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1. Architecture and anatomy of executive processes: evidence from verbal fluency and Trail Making Test in 2009 stroke patients

Author

Godefroy, Olivier, Weaver, Nick A., Roussel, Martine, Dorchies, Flore, Kassir, Rania, Biesbroek, J. Matthijs, Lee, Keon-Joo, Kim, Beom Joon, Bae, Hee-Joon, Lim, Jae-Sung, Lee, Minwoo, Yu, Kyung-Ho, Aben, Hugo P., de Kort, Paul L. M., Bordet, Régis, Lopes, Renaud, Dondaine, Thibaut, Biessels, Geert Jan, and Aarabi, Ardalan

Published
2024
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2. Strategic infarct locations for post-stroke cognitive impairment: a pooled analysis of individual patient data from 12 acute ischaemic stroke cohorts

Author

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

Published
2021
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3. Strategic white matter hyperintensity locations associated with post-stroke cognitive impairment:A multicenter study in 1568 stroke patients

Author

Coenen, Mirthe, de Kort, Floor A. S., Weaver, Nick A., Kuijf, Hugo J., Aben, Hugo P., Bae, Hee-Joon, Bordet, Regis, Chen, Christopher P. L. H., Dewenter, Anna, Doeven, Thomas, Dondaine, Thibaut, Duering, Marco, Fang, Rong, van der Giessen, Ruben S., Kim, Jonguk, Kim, Beom Joon, de Kort, Paul L. M., Koudstaal, Peter J., Lee, Minwoo, Lim, Jae-Sung, Lopes, Renaud, van Oostenbrugge, Robert J., Staals, Julie, Yu, Kyung-Ho, Biessels, Geert Jan, Biesbroek, J. Matthijs, Coenen, Mirthe, de Kort, Floor A. S., Weaver, Nick A., Kuijf, Hugo J., Aben, Hugo P., Bae, Hee-Joon, Bordet, Regis, Chen, Christopher P. L. H., Dewenter, Anna, Doeven, Thomas, Dondaine, Thibaut, Duering, Marco, Fang, Rong, van der Giessen, Ruben S., Kim, Jonguk, Kim, Beom Joon, de Kort, Paul L. M., Koudstaal, Peter J., Lee, Minwoo, Lim, Jae-Sung, Lopes, Renaud, van Oostenbrugge, Robert J., Staals, Julie, Yu, Kyung-Ho, Biessels, Geert Jan, and Biesbroek, J. Matthijs

Abstract

Background: Post-stroke cognitive impairment (PSCI) occurs in up to 50% of stroke survivors. Presence of pre-existing vascular brain injury, in particular the extent of white matter hyperintensities (WMH), is associated with worse cognitive outcome after stroke, but the role of WMH location in this association is unclear.Aims: We determined if WMH in strategic white matter tracts explain cognitive performance after stroke.Methods: Individual patient data from nine ischemic stroke cohorts with magnetic resonance imaging (MRI) were harmonized through the Meta VCI Map consortium. The association between WMH volumes in strategic tracts and domain-specific cognitive functioning (attention and executive functioning, information processing speed, language and verbal memory) was assessed using linear mixed models and lasso regression. We used a hypothesis-driven design, primarily addressing four white matter tracts known to be strategic in memory clinic patients: the left and right anterior thalamic radiation, forceps major, and left inferior fronto-occipital fasciculus.Results: The total study sample consisted of 1568 patients (39.9% female, mean age = 67.3 years). Total WMH volume was strongly related to cognitive performance on all four cognitive domains. WMH volume in the left anterior thalamic radiation was significantly associated with cognitive performance on attention and executive functioning and information processing speed and WMH volume in the forceps major with information processing speed. The multivariable lasso regression showed that these associations were independent of age, sex, education, and total infarct volume and had larger coefficients than total WMH volume.Conclusion: These results show tract-specific relations between WMH volume and cognitive performance after ischemic stroke, independent of total WMH volume. This implies that the concept of strategic lesions in PSCI extends beyond acute infarcts and also involves pre-existing WMH.Data access stat

Published
2024

4. Cognitive trajectory in the first year after first-ever ischaemic stroke in young adults: the ODYSSEY study

Author

Schellekens, Mijntje M I, primary, Springer, Ravi C S, additional, Boot, Esther M, additional, Verhoeven, Jamie I, additional, Ekker, Merel S, additional, van Alebeek, Mayte E, additional, Brouwers, Paul J A M, additional, Arntz, Renate M, additional, van Dijk, Gert W, additional, Gons, Rob A R, additional, van Uden, Inge W M, additional, den Heijer, Tom, additional, van Tuijl, Julia H, additional, de Laat, Karlijn F, additional, van Norden, Anouk G W, additional, Vermeer, Sarah E, additional, van Zagten, Marian S G, additional, Van Oostenbrugge, Robert J, additional, Wermer, Marieke J H, additional, Nederkoorn, Paul J, additional, van Rooij, Frank G, additional, van den Wijngaard, Ido R, additional, de Kort, Paul L M, additional, De Leeuw, Frank-Erik, additional, Kessels, Roy P C, additional, and Tuladhar, Anil M, additional

Published
2023
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5. Association between thrombus composition and stroke etiology in the MR CLEAN Registry biobank

Author

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

Subjects
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.

