122 results on '"de Kort, Paul L"'
Search Results
2. Strategic infarct locations for post-stroke cognitive impairment: a pooled analysis of individual patient data from 12 acute ischaemic stroke cohorts
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Weaver, Nick A, Kuijf, Hugo J, Aben, Hugo P, Abrigo, Jill, Bae, Hee-Joon, Barbay, Mélanie, Best, Jonathan G, Bordet, Régis, Chappell, Francesca M, Chen, Christopher P L H, Dondaine, Thibaut, van der Giessen, Ruben S, Godefroy, Olivier, Gyanwali, Bibek, Hamilton, Olivia K L, Hilal, Saima, Huenges Wajer, Irene M C, Kang, Yeonwook, Kappelle, L Jaap, Kim, Beom Joon, Köhler, Sebastian, de Kort, Paul L M, Koudstaal, Peter J, Kuchcinski, Gregory, Lam, Bonnie Y K, Lee, Byung-Chul, Lee, Keon-Joo, Lim, Jae-Sung, Lopes, Renaud, Makin, Stephen D J, Mendyk, Anne-Marie, Mok, Vincent C T, Oh, Mi Sun, van Oostenbrugge, Robert J, Roussel, Martine, Shi, Lin, Staals, Julie, del C Valdés-Hernández, Maria, Venketasubramanian, Narayanaswamy, Verhey, Frans R J, Wardlaw, Joanna M, Werring, David J, Xin, Xu, Yu, Kyung-Ho, van Zandvoort, Martine J E, Zhao, Lei, Biesbroek, J Matthijs, and Biessels, Geert Jan
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- 2021
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3. Association between thrombus composition and stroke etiology in the MR CLEAN Registry biobank
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Hund, Hajo M., Boodt, Nikki, Hansen, Daniel, Haffmans, Willem A., Lycklama à Nijeholt, Geert J., Hofmeijer, Jeannette, Dippel, Diederik W. J., van der Lugt, Aad, van Es, Adriaan C. G. M., van Beusekom, Heleen M. M., Majoie, Charles B. L. M., Roos, Yvo B. W. E. M., van Oostenbrugge, Robert J., van Zwam, Wim H., Boiten, Jelis, Vos, Jan Albert, Jansen, Ivo G. H., Mulder, Maxim J. H. L., Goldhoorn, Robert- Jan B., Compagne, Kars C. J., Kappelhof, Manon, Brouwer, Josje, den Hartog, Sanne J., Hinsenveld, Wouter H., Roozenbeek, Bob, Emmer, Bart J., Coutinho, Jonathan M., Schonewille, Wouter J., Wermer, Marieke J. H., van Walderveen, Marianne A. A., Staals, Julie, Martens, Jasper M., de Bruijn, Sebastiaan F., van Dijk, Lukas C., van der Worp, H. Bart, Lo, Rob H., van Dijk, Ewoud J., Boogaarts, Hieronymus D., de Vries, J., de Kort, Paul L. M., van Tuijl, Julia, Peluso, Jo P., Fransen, Puck, van den Berg, Jan S. P., van Hasselt, Boudewijn A. A. M., Aerden, Leo A. M., Dallinga, René J., Uyttenboogaart, Maarten, Eschgi, Omid, Bokkers, Reinoud P. H., Schreuder, Tobien H. C. M. L., Heijboer, Roel J. J., Keizer, Koos, Yo, Lonneke S. F., den Hertog, Heleen M., Bulut, Tomas, Brouwers, Paul J. A. M., Sprengers, Marieke E. S., Jenniskens, Sjoerd F. M., van den Berg, René, Yoo, Albert J., Beenen, Ludo F. M., Postma, Alida A., Roosendaal, Stefan D., van der Kallen, Bas F. W., van den Wijngaard, Ido R., Bot, Joost, van Doormaal, Pieter-Jan, Meijer, Anton, Ghariq, Elyas, van Proosdij, Marc P., Krietemeijer, G. Menno, Dinkelaar, Wouter, Appelman, Auke P. A., Hammer, Bas, Pegge, Sjoert, van der Hoorn, Anouk, Vinke, Saman, Flach, H. Zwenneke, Lingsma, Hester F., el Ghannouti, Naziha, Sterrenberg, Martin, Pellikaan, Wilma, Sprengers, Rita, Elfrink, Marjan, Simons, Michelle, Vossers, Marjolein, de Meris, Joke, Vermeulen, Tamara, Geerlings, Annet, van Vemde, Gina, Simons, Tiny, Messchendorp, Gert, Nicolaij, Nynke, Bongenaar, Hester, Bodde, Karin, Kleijn, Sandra, Lodico, Jasmijn, Droste, Hanneke, Wollaert, Maureen, Verheesen, Sabrina, Jeurrissen, D., Bos, Erna, Drabbe, Yvonne, Sandiman, Michelle, Aaldering, Nicoline, Zweedijk, Berber, Vervoort, Jocova, Ponjee, Eva, Romviel, Sharon, Kanselaar, Karin, Barning, Denn, Venema, Esmee, Chalos, Vicky, Geuskens, Ralph R., van Straaten, Tim, Ergezen, Saliha, Harmsma, Roger R. M., Muijres, Daan, de Jong, Anouk, Berkhemer, Olvert A., Boers, Anna M. M., Huguet, J., Groot, P. F. C., Mens, Marieke A., van Kranendonk, Katinka R., Treurniet, Kilian M., Tolhuisen, Manon L., Alves, Heitor, Weterings, Annick J., Kirkels, Eleonora L.F., Voogd, Eva J. H. F., Schupp, Lieve M., Collette, Sabine L., Groot, Adrien E. D., LeCouffe, Natalie E., Konduri, Praneeta R., Prasetya, Haryadi, Arrarte-Terreros, Nerea, Ramos, Lucas A., Radiology and Nuclear Medicine, ACS - Microcirculation, ANS - Neurovascular Disorders, Neurology, ACS - Atherosclerosis & ischemic syndromes, ANS - Cellular & Molecular Mechanisms, ANS - Compulsivity, Impulsivity & Attention, Graduate School, Biomedical Engineering and Physics, AMS - Amsterdam Movement Sciences, ANS - Brain Imaging, Adult Psychiatry, APH - Methodology, Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Damage and Repair in Cancer Development and Cancer Treatment (DARE), Cardiology, Radiology & Nuclear Medicine, Radiology and nuclear medicine, Internal medicine, Pediatrics, Amsterdam Neuroscience - Neurovascular Disorders, and CCA - Imaging and biomarkers
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Microscopy ,Ischemic stroke ,Radiology, Nuclear Medicine and imaging ,Endovascular treatment ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine ,Mechanical thrombectomy ,Stent-retriever ,Thrombus - Abstract
Purpose The composition of thrombi retrieved during endovascular thrombectomy (EVT) in acute ischemic stroke (AIS) due to large vessel occlusion (LVO) may differ depending on their origin. In this study, we investigated the association between thrombus composition and stroke etiology in a large population of patients from the Dutch MR CLEAN Registry treated with EVT in daily clinical practice. Methods The thrombi of 332 patients with AIS were histologically analyzed for red blood cells (RBC), fibrin/platelets (F/P), and white blood cells (leukocytes) using a machine learning algorithm. Stroke etiology was assessed using the Trial of Org 10,172 in acute stroke treatment (TOAST) classification. Results The thrombi of cardioembolic origin contained less RBC and more F/P than those of non-cardioembolic origin (25.8% vs 41.2% RBC [p = 0.003] and 67.1% vs 54.5% F/P [p = 0.004]). The likelihood of a non-cardioembolic source of stroke increased with increasing thrombus RBC content (OR 1.02; [95% CI 1.00–1.06] for each percent increase) and decreased with a higher F/P content (OR 1.02; [95% CI 1.00–1.06]). Thrombus composition in patients with a cardioembolic origin and undetermined origin was similar. Conclusion Thrombus composition is significantly associated with stroke etiology, with an increase in RBC and a decrease in F/P raising the odds for a non-cardioembolic cause. No difference between composition of cardioembolic thrombi and of undetermined origin was seen. This emphasizes the need for more extensive monitoring for arrhythmias and/or extended cardiac analysis in case of an undetermined origin.
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- 2023
4. Risk Factors for Symptoms of Depression and Anxiety One Year Poststroke: A Longitudinal Study
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Kootker, Joyce A., van Mierlo, Maria L., Hendriks, Jan C., Sparidans, Judith, Rasquin, Sascha M., de Kort, Paul L., Visser-Meily, Johanna M., and Geurts, Alexander C.
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- 2016
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5. Diagnostic yield and accuracy of CT angiography, MR angiography, and digital subtraction angiography for detection of macrovascular causes of intracerebral haemorrhage : prospective, multicentre cohort study
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DIAGRAM Investigators, van Asch, Charlotte J J, Velthuis, Birgitta K, Rinkel, Gabriël J E, Algra, Ale, de Kort, Gérard A P, Witkamp, Theo D, de Ridder, Johanna C M, van Nieuwenhuizen, Koen M, de Leeuw, Frank-Erik, Schonewille, Wouter J, de Kort, Paul L M, Dippel, Diederik W, Raaymakers, Theodora W M, Hofmeijer, Jeannette, Wermer, Marieke J H, Kerkhoff, Henk, Jellema, Korné, Bronner, Irene M, Remmers, Michel J M, Bienfait, Henri Paul, Witjes, Ron J G M, Greving, Jacoba P, and Klijn, Catharina J M
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- 2015
6. Sex Differences in Poststroke Cognitive Impairment: A Multicenter Study in 2343 Patients With Acute Ischemic Stroke.
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Exalto, Lieza G., Weaver, Nick A., Kuijf, Hugo J., Aben, Hugo P., Hee-Joon Bae, Best, Jonathan G., Bordet, Régis, Chen, Christopher P. L. H., van der Giessen, Ruben S., Godefroy, Olivier, Gyanwali, Bibek, Hamilton, Olivia K. L., Hilal, Saima, Huenges Wajer, Irene M. C., Jonguk Kim, Kappelle, Jaap, Beom Joon Kim, Köhler, Sebastian, de Kort, Paul L. M., and Koudstaal, Peter J.
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- 2023
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7. Psychological Factors Determine Depressive Symptomatology After Stroke
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van Mierlo, Maria L., van Heugten, Caroline M., Post, Marcel W., de Kort, Paul L., and Visser-Meily, Johanna M.
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- 2015
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8. A decrease in blood pressure is associated with unfavorable outcome in patients undergoing thrombectomy under general anesthesia
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Treurniet, Kilian M, Berkhemer, Olvert A, Immink, Rogier V, Lingsma, Hester F, Ward-van der Stam, Vivian M C, Hollmann, Markus W, Vuyk, Jaap, van Zwam, Wim H, van der Lugt, Aad, van Oostenbrugge, Robert J, Dippel, Diederik W J, Coutinho, Jonathan M, Roos, Yvo B W E M, Marquering, Henk A, Majoie, Charles B L M, Dippel, Diederik W J, Lugt, Aad van der, Majoie, Charles B L M, Roos, Yvo B W E M, van Oostenbrugge, Robert J, van Zwam, Wim H, Berkhemer, Olvert A, Fransen, Puck S S, Beumer, Debbie, van den Berg, Lucie A, Schonewille, Wouter J, Vos, Jan Albert, Majoie, Charles B L M, Roos, Yvo B W E M, Nederkoorn, Paul J, Wermer, Marieke J H, Walderveen, Marianne A A van, van Oostenbrugge, Robert J, van Zwam, Wim H, Staals, Julie, Hofmeijer, Jeannette, van Oostayen, Jacques A, Nijeholt, Geert J Lycklama à, Boiten, Jelis, Dippel, Diederik W J, Brouwer, Patrick A, Emmer, Bart J, de Bruijn, Sebastiaan F, van Dijk, Lukas C, Kappelle, L Jaap, Lo, Rob H, van Dijk, Ewoud J, de Vries, Joost, de Kort, Paul L M, van den Berg, Jan S P, van Rooij, Willem Jan J, van Hasselt, Boudewijn A A M, Aerden, Leo A M, Dallinga, René J, Visser, Marieke C, Bot, Joseph C J, Vroomen, Patrick C, Eshghi, Omid, Schreuder, Tobien H C M L, Heijboer, Roel J J, Keizer, Koos, Tielbeek, Alexander V, Hertog, Heleen M den, Gerrits, Dick G, van den Berg-Vos, Renske M, Karas, Giorgos B, Majoie, Charles B L M, van Zwam, Wim H, van der Lugt, Aad, Nijeholt, Geert J Lycklama à, van Walderveen, Marianne A A, Bot, Joseph C J, Marquering, Henk A, Beenen, Ludo F, Sprengers, Marieke E S, Jenniskens, Sjoerd F M, van den Berg, René, Berkhemer, Olvert A, Yoo, Albert J, Roos, Yvo B W E M, Koudstaal, Peter J, Boiten, Jelis, van Dijk, Ewoud J., van Oostenbrugge, Robert J, Wermer, Marieke J H, Flach, H Zwenneke, Steyerberg, Ewout W, and Lingsma, Hester F
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- 2018
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9. CT angiography and CT perfusion improve prediction of infarct volume in patients with anterior circulation stroke
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van Seeters, Tom, Biessels, Geert Jan, Kappelle, L. Jaap, van der Schaaf, Irene C., Dankbaar, Jan Willem, Horsch, Alexander D., Niesten, Joris M., Luitse, Merel J. A., Majoie, Charles B. L. M., Vos, Jan Albert, Schonewille, Wouter J., van Walderveen, Marianne A. A., Wermer, Marieke J. H., Duijm, Lucien E. M., Keizer, Koos, Bot, Joseph C. J., Visser, Marieke C., van der Lugt, Aad, Dippel, Diederik W. J., Kesselring, F. Oskar H. W., Hofmeijer, Jeannette, Lycklama à Nijeholt, Geert J., Boiten, Jelis, van Rooij, Willem Jan, de Kort, Paul L. M., Roos, Yvo B. W. E. M., Meijer, Frederick J. A., Pleiter, C. Constantijn, Mali, Willem P. T. M., van der Graaf, Yolanda, Velthuis, Birgitta K., and on behalf of the Dutch acute stroke study (DUST) investigators
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- 2016
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10. Time to Reperfusion and Treatment Effect for Acute Ischemic Stroke: A Randomized Clinical Trial
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Fransen, Puck S. S., Berkhemer, Olvert A., Lingsma, Hester F., Beumer, Debbie, van den Berg, Lucie A., Yoo, Albert J., Schonewille, Wouter J., Vos, Jan Albert, Nederkoorn, Paul J., Wermer, Marieke J. H., van Walderveen, Marianne A. A., Staals, Julie, Hofmeijer, Jeannette, van Oostayen, Jacques A., Lycklama à Nijeholt, Geert J., Boiten, Jelis, Brouwer, Patrick A., Emmer, Bart J., de Bruijn, Sebastiaan F., van Dijk, Lukas C., Kappelle, L. Jaap, Lo, Rob H., van Dijk, Ewoud J., de Vries, Joost, de Kort, Paul L. M., van den Berg, J. S. Peter, van Hasselt, Boudewijn A. A. M., Aerden, Leo A. M., Dallinga, René J., Visser, Marieke C., Bot, Joseph C. J., Vroomen, Patrick C., Eshghi, Omid, Schreuder, Tobien H. C. M. L., Heijboer, Roel J. J., Keizer, Koos, Tielbeek, Alexander V., den Hertog, Heleen M., Gerrits, Dick G., van den Berg-Vos, Renske M., Karas, Giorgos B., Steyerberg, Ewout W., Flach, H. Zwenneke, Marquering, Henk A., Sprengers, Marieke E. S., Jenniskens, Sjoerd F. M., Beenen, Ludo F. M., van den Berg, René, Koudstaal, Peter J., van Zwam, Wim H., Roos, Yvo B.W. E. M., van Oostenbrugge, Robert J., Majoie, Charles B. L. M., van der Lugt, Aad, and Dippel, Diederik W. J.
