocci, P. Medina, M. Meggy, A. Mehrabian, S. Mendoza, S. Menéndez-González, M. Mir, P. Moebus, S. Mol, M. Molina-Porcel, L. Montrreal, L. Morelli, L. Moreno, F. Morgan, K. Mosley, T. Nöthen, M.M. Muchnik, C. Mukherjee, S. Nacmias, B. Ngandu, T. Nicolas, G. Nordestgaard, B.G. Olaso, R. Orellana, A. Orsini, M. Ortega, G. Padovani, A. Paolo, C. Papenberg, G. Parnetti, L. Pasquier, F. Pastor, P. Peloso, G. Pérez-Cordón, A. Pérez-Tur, J. Pericard, P. Peters, O. Pijnenburg, Y.A.L. Pineda, J.A. Piñol-Ripoll, G. Pisanu, C. Polak, T. Popp, J. Posthuma, D. Priller, J. Puerta, R. Quenez, O. Quintela, I. Thomassen, J.Q. Rábano, A. Rainero, I. Rajabli, F. Ramakers, I. Real, L.M. Reinders, M.J.T. Reitz, C. Reyes-Dumeyer, D. Ridge, P. Riedel-Heller, S. Riederer, P. Roberto, N. Rodriguez-Rodriguez, E. Rongve, A. Allende, I.R. Rosende-Roca, M. Royo, J.L. Rubino, E. Rujescu, D. Sáez, M.E. Sakka, P. Saltvedt, I. Sanabria, Á. Sánchez-Arjona, M.B. Sanchez-Garcia, F. Juan, P.S. Sánchez-Valle, R. Sando, S.B. Sarnowski, C. Satizabal, C.L. Scamosci, M. Scarmeas, N. Scarpini, E. Scheltens, P. Scherbaum, N. Scherer, M. Schmid, M. Schneider, A. Schott, J.M. Selbæk, G. Seripa, D. Serrano, M. Sha, J. Shadrin, A.A. Skrobot, O. Slifer, S. Snijders, G.J.L. Soininen, H. Solfrizzi, V. Solomon, A. Song, Y. Sorbi, S. Sotolongo-Grau, O. Spalletta, G. Spottke, A. Squassina, A. Stordal, E. Tartan, J.P. Tárraga, L. Tesí, N. Thalamuthu, A. Thomas, T. Tosto, G. Traykov, L. Tremolizzo, L. Tybjærg-Hansen, A. Uitterlinden, A. Ullgren, A. Ulstein, I. Valero, S. Valladares, O. Broeckhoven, C.V. Vance, J. Vardarajan, B.N. van der Lugt, A. Dongen, J.V. van Rooij, J. van Swieten, J. Vandenberghe, R. Verhey, F. Vidal, J.-S. Vogelgsang, J. Vyhnalek, M. Wagner, M. Wallon, D. Wang, L.-S. Wang, R. Weinhold, L. Wiltfang, J. Windle, G. Woods, B. Yannakoulia, M. Zare, H. Zhao, Y. Zhang, X. Zhu, C. Zulaica, M. Farrer, L.A. Psaty, B.M. Ghanbari, M. Raj, T. Sachdev, P. Mather, K. Jessen, F. Ikram, M.A. de Mendonça, A. Hort, J. Tsolaki, M. Pericak-Vance, M.A. Amouyel, P. Williams, J. Frikke-Schmidt, R. Clarimon, J. Deleuze, J.-F. Rossi, G. Seshadri, S. Andreassen, O.A. Ingelsson, M. Hiltunen, M. Sleegers, K. Schellenberg, G.D. van Duijn, C.M. Sims, R. van der Flier, W.M. Ruiz, A. Ramirez, A. Lambert, J.-C. EADB GR@ACE DEGESCO EADI GERAD Demgene FinnGen ADGC CHARGE

Abstract

Characterization of the genetic landscape of Alzheimer's disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/'proxy' AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele. © 2022. The Author(s).

Published
2022

21. Non-Invasive Assessment of Damping of Blood Flow Velocity Pulsatility in Cerebral Arteries With MRI

Author

Arts, T., Onkenhout, L.P., Amier, R.P., Geest, R. van der, Harten, T. van, Kappelle, J., Kuipers, S., Osch, M.J.P. van, Bavel, E.T. van, Biessels, G.J., Zwanenburg, J.J.M., Heart-Brain Connection Consortium, Biomedical Engineering and Physics, ACS - Microcirculation, and ANS - Neurovascular Disorders

Subjects
Male, Mean arterial pressure, medicine.medical_specialty, cerebral perforating arteries, Cerebral arteries, Pulse Wave Analysis, 030204 cardiovascular system & hematology, 03 medical and health sciences, Vascular Stiffness, 0302 clinical medicine, medicine.artery, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, Pulse wave velocity, Aged, Retrospective Studies, Aorta, damping, business.industry, velocity pulsatility, Blood flow, Cerebral Arteries, Magnetic Resonance Imaging, Pulse pressure, Perforating arteries, Middle cerebral artery, Cardiology, Female, business, Blood Flow Velocity, 030217 neurology & neurosurgery, MRI
Abstract

Background: Damping of heartbeat-induced pressure pulsations occurs in large arteries such as the aorta and extends to the small arteries and microcirculation. Since recently, 7 T MRI enables investigation of damping in the small cerebral arteries. Purpose: To investigate flow pulsatility damping between the first segment of the middle cerebral artery (M1) and the small perforating arteries using magnetic resonance imaging. Study Type: Retrospective. Subjects: Thirty-eight participants (45% female) aged above 50 without history of heart failure, carotid occlusive disease, or cognitive impairment. Field Strength/Sequence: 3 T gradient echo (GE) T1-weighted images, spin-echo fluid-attenuated inversion recovery images, GE two-dimensional (2D) phase-contrast, and GE cine steady-state free precession images were acquired. At 7 T, T1-weighted images, GE quantitative-flow, and GE 2D phase-contrast images were acquired. Assessment: Velocity pulsatilities of the M1 and perforating arteries in the basal ganglia (BG) and semi-oval center (CSO) were measured. We used the damping index between the M1 and perforating arteries as a damping indicator (velocity pulsatilityM1/velocity pulsatilityCSO/BG). Left ventricular stroke volume (LVSV), mean arterial pressure (MAP), pulse pressure (PP), and aortic pulse wave velocity (PWV) were correlated with velocity pulsatility in the M1 and in perforating arteries, and with the damping index of the CSO and BG. Statistical Tests: Correlations of LVSV, MAP, PP, and PWV with velocity pulsatility in the M1 and small perforating arteries, and correlations with the damping indices were evaluated with linear regression analyses. Results: PP and PWV were significantly positively correlated to M1 velocity pulsatility. PWV was significantly negatively correlated to CSO velocity pulsatility, and PP was unrelated to CSO velocity pulsatility (P = 0.28). PP and PWV were uncorrelated to BG velocity pulsatility (P = 0.25; P = 0.68). PWV and PP were significantly positively correlated with the CSO damping index. Data Conclusion: Our study demonstrated a dynamic damping of velocity pulsatility between the M1 and small cerebral perforating arteries in relation to proximal stress. Level of Evidence: 4. Technical Efficacy: Stage 1.

