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1. Influence of personalized extended interval dosing on the natalizumab wearing-off effect - a sub-study of the NEXT-MS trial

Author

Toorop, A. A., Wessels, M. H.J., Gelissen, L. M.Y., Hoitsma, E., Zeinstra, E. M.P.E., van Rooij, L. C., van Munster, C. E.P., Vennegoor, A., Mostert, J. P., Wokke, B. H.A., Kalkers, N. F., Hoogervorst, E. L.J., van Eijk, J. J.J., Roosendaal, C. M., Kragt, J. J., Eurelings, M., van Genugten, J., Nielsen, J., Sinnige, L. G.F., Kloosterziel, M. E., Arnoldus, E. P.J., van Dijk, G. W., Bouvy, W. H., Strijbis, E. M.M., van Oosten, B. W., de Jong, B. A., Lissenberg-Witte, B. I., Rispens, T., Uitdehaag, B. M.J., Killestein, J., van Kempen, Z. L.E., Toorop, A. A., Wessels, M. H.J., Gelissen, L. M.Y., Hoitsma, E., Zeinstra, E. M.P.E., van Rooij, L. C., van Munster, C. E.P., Vennegoor, A., Mostert, J. P., Wokke, B. H.A., Kalkers, N. F., Hoogervorst, E. L.J., van Eijk, J. J.J., Roosendaal, C. M., Kragt, J. J., Eurelings, M., van Genugten, J., Nielsen, J., Sinnige, L. G.F., Kloosterziel, M. E., Arnoldus, E. P.J., van Dijk, G. W., Bouvy, W. H., Strijbis, E. M.M., van Oosten, B. W., de Jong, B. A., Lissenberg-Witte, B. I., Rispens, T., Uitdehaag, B. M.J., Killestein, J., and van Kempen, Z. L.E.

Abstract

Background and objectives: Wearing-off symptoms during natalizumab treatment in multiple sclerosis are characterized by an increase of MS-related symptoms prior to natalizumab administration. The influence of extended interval dosing (EID) on wearing-off symptoms are important to consider, as this might cause hesitancy in initiating or continuing EID. Methods: Participants of the NEXT-MS trial, in which treatment intervals are adjusted based on drug concentrations, were divided into two groups: an extended group containing participants with at least one week of additional interval extension, and a group with a fixed interval during the trial (range 4–7 weeks). Changes in the occurrence, frequency, onset, and severity of wearing-off symptoms were evaluated. Results: 255 participants were included (extended group n = 171, fixed group n = 84). The odds on occurrence of wearing-off symptoms in the extended group did not increase after extending the treatment interval. Additional analyses for frequency, onset, and severity of wearing-off symptoms showed no changes over time. Mean decrease in natalizumab drug concentration did not influence the frequency of wearing-off symptoms. Discussion: Wearing-off symptoms were not reinforced by further extending the natalizumab interval. Wearing-off symptoms might increase in a minority of patients after EID, although our data support the view that wearing-off symptoms appear to be unrelated to the decrease in natalizumab trough drug concentrations.

Published
2024

2. Automatic quantification of perivascular spaces in T2-weighted images at 7 T MRI

Author

Highfield Research Group, Circulatory Health, Brain, Regenerative Medicine and Stem Cells, Cancer, Opleiding Neurologie, Cardiovasculaire Epi Team 7a, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Neurologen, Divisie Beeld, Strategische Projecten, Beeldverwerking ISI, Structure and Connections, Verbeek-Spijkerman, Jolanda, Zwanenburg, J. J.M., Bouvy, W. H., Geerlings, M. I., Biessels, G. J., Hendrikse, J., Luijten, P. R., Kuijf, H. J., Highfield Research Group, Circulatory Health, Brain, Regenerative Medicine and Stem Cells, Cancer, Opleiding Neurologie, Cardiovasculaire Epi Team 7a, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Neurologen, Divisie Beeld, Strategische Projecten, Beeldverwerking ISI, Structure and Connections, Verbeek-Spijkerman, Jolanda, Zwanenburg, J. J.M., Bouvy, W. H., Geerlings, M. I., Biessels, G. J., Hendrikse, J., Luijten, P. R., and Kuijf, H. J.