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- 2016
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11. Diagnostic yield and accuracy of CT angiography, MR angiography, and digital subtraction angiography for detection of macrovascular causes of intracerebral haemorrhage: prospective, multicentre cohort study
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van Asch, Charlotte J J, Velthuis, Birgitta K, Rinkel, Gabriël J E, Algra, Ale, de Kort, Gérard A P, Witkamp, Theo D, de Ridder, Johanna C M, van Nieuwenhuizen, Koen M, de Leeuw, Frank-Erik, Schonewille, Wouter J, de Kort, Paul L M, Dippel, Diederik W, Raaymakers, Theodora W M, Hofmeijer, Jeannette, Wermer, Marieke J H, Kerkhoff, Henk, Jellema, Korné, Bronner, Irene M, Remmers, Michel J M, Bienfait, Henri Paul, Witjes, Ron J G M, Greving, Jacoba P, and Klijn, Catharina J M
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- 2015
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12. The Prognostic Value of CT Angiography and CT Perfusion in Acute Ischemic Stroke
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van Seeters, Tom, Biessels, Geert Jan, Kappelle, Jaap L., van der Schaaf, Irene C., Dankbaar, Jan Willem, Horsch, Alexander D., Niesten, Joris M., Luitse, Merel J., Majoie, Charles B., Vos, Jan Albert, Schonewille, Wouter J., van Walderveen, Marianne A., Wermer, Marieke J., Duijm, Lucien E., Keizer, Koos, Bot, Joseph C., Visser, Marieke C., van der Lugt, Aad, Dippel, Diederik W., Kesselring, Oskar F., Hofmeijer, Jeannette, Lycklama à Nijeholt, Geert J., Boiten, Jelis, van Rooij, Willem Jan, de Kort, Paul L., Roos, Yvo B., van Dijk, Ewoud J., Pleiter, Constantijn C., Mali, Willem P., van der Graaf, Yolanda, and Velthuis, Birgitta K.
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- 2015
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13. Prediction of Cognitive Recovery after Stroke: The Value of Diffusion-Weighted Imaging–Based Measures of Brain Connectivity
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Aben, Hugo P., de Munter, Leonie, Reijmer, Yael D., Spikman, Jacoba M., Visser-Meily, Johanna M. A., Biessels, Geert-Jan, de Kort, Paul. L. M., Study Group, Procras, and Clinical Neuropsychology
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Male ,medicine.medical_specialty ,Physical medicine and rehabilitation ,Cognition ,medicine ,Humans ,Prospective Studies ,cardiovascular diseases ,Stroke ,Aged ,Advanced and Specialized Nursing ,medicine.diagnostic_test ,business.industry ,Cognitive disorder ,Magnetic resonance imaging ,Recovery of Function ,medicine.disease ,Hospitalization ,Diffusion Magnetic Resonance Imaging ,Brain infarction ,Female ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine ,business ,Cognition Disorders ,Value (mathematics) ,Diffusion MRI - Abstract
Background and Purpose: Prediction of long-term recovery of a poststroke cognitive disorder (PSCD) is currently inaccurate. We assessed whether diffusion-weighted imaging (DWI)–based measures of brain connectivity predict cognitive recovery 1 year after stroke in patients with PSCD in addition to conventional clinical, neuropsychological, and imaging variables. Methods: This prospective monocenter cohort study included 217 consecutive patients with a clinical diagnosis of ischemic stroke, aged ≥50 years, and Montreal Cognitive Assessment score below 26 during hospitalization. Five weeks after stroke, patients underwent DWI magnetic resonance imaging. Neuropsychological assessment was performed 5 weeks and 1 year after stroke and was used to classify PSCD as absent, modest, or marked. Cognitive recovery was operationalized as a shift to a better PSCD category over time. We evaluated 4 DWI-based measures of brain connectivity: global network efficiency and mean connectivity strength, both weighted for mean diffusivity and fractional anisotropy. Conventional predictors were age, sex, level of education, clinical stroke characteristics, neuropsychological variables, and magnetic resonance imaging findings (eg, infarct size). DWI-based measures of brain connectivity were added to a multivariable model to assess additive predictive value. Results: Of 135 patients (mean age, 71 years; 95 men [70%]) with PSCD 5 weeks after ischemic stroke, 41 (30%) showed cognitive recovery. Three of 4 brain connectivity measures met the predefined threshold of P Conclusions: Current DWI-based measures of brain connectivity appear to predict recovery of PSCD but at present have no added value over conventional predictors.
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- 2021
14. The influence of psychological factors on Health-Related Quality of Life after stroke: a systematic review
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van Mierlo, Maria L., Schröder, Carin, van Heugten, Caroline M., Post, Marcel W. M., de Kort, Paul L. M., and Visser-Meily, Johanna M. A.
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- 2014
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15. A longitudinal cohort study on quality of life in stroke patients and their partners: Restore4Stroke Cohort
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van Mierlo, Maria L., van Heugten, Caroline M., Post, Marcel W. M., Lindeman, Eline, de Kort, Paul L. M., and Visser-Meily, Johanna M.A.
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- 2014
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16. TEMPORAL EVOLUTION AND PREDICTORS OF SUBJECTIVE COGNITIVE COMPLAINTS UP TO 4 YEARS AFTER STROKE.
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NIJSSE, Britta, VERBERNE, Daan P. J., VISSER-MEILY, Johanna M. A., POST, Marcel W. M., DE KORT, Paul L. M., and VAN HEUGTEN, Caroline M.
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- 2021
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17. Extent to Which Network Hubs Are Affected by Ischemic Stroke Predicts Cognitive Recovery
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Aben, Hugo P., Biessels, Geert Jan, Weaver, Nick A., Spikman, Jacoba M., Visser-Meily, Johanna M. A., de Kort, Paul L. M., Reijmer, Yael D., Jansen, Ben P. W., Clinical Neuropsychology, Molecular Neuroscience and Ageing Research (MOLAR), and Movement Disorder (MD)
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Male ,cognition ,CONNECTOME ,Brain Ischemia ,0302 clinical medicine ,Neural Pathways ,magnetic resonance imaging ,Neuropsychological assessment ,brain infarction ,Advanced and Specialised Nursing ,Brain Mapping ,medicine.diagnostic_test ,05 social sciences ,Cognitive disorder ,Cognition ,Middle Aged ,IMPAIRMENT ,diffusion tensor imaging ,ANATOMY ,Stroke ,Brain size ,Cardiology ,Female ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,medicine.medical_specialty ,DISORDERS ,Clinical Neurology ,050105 experimental psychology ,Lesion ,03 medical and health sciences ,cognitive dysfunction ,Internal medicine ,Image Interpretation, Computer-Assisted ,PARCELLATION ,medicine ,Humans ,0501 psychology and cognitive sciences ,Aged ,Advanced and Specialized Nursing ,business.industry ,Magnetic resonance imaging ,Odds ratio ,Recovery of Function ,medicine.disease ,DYSFUNCTION ,Neurology (clinical) ,business ,Cognition Disorders ,030217 neurology & neurosurgery ,Diffusion MRI - Abstract
Background and Purpose— It is uncertain what determines the potential for cognitive recovery after ischemic stroke. The extent to which strategic areas of the brain network, so-called hubs, are affected by the infarct could be a key factor. We developed a lesion impact score, which estimates the damage to network hubs by integrating information on infarct size with healthy brain network topology. We verified whether the lesion impact score indeed reflects global network disturbances in patients and assessed if it could predict cognitive recovery. Methods— Seventy-five ischemic stroke patients without signs of a prestroke cognitive disorder were included, all with evidence of a cognitive disorder during hospitalization. A brain magnetic resonance imaging and neuropsychological assessment were performed 5 weeks (±1 week) after stroke. Neuropsychological testing was repeated after 1 year to assess cognitive recovery. Brain networks were reconstructed from diffusion-weighted data and consisted of 90 gray matter regions (ie, network nodes). A standard brain network map, indicating the hub-score of each node, was obtained from network data of 44 cognitively healthy adults. For each patient, we calculated the lesion impact score by multiplying the percentage of node volume affected by the infarct with the node’s corresponding hub-score. The patients’ maximum lesion impact score was used as outcome predictor. Results— A higher lesion impact score in patients, indicating an increasing infarct size in nodes with a higher hub-score, was related to lower global brain network efficiency (β=−0.528 [−0.776 to −0.277]; P P =0.044). Conclusions— We introduced a lesion impact score that combines information on infarct size and network topology to predict long-term recovery after stroke. This score can potentially be used in a clinical setting, also without availability of high-resolution diffusion-weighted magnetic resonance imaging.
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- 2019
18. Impaired Emotion Recognition after Left Hemispheric Stroke: A Case Report and Brief Review of the Literature
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Aben, Hugo P., Reijmer, Yael D., Visser-Meily, Johanna M. A., Spikman, Jacoba M., Biessels, Geert Jan, de Kort, Paul L. M., and Study Group, PROCRAS
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Article Subject - Abstract
Impaired recognition of emotion after stroke can have important implications for social competency, social participation, and consequently quality of life. We describe a case of left hemispheric ischemic stroke with impaired recognition of specifically faces expressing fear. Three months later, the patient’s spouse reports that the patient was irritable and slow in communication, which may be caused by the impaired emotion recognition. The case is discussed in relation to the literature concerning emotion recognition and its neural correlates. Our case supports the notion that emotion recognition, including fear recognition, is regulated by a network of interconnected brain regions located in both hemispheres. We conclude that impaired emotion recognition is not uncommon after stroke and can be caused by dysfunction of this emotion-network.
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- 2017
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19. Psychological factors and subjective cognitive complaints after stroke: Beyond depression and anxiety.
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van Rijsbergen, Mariëlle W. A., Mark, Ruth E., Kop, Willem J., de Kort, Paul L. M., and Sitskoorn, Margriet M.