Published
2023
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6. White Matter Hyperintensity Volume and Poststroke Cognition: An Individual Patient Data Pooled Analysis of 9 Ischemic Stroke Cohort Studies

Author

Opleiding Neurologie, Beeldverwerking ISI, Brain, Cancer, Circulatory Health, Structure and Connections, Neurologie, Projectafdeling VCI, Neurologen, de Kort, Floor A S, Coenen, Mirthe, Weaver, Nick A, Kuijf, Hugo J, Aben, Hugo P, Bae, Hee-Joon, Bordet, Régis, Cammà, Guido, Chen, Christopher P L H, Dewenter, Anna, Duering, Marco, Fang, Rong, van der Giessen, Ruben S, Hamilton, Olivia K L, Hilal, Saima, Huenges Wajer, Irene M C, Kan, Cheuk Ni, Kim, Jonguk, Kim, Beom Joon, Köhler, Sebastian, de Kort, Paul L M, Koudstaal, Peter J, Lim, Jae-Sung, Lopes, Renaud, Mok, Vincent C T, Staals, Julie, Venketasubramanian, Narayanaswamy, Verhagen, Charlotte M, Verhey, Frans R J, Wardlaw, Joanna M, Xu, Xin, Yu, Kyung-Ho, Biesbroek, J Matthijs, Biessels, Geert Jan, Opleiding Neurologie, Beeldverwerking ISI, Brain, Cancer, Circulatory Health, Structure and Connections, Neurologie, Projectafdeling VCI, Neurologen, de Kort, Floor A S, Coenen, Mirthe, Weaver, Nick A, Kuijf, Hugo J, Aben, Hugo P, Bae, Hee-Joon, Bordet, Régis, Cammà, Guido, Chen, Christopher P L H, Dewenter, Anna, Duering, Marco, Fang, Rong, van der Giessen, Ruben S, Hamilton, Olivia K L, Hilal, Saima, Huenges Wajer, Irene M C, Kan, Cheuk Ni, Kim, Jonguk, Kim, Beom Joon, Köhler, Sebastian, de Kort, Paul L M, Koudstaal, Peter J, Lim, Jae-Sung, Lopes, Renaud, Mok, Vincent C T, Staals, Julie, Venketasubramanian, Narayanaswamy, Verhagen, Charlotte M, Verhey, Frans R J, Wardlaw, Joanna M, Xu, Xin, Yu, Kyung-Ho, Biesbroek, J Matthijs, and Biessels, Geert Jan

Published
2023

7. Sex Differences in Poststroke Cognitive Impairment: A Multicenter Study in 2343 Patients With Acute Ischemic Stroke

Author

Neurologen, Opleiding Neurologie, Beeldverwerking ISI, Brain, Cancer, Circulatory Health, Structure and Connections, Projectafdeling VCI, Neurologie, Neuropsychologie, Exalto, Lieza G, Weaver, Nick A, Kuijf, Hugo J, Aben, Hugo P, Bae, Hee-Joon, 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, Kim, Jonguk, Kappelle, L Jaap, Kim, Beom Joon, Köhler, Sebastian, de Kort, Paul L M, Koudstaal, Peter J, Lim, Jae-Sung, Makin, Stephen D J, Mok, Vincent C T, van Oostenbrugge, Robert J, Roussel, Martine, Staals, Julie, Valdés-Hernández, Maria Del C, Venketasubramanian, Narayanaswamy, Verhey, Frans R J, Wardlaw, Joanna M, Werring, David J, Xu, Xin, van Zandvoort, Martine J E, Biesbroek, J Matthijs, Chappell, Francesca M, Biessels, Geert Jan, Neurologen, Opleiding Neurologie, Beeldverwerking ISI, Brain, Cancer, Circulatory Health, Structure and Connections, Projectafdeling VCI, Neurologie, Neuropsychologie, Exalto, Lieza G, Weaver, Nick A, Kuijf, Hugo J, Aben, Hugo P, Bae, Hee-Joon, 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, Kim, Jonguk, Kappelle, L Jaap, Kim, Beom Joon, Köhler, Sebastian, de Kort, Paul L M, Koudstaal, Peter J, Lim, Jae-Sung, Makin, Stephen D J, Mok, Vincent C T, van Oostenbrugge, Robert J, Roussel, Martine, Staals, Julie, Valdés-Hernández, Maria Del C, Venketasubramanian, Narayanaswamy, Verhey, Frans R J, Wardlaw, Joanna M, Werring, David J, Xu, Xin, van Zandvoort, Martine J E, Biesbroek, J Matthijs, Chappell, Francesca M, and Biessels, Geert Jan