Published
2022

3. White matter hyperintensity shape and location feature analysis on brain MRI; proof of principle study in patients with diabetes

Author

De Bresser, Jeroen, Kuijf, Hugo J., Zaanen, Karlijn, Viergever, Max A., Hendrikse, Jeroen, Biessels, Geert Jan, Algra, A., van den Berg, E., Bouvy, W., Brundel, M., Heringa, S., Kappelle, L. J., Leemans, A., Luijten, P. R., Mali, W. P.T.M., Rutten, G. E.H.M., Vincken, K. L., Zwanenburg, J., and Pediatrics

Subjects
Male, medicine.medical_specialty, Percentile, lcsh:Medicine, behavioral disciplines and activities, Article, 030218 nuclear medicine & medical imaging, White matter, 03 medical and health sciences, 0302 clinical medicine, SDG 3 - Good Health and Well-being, Internal medicine, Diabetes mellitus, mental disorders, medicine, Brain mri, Humans, In patient, General, lcsh:Science, Aged, Aged, 80 and over, Multidisciplinary, medicine.diagnostic_test, business.industry, lcsh:R, Magnetic resonance imaging, medicine.disease, Magnetic Resonance Imaging, White Matter, Hyperintensity, medicine.anatomical_structure, White matter hyperintensity, Diabetes Mellitus, Type 2, Cerebral Small Vessel Diseases, Cardiology, Female, lcsh:Q, business, 030217 neurology & neurosurgery
Abstract

Cerebral small vessel disease is a heterogeneous disease in which various underlying etiologies can lead to different types of white matter hyperintensities (WMH). WMH shape features might aid in distinguishing these different types. In this proof of principle study in patients with type 2 diabetes mellitus (T2DM), we present a novel approach to assess WMH using shape features. Our algorithm determines WMH volume and different WMH shape and location features on 3T MRI scans. These features were compared between patients with T2DM (n = 60) and a matched control group (n = 54). Although a more traditional marker (WMH volume) was not significantly different between groups (natural log transformed Beta (95% CI): 0.07 (−0.11↔0.24)), patients with T2DM showed a larger number of non-punctuate WMH (median (10th–90th percentile), patients: 40 lesions per person (16–86); controls: 26 (5–58)) and a different shape (eccentricity) of punctuate deep WMH (Beta (95% CI): 0.40 (0.23↔0.58)) compared to controls. In conclusion, our algorithm identified WMH features that are not part of traditional WMH assessment, but showed to be distinguishing features between patients with T2DM and controls. Future studies could address these features to further unravel the etiology and functional impact of WMH.

Published
2018
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4. Cortical Microinfarcts and White Matter Connectivity in Memory Clinic Patients

Author

Ferro, Doeschka, Heinen, Rutger, Robalo, Bruno de Brito, Kuijf, Hugo, Biessels, Geert Jan, Reijmer, Yael, van den Berg, E., Brundel, M., Bouvy, W. H., Exalto, L. G., Frijns, C. J. M., Groeneveld, O., Heringa, S. M., Kalsbeek, N., Kappelle, L. J., Reijmer, Y. D., Verwer, J., de Bresser, J., Leemans, A., Luijten, P. R., Viergever, M. A., Vincken, K. L., Zwanenburg, J. J. M., Koek, H. L., Hamaker, M., Faaij, R., Pleizier, M., Vriens, E., Neurology, Pediatrics, and Erasmus MC other

Subjects
medicine.medical_specialty, Neurology, Clinical Neurology, 030204 cardiovascular system & hematology, computer.software_genre, white matter connectivity, lcsh:RC346-429, White matter, 03 medical and health sciences, 0302 clinical medicine, Neuroimaging, Voxel, Cortex (anatomy), medicine, Effects of sleep deprivation on cognitive performance, vascular cognitive impairment, lcsh:Neurology. Diseases of the nervous system, Original Research, cerebral small vessel disease, business.industry, diffusion tensor imaging, microinfarcts, medicine.anatomical_structure, Neurology (clinical), business, Neuroscience, computer, 030217 neurology & neurosurgery, Diffusion MRI, Tractography
Abstract