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PSYCHOLOGICAL factors ,PERCEIVED Stress Scale ,FIVE-factor model of personality ,MAUDSLEY personality inventory ,PERSONALITY ,ANXIETY - Abstract
Subjective Cognitive Complaints (SCC) are common after stroke and adversely affect quality of life. In the present study, we determined the associations of depression, anxiety, perceived stress and fatigue with post-stroke SCC, and whether these associations were independent of objective cognitive functioning, stroke characteristics and individual differences in personality traits and coping styles. Using a cross-sectional design, SCC and psychological measures were obtained in 208 patients (mean 3.3 ± 0.5 months after stroke; 65.9% men; mean age 64.9 ± 12.4 years). SCC were assessed using the Checklist for Cognitive and Emotional consequences following stroke (CLCE) inventory. Validated questionnaires were used to measure depression and anxiety (Hospital Anxiety and Depression Scale), perceived stress (Perceived Stress Scale), fatigue (Fatigue Assessment Scale), personality traits (Eysenck Personality Questionnaire Revised Short Scale) and coping style (Utrecht Coping List). Multivariate hierarchical linear regression analyses were used to adjust for covariates. Depression (β = 0.35), anxiety (β = 0.38), perceived stress (β = 0.39), and fatigue (β = 0.39) were associated with CLCE scores, independent of demographic, cognitive performance and stroke-related covariates. After including personality traits and coping styles in the model, independent associations with CLCE scores were found for fatigue (β = 0.26, p = .003) and neuroticism (β = 0.21, p = .05). Interventions aimed at improving psychological resilience and increasing energy levels might be a worthwhile addition to stroke rehabilitation programmes by reducing SCC and improving quality of life. [ABSTRACT FROM AUTHOR]
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- 2019
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20. Observer variability of absolute and relative thrombus density measurements in patients with acute ischemic stroke
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Santos, Emilie M. M., Yoo, Albert J., Beenen, Ludo F., Berkhemer, Olvert A., den Blanken, Mark D., Wismans, Carrie, Niessen, Wiro J., Majoie, Charles B., Marquering, Henk A., Fransen, Puck S. S., Beumer, Debbie, van den Berg, Lucie A., Lingsma, Hester F., Schonewille, Wouter J., Vos, Jan Albert, Nederkoorn, Paul J., Wermer, Marieke J. H., van Walderveen, Marianne A. A., Staals, Julie, Hofmeijer, Jeannette, van Oostayen, Jacques A., Lycklama à Nijeholt, Geert J., Boiten, Jelis, Brouwer, Patrick A., Emmer, Bart J., de Bruijn, Sebastiaan F., van Dijk, Lukas C., Kappelle, L. Jaap, Lo, Rob H., van Dijk, Ewoud J., de Vries, Joost, de Kort, Paul L. M., van den Berg, Jan S. P., A A M van Hasselt, Boudewijn, Aerden, Leo A. M., Dallinga, René J., Visser, Marieke C., Bot, Joseph C. J., Vroomen, Patrick C., Eshghi, Omid, Schreuder, Tobien H. C. M. L., Heijboer, Roel J. J., Keizer, Koos, Tielbeek, Alexander V., Hertog, Heleen M. Den, Gerrits, Dick G., van den Berg-Vos, Renske M., Sprengers, Marieke E. S., van den Berg, René, Roos, Yvo B. W. E. M., Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), RS: CARIM - R3.11 - Imaging, MUMC+: MA Neurologie (3), Klinische Neurowetenschappen, RS: CARIM - R3.03 - Cerebral small vessel disease, Other departments, ANS - Neurovascular Disorders, Graduate School, Radiology and Nuclear Medicine, Other Research, ACS - Amsterdam Cardiovascular Sciences, Biomedical Engineering and Physics, Neurology, and Radiology & Nuclear Medicine
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Male ,Observer (quantum physics) ,Computed Tomography Angiography ,Intraclass correlation ,Clinical Neurology ,Sensitivity and Specificity ,030218 nuclear medicine & medical imaging ,X-ray ,03 medical and health sciences ,Brain ischemia ,Absorptiometry, Photon ,0302 clinical medicine ,Thromboembolism ,Observer agreements ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,cardiovascular diseases ,Thrombus ,Acute ischemic stroke ,Computed tomography ,Diagnostic Neuroradiology ,Aged ,Netherlands ,Neuroradiology ,Observer Variation ,Measurement method ,business.industry ,Reproducibility of Results ,Thrombosis ,Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3] ,medicine.disease ,Cerebral Angiography ,Radiographic Image Enhancement ,Stroke ,Radiology Nuclear Medicine and imaging ,Interobserver Variation ,Acute Disease ,Radiographic Image Interpretation, Computer-Assisted ,Female ,Neurology (clinical) ,Intracranial Thrombosis ,Cardiology and Cardiovascular Medicine ,business ,Nuclear medicine ,Algorithms ,030217 neurology & neurosurgery - Abstract
Introduction Thrombus density may be a predictor for acute ischemic stroke treatment success. However, only limited data on observer variability for thrombus density measurements exist. This study assesses the variability and bias of four common thrombus density measurement methods by expert and non-expert observers. Methods For 132 consecutive patients with acute ischemic stroke, three experts and two trained observers determined thrombus density by placing three standardized regions of interest (ROIs) in the thrombus and corresponding contralateral arterial segment. Subsequently, absolute and relative thrombus densities were determined using either one or three ROIs. Intraclass correlation coefficient (ICC) was determined, and Bland–Altman analysis was performed to evaluate interobserver and intermethod agreement. Accuracy of the trained observer was evaluated with a reference expert observer using the same statistical analysis. Results The highest interobserver agreement was obtained for absolute thrombus measurements using three ROIs (ICCs ranging from 0.54 to 0.91). In general, interobserver agreement was lower for relative measurements, and for using one instead of three ROIs. Interobserver agreement of trained non-experts and experts was similar. Accuracy of the trained observer measurements was comparable to the expert interobserver agreement and was better for absolute measurements and with three ROIs. The agreement between the one ROI and three ROI methods was good. Conclusion Absolute thrombus density measurement has superior interobserver agreement compared to relative density measurement. Interobserver variation is smaller when multiple ROIs are used. Trained non-expert observers can accurately and reproducibly assess absolute thrombus densities using three ROIs. Electronic supplementary material The online version of this article (doi:10.1007/s00234-015-1607-4) contains supplementary material, which is available to authorized users.
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- 2016
21. Time to Reperfusion and Treatment Effect for Acute Ischemic Stroke : A Randomized Clinical Trial
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Fransen, Puck S S, Berkhemer, Olvert A, Lingsma, Hester F, Beumer, Debbie, van den Berg, Lucie A, Yoo, Albert J, Schonewille, Wouter J, Vos, Jan Albert, Nederkoorn, Paul J, Wermer, Marieke J H, van Walderveen, Marianne A A, Staals, Julie, Hofmeijer, Jeannette, van Oostayen, Jacques A, Lycklama À Nijeholt, Geert J, Boiten, Jelis, Brouwer, Patrick A, Emmer, Bart J, de Bruijn, Sebastiaan F, van Dijk, Lukas C, Kappelle, L Jaap, Lo, Rob H, van Dijk, Ewoud J, de Vries, Joost, de Kort, Paul L M, van den Berg, J S Peter, van Hasselt, Boudewijn A A M, Aerden, Leo A M, Dallinga, René J, Visser, Marieke C, Bot, Joseph C J, Vroomen, Patrick C, Eshghi, Omid, Schreuder, Tobien H C M L, Heijboer, Roel J J, Keizer, Koos, Tielbeek, Alexander V, den Hertog, Heleen M, Gerrits, Dick G, van den Berg-Vos, Renske M, Karas, Giorgos B, Steyerberg, Ewout W, Flach, H Zwenneke, Marquering, Henk A, Sprengers, Marieke E S, Jenniskens, Sjoerd F M, Beenen, Ludo F M, van den Berg, René, Koudstaal, Peter J, van Zwam, Wim H, and Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands (MR CLEAN) investigators
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Multicenter Study ,Research Support, Non-U.S. Gov't ,Randomized Controlled Trial ,Journal Article - Abstract
Importance: Intra-arterial treatment (IAT) for acute ischemic stroke caused by intracranial arterial occlusion leads to improved functional outcome in patients treated within 6 hours after onset. The influence of treatment delay on treatment effect is not yet known. Objective: To evaluate the influence of time from stroke onset to the start of treatment and from stroke onset to reperfusion on the effect of IAT. Design, Setting, and Participants: The Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands (MR CLEAN) was a multicenter, randomized clinical open-label trial of IAT vs no IAT in 500 patients. The time to the start of treatment was defined as the time from onset of symptoms to groin puncture (TOG). The time from onset of treatment to reperfusion (TOR) was defined as the time to reopening the vessel occlusion or the end of the procedure in cases for which reperfusion was not achieved. Data were collected from December 3, 2010, to June 3, 2014, and analyzed (intention to treat) from July 1, 2014, to September 19, 2015. Main Outcomes and Measures: Main outcome was the modified Rankin Scale (mRS) score for functional outcome (range, 0 [no symptoms] to 6 [death]). Multiple ordinal logistic regression analysis estimated the effect of treatment and tested for the interaction of time to randomization, TOG, and TOR with treatment. The effect of treatment as a risk difference on reaching independence (mRS score, 0-2) was computed as a function of TOG and TOR. Calculations were adjusted for age, National Institutes of Health Stroke Scale score, previous stroke, atrial fibrillation, diabetes mellitus, and intracranial arterial terminus occlusion. Results: Among 500 patients (58% male; median age, 67 years), the median TOG was 260 (interquartile range [IQR], 210-311) minutes; median TOR, 340 (IQR, 274-395) minutes. An interaction between TOR and treatment (P = .04) existed, but not between TOG and treatment (P = .26). The adjusted risk difference (95% CI) was 25.9% (8.3%-44.4%) when reperfusion was reached at 3 hours, 18.8% (6.6%-32.6%) at 4 hours, and 6.7% (0.4%-14.5%) at 6 hours. Conclusion and Relevance: For every hour of reperfusion delay, the initially large benefit of IAT decreases; the absolute risk difference for a good outcome is reduced by 6% per hour of delay. Patients with acute ischemic stroke require immediate diagnostic workup and IAT in case of intracranial arterial vessel occlusion. Trial Registration: trialregister.nl Identifier: NTR1804.
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- 2016
22. Automated Entire Thrombus Density Measurements for Robust and Comprehensive Thrombus Characterization in Patients with Acute Ischemic Stroke
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Santos, Emilie M. M., Niessen, Wiro J., Yoo, Albert J., Berkhemer, Olvert A., Beenen, Ludo F., Majoie, Charles B., Marquering, Henk A., Fransen, Puck S. S., Beumer, Debbie, van den Berg, Lucie A., Lingsma, Hester F., Schonewille, Wouter J., Vos, Jan Albert, Nederkoorn, Paul J., Wermer, Marieke J. H., van Walderveen, Marianne A. A., Staals, Julie, Hofmeijer, Jeannette, van Oostayen, Jacques A., Lycklama à Nijeholt, Geert J., Boiten, Jelis, Brouwer, Patrick A., Emmer, Bart J., de Bruijn, Sebastiaan F., van Dijk, Lukas C., Kappelle, L. Jaap, Lo, Rob H., van Dijk, Ewoud J., de Vries, Joost, de Kort, Paul L. M., van den Berg, Jan S. P., van Hasselt, Boudewijn A. A. M., Aerden, Leo A. M., Dallinga, René J., Visser, Marieke C., Bot, Joseph C. J., Vroomen, Patrick C., Eshghi, Omid, Schreuder, Tobien H. C. M. L., Heijboer, Roel J. J., Keizer, Koos, Tielbeek, Alexander V., den Hertog, Heleen M., Gerrits, Dick G., van den Berg-Vos, Renske M., Karas, Giorgos B., Steyerberg, Ewout W., Sprengers, Marieke E. S., van den Berg, René, Roos, Yvo B. W. E. M., Other departments, Radiology and Nuclear Medicine, ACS - Amsterdam Cardiovascular Sciences, ANS - Neurovascular Disorders, Graduate School, Other Research, Biomedical Engineering and Physics, Neurology, Public and occupational health, EMGO - Quality of care, Radiology and nuclear medicine, Amsterdam Neuroscience - Neurovascular Disorders, Medical Informatics, Radiology & Nuclear Medicine, MUMC+: MA Neurologie (3), Klinische Neurowetenschappen, RS: CARIM - R3.03 - Cerebral small vessel disease, Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), and RS: CARIM - R3.11 - Imaging
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Male ,medicine.medical_specialty ,lcsh:Medicine ,Research Support ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Absorptiometry, Photon ,0302 clinical medicine ,Interquartile range ,Linear regression ,medicine ,Journal Article ,Humans ,cardiovascular diseases ,Thrombus ,Absorptiometry ,lcsh:Science ,Non-U.S. Gov't ,Stroke ,Acute ischemic stroke ,Tomography ,Aged ,Multidisciplinary ,business.industry ,Research Support, Non-U.S. Gov't ,lcsh:R ,Thrombosis ,Cerebral Arteries ,Middle Aged ,Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3] ,medicine.disease ,Photon ,Internal ,X-Ray Computed ,Kurtosis ,cardiovascular system ,lcsh:Q ,Female ,Radiology ,Carotid Artery ,Tomography, X-Ray Computed ,business ,Carotid Artery, Internal ,030217 neurology & neurosurgery ,Research Article ,circulatory and respiratory physiology - Abstract
Contains fulltext : 168317.PDF (Publisher’s version ) (Open Access) BACKGROUND AND PURPOSE: In acute ischemic stroke (AIS) management, CT-based thrombus density has been associated with treatment success. However, currently used thrombus measurements are prone to inter-observer variability and oversimplify the heterogeneous thrombus composition. Our aim was first to introduce an automated method to assess the entire thrombus density and then to compare the measured entire thrombus density with respect to current standard manual measurements. MATERIALS AND METHOD: In 135 AIS patients, the density distribution of the entire thrombus was determined. Density distributions were described using medians, interquartile ranges (IQR), kurtosis, and skewedness. Differences between the median of entire thrombus measurements and commonly applied manual measurements using 3 regions of interest were determined using linear regression. RESULTS: Density distributions varied considerably with medians ranging from 20.0 to 62.8 HU and IQRs ranging from 9.3 to 55.8 HU. The average median of the thrombus density distributions (43.5 +/- 10.2 HU) was lower than the manual assessment (49.6 +/- 8.0 HU) (p
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- 2016
23. Association of Reperfusion With Brain Edema in Patients With Acute Ischemic Stroke : A Secondary Analysis of the MR CLEAN Trial
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Kimberly, W. Taylor, Dutra, Bruna Garbugio, Boers, Anna M. M., Alves, Heitor C. B. R., Berkhemer, Olvert A., van den Berg, Lucie, Sheth, Kevin N., Roos, Yvo B. W. E. M., van der Lugt, Aad, Beenen, Ludo F. M., Dippel, Diederik W. J., van Zwam, Wim H., van Oostenbrugge, Robert J., Lingsma, Hester F., Marquering, Henk, Majoie, Charles B. L. M., Koudstaal, Peter J., van den Berg, Lucie A., Nederkoorn, Paul J., Beumer, Debbie, Staals, Julie, Boiten, Jelis, Wermer, Marieke J. H., Kappelle, L. Jaap, van Dijk, Ewoud J., Schonewille, Wouter J., Hofmeijer, Jeannette, van Oostayen, Jacques A., Vroomen, Patrick C., de Kort, Paul L. M., Keizer, Koos, de Bruijn, Sebastiaan F., van den Berg, J. S. Peter, Schreuder, Tobien H. C. M. L., Aerden, Leo A. M., Flach, H. Zwenneke, Visser, Marieke C., den Hertog, Heleen M., Brouwer, Patrick A., Emmer, Bart J., Sprengers, Marieke E. S., van den Berg, René, Nijeholt, Geert J. Lycklamaà, van Walderveen, Marianne A. A., Lo, Rob H., de Vries, Joost, Vos, Jan Albert, Eshghi, Omid, Tielbeek, Alexander V., van Dijk, Lukas C., van Hasselt, Boudewijn A. A. M., Heijboer, Roel J. J., Dallinga, René J., Bot, Joseph C. J., Gerrits, Dick G., Fransen, Puck S. S., Marquering, Henk A., Steyerberg, Ewout W., Yoo, Albert J., Jenniskens, Sjoerd F. M., van den Berg-Vos, Renske M., Karas, Giorgos B., Brown, Martin M., Liebig, Thomas, Stijnen, Theo, Andersson, Tommy, Mattle, Heinrich, Wahlgren, Nils, van der Heijden, Esther, Ghannouti, Naziha, Fleitour, Nadine, Hooijenga, Imke, Puppels, Corina, Pellikaan, Wilma, Geerling, Annet, Lindl-Velema, Annemieke, van Vemde, Gina, Klinieken, Isala, de Ridder, Ans, Greebe, Paut, de Bont-Stikkelbroeck, José, de Meris, Joke, Janssen, Kirsten, Struijk, Willy, Licher, Silvan, Boodt, Nikki, Ros, Adriaan, Venema, Esmee, Slokkers, Ilse, Ganpat, Raymie-Jayce, Mulder, Maxim, Saiedie, Nawid, Heshmatollah, Alis, Schipperen, Stefanie, Vinken, Stefan, van Boxtel, Tiemen, Koets, Jeroen, Neurology, Radiology & Nuclear Medicine, Public Health, Radiology and nuclear medicine, VU University medical center, Amsterdam Neuroscience - Neurovascular Disorders, Beeldvorming, RS: CARIM - R3.03 - Cerebral small vessel disease, RS: CARIM - R3.11 - Imaging, MUMC+: DA BV Medisch Specialisten Radiologie (9), RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, Klinische Neurowetenschappen, MUMC+: MA Neurologie (3), Radiology and Nuclear Medicine, ACS - Amsterdam Cardiovascular Sciences, ANS - Neurovascular Disorders, Graduate School, Other Research, ARD - Amsterdam Reproduction and Development, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, ACS - Microcirculation, ACS - Atherosclerosis & ischemic syndromes, and ACS - Pulmonary hypertension & thrombosis