Published
2023

8. Validity of Early Outcomes as Indicators for Comparing Hospitals on Quality of Stroke Care

Author

Amini, Marzyeh, primary, Eijkenaar, Frank, additional, Lingsma, Hester F., additional, den Hartog, Sanne J., additional, Olthuis, Susanne G. H., additional, Martens, Jasper, additional, van der Worp, Bart, additional, van Zwam, Wim, additional, van der Hoorn, Anouk, additional, Roosendaal, Stefan D., additional, Roozenbeek, Bob, additional, Dippel, Diederik, additional, van Leeuwen, Nikki, additional, Dippel, Diederik W. J., additional, van der Lugt, Aad, additional, Majoie, Charles B. L. M., additional, Roos, Yvo B. W. E. M., additional, van Oostenbrugge, Robert J., additional, van Zwam, Wim H., additional, Boiten, Jelis, additional, Vos, Jan Albert, additional, Brouwer, Josje, additional, Hinsenveld, Wouter H., additional, Kappelhof, Manon, additional, Compagne, Kars C. J., additional, Goldhoorn, Robert‐Jan B., additional, Mulder, Maxim J. H. L., additional, Jansen, Ivo G. H., additional, van Es, Adriaan C. G. M., additional, Emmer, Bart J., additional, Coutinho, Jonathan M., additional, Schonewille, Wouter J., additional, Wermer, Marieke J. H., additional, van Walderveen, Marianne A. A., additional, Staals, Julie, additional, Hofmeijer, Jeannette, additional, Martens, Jasper M., additional, Lycklama à Nijeholt, Geert J., additional, de Bruijn, Sebastiaan F., additional, van Dijk, Lukas C., additional, van der Worp, H. Bart, additional, Lo, Rob H., additional, van Dijk, Ewoud J., additional, Boogaarts, Hieronymus D., additional, de Vries, J., additional, de Kort, Paul L. M., additional, van Tuijl, Julia, additional, Peluso, Jo Jo P., additional, Fransen, Puck, additional, van den Berg, Jan S. P., additional, van Hasselt, Boudewijn A. A. M., additional, Aerden, Leo A. M., additional, Dallinga, René J., additional, Uyttenboogaart, Maarten, additional, Eschgi, Omid, additional, Bokkers, Reinoud P. H., additional, Schreuder, Tobien H. C. M. L., additional, Heijboer, Roel J. J., additional, Keizer, Koos, additional, Yo, Lonneke S. F., additional, den Hertog, Heleen M., additional, Sturm, Emiel J. C., additional, Brouwers, Paul, additional, Sprengers, Marieke E. S., additional, Jenniskens, Sjoerd F. M., additional, van den Berg, René, additional, Yoo, Albert J., additional, Beenen, Ludo F. M., additional, Postma, Alida A., additional, van der Kallen, Bas F. W., additional, van den Wijngaard, Ido R., additional, Bot, Joost, additional, van Doormaal, Pieter‐Jan, additional, Meijer, Anton, additional, Ghariq, Elyas, additional, van Proosdij, Marc P., additional, Krietemeijer, G. Menno, additional, Peluso, Jo P., additional, Lo, Rob, additional, Dinkelaar, Wouter, additional, Appelman, Auke P. A., additional, Hammer, Bas, additional, Pegge, Sjoert, additional, Vinke, Saman, additional, Flach, H. Zwenneke, additional, el Ghannouti, Naziha, additional, Sterrenberg, Martin, additional, Puppels, Corina, additional, Pellikaan, Wilma, additional, Sprengers, Rita, additional, Elfrink, Marjan, additional, Simons, Michelle, additional, Vossers, Marjolein, additional, de Meris, Joke, additional, Vermeulen, Tamara, additional, Geerlings, Annet, additional, van Vemde, Gina, additional, Simons, Tiny, additional, van Rijswijk, Cathelijn, additional, Messchendorp, Gert, additional, Nicolaij, Nynke, additional, Bongenaar, Hester, additional, Bodde, Karin, additional, Kleijn, Sandra, additional, Lodico, Jasmijn, additional, Droste, Hanneke, additional, Wollaert, Maureen, additional, Verheesen, Sabrina, additional, Jeurrissen, D., additional, Bos, Erna, additional, Drabbe, Yvonne, additional, Sandiman, Michelle, additional, Aaldering, Nicoline, additional, Zweedijk, Berber, additional, Khalilzada, Mostafa, additional, Vervoort, Jocova, additional, Ponjee, Eva, additional, Romviel, Sharon, additional, Kanselaar, Karin, additional, Barning, Denn, additional, Venema, Esmee, additional, Chalos, Vicky, additional, Geuskens, Ralph R., additional, van Straaten, Tim, additional, Ergezen, Saliha, additional, Harmsma, Roger R. M., additional, Muijres, Daan, additional, de Jong, Anouk, additional, Berkhemer, Olvert A., additional, Boers, Anna M. M., additional, Huguet, J., additional, Groot, P. F. C., additional, Mens, Marieke A., additional, van Kranendonk, Katinka R., additional, Treurniet, Kilian M., additional, Tolhuisen, Manon L., additional, Alves, Heitor, additional, Weterings, Annick J., additional, Kirkels, Eleonora L. F., additional, Voogd, Eva J. H. F., additional, Schupp, Lieve M., additional, Collette, Sabine, additional, Groot, Adrien E. D., additional, LeCouffe, Natalie E., additional, Konduri, Praneeta R., additional, Prasetya, Haryadi, additional, Arrarte‐Terreros, Nerea, additional, and Ramos, Lucas A., additional

Published
2023
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9. 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

Author

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

Published
2015

10. Sex Differences in Poststroke Cognitive Impairment: A Multicenter Study in 2343 Patients With Acute Ischemic Stroke.

Author

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.