Published
2021

22. How Do Different Forms of Vascular Brain Injury Relate to Cognition in a Memory Clinic Population

Author

Boomsma, J.M.F., Exalto, L.G., Barkhof, F., Berg, E. van den, Bresser, J. de, Heinen, R., Leeuwis, A.E., Prins, N.D., Scheltens, P., Weinstein, H.C., Flier, W.M. van der, Biessels, G.J., Benedictus, M.R., Bremer, J., Leijenaar, J., Tijms, B.M., Wattjes, M.P., Teunissen, C.E., Koene, T., Ferro, D.A., Frijns, C.J.M., Groeneveld, O.N., Kalsbeek, N.M. van, Verwer, J.H., Kuijf, H.J., Koek, H.L., TRACE-VCI Study Grp, Neurology, Immunology, Radiology and nuclear medicine, Amsterdam Neuroscience - Neurodegeneration, APH - Personalized Medicine, and APH - Methodology

Subjects
Male, 0301 basic medicine, medicine.medical_specialty, Population, Cerebral small vessel diseases, Neuroimaging, 03 medical and health sciences, Cognition, 0302 clinical medicine, Alzheimer Disease, Bayesian multivariate linear regression, Internal medicine, medicine, Journal Article, Humans, Cerebrovascular Trauma, education, Aged, education.field_of_study, medicine.diagnostic_test, Working memory, business.industry, cerebral small vessel disease, General Neuroscience, Memory clinic, Brain, Magnetic resonance imaging, cerebrovascular disorders, General Medicine, Neuropsychological test, Mental Status and Dementia Tests, Magnetic Resonance Imaging, Hyperintensity, Psychiatry and Mental health, Clinical Psychology, 030104 developmental biology, Cardiology, cognitive disorders, Biomarker (medicine), neuropsychological test, Female, Geriatrics and Gerontology, business, Biomarkers, 030217 neurology & neurosurgery
Abstract

Background: Memory clinic patients frequently present with different forms of vascular brain injury due to different etiologies, often co-occurring with Alzheimer's disease (AD) pathology.Objective: We studied how cognition was affected by different forms of vascular brain injury, possibly in interplay with AD pathology.Methods: We included 860 memory clinic patients with vascular brain injury on magnetic resonance imaging (MRI), receiving a standardized evaluation including cerebrospinal fluid (CSF) biomarker analyses (n = 541). The cognitive profile of patients with different forms of vascular brain injury on MRI (moderate/severe white matter hyperintensities (WMH) (n = 398), microbleeds (n = 368), lacunar (n = 188) and non-lacunar (n = 96) infarct(s), macrobleeds (n = 16)) was assessed by: 1) comparison of all these different forms of vascular brain injury with a reference group (patients with only mild WMH (n = 205) without other forms of vascular brain injury), using linear regression analyses also stratified for CSF biomarker AD profile and 2) multivariate linear regression analysis.Results: The cognitive profile was remarkably similar across groups. Compared to the reference group effect sizes on all domains were < 0.2 with narrow 95% confidence intervals, except for non-lacunar infarcts on information processing speed (age, sex, and education adjusted mean difference from reference group (beta: -0.26, p = 0.05). Results were similar in the presence (n = 300) or absence (n = 241) of biomarker co-occurring AD pathology. In multivariate linear regression analysis, higher WMH burden was related to a slightly worse performance on attention and executive functioning (beta: -0.08, p = 0.02) and working memory (beta: -0.08, p = 0.04).Conclusion: Although different forms of vascular brain injury have different etiologies and different patterns of cerebral damage, they show a largely similar cognitive profile in memory clinic patients regardless of co-occurring AD pathology.

Published
2019
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24. Cerebral cortical microinfarcts in patients with internal carotid artery occlusion

Author

Brink, H. van den, Ferro, D.A., Bresser, J. de, Bron, E.E., Onkenhout, L.P., Kappelle, L.J., Biessels, G.J., Heart-Brain Connection Consortium, and Radiology & Nuclear Medicine

Subjects
Carotid Artery Diseases, Male, 0301 basic medicine, medicine.medical_specialty, chemical and pharmacologic phenomena, complex mixtures, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, Humans, Medicine, Carotid Stenosis, In patient, Cognitive impairment, Aged, cerebral hemodynamic compromise, Cerebral hypoperfusion, business.industry, Original Articles, Cerebral blood flow, internal carotid artery occlusion, cerebrovascular disease, 030104 developmental biology, Neurology, Cerebrovascular Circulation, Cardiology, Female, Neurology (clinical), Internal carotid artery occlusion, Cardiology and Cardiovascular Medicine, business, microinfarct, Carotid Artery, Internal, 030217 neurology & neurosurgery
Abstract

Cerebral cortical microinfarcts (CMI) are small ischemic lesions that are associated with cognitive impairment and probably have multiple etiologies. Cerebral hypoperfusion has been proposed as a causal factor. We studied CMI in patients with internal carotid artery (ICA) occlusion, as a model for cerebral hemodynamic compromise. We included 95 patients with a complete ICA occlusion (age 66.2 ± 8.3, 22% female) and 125 reference participants (age 65.5 ± 7.4, 47% female). Participants underwent clinical, neuropsychological, and 3 T brain MRI assessment. CMI were more common in patients with an ICA occlusion (54%, median 2, range 1–33) than in the reference group (6%, median 0; range 1–7; OR 14.3; 95% CI 6.2–33.1; p

Published
2021

27. Efficacy and safety of two 5 day insulin dosing regimens to achieve strict glycaemic control in patients with acute ischaemic stroke

Author

Vriesendorp, T.M., Roos, Y.B., Kruyt, N.D., Biessels, G.J., Kappelle, L.J., Vermeulen, M., Holleman, F., DeVries, J.H., and Hoekstra, J.B.L.

Subjects
Stroke (Disease) -- Care and treatment, Stroke (Disease) -- Patient outcomes, Stroke (Disease) -- Research, Insulin -- Dosage and administration, Insulin -- Research, Blood sugar -- Control, Blood sugar -- Research, Health, Psychology and mental health
Published
2009

28. Cortical cerebral microinfarcts on 7T MRI: Risk factors, neuroimaging correlates and cognitive functioning - The Medea-7T study

Author

Zwartbol, M.H.T., Rissanen, I., Ghaznawi, R., Bresser, J. de, Kuijf, H.J., Blom, K., Witkamp, T.D., Koek, H.L., Biessels, G.J., Hendrikse, J., Geerlings, M.I., and UCC-SMART Study Grp

Subjects
cardiovascular risk factors, Brain Infarction, Male, Large vessel, Neuroimaging, Disease, 030204 cardiovascular system & hematology, Neuropsychological Tests, cognitive functioning, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Cognition, Memory, cerebrovascular disease, cognitive functioning, dementia, cardiovascular risk factors, Medicine, Humans, Cognitive skill, Aged, Netherlands, Aged, 80 and over, Cerebral Cortex, business.industry, Original Articles, Middle Aged, Magnetic Resonance Imaging, cerebrovascular disease, Stroke, Cerebrovascular Disorders, Microinfarcts, Neurology, Heart Disease Risk Factors, Ischemic Attack, Transient, Cerebrovascular Circulation, Dementia, Female, Neurology (clinical), Cardiology and Cardiovascular Medicine, business, Neuroscience, 030217 neurology & neurosurgery
Abstract

We determined the occurrence and association of cortical cerebral microinfarcts (CMIs) at 7 T MRI with risk factors, neuroimaging markers of small and large vessel disease, and cognitive functioning. Within the Medea-7T study, a diverse cohort of older persons with normal cognition, patients with vascular disease, and memory clinic patients, we included 386 participants (68 ± 9 years) with available 7 T and 1.5 T/3T brain MRI, and risk factor and neuropsychological data. CMIs were found in 10% of participants and were associated with older age (RR = 1.79 per +10 years, 95%CI 1.28–2.50), history of stroke or TIA (RR = 4.03, 95%CI 2.18–7.43), cortical infarcts (RR = 5.28, 95%CI 2.91–9.55), lacunes (RR = 5.66, 95%CI 2.85–11.27), cerebellar infarcts (RR = 2.73, 95%CI 1.27–5.84) and decreased cerebral blood flow (RR = 1.35 per −100 ml/min, 95%CI 1.00–1.83), after adjustment for age and sex. Furthermore, participants with >2 CMIs had 0.5 SD (95%CI 0.05–0.91) lower global cognitive performance, compared to participants without CMIs. Our results indicate that CMIs on 7 T MRI are observed in vascular and memory clinic patients with similar frequency, and are associated with older age, history of stroke or TIA, other brain infarcts, and poorer global cognitive functioning.