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,Infarction ,Brain Edema ,ANGIOGRAPHY ,THERAPY ,Cerebral edema ,Brain Ischemia ,03 medical and health sciences ,0302 clinical medicine ,Midline shift ,Modified Rankin Scale ,Internal medicine ,Outcome Assessment, Health Care ,medicine ,INJURY ,Journal Article ,Humans ,030212 general & internal medicine ,cardiovascular diseases ,PREDICTORS ,Stroke ,Aged ,Netherlands ,Retrospective Studies ,Original Investigation ,THROMBOLYSIS ,business.industry ,Cerebral infarction ,Endovascular Procedures ,Odds ratio ,Thrombolysis ,Middle Aged ,medicine.disease ,MIDDLE-CEREBRAL-ARTERY ,DIFFUSION ,THRESHOLDS ,Treatment Outcome ,TISSUE ,Reperfusion ,Cardiology ,Female ,Neurology (clinical) ,business ,INFARCTION ,030217 neurology & neurosurgery - Abstract
Importance: It is uncertain whether therapeutic reperfusion with endovascular treatment yields more or less brain edema. Objective: To elucidate the association between reperfusion and brain edema. The secondary objectives were to evaluate whether brain edema could partially be responsible for worse outcomes in patients with later reperfusion or lower Alberta Stroke Program Early Computed Tomography Score. Design, Setting, and Participants: This was a post hoc analysis of the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN), which was a prospective, randomized, multicenter clinical trial of endovascular treatment compared with conventional care of patients with acute anterior circulation ischemic stroke. Of 502 patients enrolled from December 2010 to June 2014, 2 patients declined to participate. Additionally, exclusion criteria were absence of follow-up imaging or presence of parenchymal hematoma, resulting in 462 patients included in this study. Brain edema was assessed retrospectively, from December 10, 2016, to July 24, 2017, by measuring midline shift (MLS) in all available follow-up scans. Observers were blinded to clinical data. Main Outcomes and Measures: Midline shift was assessed as present or absent and as a continuous variable. Reperfusion status was assessed by the modified thrombolysis in cerebral infarction score in the endovascular treatment arm. The modified arterial occlusive lesion score was used to evaluate the recanalization status in both arms. The modified Rankin scale score at 90 days was used for functional outcome. Results: Of 462 patients, the mean (SD) age was 65 (11) years, and 41.8% (n = 193) were women. Successful reperfusion and recanalization were associated with a reduced likelihood of having MLS (adjusted common odds ratio, 0.25; 95% CI, 0.12-0.53; P
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- 2018
24. Diagnostic and Prognostic Impact of pc-ASPECTS Applied to Perfusion CT in the Basilar Artery International Cooperation Study
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Pallesen, Lars-Peder, Gerber, Johannes, Dzialowski, Imanuel, van der Hoeven, Erik J.R.J., Michel, Patrick, Pfefferkorn, Thomas, Ozdoba, Christoph, Kappelle, L. Jaap, Wiedemann, Bärbel, Khomenko, Andrei, Algra, Ale, Hill, Michael D., von Kummer, Rüdiger, Demchuk, Andrew M., Schonewille, Wouter J., Pütz, Volker, Weber, Alexandra M., Donnan, Geoffrey A., Thijs, Vincent N. S., Peeters, André Philippe, De Freitas, G., Conforto, Adriana Bastos Astos, Miranda-Alves, Maramélia A., Massaro, Ayrton Roberto, Ijäs, Petra, Bogoslovsky, Tanya, Lindsberg, Perttu Johannes, Weimar, Christian, Benemann, Jens, Kraywinkel, Klaus, Haverkamp, Christian, Michalsky, Dominik, Weissenborn, Karin, Görtler, Michael Wolfgang, Kloth, Antje, Bitsch, Andreas, Mieck, Thomas, Machetanz, Jochen, Möller, P., Huber, Roman, Kaendler, Stephen H., Rückert, Christina M., Audebert, H., Müller, Robert A., Vatankhah, Bijan, Pfefferkorn, T., Mayer, Thomas E., Szabo, Kristina, Disqué, Claudia, Busse, Otto, Berger, Christian A., Hacke, Werner, Schwammenthal, Yvonne, Orion, David, Tanné, David, Bergui, Mauro, Pozatti, Eugenio, Luijckx, Gert Jan R., Vroomen, Patrick C. A. J., Vergouwen, Mervyn D.I. I., Roos, Yvo Bwem W. E. M., Stam, Jan, De Bienfait, P., De Leeuw, Frank Erik, De Kort, Paul L. M., Dippel, Diederik W. J., Baird, Tracey A., Muir, Kathy, McDougall, N., Pagolla, Jorge, Ribó, Marc, Molina, Carlos Alberto, Gonzales, Aurora Astudillo, Gil-Peralta, Alberto, Norrving, Bo, Arnold, Marcel, Fischer, Urs, Gralla, Jan, Mattle, Heinrich P., Schroth, Gerhard, Michel, Patrik, Engelter, Stefan T., Wetzel, Stephan G., Lyrer, Philippe A., Grandjour, Joubin, Michael, Nicolaus, Baumgartner, Ralph W., Tettenborn, Barbara, Hungerbuehler, Hansjoerg, Wijman, Cristanne A. C., Caulfield, Anna Finley Inley, Lansberg, Maarten G., Schwartz, Neil E., Venkatasubramanian, Chitra, Garami, Zsolt F., Bogaard, S., Yatzu, F., and Grotta, James C.
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Medizin - Published
- 2015
25. Social Cognition Impairments in the Long Term Post Stroke.
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Nijsse, Britta, Spikman, Jacoba M., Visser-Meily, Johanna M., de Kort, Paul L., and van Heugten, Caroline M.
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To examine the presence of social cognition deficits and the relationship between social and general cognition (eg, attention, mental speed, verbal, visual, or memory abilities) in a large sample of chronic stroke patients and to identify stroke-related factors associated with social cognitive performance. Inception cohort study in which social cognition was assessed at 3-4 years post stroke. Stroke units in 6 general hospitals. The data of 148 patients were available. Fifty controls without stroke (consisting of partners of patients and acquaintances of researchers) were recruited (N=198). Not applicable. Patients underwent neuropsychological assessment by means of tests for social cognition (emotion recognition, theory of mind [ToM], empathy, and behavior regulation) and general cognition. Subgroup analysis was performed to compare right hemisphere stroke patients with left hemisphere stroke patients. Correlations between general and social cognition tests were assessed. Multiple regression analyses were performed to identify demographic and stroke-related predictors of social cognitive performance. Patients performed significantly worse on emotion recognition (assessed with the Ekman 60-Faces test on total score as well as on the emotion anger), ToM (assessed with the Cartoon test), and behavior regulation (assessed with the Hayling test). Subgroup analysis revealed no differences between right and left hemisphere patients. Social cognition tests showed significant correlations with each other and with tests for visual perception, language, mental speed, cognitive flexibility, and memory. Older age, low level of education (and for ToM, also female sex) were predictors of worse performance on social cognition tests. Social cognition impairments are present in the long term post stroke, even in a group of mildly affected stroke patients, which may contribute to their long-term problems. Severity of impairments is determined mainly by demographic factors. [ABSTRACT FROM AUTHOR]
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- 2019
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26. Social cognition impairments are associated with behavioural changes in the long term after stroke.
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Nijsse, Britta, Spikman, Jacoba M., Visser-Meily, Johanna M. A., de Kort, Paul L. M., and van Heugten, Caroline M.
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EMOTION recognition ,COGNITIVE testing ,NEUROPSYCHOLOGICAL tests ,THEORY of mind ,STROKE ,EMOTIONAL conditioning ,SOCIAL perception - Abstract
Background and purpose Behavioural changes after stroke might be explained by social cognition impairments. The aim of the present study was to investigate whether performances on social cognition tests (including emotion recognition, Theory of Mind (ToM), empathy and behaviour regulation) were associated with behavioural deficits (as measured by proxy ratings) in a group of patients with relatively mild stroke. Methods Prospective cohort study in which 119 patients underwent neuropsychological assessment with tests for social cognition (emotion recognition, ToM, empathy, and behaviour regulation) 3–4 years post stroke. Test scores were compared with scores of 50 healthy controls. Behavioural problems were assessed with the Dysexecutive Questionnaire (DEX) self rating and proxy rating scales. Pearson correlations were used to determine the relationship between the social cognition measures and DEX scores. Results Patients performed significantly worse on emotion recognition, ToM and behaviour regulation tests than controls. Mean DEX-self score did not differ significantly from the mean DEXproxy score. DEX-proxy ratings correlated with tests for emotion recognition, empathy, and behavioural regulation (lower scores on these items were associated with more problems on the DEX-proxy scale). Conclusions Social cognition impairments are present in the long term after stroke, even in a group of mildly affected stroke patients. Most of these impairments also turned out to be associated with a broad range of behavioural problems as rated by proxies of the patients. This strengthens the proposal that social cognition impairments are part of the underlying mechanism of behavioural change. Since tests for social cognition can be administered in an early stage, this would allow for timely identification of patients at risk for behavioural problems in the long term. [ABSTRACT FROM AUTHOR]
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- 2019
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27. Predicting the presence of macrovascular causes in non-traumatic intracerebral haemorrhage: the DIAGRAM prediction score.
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Hilkens, Nina A., van Asch, Charlotte J. J., Werring, David J., Wilson, Duncan, Rinkel, Gabriël J. E., Algra, Ale, Velthuis, Birgitta K., de Kort, Gérard A. P., Witkamp, Theo D., van Nieuwenhuizen, Koen M., de Leeuw, Frank-Erik, Schonewille, Wouter J., de Kort, Paul L. M., Dippel, Diederik W. J., Raaymakers, Theodora W. M., Hofmeijer, Jeannette, Wermer, Marieke J. H., Kerkhoff, Henk, Jellema, Korné, and Bronner, Irene M.
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INTRACEREBRAL hematoma ,ANEURYSMS ,THROMBOSIS ,YOUNG adults ,ANGIOGRAPHY - Abstract
Objective: A substantial part of non-traumatic intracerebral haemorrhages (ICH) arises from a macrovascular cause, but there is little guidance on selection of patients for additional diagnostic work-up. We aimed to develop and externally validate a model for predicting the probability of a macrovascular cause in patients with non-traumatic ICH.Methods: The DIagnostic AngioGRAphy to find vascular Malformations (DIAGRAM) study (n=298; 69 macrovascular cause; 23%) is a prospective, multicentre study assessing yield and accuracy of CT angiography (CTA), MRI/ magnetic resonance angiography (MRA) and intra-arterial catheter angiography in diagnosing macrovascular causes in patients with non-traumatic ICH. We considered prespecified patient and ICH characteristics in multivariable logistic regression analyses as predictors for a macrovascular cause. We combined independent predictors in a model, which we validated in an external cohort of 173 patients with ICH (78 macrovascular cause, 45%).Results: Independent predictors were younger age, lobar or posterior fossa (vs deep) location of ICH, and absence of small vessel disease (SVD). A model that combined these predictors showed good performance in the development data (c-statistic 0.83; 95% CI 0.78 to 0.88) and moderate performance in external validation (c-statistic 0.66; 95% CI 0.58 to 0.74). When CTA results were added, the c-statistic was excellent (0.91; 95% CI 0.88 to 0.94) and good after external validation (0.88; 95% CI 0.83 to 0.94). Predicted probabilities varied from 1% in patients aged 51-70 years with deep ICH and SVD, to more than 50% in patients aged 18-50 years with lobar or posterior fossa ICH without SVD.Conclusion: The DIAGRAM scores help to predict the probability of a macrovascular cause in patients with non-traumatic ICH based on age, ICH location, SVD and CTA. [ABSTRACT FROM AUTHOR]- Published
- 2018
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28. Advance directives, proxy opinions, and treatment restrictions in patients with severe stroke.
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de Kort, Floor A. S., Geurtsr, Marjolein, de Kort, Paul L. M., van Tuijl, Julia H., van Thiel, Ghislaine J. M. W., Kappelle, L. Jaap, and van der Worp, H. Bart
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INTERVIEWING ,LONGITUDINAL method ,RESEARCH methodology ,PROXY ,QUESTIONNAIRES ,TERMINAL care ,ADVANCE directives (Medical care) ,LIVING wills ,STROKE patients ,BARTHEL Index ,PATIENT autonomy ,PATIENT decision making - Abstract
Background: Patients with severe stroke often do not have the capacity to participate in discussions on treatment restrictions because of a reduced level of consciousness, aphasia, or another cognitive disorder. We assessed the role of advance directives and proxy opinions in the decision-making process of incapacitated patients. Methods: Sixty patients with severe functional dependence (Barthel Index ≤6) at day four after ischemic stroke or intracerebral hemorrhage were included in a prospective two-center cohort study. The decision-making process with respect to treatment restrictions was assessed by means of a semi-structured questionnaire administered to the treating physician at the day of inclusion. Results: Forty-nine patients (82%) did not have the capacity to participate in the decision-making process. In eight patients, there was no discussion on treatment restrictions and full care was installed. In 41 patients, the decision whether to install treatment restrictions was discussed with proxies. One patient had a written advance directive. In the remaining 40 patients, proxies based their opinion on previously expressed wishes of the patient (18 patients) or advised in the best interest of the patient (22 patients). In 36 of 41 patients, treatment restrictions were installed after agreement between physician and proxy. At six months, 23 of 49 patients had survived. In only three of them the decision on treatment restrictions was based on previously expressed wishes. Remarkably, two of these survivors could not recall any of their alleged previously expressed wishes. Conclusions: Treatment restrictions were installed in the majority of incapacitated patients after stroke. Proxy opinions frequently served as the best way to respect the patients' autonomy, but their accuracy remains unclear. [ABSTRACT FROM AUTHOR]
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- 2017
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29. Quality of life after intra-arterial treatment for acute ischemic stroke in the MR CLEAN trial--Update.