Published
2023
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11. Cognitive trajectory in the first year after first-ever ischaemic stroke in young adults: the ODYSSEY study

Author

Schellekens, Mijntje M I, Springer, Ravi C S, Boot, Esther M, Verhoeven, Jamie I, Ekker, Merel S, van Alebeek, Mayte E, Brouwers, Paul J A M, Arntz, Renate M, van Dijk, Gert W, Gons, Rob A R, van Uden, Inge W M, den Heijer, Tom, van Tuijl, Julia H, de Laat, Karlijn F, van Norden, Anouk G W, Vermeer, Sarah E, van Zagten, Marian S G, Van Oostenbrugge, Robert J, Wermer, Marieke J H, Nederkoorn, Paul J, van Rooij, Frank G, van den Wijngaard, Ido R, de Kort, Paul L M, De Leeuw, Frank-Erik, Kessels, Roy P C, and Tuladhar, Anil M

Abstract

BackgroundLimited 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.MethodsWe 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).Results393 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.ConclusionsCognitive 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.

Published
2024
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12. CT angiography and CT perfusion improve prediction of infarct volume in patients with anterior circulation stroke

Author

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

Published
2016
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13. A decrease in blood pressure is associated with unfavorable outcome in patients undergoing thrombectomy under general anesthesia

Author

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

Published
2018
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14. Network impact score is an independent predictor of post-stroke cognitive impairment: A multicenter cohort study in 2341 patients with acute ischemic stroke

Author

Projectafdeling VCI, Brain, Opleiding Neurologie, Beeldverwerking ISI, Circulatory Health, Cancer, Neurologie, Neurologen, Neuropsychologie, Structure and Connections, Biesbroek, J Matthijs, Weaver, Nick A, Aben, Hugo P, Kuijf, Hugo J, 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, Valdés-Hernández, Maria Del C, Venketasubramanian, Narayanaswamy, Verhey, Frans R J, Wardlaw, Joanna M, Werring, David J, Xin, Xu, Yu, Kyung-Ho, van Zandvoort, Martine J E, Zhao, Lei, Biessels, Geert Jan, Projectafdeling VCI, Brain, Opleiding Neurologie, Beeldverwerking ISI, Circulatory Health, Cancer, Neurologie, Neurologen, Neuropsychologie, Structure and Connections, Biesbroek, J Matthijs, Weaver, Nick A, Aben, Hugo P, Kuijf, Hugo J, 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, Valdés-Hernández, Maria Del C, Venketasubramanian, Narayanaswamy, Verhey, Frans R J, Wardlaw, Joanna M, Werring, David J, Xin, Xu, Yu, Kyung-Ho, van Zandvoort, Martine J E, Zhao, Lei, and Biessels, Geert Jan

Published
2022

15. Hospital Variation in Time to Endovascular Treatment for Ischemic Stroke: What Is the Optimal Target for Improvement?