Published
2021
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29. High mean fasting glucose levels independently predict poor outcome and delayed cerebral ischaemia after aneurysmal subarachnoid haemorrhage

Author

Kruyt, N.D., Roos, Y.W.B.M., Dorhout Mees, S.M., van den Bergh, W.M., Algra, A., Rinkel, G.J.E., and Biessels, G.J.

Subjects
Subarachnoid hemorrhage -- Complications and side effects, Subarachnoid hemorrhage -- Patient outcomes, Subarachnoid hemorrhage -- Research, Hyperglycemia -- Diagnosis, Hyperglycemia -- Research, Blood sugar monitoring -- Research, Cerebral ischemia -- Diagnosis, Cerebral ischemia -- Research, Health risk assessment -- Research, Outcome and process assessment (Health Care) -- Research, Health, Psychology and mental health
Published
2008

30. Cerebral perfusion and the burden of small vessel disease in patients referred to a memory clinic

Author

Onkenhout, L., Appelmans, N., Kappelle, L.J., Koek, D., Exalto, L., Bresser, J. de, Biessels, G.J., and Utrecht VCI Study Grp

Subjects
Male, medicine.medical_specialty, Outpatient Clinics, Hospital, Perfusion Imaging, Cognition, Memory, Risk Factors, Internal medicine, medicine.artery, Cerebral perfusion, medicine, Basilar artery, Lacunes, Humans, Cognitive Dysfunction, Perivascular space, Cerebral perfusion pressure, Referral and Consultation, Aged, Aged, 80 and over, Enlarged perivascular spaces, Memory Disorders, business.industry, Memory clinic, Middle Aged, Magnetic Resonance Imaging, Hyperintensity, Small vessel disease, White matter hyperintesities, medicine.anatomical_structure, Neurology, Quartile, Cerebral blood flow, Cerebral Small Vessel Diseases, Cerebrovascular Circulation, Stroke, Lacunar, Cardiology, Etiology, cardiovascular system, Microbleeds, Female, Neurology (clinical), Cardiology and Cardiovascular Medicine, business, Blood Flow Velocity
Abstract

Background: Cerebral small vessel disease (SVD) lesions on MRI are common in patients with cognitive impairment. It has been suggested that cerebral hypoperfusion is involved in the etiology of these lesions. Objective: The aim of the study was to determine the relationship between cerebral blood flow (CBF) and SVD burden in patients referred to a memory clinic with SVD on MRI. Method: We included 132 memory clinic patients (mean age 73 ± 10, 56% male) with SVD on MRI. We excluded patients with large non-lacunar cortical infarcts. Global CBF (mL/min per 100 mL of brain tissue) was derived from 2-dimensional phase-contrast MRI focused on the internal carotid arteries and the basilar artery. SVD burden was defined as the sum of (each 1 point): white matter hyperintensities (WMHs) Fazekas 1 or more, lacunes, microbleeds (MBs), or enlarged perivascular spaces (PVS) presence, and each SVD feature separately. Linear regression analyses were performed to study the association between CBF and SVD burden, age- and sex-adjusted. Results: Median SVD burden score was 2, 36.4% of patients had MBs, 35.6% lacunar infarcts, 48.4% intermediate to severe enlarged PVS, and 57.6% a WMH Fazekas score 2 or more. Median WMH volume was 21.4 mL (25% quartile: 9.6 mL, 75% quartile: 32.5 mL). Mean CBF ± SD was 44.0 ± 11.9 mL/min per 100 mL brain. There was no relation between CBF and overall SVD burden (CBF difference per burden score point [95% CI]: −0.5 [−2.4; 1.4] mL/min/100 mL brain, p = 0.9). CBF did also not differ according to presence or absence or an high burden of any of the individual SVD features. Moreover, there was no significant relation between WMH volume and CBF (CBF difference per ml increase in WMH [95% CI] −0.6 [−1.5; 0.3] mL/min/100 mL brain p = 0.2). Conclusion: Global CBF was not related to overall SVD burden or with individual SVD features in this memory clinic cohort, indicating that in this setting these lesions were not primarily due to cerebral hypoperfusion.

Published
2020

34. Effects of linagliptin vs glimepiride on cognitive performance in type 2 diabetes: results of the randomised double-blind, active-controlled CAROLINA-COGNITION study

Author

Biessels, G.J. (Geert Jan), Verhagen, C. (Chloë), Janssen, J. (Jolien), Berg, E. (Esther) van den, Wallenstein, G. (Gudrun), Zinman, B. (Bernard), Espeland, M.A. (Mark A.), Johansen, O.E. (Odd Erik), Biessels, G.J. (Geert Jan), Verhagen, C. (Chloë), Janssen, J. (Jolien), Berg, E. (Esther) van den, Wallenstein, G. (Gudrun), Zinman, B. (Bernard), Espeland, M.A. (Mark A.), and Johansen, O.E. (Odd Erik)

Abstract

Aims/hypothesis: Type 2 diabetes, particularly with concomitant CVD, is associated with an increased risk of cognitive impairment. We assessed the effect on accelerated cognitive decline (ACD) of the DPP-4 inhibitor linagliptin vs the sulfonylurea glimepiride in individuals with type 2 diabetes. Methods: The CAROLINA-COGNITION study was part of the randomised, double-blind, active-controlled CAROLINA trial that evaluated the cardiovascular safety of linagliptin vs glimepiride in individuals with age ≥40 and ≤85 years and HbA1c 48–69 mmol/mol (6.5–8.5%) receiving standard care, excluding insulin therapy. Participants were randomised 1:1 using an interactive telephone- and web-based system and treatment assignment was determined by a computer-generated random sequence with stratification by center. The primary cognitive outcome was occurrence of ACD at end of follow-up, defined as a regression-based index score ≤16th percentile on either the Mini-Mental State Examination (MMSE) or a composite measure of attention and executive functioning, in participants with a baseline MMSE score ≥24. Prespecified additional analyses included effects on ACD at week 160, in subgroups (sex, age, race, ethnicity, depressive symptoms, cardiovascular risk, duration of type 2 diabetes, albuminuria), and absolute changes in cognitive performance. Participants, caregivers, and people involved in measurements, examinations or adjudication, were all masked to treatment assignment. Results: Of 6033 participants recruited from hospital and primary care sites, 3163 (38.0% female, mean age/diabetes duration 64/7.6 years, MMSE score 28.5, HbA1c 54 mmol/mol [7.1%]) represent the CAROLINA-COGNITION cohort. Over median 6.1 years, ACD occurred in 27.8% (449/1618, linagliptin) vs 27.6% (426/1545, glimepiride), OR 1.01 (95% CI 0.86, 1.18). Also, no differences in ACD were observed at week 160 (OR 1.07 [0.91, 1.25]), between treatments across subgroups, or for absolute cognitive changes. Conclusions/inte

Published
2021
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35. Strategic infarct locations for post-stroke cognitive impairment: a pooled analysis of individual patient data from 12 acute ischaemic stroke cohorts