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Schreuders, Jennifer, Van Den Berg, Lucie A., Fransen, Puck S. S., Berkhemer, Olvert A., Beumer, Debbie, Lingsma, Hester F., Van Oostenbrugge, Robert J., Van Zwam, Wim H., Majoie, Charles B. L. M., Van Der Lugt, Aad, De Kort, Paul L. M., Roos, Yvo B. W. E. M., and Dippel, Diederik W. J.
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ARTERIAL occlusions ,INTRACRANIAL arterial diseases ,TRANSIENT ischemic attack treatment ,QUALITY of life measurement ,INTRA-arterial infusions - Abstract
Background: Health-related quality of life measured with the EuroQol Group 5-Dimension Self-Report Questionnaire was one of the secondary outcomes in the Multicenter Randomized Clinical trial of Endovascular treatment for Acute ischemic stroke in the Netherlands (MR CLEAN).We reported no statistically significant difference in EuroQol Group 5-Dimension Self-Report Questionnaire score between the intervention and control groups, but deaths were not included. Aims: Reanalyze the effect of intra-arterial treatment for large vessel occlusion in acute ischemic stroke patients on health-related quality of life in more detail. We now include patients who died during follow-up. Methods: The EuroQol Group 5-Dimension Self-Report Questionnaire questionnaires were obtained 90 days after treatment. We used the Dutch tariff to derive a utility index from the EuroQol Group 5-Dimension Self-Report Questionnaire score. Treatment effect was estimated with the Mann-Whitney U test and linear regression. The effect of treatment on the distribution of EuroQol Group 5-Dimension Self-Report Questionnaire dimension scores was assessed with ordinal logistic regression. Results: We obtained EuroQol Group 5-Dimension Self-Report Questionnaire scores from 457 (91.7%) of the 500 patients, including 108 who died before follow-up. Median EuroQol Group 5-Dimension Self-Report Questionnaire score in the intervention group was 0.57, and 0.39 in the control group (p=0.03). Treatment effect estimated with linear regression was 0.07 (95%CI: -0.001 to 0.143). Treatment specifically affected EuroQol Group 5-Dimension Self- Report Questionnaire dimensions "mobility" (OR: 0.43, 95%CI: 0.29-0.66), "self-care" (OR: 0.60, 95%CI: 0.41-0.89), and "usual activities" (OR: 0.53, 95%CI: 0.36-0.79). Conclusion: Treatment had a limited effect on quality of life, as measured with the EuroQol Group 5-Dimension Self-Report Questionnaire. Nevertheless, patients with acute ischemic stroke caused by an intracranial occlusion in the anterior circulation, who had intra-arterial treatment, experience better health-related quality of life than patients without intra-arterial treatment. Trial Registration: URL: http://www.isrctn.com/ISRCTN10888758 Unique identifier: ISRCTN10888758 [ABSTRACT FROM AUTHOR]
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- 2017
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30. Predictive accuracy of physicians’ estimates of outcome after severe stroke.
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Geurts, Marjolein, de Kort, Floor A. S., de Kort, Paul L. M., van Tuijl, Julia H., Kappelle, L. Jaap, and van der Worp, H. Bart
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TERMINAL care ,STROKE prognosis ,STROKE-related mortality ,QUALITY of life ,MEDICAL decision making ,FOLLOW-up studies (Medicine) - Abstract
Introduction: End-of-life decisions after stroke should be guided by accurate estimates of the patient’s prognosis. We assessed the accuracy of physicians’ estimates regarding mortality, functional outcome, and quality of life in patients with severe stroke. Methods: Treating physicians predicted mortality, functional outcome (modified Rankin scale (mRS)), and quality of life (visual analogue scale (VAS)) at six months in patients with major disabling stroke who had a Barthel Index ≤6 (of 20) at day four. Unfavorable functional outcome was defined as mRS >3, non-satisfactory quality of life as VAS <60. Patients were followed-up at six months after stroke. We compared physicians’ estimates with actual outcomes. Results: Sixty patients were included, with a mean age of 72 years. Of fifteen patients who were predicted to die, one actually survived at six months (positive predictive value (PPV), 0.93; 95% CI, 0.66–0.99). Of thirty patients who survived, one was predicted to die (false positive rate (FPR), 0.03; 95%CI 0.00–0.20). Of forty-six patients who were predicted to have an unfavorable outcome, four had a favorable outcome (PPV, 0.93; 95% CI, 0.81–0.98; FPR, 0.30; 95% CI; 0.08–0.65). Prediction of non-satisfactory quality of life was less accurate (PPV, 0.63; 95% CI, 0.26–0.90; FPR, 0.18; 95% CI 0.05–0.44). Conclusions: In patients with severe stroke, treating physicians’ estimation of the risk of mortality or unfavorable functional outcome at six months is relatively inaccurate. Prediction of quality of life is even more imprecise. [ABSTRACT FROM AUTHOR]
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- 2017
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31. Treatment restrictions in patients with severe stroke are associated with an increased risk of death.
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Geurts, Marjolein, de Kort, Floor A. S., de Kort, Paul L. M., van Tuijl, Julia H., van Thiel, Ghislaine J. M. W., Kappelle, L. Jaap, and van der Worp, H. Bart
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- 2017
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32. Temporal Evolution of Poststroke Cognitive Impairment Using the Montreal Cognitive Assessment.
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Nijsse, Britta, Visser-Meily, Johanna M. A., van Mierlo, Maria L., Post, Marcel W. M., de Kort, Paul L. M., and van Heugten, Caroline M.
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- 2017
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33. Psychological factors are associated with subjective cognitive complaints 2 months post-stroke.
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Nijsse, Britta, van Heugten, Caroline M., van Mierlo, Marloes L., Post, Marcel W. M., de Kort, Paul L. M., and Visser-Meily, Johanna M. A.
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PSYCHOLOGICAL factors ,COGNITION disorders ,STROKE patients ,SELF-efficacy ,PESSIMISM ,ANXIETY ,MENTAL depression ,ANXIETY disorders ,STROKE ,ADAPTABILITY (Personality) ,AGE distribution ,MULTIVARIATE analysis ,PERSONALITY ,REGRESSION analysis ,SEX distribution ,CROSS-sectional method ,SELF diagnosis ,PSYCHOLOGY - Abstract
The aim of this study was to investigate which psychological factors are related to post-stroke subjective cognitive complaints, taking into account the influence of demographic and stroke-related characteristics, cognitive deficits and emotional problems. In this cross-sectional study, 350 patients were assessed at 2 months post-stroke, using the Checklist for Cognitive and Emotional consequences following stroke (CLCE-24) to identify cognitive complaints. Psychological factors were: proactive coping, passive coping, self-efficacy, optimism, pessimism, extraversion, and neuroticism. Associations between CLCE-24 cognition score and psychological factors, emotional problems (depressive symptoms and anxiety), cognitive deficits, and demographic and stroke characteristics were examined using Spearman correlations and multiple regression analyses. Results showed that 2 months post-stroke, 270 patients (68.4%) reported at least one cognitive complaint. Age, sex, presence of recurrent stroke(s), comorbidity, cognitive deficits, depressive symptoms, anxiety, and all psychological factors were significantly associated with the CLCE-24 cognition score in bivariate analyses. Multiple regression analysis showed that psychological factors explained 34.7% of the variance of cognitive complaints independently, and 8.5% (p < .001) after taking all other factors into account. Of all psychological factors, proactive coping was independently associated with cognitive complaints (p < .001), showing that more proactive coping related to less cognitive complaints. Because cognitive complaints are common after stroke and are associated with psychological factors, it is important to focus on these factors in rehabilitation programmes. [ABSTRACT FROM PUBLISHER]
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- 2017
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34. Cognitive performance and poor long-term functional outcome after young stroke.
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Schaapsmeerders, Pauline, Synhaeve, Nathalie E., Arntz, Renate M., Maaijwee, Noortje A. M., Rutten-Jacobs, Loes C. A., Schoonderwaldt, Henny C., Dorresteijn, Lucille D. A., de Kort, Paul L. M., van Dijk, Ewoud J., Kessels, Roy P. C., and de Leeuw, Frank-Erik
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- 2015
35. Poor Long-Term Functional Outcome After Stroke Among Adults Aged 18 to 50 Years: Follow-Up of Transient Ischemic Attack and Stroke Patients and Unelucidated Risk Factor Evaluation (FUTURE) Study.
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Synhaeve, Nathalie E, Arntz, Renate M, Maaijwee, Noortje A M, Rutten-Jacobs, Loes C A, Schoonderwaldt, Henny C, Dorresteijn, Lucille D A, de Kort, Paul L M, van Dijk, Ewoud J, and de Leeuw, Frank-Erik
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- 2014
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36. Observational Dutch Young Symptomatic StrokE studY (ODYSSEY): study rationale and protocol of a multicentre prospective cohort study.
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Arntz, Renate M., van Alebeek, Mayte E., Synhaeve, Nathalie E., Brouwers, Paul J., van Dijk, Gert W., Gons, Rob A., den Heijer, Tom, de Kort, Paul L. M., de Laat, Karlijn F., van Norden, Anouk G., Vermeer, Sarah E., van der Vlugt, Maureen J., Kessels, Roy P. C., van Dijk, Ewoud J., and de Leeuw, Frank-Erik
- Abstract
Background: The proportion of strokes occurring in younger adults has been rising over the past decade. Due to the far longer life expectancy in the young, stroke in this group has an even larger socio-economic impact. However, information on etiology and prognosis remains scarce. Methods/design: ODYSSEY is a multicentre prospective cohort study on the prognosis and risk factors of patients with a first-ever TIA, ischemic stroke or intracerebral hemorrhage aged 18 to 49 years. Our aim is to include 1500 patients. Primary outcome will be all cause mortality and risk of recurrent vascular events. Secondary outcome will be the risk of post-stroke epilepsy and cognitive impairment. Patients will complete structured questionnaires on outcome measures and risk factors. Both well-documented and less well-documented risk factors and potentially acute trigger factors will be investigated. Patients will be followed every 6 months for at least 3 years. In addition, an extensive neuropsychological assessment will be administered both at baseline and 1 year after the stroke/ TIA. Furthermore we will include 250 stroke-free controls, who will complete baseline assessment and one neuropsychological assessment. Discussion: ODYSSEY is designed to prospectively determine prognosis after a young stroke and get more insight into etiology of patients with a TIA, ischemic stroke and intracerebral hemorrhage in patients aged 18 to 49 years old in a large sample size. [ABSTRACT FROM AUTHOR]
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- 2014
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37. Exploring near and far regions of space: Distance-specific visuospatial neglect after stroke.
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Van der Stoep, Nathan, Visser-Meily, Johanna M. A., Kappelle, L. Jaap, de Kort, Paul L. M., Huisman, Krista D., Eijsackers, Anja L. H., Kouwenhoven, Mirjam, Van der Stigchel, Stefan, and Nijboer, Tanja C. W.
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UNILATERAL neglect ,STROKE ,PATIENTS ,NEUROPSYCHOLOGICAL tests ,CEREBROVASCULAR disease patients - Abstract
Visuospatial neglect has been observed in the horizontal (left/right) and vertical (up/down) dimension and depends on the distance at which a task is presented (near/far). Previously, studies have mainly focused on investigating the overall severity of neglect in near and far space in a group of neglect patients instead of examining subgroups of neglect patients with different types of distance-specific neglect. We investigated the spatial specificity (near vs. far space), frequency, and severity of neglect in the horizontal and vertical dimensions in a large group of stroke patients. We used three tasks to assess neglect in near (30 cm) and far (120 cm) space: a shape cancellation, letter cancellation, and a line bisection task. Patients were divided into four groups based on their performance: a group without neglect (N–F–), a near only neglect (N+F–), a far only neglect (N–F+), and a near and far neglect group (N+F+). About 40% of our sample showed neglect. Depending on the task, N+F– was observed in 8 to 22% of the sample, whereas N–F+ varied between 8% and 11%, and N+F+ varied between 11% to 14% of the sample. The current findings indicate that horizontal and vertical biases in performance can be confined to one region of space and are task dependent. We recommend testing for far space neglect during neuropsychological assessments in clinical practice, because this cannot be diagnosed using standard paper-and-pencil tasks. [ABSTRACT FROM PUBLISHER]
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- 2013
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38. The COMPlaints After Stroke (COMPAS) study: protocol for a Dutch cohort study on poststroke subjective cognitive complaints.
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van Rijsbergen, Marielle W. A., Mark, Ruth E., de Kort, Paul L. M., and Sitskoorn, Margriet M.
- Abstract
Background: Although many studies have assessed poststroke objective cognitive impairment, only a few have evaluated patients' subjective cognitive complaints (SCC). Although these SCC are found to be common in the early and chronic phases after stroke, knowledge about their risk factors, course over time, differences with healthy controls and their diagnostic relevance is limited. The aim of the COMPlaints After Stroke (COMPAS) study is therefore to determine the possible risk factors, prognosis, time course and predictive value of SCC in the first 2 years after stroke. Methods and design: A prospective cohort study is conducted in which patients are compared to non-stroke controls at 3, 6, 12 and 24 months after stroke. Approximately 300 patients are recruited from the stroke units of three hospitals in the Netherlands, while 300 controls are sought among the relatives (spouses excluded) and social networks of participants. A wide range of subjective and objective variables is assessed in both groups using interviews, questionnaires and neuropsychological assessment. The primary outcomes include SCC and objective cognitive impairment, whereas secondary outcomes are quality of life, subjective recovery and daily life functioning. Ethics and dissemination: The study is being carried out in agreement with the Declaration of Helsinki and the Medical Research Involving Human Subjects Act. The protocol has been approved by the medical ethics committees of the participating centres and all participants give written informed consent. The results will be published in peer-reviewed journals and disseminated to the medical society and general public. Discussion: The COMPAS study is the first to systematically evaluate poststroke SCC in a prospective longitudinal design, taking a wide range of subjective and objective variables into account. The results obtained can be used to accurately inform patients and their families, as well as to develop patient-tailored intervention programmes to ultimately improve stroke patient care. [ABSTRACT FROM AUTHOR]
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- 2013
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39. Stroke-Associated Infection Is an Independent Risk Factor for Poor Outcome after Acute Ischemic Stroke: Data from the Netherlands Stroke Survey.