Author

den Hartog, Sanne J., primary, Lingsma, Hester F., additional, van Doormaal, Pieter‐Jan, additional, Hofmeijer, Jeannette, additional, Yo, Lonneke S. F., additional, Majoie, Charles B. L. M., additional, Dippel, Diederik W. J., additional, van der Lugt, Aad, additional, Roozenbeek, Bob, additional, Roos, Yvo B. W. E. M., additional, van Oostenbrugge, Robert J., additional, van Zwam, Wim H., additional, Boiten, Jelis, additional, Vos, Jan Albert, additional, Jansen, Ivo G. H., additional, Mulder, Maxim J. H. L., additional, Goldhoorn, Robert‐ Jan B., additional, Compagne, Kars C. J., additional, Kappelhof, Manon, additional, Brouwer, Josje, additional, den Hartog, Sanne J., additional, Hinsenveld, Wouter H., additional, van Es, Adriaan C. G. M., additional, Emmer, Bart J., additional, Coutinho, Jonathan M., additional, Schonewille, Wouter J., additional, Wermer, Marieke J. H., additional, van Walderveen, Marianne A. A., additional, Staals, Julie, additional, Martens, Jasper M., additional, Lycklama à Nijeholt, Geert J., additional, de Bruijn, Sebastiaan F., additional, van Dijk, Lukas C., additional, van der Worp, H. Bart, additional, Lo, Rob H., additional, van Dijk, Ewoud J., additional, Boogaarts, Hieronymus D., additional, de Vries, J., additional, de Kort, Paul L. M., additional, van Tuijl, Julia, additional, Peluso, Jo P., additional, Fransen, Puck, additional, van den Berg, Jan S. P., additional, van Hasselt, Boudewijn A. A. M., additional, Aerden, Leo A. M., additional, Dallinga, René J., additional, Uyttenboogaart, Maarten, additional, Eschgi, Omid, additional, Bokkers, Reinoud P. H., additional, Schreuder, Tobien H. C. M. L., additional, Heijboer, Roel J. J., additional, Keizer, Koos, additional, den Hertog, Heleen M., additional, Sturm, Emiel J. C., additional, Brouwers, Paul J. A. M., additional, Sprengers, Marieke E. S., additional, Jenniskens, Sjoerd F. M., additional, van den Berg, René, additional, Yoo, Albert J., additional, Beenen, Ludo F. M., additional, Postma, Alida A., additional, Roosendaal, Stefan D., additional, van der Kallen, Bas F. W., additional, van den Wijngaard, Ido R., additional, Bot, Joost, additional, Meijer, Anton, additional, Ghariq, Elyas, additional, van Proosdij, Marc P., additional, Menno Krietemeijer, G., additional, Gerrits, Dick, additional, Dinkelaar, Wouter, additional, Appelman, Auke P. A., additional, Hammer, Bas, additional, Pegge, Sjoert, additional, van der Hoorn, Anouk, additional, Vinke, Saman, additional, Zwenneke Flach, H, additional, Ghannouti, Naziha el, additional, Sterrenberg, Martin, additional, Pellikaan, Wilma, additional, Sprengers, Rita, additional, Elfrink, Marjan, additional, Simons, Michelle, additional, Vossers, Marjolein, additional, de Meris, Joke, additional, Vermeulen, Tamara, additional, Geerlings, Annet, additional, van Vemde, Gina, additional, Simons, Tiny, additional, Messchendorp, Gert, additional, Nicolaij, Nynke, additional, Bongenaar, Hester, additional, Bodde, Karin, additional, Kleijn, Sandra, additional, Lodico, Jasmijn, additional, Droste, Hanneke, additional, Wollaert, Maureen, additional, Verheesen, Sabrina, additional, Jeurrissen, D., additional, Bos, Erna, additional, Drabbe, Yvonne, additional, Sandiman, Michelle, additional, Aaldering, Nicoline, additional, Zweedijk, Berber, additional, Vervoort, Jocova, additional, Ponjee, Eva, additional, Romviel, Sharon, additional, Kanselaar, Karin, additional, Barning, Denn, additional, Venema, Esmee, additional, Chalos, Vicky, additional, Geuskens, Ralph R., additional, van Straaten, Tim, additional, Ergezen, Saliha, additional, Harmsma, Roger R. M., additional, Muijres, Daan, additional, de Jong, Anouk, additional, Berkhemer, Olvert A., additional, Boers, Anna M. M., additional, Huguet, J., additional, Groot, P. F. C., additional, Mens, Marieke A., additional, van Kranendonk, Katinka R., additional, Treurniet, Kilian M., additional, Tolhuisen, Manon L., additional, Alves, Heitor, additional, Weterings, Annick J., additional, Kirkels, Eleonora L. F., additional, Voogd, Eva J. H. F., additional, Schupp, Lieve M., additional, Collette, Sabine L., additional, Groot, Adrien E. D., additional, LeCouffe, Natalie E., additional, Konduri, Praneeta R., additional, Prasetya, Haryadi, additional, Arrarte‐Terreros, Nerea, additional, and Ramos, Lucas A., additional

Published
2021
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16. Time to Reperfusion and Treatment Effect for Acute Ischemic Stroke: A Randomized Clinical Trial

Author

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.

Published
2016
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17. 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

Author

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

Published
2015
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18. Prediction of Cognitive Recovery after Stroke: The Value of Diffusion-Weighted Imaging–Based Measures of Brain Connectivity

Author

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

Subjects
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.