Author

Weaver, N.A., Weaver, N.A., Kuijf, H.J., Aben, H.P., Abrigo, J., Bae, H.J., Barbay, M., Best, J.G., Bordet, R., Chappell, F.M., Chen, C.P.L.H., Dondaine, T., van der Giessen, R.S., Godefroy, O., Gyanwali, B., Hamilton, O.K.L., Hilal, S., Wajer, I.M.C.H., Kang, Y., Kappelle, L.J., Kim, B.J., Köhler, S., de Kort, P.L.M., Koudstaal, P.J., Kuchcinski, G., Lam, B.Y.K., Lee, B.C., Lee, K.J., Lim, J.S., Lopes, R., Makin, S.D.J., Mendyk, A.M., Mok, V.C.T., Oh, M.S., van Oostenbrugge, R.J., Roussel, M., Shi, L., Staals, J., Valdes-Hernandez, M.D., Venketasubramanian, N., Verhey, F.R.J., Wardlaw, J.M., Werring, D.J., Xin, X., Yu, K.H., van Zandvoort, M.J.E., Zhao, L., Biesbroek, J.M., Biessels, G.J., Weaver, N.A., Weaver, N.A., Kuijf, H.J., Aben, H.P., Abrigo, J., Bae, H.J., Barbay, M., Best, J.G., Bordet, R., Chappell, F.M., Chen, C.P.L.H., Dondaine, T., van der Giessen, R.S., Godefroy, O., Gyanwali, B., Hamilton, O.K.L., Hilal, S., Wajer, I.M.C.H., Kang, Y., Kappelle, L.J., Kim, B.J., Köhler, S., de Kort, P.L.M., Koudstaal, P.J., Kuchcinski, G., Lam, B.Y.K., Lee, B.C., Lee, K.J., Lim, J.S., Lopes, R., Makin, S.D.J., Mendyk, A.M., Mok, V.C.T., Oh, M.S., van Oostenbrugge, R.J., Roussel, M., Shi, L., Staals, J., Valdes-Hernandez, M.D., Venketasubramanian, N., Verhey, F.R.J., Wardlaw, J.M., Werring, D.J., Xin, X., Yu, K.H., van Zandvoort, M.J.E., Zhao, L., Biesbroek, J.M., and Biessels, G.J.

Abstract

Background Post-stroke cognitive impairment (PSCI) occurs in approximately half of people in the first year after stroke. Infarct location is a potential determinant of PSCI, but a comprehensive map of strategic infarct locations predictive of PSCI is unavailable. We aimed to identify infarct locations most strongly predictive of PSCI after acute ischaemic stroke and use this information to develop a prediction model. Methods In this large-scale multicohort lesion-symptom mapping study, we pooled and harmonised individual patient data from 12 cohorts through the Meta-analyses on Strategic Lesion Locations for Vascular Cognitive Impairment using Lesion-Symptom Mapping (Meta VCI Map) consortium. The identified cohorts (as of Jan 1, 2019) comprised patients with acute symptomatic infarcts on CT or MRI (with available infarct segmentations) and a cognitive assessment up to 15 months after acute ischaemic stroke onset. PSCI was defined as performance lower than the fifth percentile of local normative data, on at least one cognitive domain on a multidomain neuropsychological assessment or on the Montreal Cognitive Assessment. Voxel-based lesion-symptom mapping (VLSM) was used to calculate voxel-wise odds ratios (ORs) for PSCI that were mapped onto a three-dimensional brain template to visualise PSCI risk per location. For the prediction model of PSCI risk, a location impact score on a 5-point scale was derived from the VLSM results on the basis of the mean voxel-wise coefficient (ln[OR]) within each patient's infarct. We did combined internal-external validation by leave-one-cohort-out cross-validation for all 12 cohorts using logistic regression. Predictive performance of a univariable model with only the location impact score was compared with a multivariable model with addition of other clinical PSCI predictors (age, sex, education, time interval between stroke onset and cognitive assessment, history of stroke, and total infarct volume). Testing of visual ratings was d

Published
2021

36. Progress toward standardized diagnosis of vascular cognitive impairment

Author

Skrobot, Olivia A., Black, Sandra E., Chen, Christopher, DeCarli, Charles, Erkinjuntti, Timo, Ford, Gary A., Kalaria, Rajesh N., O'Brien, John, Pantoni, Leonardo, Pasquier, Florence, Roman, Gustavo C., Wallin, Anders, Sachdev, Perminder, Skoog, Ingmar, Ben-Shlomo, Yoav, Passmore, Anthony P., Love, Seth, Kehoe, Patrick G., Taragano, F.E., Kril, J., Cavalieri, M., Jellinger, K.A., Kovacs, G.G., Engelborghs, S., Lafosse, C., Bertolucci, P.H., Brucki, S., Caramelli, P., de Toledo Ferraz Alves, T.C., Bocti, C., Fulop, T., Hogan, D.B., Hsiung, G.R., Kirk, A., Leach, L., Robillard, A., Sahlas, D.J., Guo, Q., Tian, J., Hokkanen, L., Jokinen, H., Benisty, S., Deramecourt, V., Hauw, J., Lenoir, H., Tsatali, M., Tsolaki, M., Sundar, U., Coen, R.F., Korczyn, A.D., Altieri, M., Baldereschi, M., Caltagirone, C., Caravaglios, G., Di Carlo, A., Di Piero, V., Gainotti, G., Galluzzi, S., Logroscino, G., Mecocci, P., Moretti, D.V., Padovani, A., Fukui, T., Ihara, M., Mizuno, T., Kim, S.Y., Akinyemi, R., Baiyewu, O., Ogunniyi, A., Szczudlik, A., Bastos-Leite, A.J., Firmino, H., Massano, J., Verdelho, A., Kruglov, L.S., Ikram, M.K., Kandiah, N., Arana, E., Barroso-Ribal, J., Calatayud, T., Cruz-Jentoft, A.J., López-Pousa, S., Martinez-Lage, P., Mataro, M., Börjesson-Hanson, A., Englund, E., Laukka, E.J., Qiu, C., Viitanen, M., Biessels, G.J., de Leeuw, F.-E., den Heijer, T., Exalto, L.G., Kappelle, L.J., Prins, N.D., Richard, E., Schmand, B., van den Berg, E., van der Flier, W.M., Bilgic, B., Allan, L.M., Archer, J., Attems, J., Bayer, A., Blackburn, D., Brayne, C., Bullock, R., Connelly, P.J., Farrant, A., Fish, M., Harkness, K., Ince, P.G., Langhorne, Peter, Mann, J., Matthews, F.E., Mayer, P., Pendlebury, S.T., Perneczky, R., Peters, R., Smithard, D., Stephan, B.C., Swartz, J.E., Todd, S., Werring, D.J., Wijayasiri, S.N., Wilcock, G., Zamboni, G., Au, R., Borson, S., Bozoki, A., Browndyke, J.N., Corrada, M.M., Crane, P.K., Diniz, B.S., Etcher, L., Fillit, H., Greenberg, S.M., Grinberg, L.T., Hurt, S.W., Lamar, M., Mielke, M., Ott, B.R., Perry, G., Powers, W.J., Ramos-Estebanez, C., Reed, B., Roberts, R.O., Romero, J.R., Saykin, A.J., Seshadri, S., Silbert, L., Stern, Y., Zarow, C., Epidemiology, Neurology, General Practice, VICCCS Grp, Clinicum, Neurologian yksikkö, Department of Neurosciences, University of Helsinki, Department of Physics, HUS Neurocenter, Amsterdam Neuroscience - Neurodegeneration, APH - Personalized Medicine, and APH - Methodology

Subjects
0301 basic medicine, Neurology, Delphi Technique, Epidemiology, Delphi method, Delphi, Vascular dementia, 3124 Neurology and psychiatry, 0302 clinical medicine, SMALL VESSEL DISEASE, Neuropsychological assessment, Stroke, medicine.diagnostic_test, Health Policy, Neuropsychology, CLINICAL-CRITERIA, Brain, Cognition, 3. Good health, ALZHEIMERS-DISEASE, Settore MED/26 - NEUROLOGIA, Psychiatry and Mental health, Vascular cognitive impairment, NINDS-AIREN, ACUTE STROKE, STROKE, Clinical psychology, medicine.medical_specialty, Clinical Neurology, MINI-MENTAL-STATE, Guidelines, ATROPHY, 03 medical and health sciences, Cellular and Molecular Neuroscience, WHITE-MATTER CHANGES, Developmental Neuroscience, Vascular, medicine, Journal Article, Dementia, Humans, Intensive care medicine, business.industry, Dementia, Vascular, 3112 Neurosciences, medicine.disease, Criteria, 030104 developmental biology, consensus, Consensus, Neurology (clinical), Geriatrics and Gerontology, Psychiatry and Mental Health, CEREBRAL-BLOOD-FLOW, Human medicine, business, 030217 neurology & neurosurgery
Abstract