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Vermeij, Frederique H., Scholte op Reimer, Wilma J. M., de Man, Peter, van Oostenbrugge, Robert J., Franke, Cees L., de Jong, Gosse, de Kort, Paul L. M., and Dippel, Diederik W. J.
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CEREBRAL ischemia ,RISK factors of pneumonia ,COHORT analysis ,URINARY tract infections ,DISEASE risk factors - Abstract
Background: Infections are a common and serious threat to patients with acute ischemic stroke. The aim of this study was to assess the effect of infection on mortality and functional outcome at discharge and at 1 year. Methods: From a consecutive cohort study in 11 centers, the Netherlands Stroke Survey, we selected 521 patients with ischemic stroke admitted to hospital within 48 h of onset. Stroke-associated infection was defined as infection occurring within 7 days after admission. Poor outcome (modified Rankin score >2) was recorded at discharge and at 1 year. Results: Stroke-associated infection occurred in 78 patients (15%); 39 of these (7.5%) had pneumonia and 23 (4.4%) had urinary tract infection. Overall, 276 patients (53%) had a poor outcome at 1 year. Poor outcome was recorded in 69 patients with stroke-associated infection (88%), and 37 of the 78 patients with stroke-associated infection (47%) had died at 1 year. After adjustment for confounders, stroke-associated infection was associated with poor outcome at discharge [odds ratio (OR) 2.6, 95% confidence interval (CI) 1.0–6.7] and at 1 year (OR 3.8, 95% CI 1.8–8.9). Pneumonia had a stronger association with poor outcome at 1 year (OR 10, 95% CI 2.2–46). Conclusions: This study suggests that stroke-associated infection, in particular pneumonia, is independently associated with poor functional outcome after ischemic stroke. Copyright © 2009 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]
- Published
- 2009
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40. A pilot study of rivastigmine in the treatment of delirium after stroke: A safe alternative.
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Oldenbeuving, Annemarie W., de Kort, Paul L. M., Jansen, Ben P. W., Kappelle, L. Jaap, and Roks, Gerwin
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PARASYMPATHOMIMETIC agents , *DELIRIUM , *CEREBROVASCULAR disease patients , *RANDOMIZED controlled trials , *THERAPEUTICS - Abstract
Background: Delirium is a common disorder in the early phase of stroke. Given the presumed cholinergic deficiency in delirium, we tested treatment with the acetylcholinesterase inhibitor rivastigmine. Methods: This pilot study was performed within an epidemiological study. In 527 consecutive stroke patients presence of delirium was assessed during the first week with the confusion assessment method. Severity was scored with the delirium rating scale (DRS). Sixty-two patients developed a delirium in the acute phase of stroke. Only patients with a severe and persistent delirium (defined as a DRS of 12 or more for more than 24 hours) were enrolled in the present study. In total 26 fulfilled these criteria of whom 17 were treated with orally administered rivastigmine with a total dose between 3 and 12 mg a day. Eight patients could not be treated because of dysphagia and one because of early discharge. Results: No major side effects were recorded. In 16 patients there was a considerable decrease in severity of delirium. The mean DRS declined from 14.8 on day one to 8.5 after therapy and 5.6 after tapering. The mean duration of delirium was 6.7 days (range; 2-17). Conclusion: Rivastigmine is safe in stroke patients with delirium even after rapid titration. In the majority of patients the delirium improved after treatment. A randomized controlled trial is needed to establish the usefulness of rivastigmine in delirium after stroke. Trial registration: Nederlands Trial Register NTR1395 [ABSTRACT FROM AUTHOR]
- Published
- 2008
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41. The Role of Executive Functioning in Spontaneous Confabulation.
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Nys, Gudrun M. S., van Zandvoort, Martine J. E., Roks, Gerwin, Kappelle, L. Jaap, de Kort, Paul L. M., and de Haan, Edward H. F.
- Published
- 2004
42. Rivastigmine for the Treatment of Delirium - A Review.
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Oldenbeuving, Annemarie W., de Kort, Paul L. M., and Roks, Gerwin
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- *
DELIRIUM , *NEUROBEHAVIORAL disorders , *CHOLINERGIC mechanisms , *PATHOLOGICAL physiology , *TREATMENT of diseases in older people , *THERAPEUTICS - Abstract
Delirium is a common disorder in hospitalised elderly patients. It is a complex neuropsychiatric syndrome with disturbance of consciousness, attention, cognition and perception. Treatment is based on identification and correction of the underlying cause together with symptomatic treatment. Decreased cholinergic activity is often considered to be one of the essential features in the pathophysiology of delirium. Therefore, correction of this cholinergic deficiency appears to be a promising approach. In this article we describe the pathophysiology of delirium, the pharmacological properties of rivastigmine and the use of rivastigmine in the prevention and symptomatic treatment of delirium. [ABSTRACT FROM AUTHOR]
- Published
- 2010
43. Publisher Correction : Stroke genetics informs drug discovery and risk prediction across ancestries
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Mishra, Aniket, Malik, Rainer, He, Yunye, Rosand, Jonathan, Sabatine, Marc S, Sacco, Ralph L, Saleheen, Danish, Sandset, Else Charlotte, Salomaa, Veikko, Sargurupremraj, Muralidharan, Sasaki, Makoto, Satizabal, Claudia L, Schmidt, Carsten O, Georgakis, Marios K, Shimizu, Atsushi, Smith, Nicholas L, Sloane, Kelly L, Sutoh, Yoichi, Sun, Yan V, Tanno, Kozo, Tiedt, Steffen, Tatlisumak, Turgut, Torres-Aguila, Nuria P, Tiwari, Hemant K, Caro, Ilana, Trégouët, David-Alexandre, Trompet, Stella, Tuladhar, Anil Man, Tybjærg-Hansen, Anne, van Vugt, Marion, Vibo, Riina, Verma, Shefali S, Wiggins, Kerri L, Wennberg, Patrik, Woo, Daniel, Krebs, Kristi, Wilson, Peter W F, Xu, Huichun, Yang, Qiong, Yoon, Kyungheon, Consortium, COMPASS, Consortium, INVENT, Initiative, Dutch Parelsnoer, Biobank, Estonian, Consortium, PRECISE4Q, Consortium, FinnGen, Liaw, Yi-Ching, Network, NINDS Stroke Genetics, Consortium, MEGASTROKE, Consortium, SIREN, Group, China Kadoorie Biobank Collaborative, Program, VA Million Veteran, Consortium, International Stroke Genetics, Japan, Biobank, Consortium, CHARGE, Consortium, GIGASTROKE, Millwood, Iona Y, Vaura, Felix C, Gieger, Christian, Ninomiya, Toshiharu, Grabe, Hans J, Jukema, J Wouter, Rissanen, Ina L, Strbian, Daniel, Kim, Young Jin, Chen, Pei-Hsin, Mayerhofer, Ernst, Howson, Joanna M M, Lin, Kuang, Irvin, Marguerite R, Adams, Hieab, Wassertheil-Smoller, Sylvia, Christensen, Kaare, Ikram, Mohammad A, Rundek, Tatjana, Worrall, Bradford B, Lathrop, G Mark, Riaz, Moeen, Simonsick, Eleanor M, Winsvold, Bendik Slagsvold, Kõrv, Janika, França, Paulo H C, Zand, Ramin, Prasad, Kameshwar, Frikke-Schmidt, Ruth, de Leeuw, Frank-Erik, Liman, Thomas G., Haeusler, Karl Georg, Ruigrok, Ynte M, Heuschmann, Peter Ulrich, Srinivasasainagendra, Vinodh, Longstreth, W. T., Jung, Keum Ji, Bastarache, Lisa, Paré, Guillaume, Damrauer, Scott M, Chasman, Daniel I, Rotter, Jerome I, Anderson, Christopher D, Zwart, John-Anker, Niiranen, Teemu J, Parodi, Livia, Fornage, Myriam, Liaw, Yung-Po, Seshadri, Sudha, Fernández-Cadenas, Israel, Walters, Robin G, Ruff, Christian T, Owolabi, Mayowa O, Huffman, Jennifer E, Milani, Lili, Kamatani, Yoichiro, Hachiya, Tsuyoshi, Bae, Hee-Joon, Dichgans, Martin, Debette, Stephanie, Chauhan, Ganesh, Chong, Michael R, Tomppo, Liisa, Akinyemi, Rufus, Roshchupkin, Gennady V, Habib, Naomi, Jee, Yon Ho, Thomassen, Jesper Qvist, Abedi, Vida, Jürgenson, Tuuli, Cárcel-Márquez, Jara, Nygaard, Marianne, Leonard, Hampton L, Yang, Chaojie, Yonova-Doing, Ekaterina, Knol, Maria J, Lewis, Adam J, Judy, Renae L, Ago, Tetsuro, Amouyel, Philippe, Namba, Shinichi, Armstrong, Nicole D, Bakker, Mark K, Bartz, Traci M, Bennett, David A, Bis, Joshua C, Bordes, Constance, Børte, Sigrid, Cain, Anael, Ridker, Paul M, Cho, Kelly, Posner, Daniel C, Chen, Zhengming, Cruchaga, Carlos, Cole, John W, de Jager, Phil L, de Cid, Rafael, Endres, Matthias, Ferreira, Leslie E, Geerlings, Mirjam I, Gasca, Natalie C, Gudnason, Vilmundur, Kamanu, Frederick K, Hata, Jun, He, Jing, Heath, Alicia K, Ho, Yuk-Lam, Havulinna, Aki S, Hopewell, Jemma C, Hyacinth, Hyacinth I, Inouye, Michael, Jacob, Mina A, Jeon, Christina E, Koido, Masaru, Jern, Christina, Kamouchi, Masahiro, Keene, Keith L, Kitazono, Takanari, Kittner, Steven J, Konuma, Takahiro, Kumar, Amit, Lacaze, Paul, Launer, Lenore J, Lee, Keon-Joo, Le Grand, Quentin, Lepik, Kaido, Li, Jiang, Li, Liming, Manichaikul, Ani, Markus, Hugh S, Marston, Nicholas A, Meitinger, Thomas, Mitchell, Braxton D, Montellano, Felipe A, Morisaki, Takayuki, Shi, Mingyang, Mosley, Thomas H, Nalls, Mike A, Nordestgaard, Børge G, O'Donnell, Martin J, Okada, Yukinori, Onland-Moret, N Charlotte, Ovbiagele, Bruce, Peters, Annette, Psaty, Bruce M, Rich, Stephen S, Bis, Joshua C, Lee, Jin-Moo, Cheng, Yu-Ching, Meschia, James F, Chen, Wei Min, Sale, Michèle M, Zonderman, Alan B, Evans, Michele K, Wilson, James G, Correa, Adolfo, Traylor, Matthew, Lewis, Cathryn M, Carty, Cara L, Reiner, Alexander, Haessler, Jeffrey, Langefeld, Carl D, Gottesman, Rebecca F, Yaffe, Kristine, Liu, Yong Mei, Kooperberg, Charles, Lange, Leslie A, Furie, Karen L, Arnett, Donna K, Benavente, Oscar R, Grewal, Raji P, Peddareddygari, Leema Reddy, Hveem, Kristian, Lindstrom, Sara, Wang, Lu, Smith, Erin N, Gordon, William, van Hylckama Vlieg, Astrid, de Andrade, Mariza, Brody, Jennifer A, Pattee, Jack W, Brumpton, Ben M, Suchon, Pierre, Chen, Ming-Huei, Frazer, Kelly A, Turman, Constance, Germain, Marine, MacDonald, James, Braekkan, Sigrid K, Armasu, Sebastian M, Pankratz, Nathan, Jackson, Rebecca D, Nielsen, Jonas B, Giulianini, Franco, Puurunen, Marja K, Ibrahim, Manal, Heckbert, Susan R, Bammler, Theo K, McCauley, Bryan M, Taylor, Kent D, Pankow, James S, Reiner, Alexander P, Gabrielsen, Maiken E, Deleuze, Jean-François, O'Donnell, Chris J, Kim, Jihye, McKnight, Barbara, Kraft, Peter, Hansen, John-Bjarne, Rosendaal, Frits R, Heit, John A, Tang, Weihong, Morange, Pierre-Emmanuel, Johnson, Andrew D, Kabrhel, Christopher, van Dijk, Ewoud J, Koudstaal, Peter J, Luijckx, Gert-Jan, Nederkoorn, Paul J, van Oostenbrugge, Robert J, Visser, Marieke C, Wermer, Marieke J H, Kappelle, L Jaap, Esko, Tõnu, Metspalu, Andres, Mägi, Reedik, Nelis, Mari, Irvin, Marguerite R, de Leeuw, Frank-Erik, Levi, Christopher R, Maguire, Jane, Jiménez-Conde, Jordi, Sharma, Pankaj, Sudlow, Cathie L M, Rannikmäe, Kristiina, Schmidt, Reinhold, Slowik, Agnieszka, Pera, Joanna, Thijs, Vincent N S, Lindgren, Arne G, Ilinca, Andreea, Melander, Olle, Engström, Gunnar, Rexrode, Kathryn M, Rothwell, Peter M, Stanne, Tara M, Johnson, Julie A, Danesh, John, Butterworth, Adam S, Heitsch, Laura, Boncoraglio, Giorgio B, Kubo, Michiaki, Pezzini, Alessandro, Rolfs, Arndt, Giese, Anne-Katrin, Weir, David, Ross, Owen A, Lemmons, Robin, Soderholm, Martin, Cushman, Mary, Jood, Katarina, McDonough, Caitrin W, Bell, Steven, Linkohr, Birgit, Lee, Tsong-Hai, Putaala, Jukka, Anderson, Christopher D, Lopez, Oscar L, Jian, Xueqiu, Schminke, Ulf, Cullell, Natalia, Delgado, Pilar, Ibañez, Laura, Krupinski, Jerzy, Lioutas, Vasileios, Matsuda, Koichi, Montaner, Joan, Muiño, Elena, Roquer, Jaume, Sarnowski, Chloe, Sattar, Naveed, Sibolt, Gerli, Teumer, Alexander, Rutten-Jacobs, Loes, Kanai, Masahiro, Gretarsdottir, Solveig, Rost, Natalia