Published
2021

20. Effect of First‐Pass Reperfusion on Outcome After Endovascular Treatment for Ischemic Stroke

Author

den Hartog, Sanne J., primary, Zaidat, Osama, additional, Roozenbeek, Bob, additional, van Es, Adriaan C. G. M., additional, Bruggeman, Agnetha A. E., additional, Emmer, Bart J., additional, Majoie, Charles B. L. M., additional, van Zwam, Wim H., additional, van den Wijngaard, Ido R., additional, van Doormaal, Pieter Jan, additional, Lingsma, Hester F., additional, Burke, James F., additional, Dippel, Diederik W. J., additional, van der Lugt, Aad, additional, Roos, Yvo B. W. E. M., additional, van Oostenbrugge, Robert J., additional, Boiten, Jelis, additional, Vos, Jan Albert, additional, Jansen, Ivo G. H., additional, Mulder, Maxim J. H. L., additional, Goldhoorn, Robert‐Jan B., additional, Compagne, Kars C. J., additional, Kappelhof, Manon, additional, Brouwer, Josje, additional, Hinsenveld, Wouter H., additional, Coutinho, Jonathan M., additional, Schonewille, Wouter J., additional, Wermer, Marieke J. H., additional, van Walderveen, Marianne A. A., additional, Staals, Julie, additional, Hofmeijer, Jeannette, additional, Martens, Jasper M., additional, Lycklama à Nijeholt, Geert J., additional, de Bruijn, Sebastiaan F., additional, van Dijk, Lukas C., additional, van der Worp, H. Bart, additional, Lo, Rob H., additional, van Dijk, Ewoud J., additional, Boogaarts, Hieronymus D., additional, de Vries, J., additional, de Kort, Paul L. M., additional, van Tuijl, Julia, additional, Peluso, Jo P., additional, Fransen, Puck, additional, van den Berg, Jan S. P., additional, van Hasselt, Boudewijn A. A. M., additional, Aerden, Leo A. M., additional, Dallinga, René J., additional, Uyttenboogaart, Maarten, additional, Eschgi, Omid, additional, Bokkers, Reinoud P. H., additional, Schreuder, Tobien H. C. M. L., additional, Heijboer, Roel J. J., additional, Keizer, Koos, additional, Yo, Lonneke S. F., additional, den Hertog, Heleen M., additional, Sturm, Emiel J. C., additional, Brouwers, Paul J. A. M., additional, Sprengers, Marieke E. S., additional, Jenniskens, Sjoerd F. M., additional, van den Berg, René, additional, Yoo, Albert J., additional, Beenen, Ludo F. M., additional, Postma, Alida A., additional, Roosendaal, Stefan D., additional, van der Kallen, Bas F. W., additional, Bot, Joost, additional, Meijer, Anton, additional, Ghariq, Elyas, additional, van Proosdij, Marc P., additional, Krietemeijer, G. Menno, additional, Gerrits, Dick, additional, Dinkelaar, Wouter, additional, Appelman, Auke P. A., additional, Hammer, Bas, additional, Pegge, Sjoert, additional, van der Hoorn, Anouk, additional, Vinke, Saman, additional, Flach, H. Zwenneke, additional, el Ghannouti, Naziha, additional, Sterrenberg, Martin, additional, Pellikaan, Wilma, additional, Sprengers, Rita, additional, Elfrink, Marjan, additional, Simons, Michelle, additional, Vossers, Marjolein, additional, de Meris, Joke, additional, Vermeulen, Tamara, additional, Geerlings, Annet, additional, van Vemde, Gina, additional, Simons, Tiny, additional, Messchendorp, Gert, additional, Nicolaij, Nynke, additional, Bongenaar, Hester, additional, Bodde, Karin, additional, Kleijn, Sandra, additional, Lodico, Jasmijn, additional, Droste, Hanneke, additional, Wollaert, Maureen, additional, Verheesen, Sabrina, additional, Jeurrissen, D., additional, Bos, Erna, additional, Drabbe, Yvonne, additional, Sandiman, Michelle, additional, Aaldering, Nicoline, additional, Zweedijk, Berber, additional, Vervoort, Jocova, additional, Ponjee, Eva, additional, Romviel, Sharon, additional, Kanselaar, Karin, additional, Barning, Denn, additional, Venema, Esmee, additional, Chalos, Vicky, additional, Geuskens, Ralph R., additional, van Straaten, Tim, additional, Ergezen, Saliha, additional, Harmsma, Roger R. M., additional, Muijres, Daan, additional, de Jong, Anouk, additional, Berkhemer, Olvert A., additional, Boers, Anna M. M., additional, Huguet, J., additional, Groot, P. F. C., additional, Mens, Marieke A., additional, van Kranendonk, Katinka R., additional, Treurniet, Kilian M., additional, Tolhuisen, Manon L., additional, Alves, Heitor, additional, Weterings, Annick J., additional, Kirkels, Eleonora L. F., additional, Voogd, Eva J. H. F., additional, Schupp, Lieve M., additional, Collette, Sabine L., additional, Groot, Adrien E. D., additional, LeCouffe, Natalie E., additional, Konduri, Praneeta R., additional, Prasetya, Haryadi, additional, Arrarte‐Terreros, Nerea, additional, and Ramos, Lucas A., additional

Published
2021
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22. National Institutes of Health Stroke Scale: An Alternative Primary Outcome Measure for Trials of Acute Treatment for Ischemic Stroke