Hanna Jokinen tutkimusryhmän jäsenenä (VICCCS Grp) Introduction: Progress in understanding and management of vascular cognitive impairment (VCI) has been hampered by lack of consensus on diagnosis, reflecting the use of multiple different assessment protocols. A large multinational group of clinicians and researchers participated in a two-phase Vascular Impairment of Cognition Classification Consensus Study (VICCCS) to agree on principles (VICCCS-1) and protocols (VICCCS-2) for diagnosis of VCI. We present VICCCS-2. Methods: We used VICCCS-1 principles and published diagnostic guidelines as points of reference for an online Delphi survey aimed at achieving consensus on clinical diagnosis of VCI. Results: Six survey rounds comprising 65-79 participants agreed guidelines for diagnosis of VICCCS-revised mild and major forms of VCI and endorsed the National Institute of Neurological Disorders-Canadian Stroke Network neuropsychological assessment protocols and recommendations for imaging. Discussion: The VICCCS-2 suggests standardized use of the National Institute of Neurological Disorders-Canadian Stroke Network recommendations on neuropsychological and imaging assessment for diagnosis of VCI so as to promote research collaboration. (C) 2017 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Published
2018
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38. Small vessel disease lesion type and brain atrophy

Author

Heinen, R., Groeneveld, O.N., Barkhof, F., Bresser, J. de, Exalto, L.G., Kuijf, H.J., Prins, N.D., Scheltens, P., Flier, W.M. van der, Biessels, G.J., and TRACE-VCI Study Grp

Subjects
cerebral small vessel disease, cerebral microbleeds, magnetic resonance imaging, Alzheimer's disease, white matter hyperintensities, vascular cognitive impairment, brain atrophy, lacunes
Abstract

IntroductionIt is unknown whether different types of small vessel disease (SVD), differentially relate to brain atrophy and if co-occurring Alzheimer's disease pathology affects this relation.MethodsIn 725 memory clinic patients with SVD (mean age 67 +/- 8 years, 48% female) we compared brain volumes of those with moderate/severe white matter hyperintensities (WMHs; n = 326), lacunes (n = 132) and cerebral microbleeds (n = 321) to a reference group with mild WMHs (n = 197), also considering cerebrospinal fluid (CSF) amyloid status in a subset of patients (n = 488).ResultsWMHs and lacunes, but not cerebral microbleeds, were associated with smaller gray matter (GM) volumes. In analyses stratified by CSF amyloid status, WMHs and lacunes were associated with smaller total brain and GM volumes only in amyloid-negative patients. SVD-related atrophy was most evident in frontal (cortical) GM, again predominantly in amyloid-negative patients.DiscussionAmyloid status modifies the differential relation between SVD lesion type and brain atrophy in memory clinic patients.

Published
2020

39. Nonfocal Transient Neurological Attacks Are Associated With Cerebral Small Vessel Disease

Author

Oudeman, E.A., Greving, J.P., Berg-Vos, R.M. van den, Biessels, G.J., Bron, E.E., Oostenbrugge, R. van, Bresser, J. de, Kappelle, L.J., Heart-Brain Connection Consortium, Medical Informatics, Radiology & Nuclear Medicine, RS: Carim - B05 Cerebral small vessel disease, MUMC+: MA Neurologie (3), Klinische Neurowetenschappen, RS: CARIM - R3.03 - Cerebral small vessel disease, and MUMC+: MA Med Staf Spec Neurologie (9)

Subjects
Male, medicine.medical_specialty, SYMPTOMS, Ischemia, Clinical Neurology, Vision Disorders, Amnesia, Unconsciousness, Dizziness, neurologic manifestations, Paraparesis, Internal medicine, medicine, Dementia, odds ratio, Humans, Advanced and Specialised Nursing, Paresthesia, Confusion, Stroke, Gait Disorders, Neurologic, ISCHEMIC ATTACK, Aged, Advanced and Specialized Nursing, RISK, business.industry, ABNORMALITIES, Odds ratio, Recovery of Function, Middle Aged, medicine.disease, Magnetic Resonance Imaging, White Matter, Hyperintensity, Logistic Models, Ischemic Attack, Transient, Heart failure, Case-Control Studies, Cerebral Small Vessel Diseases, Cardiology, Female, Neurology (clinical), medicine.symptom, business, Cardiology and Cardiovascular Medicine, STROKE
Abstract

Background and Purpose— Nonfocal transient neurological attacks (TNAs), such as unsteadiness, bilateral weakness, or confusion, are associated with an increased risk of stroke and dementia. Cerebral ischemia plays a role in their pathogenesis, but the precise mechanisms are unknown. We hypothesized that cerebral small vessel disease is involved in the pathogenesis of TNAs and assessed the relation between TNAs and manifestations of cerebral small vessel disease on magnetic resonance imaging. Methods— We included participants from the HBC (Heart-Brain Connection) study. In this study, hemodynamic and cardiovascular contributions to cognitive impairment have been studied in patients with heart failure, carotid artery occlusion, or possible vascular cognitive impairment, as well as in a reference group. We excluded participants with a history of stroke or transient ischemic attacks. The occurrence of the following 8 TNAs was assessed with a standardized interview: unconsciousness, confusion, amnesia, unsteadiness, bilateral leg weakness, blurred vision, nonrotatory dizziness, and paresthesias. The occurrence of TNAs was related to the presence of lacunes or white matter hyperintensities (Fazekas score, ≥2; early confluent or confluent lesions) in logistic regression analysis, adjusted for age, sex, and hypertension. Results— Of 304 participants (60% men; mean age, 67±9 years), 63 participants (21%) experienced ≥1 TNAs. Lacunes and early confluent or confluent white matter hyperintensities were more common in participants with TNAs than in participants without TNAs (35% versus 20%; adjusted odds ratio, 2.32 [95% CI, 1.22–4.40] and 48% versus 27%; adjusted odds ratio, 2.65 [95% CI, 1.44–4.90], respectively). Conclusions— In our study, TNAs are associated with the presence of lacunes and early confluent or confluent white matter hyperintensities of presumed vascular origin, which indicates that cerebral small vessel disease might play a role in the pathogenesis of TNAs.

Published
2019

40. Hemoglobin and anemia in relation to dementia risk and accompanying changes on brain MRI

Author

Wolters, F.J., Zonneveld, H.I., Licher, S., Cremers, L.G.M., Ikram, M.K., Koudstaal, P.J., Vernooij, M.W., Ikram, M.A., Buchem, M.A. van, Biessels, G.J., Rocca, H.P.B. la, Craen, A.J. de, Flier, W.M. van der, Kappelle, L.J., Mooijaart, S.P., Niessen, W., Oostenbrugge, R. van, Roos, A. de, Rossum, A.C. van, Daemen, M.J., Heart Brain Connection, Epidemiology, Neurology, Radiology & Nuclear Medicine, Cardiologie, MUMC+: MA Med Staf Spec Cardiologie (9), RS: Carim - H02 Cardiomyopathy, RS: CARIM - R2.02 - Cardiomyopathy, MUMC+: MA Neurologie (3), Klinische Neurowetenschappen, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, RS: Carim - B05 Cerebral small vessel disease, and RS: CARIM - R3.03 - Cerebral small vessel disease