S, Yusuf, Salim, Almgren, Peter, Ay, Hakan, Bevan, Steve, Brown, Robert D, Carrera, Caty, Buring, Julie E, Chen, Wei-Min, Cotlarciuc, Ioana, de Bakker, Paul I W, DeStefano, Anita L, den Hoed, Marcel, Duan, Qing, Engelter, Stefan T, Falcone, Guido J, Gustafsson, Stefan, Hassan, Ahamad, Holliday, Elizabeth G, Howard, George, Hsu, Fang-Chi, Ingelsson, Erik, Harris, Tamara B, Kissela, Brett M, Kleindorfer, Dawn O, Langenberg, Claudia, Lemmens, Robin, Leys, Didier, Lin, Wei-Yu, Lorentzen, Erik, Magnusson, Patrik K, McArdle, Patrick F, Pulit, Sara L, Rice, Kenneth, Sakaue, Saori, Sapkota, Bishwa R, Tanislav, Christian, Thorleifsson, Gudmar, Thorsteinsdottir, Unnur, Tzourio, Christophe, van Duijn, Cornelia M, Walters, Matthew, Wareham, Nicholas J, Amin, Najaf, Aparicio, Hugo J, Attia, John, Beiser, Alexa S, Berr, Claudine, Bustamante, Mariana, Caso, Valeria, Choi, Seung Hoan, Chowhan, Ayesha, Dartigues, Jean-François, Delavaran, Hossein, Dörr, Marcus, Ford, Ian, Gurpreet, Wander S, Hamsten, Anders, Hozawa, Atsushi, Ingelsson, Martin, Iwasaki, Motoki, Kaffashian, Sara, Kalra, Lalit, Kjartansson, Olafur, Kloss, Manja, Labovitz, Daniel L, Laurie, Cathy C, Li, Linxin, Lind, Lars, Lindgren, Cecilia M, Makoto, Hirata, Minegishi, Naoko, Morris, Andrew P, Müller-Nurasyid, Martina, Norrving, Bo, Ogishima, Soichi, Parati, Eugenio A, Pedersen, Nancy L, Perola, Markus, Jousilahti, Pekka, Pileggi, Silvana, Rabionet, Raquel, Riba-Llena, Iolanda, Ribasés, Marta, Romero, Jose R, Rudd, Anthony G, Sarin, Antti-Pekka, Sarju, Ralhan, Satoh, Mamoru, Sawada, Norie, Sigurdsson, Ásgeir, Smith, Albert, Stine, O Colin, Stott, David J, Strauch, Konstantin, Takai, Takako, Tanaka, Hideo, Touze, Emmanuel, Tsugane, Shoichiro, Uitterlinden, Andre G, Valdimarsson, Einar M, van der Lee, Sven J, Wakai, Kenji, Williams, Stephen R, Wolfe, Charles D A, Wong, Quenna, Yamaji, Taiki, Sanghera, Dharambir K, Stefansson, Kari, Martinez-Majander, Nicolas, Sobue, Kenji, Soriano-Tárraga, Carolina, Völzke, Henry, Akpa, Onoja, Sarfo, Fred S, Akpalu, Albert, Obiako, Reginald, Wahab, Kolawole, Osaigbovo, Godwin, Owolabi, Lukman, Komolafe, Morenikeji, Jenkins, Carolyn, Arulogun, Oyedunni, Ogbole, Godwin, Adeoye, Abiodun M, Akinyemi, Joshua, Agunloye, Atinuke, Fakunle, Adekunle G, Uvere, Ezinne, Olalere, Abimbola, Adebajo, Olayinka J, Chen, Junshi, Clarke, Robert, Collins, Rory, Guo, Yu, Wang, Chen, Lv, Jun, Peto, Richard, Chen, Yiping, Fairhurst-Hunter, Zammy, Hill, Michael, Pozarickij, Alfred, Schmidt, Dan, Stevens, Becky, Turnbull, Iain, Yu, Canqing, Le Grand, Quentin, Ferreira, Leslie E, Nagai, Akiko, Murakami, Yoishinori, Geerlings, Mirjam I, Gasca, Natalie C, Gudnason, Vilmundur, van Vugt, Marion, Shiroma, Eric J, Sigurdsson, Sigurdur, Ghanbari, Mohsen, Boerwinkle, Eric, Fongang, Bernard, Wang, Ruiqi, Ikram, Mohammad K, Völker, Uwe, de Jager, Phil L, de Cid, Rafael, Nordestgaard, Børge G, Sargurupremraj, Muralidharan, Verma, Shefali S, de Laat, Karlijn F, van Norden, Anouk G W, de Kort, Paul L, Vermeer, Sarah E, Brouwers, Paul J A M, Gons, Rob A R, den Heijer, Tom, van Dijk, Gert W, van Rooij, Frank G W, Aamodt, Anne H, Skogholt, Anne H, Willer, Cristen J, Heuch, Ingrid, Hagen, Knut, Fritsche, Lars G, Pedersen, Linda M, Ellekjær, Hanne, Zhou, Wei, Martinsen, Amy E, Kristoffersen, Espen S, Thomas, Laurent F, Kleinschnitz, Christoph, Frantz, Stefan, Ungethüm, Kathrin, Gallego-Fabrega, Cristina, Lledós, Miquel, Llucià-Carol, Laia, Sobrino, Tomas, Campos, Francisco, Castillo, José, Freijó, Marimar, Arenillas, Juan Francisco, Obach, Victor, Álvarez-Sabín, José, Molina, Carlos A, Ribó, Marc, Muñoz-Narbona, Lucia, Lopez-Cancio, Elena, Millán, Mònica, Diaz-Navarro, Rosa, Vives-Bauza, Cristòfol, Serrano-Heras, Gemma, Segura, Tomás, Dhar, Rajat, Delgado-Mederos, Raquel, Prats-Sánchez, Luis, Camps-Renom, Pol, Blay, Natalia, Sumoy, Lauro, Martí-Fàbregas, Joan, Schnohr, Peter, Jensen, Gorm B, Benn, Marianne, Afzal, Shoaib, Kamstrup, Pia R, van Setten, Jessica, van der Laan, Sander W, Vonk, Jet M J, Kim, Bong-Jo, Curtze, Sami, Tiainen, Marjaana, Kinnunen, Janne, Menon, Vilas, Sung, Yun Ju, Yang, Chengran, Saillour-Glenisson, Florence, Gravel, Simon, Onland-Moret, N Charlotte, and Heath, Alicia K
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Stroke ,Multidisciplinary ,Genetic markers ,ddc:500 ,Predictive markers ,Genome-wide association studies - Published
- 2022
44. Subjective cognitive complaints after stroke: Prevalence, determinants and course over time
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Rijsbergen, Maria, Sitskoorn, Margriet, Mark, Ruth, de Kort, Paul L M, van Heugten, C.M., Visser, L.H., Gehring, Karin, Huis in 't Veld, Elisabeth, Rutten, Geert-Jan, and Cognitive Neuropsychology
- Abstract
In Nederland worden jaarlijks circa 41.000 mensen getroffen door een cerebrovasculair accident (CVA), ook wel beroerte genoemd. Ondanks dat de behandelmogelijkheden in de acute fase de laatste jaren sterk zijn verbeterd, is een CVA nog altijd een van de belangrijkste oorzaken van overlijden en hebben mensen die het overleven vaak te kampen met blijvende beperkingen op fysiek, emotioneel en/of cognitief gebied. Cognitieve problemen (bijvoorbeeld vergeetachtigheid en concentratieproblemen) na een CVA zijn de laatste jaren regelmatig onderwerp geweest van wetenschappelijk onderzoek, mede omdat deze problemen deelname aan een revalidatieprogramma en het opvolgen van therapie sterk kunnen belemmeren. De meeste studies hebben cognitieve problemen na een CVA onderzocht door met behulp van neuropsychologische tests het cognitieve functioneren objectief te bepalen. Er is tot nu toe veel minder aandacht geweest voor de subjectieve ervaring van deze cognitieve problemen, oftewel: welke cognitieve problemen ervaren mensen zelf na hun CVA en in hoeverre zijn deze van invloed op hun dagelijkse leven? In haar proefschrift onderzocht Mariëlle van Rijsbergen daarom het voorkomen van subjectieve cognitieve klachten, de factoren die geassocieerd zijn met het rapporteren van dergelijke klachten en het beloop van de klachten gedurende het eerste jaar na een CVA. Uit het onderzoek bleek dat een groot deel van de mensen na een CVA subjectieve cognitieve klachten heeft (schatting > 89% op drie maanden en > 80% op twaalf maanden). Dit leidt bij meer dan de helft tot twee derde van de patiënten tot problemen in het dagelijks leven. Dit benadrukt het belang voor clinici om alert te zijn op de aanwezigheid van dergelijke klachten na een CVA. Daarbij dient wel bedacht te worden dat niet iedereen die cognitieve problemen in het dagelijkse leven ervaart, hierover zal klagen. Wanneer mensen voor deze problemen kunnen compenseren en/of ze ondervinden er geen hinder van bij hun activiteiten, is er wellicht ook geen behoefte aan hulp voor deze problemen. Diverse factoren bleken geassocieerd met het ervaren van subjectieve cognitieve problemen. Naast objectieve cognitieve beperkingen, zijn ook factoren die psychologische spanningen reflecteren (zoals depressie, angst en/of stress) en vermoeidheid sterk gerelateerd aan subjectieve cognitieve klachten gedurende het eerste jaar na een CVA. Demografische en klinische kenmerken (zoals ernst van het CVA) speelden daarentegen nauwelijks tot geen rol. Wanneer een patiënt drie maanden na een CVA subjectieve cognitieve klachten rapporteert, is de kans groot dat deze klachten op twaalf maanden ook nog aanwezig zullen zijn. Het ervaren van symptomen van een depressie en een algemeen gevoel van stress drie maanden na een CVA zijn daarbij onafhankelijke voorspellers voor het ervaren van subjectieve cognitieve klachten een jaar na een CVA. De resultaten van het proefschrift laten zien dat subjectieve cognitieve klachten na een CVA serieus genomen dienen te worden. Evaluatie van objectief cognitief functioneren, psychologische spanningen, vermoeidheid en persoonlijkheidstrekken kunnen daarbij aanknopingspunten voor behandeling opleveren. Het reduceren van het aantal en vooral de impact van subjectieve cognitieve klachten op het dagelijkse leven, kan het welzijn van patiënten na een CVA verbeteren.
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- 2017
45. Cognitive trajectory in the first year after first-ever ischaemic stroke in young adults: the ODYSSEY study.
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Schellekens MMI, Springer RCS, Boot EM, Verhoeven JI, Ekker MS, van Alebeek ME, Brouwers PJAM, Arntz RM, van Dijk GW, Gons RAR, van Uden IWM, den Heijer T, van Tuijl JH, de Laat KF, van Norden AGW, Vermeer SE, van Zagten MSG, Van Oostenbrugge RJ, Wermer MJH, Nederkoorn PJ, van Rooij FG, van den Wijngaard IR, de Kort PLM, De Leeuw FE, Kessels RPC, and Tuladhar AM
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- Humans, Adult, Male, Female, Middle Aged, Prospective Studies, Young Adult, Neuropsychological Tests, Cognition physiology, Adolescent, Recovery of Function, Executive Function physiology, Age Factors, Ischemic Stroke complications, Ischemic Stroke psychology, Cognitive Dysfunction
- Abstract
Background: Limited data exists on cognitive recovery in young stroke patients. We aimed to investigate the longitudinal course of cognitive performance during the first year after stroke at young age and identify predictors for cognitive recovery., Methods: We conducted a multicentre prospective cohort study between 2013 and 2021, enrolling patients aged 18-49 years with first-ever ischaemic stroke. Cognitive assessments were performed within 6 months and after 1 year following the index event, covering seven cognitive domains. Composite Z-scores using normative data determined cognitive impairment (Z-score<-1.5). A Reliable Change Index (RCI) assessed cognitive recovery (RCI>1.96) or decline (RCI<-1.96)., Results: 393 patients (median age 44.3 years, IQR 38.4-47.2) completed cognitive assessments with a median time interval of 403 days (IQR 364-474) between assessments. Based on RCI, a similar proportion of patients showed improvement and decline in each cognitive domain, while the majority exhibited no cognitive change. Among cognitively impaired patients at baseline, improvements were observed in processing speed (23.1%), visuoconstruction (40.1%) and executive functioning (20.0%). Younger age was associated with better cognitive recovery in visuoconstruction, and larger lesion volume was related to cognitive recovery in processing speed. No other predictors for cognitive recovery were identified., Conclusions: Cognitive impairment remains prevalent in young stroke even 1 year after the event. Most patients showed no cognitive change, however, recovery may have occurred in the early weeks after stroke, which was not assessed in our study. Among initially cognitively impaired patients, cognitive recovery is observed in processing speed, visuoconstruction and executive functioning. It is still not possible to predict cognitive recovery in individual patients., Competing Interests: Competing interests: AMT is a junior staff member of the Dutch Heart Foundation (grant number 2016T044). F-EDL is a clinical established investigator of the Dutch Heart Foundation (2014 T060). MJHW has received a VIDI grant (9171337) of the ZonMw/NWO and the clinical established investigator Dutch Heart Foundation grant (2016T86)., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2024
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46. White Matter Hyperintensity Volume and Poststroke Cognition: An Individual Patient Data Pooled Analysis of 9 Ischemic Stroke Cohort Studies.