Author

Chalos, Vicky, van der Ende, Nadinda A. M., Lingsma, Hester F., Mulder, Maxim J. H. L., Venema, Esmee, Dijkland, Simone A., Berkhemer, Olvert A., Yoo, Albert J., Broderick, Joseph P., Palesch, Yuko Y., Yeatts, Sharon D., Roos, Yvo B. W. E. M., van Oostenbrugge, Robert J., van Zwam, Wim H., Majoie, Charles B. L. M., van der Lugt, Aad, Roozenbeek, Bob, Dippel, Diederik W. J., Fransen, Puck S. S., Beumer, Debbie, van den Berg, Lucie A., 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., Nijeholt, Geert J. Lycklama A., 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 Rooij, Willem Jan J., van den Berg, Jan S. P., van Hasselt, Boudewijn A. A. M., Aerden, Leo A. M., Dallinga, Rene 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, Rene, Koudstaal, Peter J., Radiology and nuclear medicine, VU University medical center, Neurology, Amsterdam Neuroscience - Neurovascular Disorders, ACS - Atherosclerosis & ischemic syndromes, Public Health, Radiology & Nuclear Medicine, Radiology and Nuclear Medicine, ANS - Neurovascular Disorders, ACS - Microcirculation, ACS - Amsterdam Cardiovascular Sciences, Graduate School, ACS - Pulmonary hypertension & thrombosis, AGEM - Digestive immunity, AGEM - Re-generation and cancer of the digestive system, ARD - Amsterdam Reproduction and Development, MUMC+: MA Neurologie (3), Klinische Neurowetenschappen, MUMC+: Hersen en Zenuw Centrum (3), RS: Carim - B05 Cerebral small vessel disease, Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), RS: Carim - B06 Imaging, MUMC+: MA AIOS Neurologie (9), and MUMC+: MA Med Staf Spec Neurologie (9)

Subjects
Male, endovascular treatment, Original Contributions, 030204 cardiovascular system & hematology, law.invention, Brain Ischemia, 0302 clinical medicine, Randomized controlled trial, Modified Rankin Scale, Informed consent, law, Stroke, Netherlands, Confounding, Endovascular Procedures, informed consent, Middle Aged, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], stroke, 3. Good health, thrombectomy, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, outcome, Female, Cardiology and Cardiovascular Medicine, SURROGATE END-POINTS, CLINICAL-TRIALS, medicine.medical_specialty, Mechanical Thrombolysis, ENDOVASCULAR THERAPY, Clinical Sciences, 03 medical and health sciences, ALTEPLASE, Internal medicine, medicine, Humans, cardiovascular diseases, PLASMINOGEN-ACTIVATOR, Aged, Advanced and Specialized Nursing, Surrogate endpoint, business.industry, Other Research Radboud Institute for Health Sciences [Radboudumc 0], Odds ratio, medicine.disease, United States, RANDOMIZED-TRIAL, Clinical trial, SEVERITY, National Institutes of Health (U.S.), Neurology (clinical), business, 030217 neurology & neurosurgery, Follow-Up Studies, NIHSS
Abstract

Supplemental Digital Content is available in the text., Background and Purpose— The modified Rankin Scale (mRS) at 3 months is the most commonly used primary outcome measure in stroke treatment trials, but it lacks specificity and requires long-term follow-up interviews, which consume time and resources. An alternative may be the National Institutes of Health Stroke Scale (NIHSS), early after stroke. Our aim was to evaluate whether the NIHSS assessed within 1 week after treatment could serve as a primary outcome measure for trials of acute treatment for ischemic stroke. Methods— We used data from 2 randomized controlled trials of endovascular treatment for ischemic stroke: the positive MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands; N=500) and the neutral IMS (Interventional Management of Stroke) III trial (N=656). We used a causal mediation model, with linear and ordinal logistic regression adjusted for confounders, to evaluate the NIHSS 24 hours and 5 to 7 days after endovascular treatment as primary outcome measures (instead of the mRS at 3 months) in both trials. Patients who had died before the NIHSS was assessed received the maximum score of 42. NIHSS+1 was then log10-transformed. Results— In both trials, there was a significant correlation between the NIHSS at 24 hours and 5 to 7 days and the mRS. In MR CLEAN, we found a significant effect of endovascular treatment on the mRS and on the NIHSS at 24 hours and 5 to 7 days. After adjustment for NIHSS at 24 hours and 5 to 7 days, the effect of endovascular treatment on the mRS decreased from common odds ratio 1.68 (95% CI, 1.22–2.32) to respectively 1.36 (95% CI, 0.97–1.91) and 1.24 (95% CI, 0.87–1.79), indicating that treatment effect on the mRS is in large part mediated by the NIHSS. In the IMS III trial there was no treatment effect on the NIHSS at 24 hours and 5 to 7 days, corresponding with the absence of a treatment effect on the mRS. Conclusions— The NIHSS within 1 week satisfies the requirements for a surrogate end point and may be used as a primary outcome measure in trials of acute treatment for ischemic stroke, particularly in phase II(b) trials. This could reduce stroke-outcome assessment to its essentials (ie, neurological deficit), and reduce trial duration and costs. Whether and under which conditions it could be used in phase III trials requires a debate in the field with all parties. Clinical Trial Registration— URL: http://www.isrctn.com. Unique identifier: ISRCTN10888758; https://www.clinicaltrials.gov. Unique identifier: NCT00359424.