Subjects
Male, Serum, Comorbidity, Rotterdam Study, Hemoglobins, Risk Factors, Neural Pathways, HYPERVISCOSITY, GENERAL-POPULATION, education.field_of_study, Hazard ratio, Brain, Anemia, ASSOCIATION, Middle Aged, Magnetic Resonance Imaging, White Matter, PREVALENCE, COMMUNITY, CARDIOVASCULAR-DISEASE, Female, Alzheimer's disease, HEMATOCRIT, Brain Infarction, medicine.medical_specialty, Population, Neuroimaging, Article, Alzheimer Disease, Internal medicine, medicine, Dementia, Humans, Cerebral perfusion pressure, education, OLDER, business.industry, medicine.disease, ROTTERDAM, CEREBRAL-BLOOD-FLOW, Neurology (clinical), Hemoglobin, business
Abstract

ObjectiveTo determine the long-term association of hemoglobin levels and anemia with risk of dementia, and explore underlying substrates on brain MRI in the general population.MethodsSerum hemoglobin was measured in 12,305 participants without dementia of the population-based Rotterdam Study (mean age 64.6 years, 57.7% women). We determined risk of dementia and Alzheimer disease (AD) (until 2016) in relation to hemoglobin and anemia. Among 5,267 participants without dementia with brain MRI, we assessed hemoglobin in relation to vascular brain disease, structural connectivity, and global cerebral perfusion.ResultsDuring a mean follow-up of 12.1 years, 1,520 individuals developed dementia, 1,194 of whom had AD. We observed a U-shaped association between hemoglobin levels and dementia (p = 0.005), such that both low and high hemoglobin levels were associated with increased dementia risk (hazard ratio [95% confidence interval (CI)], lowest vs middle quintile 1.29 [1.09–1.52]; highest vs middle quintile 1.20 [1.00–1.44]). Overall prevalence of anemia was 6.1%, and anemia was associated with a 34% increased risk of dementia (95% CI 11%–62%) and 41% (15%–74%) for AD. Among individuals without dementia with brain MRI, similar U-shaped associations were seen of hemoglobin with white matter hyperintensity volume (p = 0.03), and structural connectivity (for mean diffusivity, p < 0.0001), but not with presence of cortical and lacunar infarcts. Cerebral microbleeds were more common with anemia. Hemoglobin levels inversely correlated to cerebral perfusion (p < 0.0001).ConclusionLow and high levels of hemoglobin are associated with an increased risk of dementia, including AD, which may relate to differences in white matter integrity and cerebral perfusion.

Published
2019

41. Circle of Willis variations in migraine patients with ischemic stroke

Author

Hamming, A.M., Walderveen, M.A.A. van, Mulder, I.A., Schaaf, I.C. van der, Kappelle, L.J., Velthuis, B.K., Ferrari, M.D., Terwindt, G.M., Visser, M.C., Schonewille, W., Algra, A., Wermer, M.J.H., Majoie, C.B., Roos, Y.B., Duijm, L.E., Keizer, K., Lugt, A. van der, Dippel, D.W., Droogh-de Greeve, K.E., Bienfait, H.P., Nijeholt, G.J.L.A., Boiten, J., Duyndam, D., Kwa, V.I., Meijer, F.J., Dijk, E.J. van, Kesselring, F.O., Hofmeijer, J., Vos, J.A., Rooij, W.J. van, Kort, P.L. de, Pleiter, C.C., Bakker, S.L., Bot, J., Dankbaar, J.W., Mali, W.P., Seeters, T. van, Horsch, A.D., Niesten, J.M., Biessels, G.J., Luitse, M.J., Graaf, Y. van der, Dutch Acute Stroke Study, Amsterdam Neuroscience - Neurovascular Disorders, and Neurology

Subjects
Male, Computed Tomography Angiography, Brain Ischemia, Behavioral Neuroscience, 0302 clinical medicine, Risk Factors, Prevalence, Medicine, migraine, Prospective Studies, Non-U.S. Gov't, Circle of Willis/diagnostic imaging, circle of Willis, humans, Stroke, Original Research, Computed Tomography Angiography/methods, neuroimaging, Research Support, Non-U.S. Gov't, 05 social sciences, Brain, Middle Aged, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], Brain Ischemia/diagnosis, Female, Rare cancers Radboud Institute for Health Sciences [Radboudumc 9], Adult, medicine.medical_specialty, Migraine Disorders, Research Support, Brain/blood supply, 050105 experimental psychology, 03 medical and health sciences, All institutes and research themes of the Radboud University Medical Center, medicine.artery, Internal medicine, Journal Article, Anterior cerebral artery, Humans, 0501 psychology and cognitive sciences, Migraine Disorders/complications, Posterior communicating artery, Risk factor, Aged, Analysis of Variance, business.industry, computed tomography, Odds ratio, medicine.disease, Migraine, International Classification of Headache Disorders, strokes, business, 030217 neurology & neurosurgery, Stroke/complications, Circle of Willis
Abstract

Objectives: Migraine is a risk factor for stroke, which might be explained by a higher prevalence in anatomical variants in the circle of Willis (CoW). Here, we compared the presence of CoW variants in patients with stroke with and without migraine. Materials and Methods: Participants were recruited from the prospective Dutch acute Stroke Study. All participants underwent CT angiography on admission. Lifetime migraine history was assessed with a screening questionnaire and confirmed by an interview based on International Classification of Headache Disorders criteria. The CoW was assessed for incompleteness/hypoplasia (any segment 1/3), and for posterior communicating artery (Pcom) dominance (Pcom–P1 difference > 1/3). Odds ratios with adjustments for age and sex (aOR) were calculated with logistic regression. Results: We included 646 participants with stroke, of whom 52 had a history of migraine. Of these, 45 (87%) had an incomplete or hypoplastic CoW versus 506 (85%) of the 594 participants without migraine (aOR: 1.47; 95% CI: 0.63–3.44). There were no differences between participants with and without migraine in variations of the anterior or posterior CoW, anterior cerebral artery asymmetry (aOR: 0.86; 95% CI: 0.43–1.74), or Pcom dominance (aOR: 0.64; 95% CI: 0.32–1.30). There were no differences in CoW variations between migraine patients with or without aura. Conclusion: We found no significant difference in the completeness of the CoW in acute stroke patients with migraine compared to those without.

Published
2019
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43. Diabetes-specific dementia risk score (DSDRS) predicts cognitive performance in patients with type 2 diabetes at high cardio-renal risk

Author

Verhagen, C. (Chloë), Janssen, J. (Jolien), Exalto, L.G. (Lieza G.), Berg, E. (Esther) van den, Johansen, O.E. (Odd Erik), Biessels, G.J. (Geert Jan), Verhagen, C. (Chloë), Janssen, J. (Jolien), Exalto, L.G. (Lieza G.), Berg, E. (Esther) van den, Johansen, O.E. (Odd Erik), and Biessels, G.J. (Geert Jan)

Abstract

Aim: To investigate the relationship between the diabetes-specific dementia risk score (DSDRS) and concurrent and

Published
2020
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44. The Impact of Strategic White Matter Hyperintensity Lesion Location on Language

Author

Hilal, S. (Saima), Biesbroek, J.M. (J. Matthijs), Vrooman, H.A. (Henri), Chong, E. (Eddie), Kuijf, H.J. (Hugo J.), Venketasubramanian, N. (Narayanaswamy), Cheng, C.-Y. (Ching-Yu), Wong, T.Y. (Tien Yin), Biessels, G.J. (Geert Jan), Chen, C. (Christopher), Hilal, S. (Saima), Biesbroek, J.M. (J. Matthijs), Vrooman, H.A. (Henri), Chong, E. (Eddie), Kuijf, H.J. (Hugo J.), Venketasubramanian, N. (Narayanaswamy), Cheng, C.-Y. (Ching-Yu), Wong, T.Y. (Tien Yin), Biessels, G.J. (Geert Jan), and Chen, C. (Christopher)

