Publications by authors named "Geert Jan Biessels"

Intracerebral blood volume changes along the cardiac cycle cause volumetric strain in brain tissue, measurable with displacement encoding with stimulated echoes (DENSE) magnetic resonance imaging. Individual volumetric strain maps show compressing and expanding voxels, raising the question whether systolic compressions reflect a physiological phenomenon. In DENSE data from nine healthy volunteers, voxels were grouped into three clusters according to volumetric strain in a tissue mask excluding extracerebral blood vessels and cerebrospinal fluid using a two-stage clustering approach.

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  • White matter hyperintensities (WMH) increase with age and vary significantly between individuals, prompting the need for age- and sex-specific data for better assessment.
  • This study pooled data from nearly 15,000 healthy individuals aged 18-97 to analyze WMH volumes using MRI and established centile curves based on age and sex.
  • Findings reveal that WMH volumes increase significantly with age, with females having larger volumes, and these changes follow different patterns based on specific white matter locations, providing valuable normative data for clinical interpretations.
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Background: Cerebral small vessel disease (SVD) is manifested on magnetic resonance imaging (MRI) by white matter hyperintensities, lacunes, microbleeds, and atrophy. While these manifestations can be part of normal aging, a high burden has been associated with cognitive impairment and vascular events. Distinguishing between normal versus abnormal SVD lesion burden in clinical practice remains complex.

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  • The study aimed to evaluate relationships between three key cerebrovascular functions (blood-brain barrier permeability, vascular pulsatility, and cerebrovascular reactivity) in patients with cerebral small vessel diseases (SVD), including both sporadic cases and a genetic condition known as CADASIL.
  • Researchers used advanced brain imaging techniques to analyze these functions in a group of 77 patients, assessing how they relate to SVD severity, subtype, and specific brain changes.
  • Findings revealed that worse white matter hyperintensity (WMH) was linked to lower cerebrovascular reactivity and blood plasma volume fraction, with the type of SVD having little impact on these vascular functions after accounting for WMH severity.
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MRI-visible enlarged perivascular spaces (EPVS) are common in patients with cognitive impairment and possibly linked to Alzheimer's disease (AD) and cerebral amyloid angiopathy (CAA). In a study of memory clinic patients (n = 450; mean age 66.5 ± 7.

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  • Tau-PET is a diagnostic tool for Alzheimer's disease that shows promise in research, but its effectiveness in everyday clinical settings is still unclear.
  • The TAP-TAU study will include 300 patients with mild cognitive impairments from five Dutch memory clinics to assess how tau-PET affects diagnosis, patient management, and anxiety levels.
  • The study has received ethics approval and aims to begin participant enrollment in October 2024, with potential findings that could enhance understanding of tau-PET's real-world clinical value.
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  • * Three distinct subtypes were found: one with early logical memory changes progressing to tau and white matter issues, another showing early white matter changes with older age and hypertension, and a third resembling typical Alzheimer's disease with early tau signals.
  • * The findings suggest that the diversity in these individuals is influenced by co-existing conditions, particularly vascular diseases, indicating that understanding these variations is crucial for better grasping Alzheimer’s disease progression.
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  • White matter hyperintensities (WMH) are linked to cognitive impairment but solely measuring their volume doesn't fully explain the cognitive deficits.
  • Lesion network mapping (LNM) offers a new way to assess how WMH connects with brain networks, potentially improving our understanding of their impact on cognition.
  • In a study of 3,485 patients, LNM scores outperformed WMH volumes in predicting cognitive performance, especially in attention, processing speed, and verbal memory, but not for language functions.
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  • Preservation of brain health is a global priority, with traditional therapies targeting intrinsic brain issues but new evidence highlights the role of peripheral organs in brain dysfunction.
  • Dysfunction in organs like the gut, liver, kidney, and lung is increasingly recognized as a significant factor affecting age-related brain problems, including dementia.
  • The review suggests a framework for understanding how these organ dysfunctions can influence brain health and offers recommendations for public health strategies and clinical care to address these connections.
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  • Cognitive impairment is prevalent in heart failure (HF) patients, and the study investigates sex differences in cognitive functioning linked to HF characteristics and brain injury.
  • The research involved 162 HF patients who underwent neuropsychological assessments and brain MRI, revealing that women tend to perform better in global cognition and memory compared to men, despite differences in HF characteristics between sexes.
  • Results showed that while some cognitive differences were associated with ischemic causes of HF, others, particularly in global cognition, persisted even after accounting for vascular brain injury factors.
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Background And Objectives: Despite the mechanistic potential of sodium-glucose cotransporter 2 inhibitor (SGLT2i) to improve neurologic outcomes, the efficacy of SGLT2i in neurodegenerative disorders among patients with type 2 diabetes is not well established. This population-based cohort study aimed to investigate the association of SGLT2i use with risks of incident dementia and Parkinson disease (PD) in patients with type 2 diabetes.

Methods: This was a retrospective examination of data from a cohort of 1,348,362 participants with type 2 diabetes (≥40 years), who started antidiabetic drugs from 2014 to 2019, evaluated using the Korean National Health Insurance Service Database.