Published
2020
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23. Endovascular Treatment With or Without Prior Intravenous Alteplase for Acute Ischemic Stroke

Author

Chalos, Vicky, primary, LeCouffe, Natalie E., additional, Uyttenboogaart, Maarten, additional, Lingsma, Hester F., additional, Mulder, Maxim J. H. L., additional, Venema, Esmee, additional, Treurniet, Kilian M., additional, Eshghi, Omid, additional, van der Worp, H. Bart, additional, van der Lugt, Aad, additional, Roos, Yvo B. W. E. M., additional, Majoie, Charles B. L. M., additional, Dippel, Diederik W. J., additional, Roozenbeek, Bob, additional, Coutinho, Jonathan M., additional, van Oostenbrugge, Robert J., additional, van Zwam, Wim H., additional, Boiten, Jelis, additional, Vos, Jan Albert, additional, Jansen, Ivo G. H., additional, Goldhoorn, Robert‐Jan B., additional, Schonewille, Wouter J., additional, Wermer, Marieke J. H., additional, van Walderveen, Marianne A. A., additional, Staals, Julie, additional, Hofmeijer, Jeannette, additional, Martens, Jasper M., additional, Lycklama à Nijeholt, Geert J., additional, Emmer, Bart J., additional, de Bruijn, Sebastiaan F., additional, van Dijk, Lukas C., additional, Lo, Rob H., additional, van Dijk, Ewoud J., additional, Boogaarts, Hieronymus D., additional, de Kort, Paul L. M., additional, Peluso, Jo J. P., additional, van den Berg, Jan S. P., additional, van Hasselt, Boudewijn A. A. M., additional, Aerden, Leo A. M., additional, Dallinga, René J., additional, Schreuder, Tobien H. C. M. L., additional, Heijboer, Roel J. J., additional, Keizer, Koos, additional, Yo, Lonneke S. F., additional, den Hertog, Heleen M., additional, Sturm, Emiel J. C., additional, Sprengers, Marieke E. S., additional, Jenniskens, Sjoerd F. M., additional, van den Berg, René, additional, Yoo, Albert J., additional, Beenen, Ludo F. M., additional, Roosendaal, Stefan D., additional, van der Kallen, Bas F. W., additional, van den Wijngaard, Ido R., additional, van Es, Adriaan C. G. M., additional, Bot, Joseph C. J., additional, van Doormaal, Pieter‐Jan, additional, Flach, H. Zwenneke, additional, el Ghannouti, Naziha, additional, Sterrenberg, Martin, additional, Puppels, Corina, additional, Pellikaan, Wilma, additional, Sprengers, Rita, additional, Elfrink, Marjan, additional, de Meris, Joke, additional, Vermeulen, Tamara, additional, Geerlings, Annet, additional, van Vemde, Gina, additional, Simons, Tiny, additional, van Rijswijk, Cathelijn, additional, Messchendorp, Gert, additional, Bongenaar, Hester, additional, Bodde, Karin, additional, Kleijn, Sandra, additional, Lodico, Jasmijn, additional, Droste, Hanneke, additional, Wollaert, M., additional, Jeurrissen, D., additional, Bos, Ernas, additional, Drabbe, Yvonne, additional, Zweedijk, Berber, additional, Khalilzada, Mostafa, additional, Compagne, Kars C. J., additional, Geuskens, Ralph R., additional, van Straaten, Tim, additional, Ergezen, Saliha, additional, Harmsma, Roger R. M., additional, de Jong, Anouk, additional, Hinsenveld, Wouter, additional, Berkhemer, Olvert A., additional, Boers, Anna M. M., additional, Groot, P. F. C., additional, Mens, Marieke A., additional, van Kranendonk, Katinka R., additional, Kappelhof, Manon, additional, Tolhuijsen, Manon L., additional, and Alves, Heitor, additional

Published
2019
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27. The Meta VCI Map consortium for meta-analyses on strategic lesion locations for vascular cognitive impairment using lesion-symptom mapping : Design and multicenter pilot study

Author

Weaver, Nick A, Zhao, Lei, Biesbroek, J Matthijs, Kuijf, Hugo J, Aben, Hugo P, Bae, Hee-Joon, Caballero, Miguel Á A, Chappell, Francesca M, Chen, Christopher P L H, Dichgans, Martin, Duering, Marco, Georgakis, Marios K, van der Giessen, Ruben S, Gyanwali, Bibek, Hamilton, Olivia K L, Hilal, Saima, Vom Hofe, Elise M, de Kort, Paul L M, Koudstaal, Peter J, Lam, Bonnie Y K, Lim, Jae-Sung, Makin, Stephen D J, Mok, Vincent C T, Shi, Lin, Valdés Hernández, Maria C, Venketasubramanian, Narayanaswamy, Wardlaw, Joanna M, Wollenweber, Frank A, Wong, Adrian, Xin, Xu, Meta VCI Map consortium, Biessels, Geert Jan, Weaver, Nick A, Zhao, Lei, Biesbroek, J Matthijs, Kuijf, Hugo J, Aben, Hugo P, Bae, Hee-Joon, Caballero, