Publications by authors named "R Kessels"
Introduction: Reduced white matter integrity outside the stroke lesion may be a potential contributor of post-stroke cognitive impairment. We aimed to investigate how a stroke lesion affects the integrity of surrounding white matter, and whether the integrity of the non-lesioned part of white matter tracts is associated with cognitive performance after ischemic stroke in young adults.
Methods: Patients from the ODYSSEY study, aged 18-49 years, with a first-ever ischemic stroke, underwent 3T MRI and cognitive assessment within six months after the index event.
Article Synopsis
- * This review examines the effectiveness of non-pharmacological interventions for apathy across different conditions similar to KS, including dementia, Parkinson's disease, schizophrenia, and traumatic brain injury, drawing on 22 systematic reviews and 32 empirical studies.
- * Successful interventions for severely cognitively impaired individuals rely on external stimulation rather than intrinsic motivation, highlighting the need to tailor treatments to the individual's interests and assess the specific apathetic behaviors before starting any intervention.
Background: Historically, patients with metastatic renal cell carcinoma (mRCC) have been offered upfront cytoreductive nephrectomy (CN) followed by systemic therapy. Currently, CN is no longer the standard of care (SOC) based on the randomised phase 3 CARMENA study performed in the vascular endothelial growth factor receptor tyrosine kinase inhibitor era. With the advent of immune checkpoint inhibitor (ICI) combination therapy in first line, the role of CN needs to be reassessed.
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- The study examined the impact of cerebellar anodal transcranial direct current stimulation (tDCS) on cognitive performance among patients suffering from cerebellar cognitive affective syndrome (CCAS), where no established treatment currently exists.
- It involved 35 participants in a randomized, double-blind, sham-controlled trial with assessments of cognitive function, ataxia severity, mood, and quality of life over several months.
- The results showed no significant improvement in cognitive performance from tDCS, but did indicate a noteworthy reduction in ataxia severity, suggesting tDCS may have potential benefits for motor-related symptoms in cerebellar disorders.
: The estimand framework offers a structured approach to define the treatment effect to be estimated in a clinical study. Defining the estimand upfront helps formulating the research question and informs study design, data collection and statistical analysis methods. Since the Trials within Cohorts (TwiCs) design has unique characteristics, the objective of this study is to describe considerations and provide guidance for formulating estimands for TwiCs studies.
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