Abstract

Objective: The impact of white matter hyperintensities (WMH) on language possibly depends on lesion location through disturbance of strategic white matter tracts. We examined the impact of WMH location on language in elderly Asians. Design: Cross-sectional. Setting: Population-based. Participants: Eight-hundred nineteen residents of Singapore, ages (≥65 years). Measurements: Clinical, cognitive and 3T magnetic resonance imaging assessments were performed on all participants. Language was assessed using the Modified Boston Naming Test (MBNT) and Verbal Fluency (VF). Hypothesis-free region-of-interest-based (ROI) analyses based on major white matter tracts were used to determine the association between WMH location and language. Conditional dependencies between the regional WMH volumes and language were examined using Bayesian-network analysis. Results: ROI-based analyses showed that WMH located within the anterior thalamic radiation (mean difference: −0.12, 95% confidence interval [CI]: −0.22; −0.02, p = 0.019) and uncinate fasciculus (mean difference: −0.09, 95% CI: −0.18; −0.01, p = 0.022) in the left hemisphere were significantly associated with worse VF but did not survive multiple testing. Conversely, WMH volume in the left cingulum of cingulate gyrus was significantly associated with MBNT performance (mean difference: −0.09, 95% CI: −0.17; −0.02, p = 0.016). Bayesian-network analyses confirmed the left cingulum of cingulate gyrus as a direct determinant of MBNT performance. Conclusion: Our findings identify the left cingulum of cingulate gyrus as a strategic white matter tract for MBNT, suggesting that language – is sensitive to subcortical ischemic damage. Future studies on the role of sporadic ischemic lesions and vascular cognitive impairment should not only focus on total WMH volume but should also take WMH lesion location into account when addressing language.

Published
2020
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46. Vascular dysfunction

Author

Sweeney, M.D., Montagne, A., Sagare, A.P., Nation, D.A., Schneider, L.S., Chui, H.C., Harrington, M.G., Pa, J., Law, M., Wang, D.J.J., Jacobs, R.E., Doubal, F.N., Ramirez, J., Black, S.E., Nedergaard, M., Benveniste, H., Dichgans, M., Iadecola, C., Love, S., Bath, P.M., Markus, H.S., Salman, R.A., Allan, S.M., Quinn, T.J., Kalaria, R.N., Werring, D.J., Carare, R.O., Touyz, R.M., Williams, S.C.R., Moskowitz, M.A., Katusic, Z.S., Lutz, S.E., Lazarov, O., Minshall, R.D., Rehman, J., Davis, T.P., Wellington, C.L., Gonzalez, H.M., Yuan, C., Lockhart, S.N., Hughes, T.M., Chen, C.L.H., Sachdev, P., O'Brien, J.T., Skoog, I., Pantoni, L., Gustafson, D.R., Biessels, G.J., Wallin, A., Smith, E.E., Mok, V., Wong, A., Passmore, P., Barkof, F., Muller, M., Breteler, M.M.B., Roman, G.C., Hamel, E., Seshadri, S., Gottesman, R.F., Buchem, M.A. van, Arvanitakis, Z., Schneider, J.A., Drewes, L.R., Hachinski, V., Finch, C.E., Toga, A.W., Wardlaw, J.M., and Zlokovic, B.V.

Subjects
Vascular, Alzheimer's disease, Cerebral blood flow, Biomarkers, Blood-brain barrier, MRI
Abstract

Increasing evidence recognizes Alzheimer's disease (AD) as a multifactorial and heterogeneous disease with multiple contributors to its pathophysiology, including vascular dysfunction. The recently updated AD Research Framework put forth by the National Institute on Aging-Alzheimer's Association describes a biomarker-based pathologic definition of AD focused on amyloid, tau, and neuronal injury. In response to this article, here we first discussed evidence that vascular dysfunction is an important early event in AD pathophysiology. Next, we examined various imaging sequences that could be easily implemented to evaluate different types of vascular dysfunction associated with, and/or contributing to, AD pathophysiology, including changes in blood-brain barrier integrity and cerebral blood flow. Vascular imaging biomarkers of small vessel disease of the brain, which is responsible for >50% of dementia worldwide, including AD, are already established, well characterized, and easy to recognize. We suggest that these vascular biomarkers should be incorporated into the AD Research Framework to gain a better understanding of AD pathophysiology and aid in treatment efforts. (C) 2018 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Published
2019

47. [Risk of vitamin K antagonists in cases of cerebral microbleeds]

Author

Verhaar, BJH, Muller, M, Vernooij, Meike W., Biessels, G.J., Internal medicine, APH - Aging & Later Life, and ACS - Atherosclerosis & ischemic syndromes

Abstract

Cerebral microbleeds are associated with a higher risk of intracerebral hemorrhage.- When microbleeds are detected, the possible underlying pathology should be considered; this includes cerebral amyloid angiopathy and other factors that increase the risk of haemorrhage, particularly hypertension. - No randomised trials have yet been conducted into haemorrhagic complications and cerebral infarctions in patients with microbleeds who take vitamin K antagonists. This means that it is not clear whether the intended prevention of cerebral infarctions outweighs the increased risk of haemorrhage associated with use of vitamin K antagonists by these patients.- When deciding whether or not an older patient should be given anticoagulants the following should be taken into consideration as well: comorbidities, polypharmacy, the risk of falls and the probability that the patient can be optimally titrated to vitamin K antagonists. - If there is an increased risk of intracerebral haemorrhage but anticoagulants are indicated, direct oral anticoagulants (DOACs) might be preferable to vitamin K antagonists in patients with a history of cerebral microbleeds.

Published
2018

48. CT angiography and CT perfusion improve prediction of infarct volume in patients with anterior circulation stroke

Author

Seeters, T. van, Biessels, G.J., Kappelle, L.J., Schaaf, I.C. van der, Dankbaar, J.W., Horsch, A.D., Niesten, J.M., Luitse, M.J., Majoie, C.B., Vos, J.A., Schonewille, W.J., Walderveen, M.A. van, Wermer, M.J., Duijm, L.E.M., Keizer, K., Bot, J.C., Visser, M.C, Lugt, A. van der, Dippel, D.W., Kesselring, F.O., Hofmeijer, J., Lycklama a Nijeholt, G.J., Boiten, J., Rooij, W.J. van, Kort, P.L. de, Roos, Y.B., Meijer, F.J.A., Pleiter, C.C., Mali, W.P., Graaf, Y. van der, Velthuis, B.K., Dijk, E.J. van, Radiology and nuclear medicine, ICaR - Ischemia and repair, ANS - Neurovascular Disorders, Radiology and Nuclear Medicine, ACS - Amsterdam Cardiovascular Sciences, Neurology, Clinical Neurophysiology, Faculty of Behavioural, Management and Social Sciences, Faculty of Science and Technology, and Radiology & Nuclear Medicine

Subjects
Male, Neurology, Computed Tomography Angiography, Perfusion scanning, 030204 cardiovascular system & hematology, 0302 clinical medicine, Prospective Studies, Non-U.S. Gov't, Stroke, Netherlands, Computed tomography angiography, Neuroradiology, Aged, 80 and over, Ischemic stroke, medicine.diagnostic_test, Research Support, Non-U.S. Gov't, Middle Aged, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], Multicenter Study, CT angiography, Radiology Nuclear Medicine and imaging, Cerebrovascular Circulation, Predictive value of tests, cardiovascular system, Female, Neurosurgery, Radiology, Cardiology and Cardiovascular Medicine, Rare cancers Radboud Institute for Health Sciences [Radboudumc 9], Brain Infarction, medicine.medical_specialty, Clinical Neurology, Observational Study, Research Support, METIS-320852, IR-103002, 03 medical and health sciences, Predictive Value of Tests, medicine, Journal Article, Humans, Radiology, Nuclear Medicine and imaging, cardiovascular diseases, Diagnostic Neuroradiology, Aged, business.industry, medicine.disease, Logistic Models, Infarct volume, Angiography, CT perfusion, Neurology (clinical), business, Prediction, 030217 neurology & neurosurgery, Follow-Up Studies
Abstract

Introduction We investigated whether baseline CT angiography (CTA) and CT perfusion (CTP) in acute ischemic stroke could improve prediction of infarct presence and infarct volume on follow-up imaging. Methods We analyzed 906 patients with suspected anterior circulation stroke from the prospective multicenter Dutch acute stroke study (DUST). All patients underwent baseline non-contrast CT, CTA, and CTP and follow-up non-contrast CT/MRI after 3 days. Multivariable regression models were developed including patient characteristics and non-contrast CT, and subsequently, CTA and CTP measures were added. The increase in area under the curve (AUC) and R2 was assessed to determine the additional value of CTA and CTP. Results At follow-up, 612 patients (67.5 %) had a detectable infarct on CT/MRI; median infarct volume was 14.8 mL (interquartile range (IQR) 2.8–69.6). Regarding infarct presence, the AUC of 0.82 (95 % confidence interval (CI) 0.79–0.85) for patient characteristics and non-contrast CT was improved with addition of CTA measures (AUC 0.85 (95 % CI 0.82–0.87); p

Published
2016
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49. Cerebral Perfusion and the Occurrence of Nonfocal Transient Neurological Attacks

Author

Oudeman, E.A. (Eline A.), Bron, E.E. (Esther), Berg-Vos, R.M. (R.) van den, Greving, J.P. (Jacoba), Biessels, G.J. (Geert Jan), Klijn, C.J.M. (Catharina J.M.), Kappelle, L.J. (Jaap), Oudeman, E.A. (Eline A.), Bron, E.E. (Esther), Berg-Vos, R.M. (R.) van den, Greving, J.P. (Jacoba), Biessels, G.J. (Geert Jan), Klijn, C.J.M. (Catharina J.M.), and Kappelle, L.J. (Jaap)

Abstract

INTRODUCTION: Nonfocal transient neurological attacks (TNAs) are associated with an increased risk of cardiac events, stroke and dementia. Their etiology is still unknown. Global cerebral hypoperfusion has been suggested to play a role in their etiology, but this has not been investigated. We assessed whether lower total brain perfusion is associated with a higher occurrence of TNAs. METHODS: Between 2015 and 2018, patients with heart failure were included in the Heart Brain Connection study. Patients underwent brain magnetic resonance imaging, including quantitative magnetic resonance angiography (QMRA) to measure cerebral blood flow (CBF). We calculated total brain perfusion of each participant by dividing total CBF by brain volume. Patients were interviewed with a standardized questionnaire on the occurrence of TNAs by physicians who were blinded to QMRA flow status. We assessed the relation between total brain perfusion and the occurrence of TNAs with Poisson regression analysis. RESULTS: Of 136 patients (mean age 70 years, 68% men), 29 (21%) experienced ≥1 TNAs. Nonrotatory dizziness was the most common subtype of TNA. Patients with TNAs were more often female and more often had angina pectoris than patients without TNAs, but total CBF and total brain perfusion were not different between both groups. Total brain perfusion was not associated with the occurrence of TNAs (adjusted risk ratio 1.12, 95% CI 0.88-1.42). CONCLUSION: We found no association between total brain perfusion and the occurrence of TNAs in patients with heart failure.

Published
2019
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50. Temporal profile of body temperature in acute ischemic stroke: Relation to infarct size and outcome

Author

Geurts, M. (Marjolein), Scheijmans, F.E.V. (Féline E.V.), Seeters, T. (Tom) van, Biessels, G.J., Kappelle, L.J. (Jaap), Velthuis, B.K. (Birgitta K.), Worp, H.B. (Bart) van der, Majoie, C.B. (Charles), Roos, Y.B.W.E.M. (Yvo), Duijm, L.E.M. (Lucien), Keizer, K. (Koos), Lugt, A. (Aad) van der, Dippel, D.W.J. (Diederik), Greve, D. (Droogh-de), Bienfait, H.P. (Henri), Walderveen, M.A.A. (Marianne) van, Wermer, M.J.H. (Marieke), Lycklama à Nijeholt, G.J. (Geert), Boiten, J. (Jelis), Duyndam, A. (Anita), Kwa, V.I.H., Meijer, F.J. (F.), Dijk, E.J. (Ewoud) van, Kesselring, A.M. (Anouk), Hofmeijer, J., Vos, J.A. (Jan Albert), Schonewille, W.J. (Wouter), Rooij, W.J. (W.) van, Kort, P.L.M. (Paul) de, Pleiter, C.C. (C.), Bakker, S.L.M. (Stef), Bot, J., Visser, M.C. (Marieke), Velthuis, B.K. (Birgitta), Schaaf, I.C. (Irene) van der, Dankbaar, J.W. (Jan), Mali, W.P. (Willem), van Seeters, T., Horsch, A.D. (Alexander D.), Niesten, J.M. (Joris), Biessels, G.J. (Geert Jan), Luitse, J.S.K., Graaf, Y. (Yolanda) van der, Geurts, M. (Marjolein), Scheijmans, F.E.V. (Féline E.V.), Seeters, T. (Tom) van, Biessels, G.J., Kappelle, L.J. (Jaap), Velthuis, B.K. (Birgitta K.), Worp, H.B. (Bart) van der, Majoie, C.B. (Charles), Roos, Y.B.W.E.M. (Yvo), Duijm, L.E.M. (Lucien), Keizer, K. (Koos), Lugt, A. (Aad) van der, Dippel, D.W.J. (Diederik), Greve, D. (Droogh-de), Bienfait, H.P. (Henri), Walderveen, M.A.A. (Marianne) van, Wermer, M.J.H. (Marieke), Lycklama à Nijeholt, G.J. (Geert), Boiten, J. (Jelis), Duyndam, A. (Anita), Kwa, V.I.H., Meijer, F.J. (F.), Dijk, E.J. (Ewoud) van, Kesselring, A.M. (Anouk), Hofmeijer, J., Vos, J.A. (Jan Albert), Schonewille, W.J. (Wouter), Rooij, W.J. (W.) van, Kort, P.L.M. (Paul) de, Pleiter, C.C. (C.), Bakker, S.L.M. (Stef), Bot, J., Visser, M.C. (Marieke), Velthuis, B.K. (Birgitta), Schaaf, I.C. (Irene) van der, Dankbaar, J.W. (Jan), Mali, W.P. (Willem), van Seeters, T., Horsch, A.D. (Alexander D.), Niesten, J.M. (Joris), Biessels, G.J. (Geert Jan), Luitse, J.S.K., and Graaf, Y. (Yolanda) van der

Abstract

Background: High body temperatures after ischemic stroke have been associated with larger infarct size, but the temporal profile of this relation is unknown. We assess the relation between temporal profile of body temperature and infarct size and functional outcome in patients with acute ischemic stroke. Methods: In 419 patients with acute ischemic stroke we assessed the relation between body temperature on admission and during the first 3 days with both infarct size and functional outcome. Infarct size was measured in milliliters on CT or MRI after 3 days. Poor functional outcome was defined as a modified Rankin Scale score ≥3 at 3 months. Results: Body temperature on admission was not associated with infarct size or poor outcome in adjusted analyses. By contrast, each additional 1.0 °C in body temperature on day 1 was associated with 0.31 ml larger infarct size (95% confidence interval (CI) 0.04-0.59), on day 2 with 1.13 ml larger infarct size(95% CI, 0.83-1.43), and on day 3 with 0.80 ml larger infarct size (95% CI, 0.48-1.12), in adjusted linear regression analyses. Higher peak body temperatures on days two and three were also associated with poor outcome (adjusted relative risks per additional 1.0 °C in body temperature, 1.52 (95% CI, 1.17-1.99) and 1.47 (95% CI, 1.22-1.77), respectively). Conclusions: Higher peak body temperatures during the first days after ischemic stroke, rather than on admission, are associated with larger infarct size and poor functional outcome. This suggests that prevention of high temperatures may improve outcome if continued for at least 3 days.

Published
2016
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