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de Kort FAS, Coenen M, Weaver NA, Kuijf HJ, Aben HP, Bae HJ, Bordet R, Cammà G, Chen CPLH, Dewenter A, Duering M, Fang R, van der Giessen RS, Hamilton OKL, Hilal S, Huenges Wajer IMC, Kan CN, Kim J, Kim BJ, Köhler S, de Kort PLM, Koudstaal PJ, Lim JS, Lopes R, Mok VCT, Staals J, Venketasubramanian N, Verhagen CM, Verhey FRJ, Wardlaw JM, Xu X, Yu KH, Biesbroek JM, and Biessels GJ
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- Humans, Female, Male, Brain diagnostic imaging, Brain pathology, Cognition, Cohort Studies, Magnetic Resonance Imaging, Infarction pathology, Neuropsychological Tests, Ischemic Stroke complications, White Matter diagnostic imaging, White Matter pathology, Brain Injuries pathology, Stroke complications, Stroke diagnostic imaging, Stroke pathology
- Abstract
Background: White matter hyperintensities (WMH) are associated with cognitive dysfunction after ischemic stroke. Yet, uncertainty remains about affected domains, the role of other preexisting brain injury, and infarct types in the relation between WMH burden and poststroke cognition. We aimed to disentangle these factors in a large sample of patients with ischemic stroke from different cohorts., Methods: We pooled and harmonized individual patient data (n=1568) from 9 cohorts, through the Meta VCI Map consortium (www.metavcimap.org). Included cohorts comprised patients with available magnetic resonance imaging and multidomain cognitive assessment <15 months poststroke. In this individual patient data meta-analysis, linear mixed models were used to determine the association between WMH volume and domain-specific cognitive functioning ( Z scores; attention and executive functioning, processing speed, language and verbal memory) for the total sample and stratified by infarct type. Preexisting brain injury was accounted for in the multivariable models and all analyses were corrected for the study site as a random effect., Results: In the total sample (67 years [SD, 11.5], 40% female), we found a dose-dependent inverse relationship between WMH volume and poststroke cognitive functioning across all 4 cognitive domains (coefficients ranging from -0.09 [SE, 0.04, P =0.01] for verbal memory to -0.19 [SE, 0.03, P <0.001] for attention and executive functioning). This relation was independent of acute infarct volume and the presence of lacunes and old infarcts. In stratified analyses, the relation between WMH volume and domain-specific functioning was also largely independent of infarct type., Conclusions: In patients with ischemic stroke, increasing WMH volume is independently associated with worse cognitive functioning across all major domains, regardless of old ischemic lesions and infarct type., Competing Interests: Disclosures Dr H.-J. Bae reports grants from Chong Gun Dang Pharmaceutical Corp and Korean Drug Co, Ltd outside of the submitted work. Dr G.J. Biessels reports grants from The Netherlands Organisation for Health Research and Development (ZonMW), during the conduct of the study. The other authors report no conflicts.
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- 2023
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47. Risk Factors and Causes of Ischemic Stroke in 1322 Young Adults.
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Ekker MS, Verhoeven JI, Schellekens MMI, Boot EM, van Alebeek ME, Brouwers PJAM, Arntz RM, van Dijk GW, Gons RAR, van Uden IWM, den Heijer T, de Kort PLM, de Laat KF, van Norden AGW, Vermeer SE, van Zagten MSG, van Oostenbrugge RJ, Wermer MJH, Nederkoorn PJ, Zonneveld TP, Kerkhoff H, Rooyer FA, van Rooij FG, van den Wijngaard IR, Klijn CJM, Tuladhar AM, and de Leeuw FE
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- Male, Humans, Young Adult, Child, Adult, Female, Prospective Studies, Risk Factors, Ischemic Stroke complications, Stroke therapy, Atherosclerosis complications
- Abstract
Background: Identification of risk factors and causes of stroke is key to optimize treatment and prevent recurrence. Up to one-third of young patients with stroke have a cryptogenic stroke according to current classification systems (Trial of ORG 10172 in Acute Stroke Treatment [TOAST] and atherosclerosis, small vessel disease, cardiac pathology, other causes, dissection [ASCOD]). The aim was to identify risk factors and leads for (new) causes of cryptogenic ischemic stroke in young adults, using the pediatric classification system from the IPSS study (International Pediatric Stroke Study)., Methods: This is a multicenter prospective cohort study conducted in 17 hospitals in the Netherlands, consisting of 1322 patients aged 18 to 49 years with first-ever, imaging confirmed, ischemic stroke between 2013 and 2021. The main outcome was distribution of risk factors according to IPSS classification in patients with cryptogenic and noncryptogenic stroke according to the TOAST and ASCOD classification., Results: The median age was 44.2 years, and 697 (52.7%) were men. Of these 1322 patients, 333 (25.2%) had a cryptogenic stroke according to the TOAST classification. Additional classification using the ASCOD criteria reduced the number patients with cryptogenic stroke from 333 to 260 (19.7%). When risk factors according to the IPSS were taken into account, the number of patients with no potential cause or risk factor for stroke reduced to 10 (0.8%)., Conclusions: Among young adults aged 18 to 49 years with a cryptogenic ischemic stroke according to the TOAST classification, risk factors for stroke are highly prevalent. Using a pediatric classification system provides new leads for the possible causes in cryptogenic stroke, and could potentially lead to more tailored treatment for young individuals with stroke.
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- 2023
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48. Trigger Factors for Stroke in Young Adults: A Case-Crossover Study.
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Ekker MS, Verhoeven JI, Rensink KML, Schellekens MMI, Boot EM, van Alebeek ME, Brouwers PJAM, Arntz RM, van Dijk GW, Gons RAR, van Uden IWM, den Heijer T, de Kort PLM, de Laat KF, van Norden AGW, Vermeer SE, van Zagten M, van Oostenbrugge RJ, Wermer MJH, Nederkoorn PJ, Kerkhoff H, Rooyer F, van Rooij FG, van den Wijngaard IR, Klijn CJM, Tuladhar AM, and de Leeuw FE
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- Aged, Male, Humans, Young Adult, Adult, Female, Cross-Over Studies, Risk Factors, Cerebral Hemorrhage etiology, Cerebral Hemorrhage complications, Stroke epidemiology, Stroke etiology, Ischemic Stroke complications, Illicit Drugs
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Background and Objectives: Causes of stroke in young adults differ from those in the elderly individuals, and in a larger percentage, no cause can be determined. To gain more insight into the etiology of (cryptogenic) stroke in the young population, we investigated whether trigger factors, such as short-lasting exposure to toxins or infection, may play a role., Methods: Patients aged 18-49 years with a first-ever ischemic stroke or intracerebral hemorrhage (ICH) in 17 participating centers in the Netherlands completed a questionnaire about exposure to 9 potential trigger factors in hazard periods and on a regular yearly basis. A case-crossover design was used to assess relative risks (RRs) with 95% confidence intervals (95% CIs) by the Mantel-Haenszel case-crossover method, for any stroke (ischemic stroke and ICH combined) and for different etiologic subgroups of ischemic stroke., Results: One thousand one hundred forty-six patients completed the questionnaire (1,043 patients with an ischemic stroke and 103 with an ICH, median age 44.0 years, 52.6% men). For any stroke, an increased risk emerged within 1 hour of cola consumption (RR 2.0, 95% CI 1.5-2.8) and vigorous physical exercise (RR 2.6, 95% CI 2.2-3.0), within 2 hours after sexual activity (RR 2.4, 95% CI 1.6-3.5), within 4 hours after illicit drug use (RR 2.8, 95% CI 1.7-4.9), and within 24 hours after fever or flu-like disease (RR 14.1, 95% CI 10.5-31.2; RR 13.9, 95% CI 8.9-21.9). Four trigger factors increased the risk of other determined and cryptogenic ischemic stroke, 3 that of cardioembolic stroke, 2 that of large vessel atherosclerosis and likely atherothrombotic stroke combined and stroke with multiple causes, and none that of stroke due to small vessel disease., Discussion: We identified cola consumption, vigorous physical exercise, sexual activity, illicit drug use, fever, and flu-like disease as potential trigger factors for stroke in the young population and found differences in the type and number of trigger factors associated with different etiologic subgroups of ischemic stroke. These findings might help in better understanding the pathophysiologic mechanisms of (cryptogenic) stroke in the young population., (© 2022 American Academy of Neurology.)
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- 2023
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49. Improvements in Endovascular Treatment for Acute Ischemic Stroke: A Longitudinal Study in the MR CLEAN Registry.
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Compagne KCJ, Kappelhof M, Hinsenveld WH, Brouwer J, Goldhoorn RB, Uyttenboogaart M, Bokkers RPH, Schonewille WJ, Martens JM, Hofmeijer J, van der Worp HB, Lo RTH, Keizer K, Yo LSF, Lycklama À Nijeholt GJ, den Hertog HM, Sturm EJC, Brouwers PJAM, van Walderveen MAA, Wermer MJH, de Bruijn SF, van Dijk LC, Boogaarts HD, van Dijk EJ, van Tuijl JH, Peluso JPP, de Kort PLM, van Hasselt BAAM, Fransen PS, Schreuder THCML, Heijboer RJJ, Jenniskens SFM, Sprengers MES, Ghariq E, van den Wijngaard IR, Roosendaal SD, Meijer AFJA, Beenen LFM, Postma AA, van den Berg R, Yoo AJ, van Doormaal PJ, van Proosdij MP, Krietemeijer MGM, Gerrits DG, Hammer S, Vos JA, Boiten J, Coutinho JM, Emmer BJ, van Es ACGM, Roozenbeek B, Roos YBWEM, van Zwam WH, van Oostenbrugge RJ, Majoie CBLM, Dippel DWJ, and van der Lugt A
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- Humans, Longitudinal Studies, Registries, Thrombectomy methods, Treatment Outcome, Brain Ischemia diagnostic imaging, Brain Ischemia surgery, Endovascular Procedures methods, Ischemic Stroke, Stroke diagnostic imaging, Stroke surgery
- Abstract
Background: We evaluated data from all patients in the Netherlands who underwent endovascular treatment for acute ischemic stroke in the past 3.5 years, to identify nationwide trends in time to treatment and procedural success, and assess their effect on clinical outcomes., Methods: We included patients with proximal occlusions of the anterior circulation from the second and first cohorts of the MR CLEAN (Multicenter Randomized Clinical trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) Registry (March 2014 to June 2016; June 2016 to November 2017, respectively). We compared workflow times and rates of successful reperfusion (defined as an extended Thrombolysis in Cerebral Infarction score of 2B-3) between cohorts and chronological quartiles (all included patients stratified in chronological quartiles of intervention dates to create equally sized groups over the study period). Multivariable ordinal logistic regression was used to assess differences in the primary outcome (ordinal modified Rankin Scale at 90 days)., Results: Baseline characteristics were similar between cohorts (second cohort n=1692, first cohort n=1488) except for higher age, poorer collaterals, and less signs of early ischemia on computed tomography in the second cohort. Time from stroke onset to groin puncture and reperfusion were shorter in the second cohort (median 185 versus 210 minutes; P <0.001 and 236 versus 270 minutes; P <0.001, respectively). Successful reperfusion was achieved more often in the second than in the first cohort (72% versus 66%; P <0.001). Functional outcome significantly improved (adjusted common odds ratio 1.23 [95% CI, 1.07-1.40]). This effect was attenuated by adjustment for time from onset to reperfusion (adjusted common odds ratio, 1.12 [95% CI, 0.98-1.28]) and successful reperfusion (adjusted common odds ratio, 1.13 [95% CI, 0.99-1.30]). Outcomes were consistent in the analysis per chronological quartile., Conclusions: Clinical outcomes after endovascular treatment for acute ischemic stroke in routine clinical practice have improved over the past years, likely resulting from improved workflow times and higher successful reperfusion rates.
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- 2022
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50. Network impact score is an independent predictor of post-stroke cognitive impairment: A multicenter cohort study in 2341 patients with acute ischemic stroke.
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Biesbroek JM, Weaver NA, Aben HP, Kuijf HJ, Abrigo J, Bae HJ, Barbay M, Best JG, Bordet R, Chappell FM, Chen CPLH, Dondaine T, van der Giessen RS, Godefroy O, Gyanwali B, Hamilton OKL, Hilal S, Huenges Wajer IMC, Kang Y, Kappelle LJ, Kim BJ, Köhler S, de Kort PLM, Koudstaal PJ, Kuchcinski G, Lam BYK, Lee BC, Lee KJ, Lim JS, Lopes R, Makin SDJ, Mendyk AM, Mok VCT, Oh MS, van Oostenbrugge RJ, Roussel M, Shi L, Staals J, Valdés-Hernández MDC, Venketasubramanian N, Verhey FRJ, Wardlaw JM, Werring DJ, Xin X, Yu KH, van Zandvoort MJE, Zhao L, and Biessels GJ
- Subjects
- Cohort Studies, Humans, Infarction complications, Cognitive Dysfunction complications, Ischemic Stroke complications, Stroke diagnosis
- Abstract
Background: Post-stroke cognitive impairment (PSCI) is a common consequence of stroke. Accurate prediction of PSCI risk is challenging. The recently developed network impact score, which integrates information on infarct location and size with brain network topology, may improve PSCI risk prediction., Aims: To determine if the network impact score is an independent predictor of PSCI, and of cognitive recovery or decline., Methods: We pooled data from patients with acute ischemic stroke from 12 cohorts through the Meta VCI Map consortium. PSCI was defined as impairment in ≥ 1 cognitive domain on neuropsychological examination, or abnormal Montreal Cognitive Assessment. Cognitive recovery was defined as conversion from PSCI < 3 months post-stroke to no PSCI at follow-up, and cognitive decline as conversion from no PSCI to PSCI. The network impact score was related to serial measures of PSCI using Generalized Estimating Equations (GEE) models, and to PSCI stratified according to post-stroke interval (<3, 3-12, 12-24, >24 months) and cognitive recovery or decline using logistic regression. Models were adjusted for age, sex, education, prior stroke, infarct volume, and study site., Results: We included 2341 patients with 4657 cognitive assessments. PSCI was present in 398/844 patients (47%) <3 months, 709/1640 (43%) at 3-12 months, 243/853 (28%) at 12-24 months, and 208/522 (40%) >24 months. Cognitive recovery occurred in 64/181 (35%) patients and cognitive decline in 26/287 (9%). The network impact score predicted PSCI in the univariable (OR 1.50, 95%CI 1.34-1.68) and multivariable (OR 1.27, 95%CI 1.10-1.46) GEE model, with similar ORs in the logistic regression models for specified post-stroke intervals. The network impact score was not associated with cognitive recovery or decline., Conclusions: The network impact score is an independent predictor of PSCI. As such, the network impact score may contribute to a more precise and individualized cognitive prognostication in patients with ischemic stroke. Future studies should address if multimodal prediction models, combining the network impact score with demographics, clinical characteristics and other advanced brain imaging biomarkers, will provide accurate individualized prediction of PSCI. A tool for calculating the network impact score is freely available at https://metavcimap.org/features/software-tools/lsm-viewer/., (Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.)
- Published
- 2022
- Full Text
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