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  • After people are diagnosed with vascular cognitive impairment (VCI), they often get confusing care from different types of healthcare professionals, making it hard for them to get the help they really need.
  • A study was done with healthcare workers to understand their views on how to improve care for VCI patients and their caregivers.
  • The findings showed that it's important for healthcare workers to know about VCI, that care needs to be better organized, and that it would help if different types of healthcare experts worked together more closely.
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Purpose: Post-stroke (PS) cognitive impairment (CI) is frequent and its devastating functional and vital consequences are well known. Despite recent guidelines, they are still largely neglected. A large number of recent studies have re-examined the epidemiology, diagnosis, imaging determinants and management of PSCI.

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Objectives: The few voxel-wise lesion-symptom mapping (VLSM) studies aimed at identifying the anatomy of executive function are limited by the absence of a model and by small populations. Using Trail Making Test (TMT) and verbal fluency and a model of their architectures, our objective was to identify the key structures underlying two major executive processes, set-shifting and strategic word search.

Methods: We applied a validated VLSM analysis to harmonized cognitive and imaging data from 2009 ischemic stroke patients as a part of the Meta VCI Map consortium.

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Background And Objective: Atrial fibrillation (AF) is the most common cardiac arrhythmia, inducing accelerated and irregular beating. Beside well-known disabling symptoms - such as palpitations, reduced exercise tolerance, and chest discomfort - there is growing evidence that an alteration of deep cerebral hemodynamics due to AF increases the risk of vascular dementia and cognitive impairment, even in the absence of clinical strokes. The alteration of deep cerebral circulation in AF represents one of the least investigated among the possible mechanisms.

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Peak width of skeletonized mean diffusivity (PSMD) is an emerging diffusion-MRI based marker to study subtle early alterations to white matter microstructure. We assessed PSMD over the clinical continuum in Dutch-type hereditary CAA (D-CAA) and its association with other CAA-related MRI-markers and cognitive symptoms. We included (pre)symptomatic D-CAA mutation-carriers and calculated PSMD from diffusion-MRI data.

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 Higher blood pressure variability (BPV) predisposes to cognitive decline. To investigate underlying mechanisms, we measured 24-h ambulatory BPV, nocturnal dipping and orthostatic hypotension in 518 participants with vascular cognitive impairment, carotid occlusive disease, heart failure, or reference participants. We determined cross-sectional associations between BPV indices and plasma biomarkers of neuronal injury (neurofilament light chain) and Alzheimer's disease (phosphorylated-tau-181 and Aβ42/Aβ40).

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Background: Orthostatic hypotension (OH) is associated with an increased risk of dementia, potentially attributable to cerebral hypoperfusion. We investigated which patterns and characteristics of OH are related to cognition or to potentially underlying structural brain injury in hemodynamically impaired patients and healthy reference participants.

Methods: Participants with carotid occlusive disease or heart failure, and reference participants from the Heart-Brain Connection Study underwent OH measurements, neuropsychological assessment and brain MRI.

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Background: Post-stroke cognitive impairment (PSCI) occurs in up to 50% of stroke survivors. Presence of pre-existing vascular brain injury, in particular the extent of white matter hyperintensities (WMH), is associated with worse cognitive outcome after stroke, but the role of WMH location in this association is unclear.

Aims: We determined if WMH in strategic white matter tracts explain cognitive performance after stroke.

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Background: Cortical microinfarcts (CMI) were attributed to cerebrovascular disease and cerebral amyloid angiopathy (CAA). CAA is frequent in Down syndrome (DS) while hypertension is rare, yet no studies have assessed CMI in DS.

Methods: We included 195 adults with DS, 63 with symptomatic sporadic Alzheimer's disease (AD), and 106 controls with 3T magnetic resonance imaging.

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Introduction: White matter hyperintensities of presumed vascular origin (WMH) are associated with cognitive impairment and are a key imaging marker in evaluating cognitive health. However, WMH volume alone does not fully account for the extent of cognitive deficits and the mechanisms linking WMH to these deficits remain unclear. We propose that lesion network mapping (LNM), enables to infer if brain networks are connected to lesions, and could be a promising technique for enhancing our understanding of the role of WMH in cognitive disorders.

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Background And Objectives: Cerebral small vessel disease (cSVD) is a major cause of stroke and dementia, but little is known about disease mechanisms at the level of the small vessels. 7T-MRI allows assessing small vessel function in vivo in different vessel populations. We hypothesized that multiple aspects of small vessel function are altered in patients with cSVD and that these abnormalities relate to disease burden.

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Background: We hypothesize that Alzheimer's disease (AD)-related pathology may accelerate cognitive decline in patients with cardiovascular diseases.

Objective: To investigate the association between blood-based biomarkers of AD, astrocyte activation, and neurodegeneration and cognitive decline.

Methods: From the multi-center Heart-Brain study, we included 412 patients with heart failure, carotid occlusive disease or vascular cognitive impairment (age:68.

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