Background and purpose: Cerebral microinfarcts (CMIs) are associated with cognitive impairment and dementia. CMIs might affect cognitive performance through disruption of cerebral networks. We investigated in memory clinic patients whether cortical CMIs are clustered in specific brain regions and if presence of cortical CMIs is associated with reduced white matter (WM) connectivity in tracts projecting to these regions.Methods: 164 memory clinic patients with vascular brain injury with a mean age of 72 +/- 11 years (54% male) were included. All underwent 3 tesla MRI, including a diffusion MRI and cognitive testing. Cortical CMIs were rated according to established criteria and their spatial location was marked. Diffusion imaging-based tractography was used to reconstruct WM connections and voxel based analysis (VBA) to assess integrity of WM directly below the cortex. WM connectivity and integrity were compared between patients with and without cortical CMIs for the whole brain and regions with a high CMI burden.Results: 30 patients (18%) had at least 1 cortical CMI [range 1-46]. More than 70% of the cortical CMIs were located in the superior frontal, middle frontal, and pre- and postcentral brain regions (covering 16% of the cortical surface). In these high CMI burden regions, presence of cortical CMIs was not associated with WM connectivity after correction for conventional neuroimaging markers of vascular injury. WM connectivity in the whole brain and WM voxels directly underneath the cortical surface did not differ between patients with and without cortical CMIs.Conclusion: Cortical CMIs displayed a strong local clustering in highly interconnected frontal, pre- and postcentral brain regions. Nevertheless, WM connections projecting to these regions were not disproportionally impaired in patients with compared to patients without cortical CMIs. Alternative mechanisms, such as focal disturbances in cortical structure and functioning, may better explain CMI associated cognitive impairment.

Published
2019
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5. Cover Image, Volume 29, Issue 9

Author

Bouvy, W. H., Geurts, L. J., Kuijf, H. J., Luijten, P. R., Kappelle, L. J., Biessels, G. J., and Zwanenburg, J. J M

Subjects
Radiology Nuclear Medicine and imaging, Molecular Medicine, Spectroscopy
Abstract

The cover image, by Willem H. Bouvy et al., is based on the Special Issue Research Article Assessment of blood flow velocity and pulsatility in cerebral perforating arteries with 7-T quantitative flow MRI, DOI: 10.1002/nbm.3306. Image Design Credit: Lennart Geurts. This work was supported by the European Research Council, ERC grant agreement n°33733.

Published
2016

7. Assessment of blood flow velocity and pulsatility in cerebral perforating arteries with 7-T quantitative flow MRI

Author

Opleiding Neurologie, Brain, Beeldverwerking ISI, Highfield Research Group, Circulatory Health, Cancer, Regenerative Medicine and Stem Cells, ZL Cerebrovasculaire Ziekten Medisch, ZL Algemene Neurologie Medisch, Bouvy, W. H., Geurts, L. J., Kuijf, H. J., Luijten, P. R., Kappelle, L. J., Biessels, G. J., Zwanenburg, J. J M, Opleiding Neurologie, Brain, Beeldverwerking ISI, Highfield Research Group, Circulatory Health, Cancer, Regenerative Medicine and Stem Cells, ZL Cerebrovasculaire Ziekten Medisch, ZL Algemene Neurologie Medisch, Bouvy, W. H., Geurts, L. J., Kuijf, H. J., Luijten, P. R., Kappelle, L. J., Biessels, G. J., and Zwanenburg, J. J M

