INTRODUCTIONChronic cerebral hypoperfusion is one of the assumed pathophysiological mechanisms underlying vascular cognitive impairment (VCI). We investigated the association between baseline... Show moreINTRODUCTIONChronic cerebral hypoperfusion is one of the assumed pathophysiological mechanisms underlying vascular cognitive impairment (VCI). We investigated the association between baseline cerebral blood flow (CBF) and cognitive decline after 2 years in patients with VCI and reference participants.METHODSOne hundred eighty-one participants (mean age 66.3 ± 7.4 years, 43.6% women) underwent arterial spin labeling (ASL) magnetic resonance imaging (MRI) and neuropsychological assessment at baseline and at 2-year follow-up. We determined the association between baseline global and lobar CBF and cognitive decline with multivariable regression analysis.RESULTSLower global CBF at baseline was associated with more global cognitive decline in VCI and reference participants. This association was most profound in the domain of attention/psychomotor speed. Lower temporal and frontal CBF at baseline were associated with more cognitive decline in memory.DISCUSSIONOur study supports the role of hypoperfusion in the pathophysiological and clinical progression of VCI. Show less
Vlastra, W.; Nieuwkerk, A.C. van; Bronzwaer, A.S.G.T.; Versteeg, A.; Bron, E.E.; Niessen, W.J.; ... ; Delewi, R. 2020
BACKGROUND Transcatheter aortic valve implantation (TAVI) is a minimally invasive, life-saving treatment for patients with severe aortic valve stenosis that improves quality of life. We examined... Show moreBACKGROUND Transcatheter aortic valve implantation (TAVI) is a minimally invasive, life-saving treatment for patients with severe aortic valve stenosis that improves quality of life. We examined cardiac output and cerebral blood flow in patients undergoing TAVI to test the hypothesis that improved cardiac output after TAVI is associated with an increase in cerebral blood flow. DESIGN Prospective cohort study. SETTING European high-volume tertiary multidisciplinary cardiac care. PARTICIPANTS Thirty-one patients (78.3 +/- 4.6 years; 61% female) with severe symptomatic aortic valve stenosis. MEASUREMENTS Noninvasive prospective assessment of cardiac output (L/min) by inert gas rebreathing and cerebral blood flow of the total gray matter (mL/100 g per min) using arterial spin labeling magnetic resonance imaging in resting state less than 24 hours before TAVI and at 3-month follow-up. Cerebral blood flow change was defined as the difference relative to baseline. RESULTS On average, cardiac output in patients with severe aortic valve stenosis increased from 4.0 +/- 1.1 to 5.4 +/- 2.4 L/min after TAVI (P= .003). The increase in cerebral blood flow after TAVI strongly varied between patients (7% +/- 24%;P= .41) and related to the increase in cardiac output, with an 8.2% (standard error = 2.3%;P= .003) increase in cerebral blood flow per every additional liter of cardiac output following the TAVI procedure. CONCLUSION Following TAVI, there was an association of increase in cardiac output with increase in cerebral blood flow. These findings encourage future larger studies to determine the influence of TAVI on cerebral blood flow and cognitive function. Show less
Poor performance status at presentation is the strongest indicator of poor short-term survival, whereas low disease load and favorable tumor histology are associated with longer-term survival. (C)... Show morePoor performance status at presentation is the strongest indicator of poor short-term survival, whereas low disease load and favorable tumor histology are associated with longer-term survival. (C) 2016 by American Society of Clinical Oncology Show less
Möller, C.; Pijnenburg, Y.A.; Van der Flier, W.M.; Versteeg, A.; Tijms, B.; De Munck, J.C.; ... ; Wink, A.M. 2016
Conclusion: The SVM can be used in single-subject discrimination and can help the clinician arrive at a diagnosis. The SVM can be used to distinguish disease-specific GM patterns in patients with... Show moreConclusion: The SVM can be used in single-subject discrimination and can help the clinician arrive at a diagnosis. The SVM can be used to distinguish disease-specific GM patterns in patients with AD and those with bvFTD as compared with normal aging by using common T1-weighted structural MR imaging. Show less
Möller, C.; Hafkemeijer, A.; Pijnenburg, Y.A.; Rombouts, S.A.; Van der Grond, J.; Dopper, E.; ... ; Van der Flier, W.M. 2016
We examined patterns of cortical thickness loss and cognitive decline over time in 19 patients with Alzheimer's disease (AD), 10 with behavioral variant frontotemporal dementia (bvFTD), and 34... Show moreWe examined patterns of cortical thickness loss and cognitive decline over time in 19 patients with Alzheimer's disease (AD), 10 with behavioral variant frontotemporal dementia (bvFTD), and 34 controls with a mean interval of 2.1 ± 0.4 years. We measured vertexwise and regional cortical thickness changes of 6 lobar regions of interest between groups with the longitudinal FreeSurfer pipeline. Compared with controls, AD and bvFTD had a steeper rate of cognitive decline and showed faster cortical thinning per year. Decrease of thickness over time was highest in AD and generalized throughout the whole brain, most pronounced posteriorly, whereas bvFTD patients had a more selective loss in frontal cortex and in anterior parts of the temporal lobes. In a direct comparison, AD patients showed faster cortical thinning in the insula, temporal, and parietal regions, whereas bvFTD patients only showed faster cortical thinning in the orbitofrontal gyrus. Decline of cognitive performances was in line with cortical thinning and deteriorated the most in AD patients. Show less
Moller, C.; Hafkemeijer, A.; Pijnenburg, Y.A.L.; Rombouts, S.A.R.B.; Grond, J. van der; Dopper, E.; ... ; Flier, W.M. van der 2016