Published
2016

8. Cover Image, Volume 29, Issue 9

Author

Opleiding Neurologie, Brain, Highfield Research Group, Circulatory Health, Beeldverwerking ISI, ZL Cerebrovasculaire Ziekten Medisch, ZL Algemene Neurologie Medisch, Cancer, Bouvy, W. H., Geurts, L. J., Kuijf, H. J., Luijten, P. R., Kappelle, L. J., Biessels, G. J., Zwanenburg, J. J M, Opleiding Neurologie, Brain, Highfield Research Group, Circulatory Health, Beeldverwerking ISI, ZL Cerebrovasculaire Ziekten Medisch, ZL Algemene Neurologie Medisch, Cancer, Bouvy, W. H., Geurts, L. J., Kuijf, H. J., Luijten, P. R., Kappelle, L. J., Biessels, G. J., and Zwanenburg, J. J M

Published
2016

9. MRBrainS Challenge: Online Evaluation Framework for Brain Image Segmentation in 3T MRI Scans

Author

Mendrik, AM, Vincken, KL, Kuijf, HJ, Breeuwer, M, Bouvy, W, de Bresser, J, Alansary, A, de Bruijne, M, Caras, A, El-Baz, A, Jogh, A, Katyal, AR, Khan, AR, van der Lijn, F, Mahmood, Q, Mukherjee, R, van Opbroek, A, Paneri, S, Pereira, S, Persson, M, Rajch, M, Sarikaya, D, Smedby, Örjan, Silval, CA, Vrooman, HA, Vyas, S, Wang, Chunliang, Zhao, L, Biessels, GJ, Viergever, MA, Mendrik, AM, Vincken, KL, Kuijf, HJ, Breeuwer, M, Bouvy, W, de Bresser, J, Alansary, A, de Bruijne, M, Caras, A, El-Baz, A, Jogh, A, Katyal, AR, Khan, AR, van der Lijn, F, Mahmood, Q, Mukherjee, R, van Opbroek, A, Paneri, S, Pereira, S, Persson, M, Rajch, M, Sarikaya, D, Smedby, Örjan, Silval, CA, Vrooman, HA, Vyas, S, Wang, Chunliang, Zhao, L, Biessels, GJ, and Viergever, MA

Abstract

Many methods have been proposed for tissue segmentation in brain MRI scans. The multitude of methods proposed complicates the choice of one method above others. We have therefore established the MRBrainS online evaluation framework for evaluating (semi)automatic algorithms that segment gray matter (GM), white matter (WM), and cerebrospinal fluid (CSF) on 3T brain MRI scans of elderly subjects (65–80 y). Participants apply their algorithms to the provided data, after which their results are evaluated and ranked. Full manual segmentations of GM, WM, and CSF are available for all scans and used as the reference standard. Five datasets are provided for training and fifteen for testing. The evaluated methods are ranked based on their overall performance to segment GM, WM, and CSF and evaluated using three evaluation metrics (Dice, H95, and AVD) and the results are published on the MRBrainS13 website. We present the results of eleven segmentation algorithms that participated in the MRBrainS13 challenge workshop at MICCAI, where the framework was launched, and three commonly used freeware packages: FreeSurfer, FSL, and SPM. The MRBrainS evaluation framework provides an objective and direct comparison of all evaluated algorithms and can aid in selecting the best performing method for the segmentation goal at hand., QC 20160112. QC 20160113

Published
2015
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10. Inquiry dialogues inside a framework for persuasion

Author

Bouvy, W., Prakken, prof. dr. mr. H. (Thesis Advisor), Black, dr. E, Bouvy, W., Prakken, prof. dr. mr. H. (Thesis Advisor), and Black, dr. E

Abstract

This thesis is a comparison of a system for inquiry dialogues and a framework for persuasion dialogues in order to reconcile their differences, determine which differences cannot be reconciled and determine the cost of this reconciliation to their fundamental properties. The systems that are compared are Prakken’s framework for persuasion dialogues and Black and Hunter’s system for inquiry dialogues. Two new systems are defined where the structure of Black and Hunter’s system is described using Prakken’s framework. In one of the systems, the structure of Black and Hunter’s system is adapted, while maintaining most of the fundamental properties. In the other system, Black and Hunter’s system is unchanged, and Prakken’s framework is adapted where necessary. For both systems, conversion functions are given and proofs are provided to show that dialogues in the systems are equivalent to dialogues in the original system. From the two new systems, it is shown that inquiry and persuasion are closely related, and that both systems are capable of expressing both types of dialogue with a few specific alterations. Most research that has been done for persuasion dialogues is therefore likely to be applicable to inquiry dialogues as well.

Published
2011

11. Automatic quantification of perivascular spaces in T2-weighted images at 7 T MRI.

Author

Spijkerman JM, Zwanenburg JJM, Bouvy WH, Geerlings MI, Biessels GJ, Hendrikse J, Luijten PR, and Kuijf HJ

Abstract

Perivascular spaces (PVS) are believed to be involved in brain waste disposal. PVS are associated with cerebral small vessel disease. At higher field strengths more PVS can be observed, challenging manual assessment. We developed a method to automatically detect and quantify PVS. A machine learning approach identified PVS in an automatically positioned ROI in the centrum semiovale (CSO), based on -resolution T2-weighted TSE scans. Next, 3D PVS tracking was performed in 50 subjects (mean age 62.9 years (range 27-78), 19 male), and quantitative measures were extracted. Maps of PVS density, length, and tortuosity were created. Manual PVS annotations were available to train and validate the automatic method. Good correlation was found between the automatic and manual PVS count: ICC (absolute/consistency) is 0.64/0.75, and Dice similarity coefficient (DSC) is 0.61. The automatic method counts fewer PVS than the manual count, because it ignores the smallest PVS (length <2 mm). For 20 subjects manual PVS annotations of a second observer were available. Compared with the correlation between the automatic and manual PVS, higher inter-observer ICC was observed (0.85/0.88), but DSC was lower (0.49 in 4 persons). Longer PVS are observed posterior in the CSO compared with anterior in the CSO. Higher PVS tortuosity are observed in the center of the CSO compared with the periphery of the CSO. Our fully automatic method can detect PVS in a 2D slab in the CSO, and extract quantitative PVS parameters by performing 3D tracking. This method enables automated quantitative analysis of PVS., (© 2022 The Author(s).)

Published
2022
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12. Microbleeds as a predictor of intracerebral haemorrhage and ischaemic stroke after a TIA or minor ischaemic stroke: a cohort study.

Author

Kwa VI, Algra A, Brundel M, Bouvy W, and Kappelle LJ

Abstract

Objectives: We examined whether patients with cerebral microbleeds on MRI, who started and continued antithrombotic medication for years, have an increased risk of symptomatic intracerebral haemorrhage (ICH)., Design: Prospective cohort study., Settings: Multicentre outpatient clinics in the Netherlands., Participants: We followed 397 patients with newly diagnosed transient ischaemic attack (TIA) or minor ischaemic stroke receiving anticoagulants or antiplatelet drugs. 58% were men. The mean age was 65.3 years. 395 (99%) patients were white Europeans. MRI including a T2*-weighted gradient echo was performed within 3 months after start of medication. 48 (12%) patients had one or more microbleeds. They were followed every 6 months by telephone for a mean of 3.8 years., Primary and Secondary Outcome Measures: Primary outcome was a symptomatic ICH. Secondary outcome were all strokes, ischaemic stroke, myocardial infarct, death from all vascular causes, death from non-vascular causes and death from all causes., Results: Five patients (1%) suffered from a symptomatic ICH. One ICH occurred in a patient with microbleeds at baseline (adjusted HR 2.6, 95% CI 0.3 to 27). The incidence of all strokes during follow-up was higher in patients with than without microbleeds (adjusted HR 2.3, 95% CI 1.0 to 5.3), with a dose-response relationship. The incidences of ischaemic stroke, vascular death, non-vascular death and death of all causes were higher in patients with microbleeds, but not statistically significant., Conclusions: In our cohort of patients using antithrombotic drugs after a TIA or minor ischaemic stroke, we found that microbleeds on MRI are associated with an increased risk of future stroke in general, but we did not find an increased risk of symptomatic ICH.

Published
2013
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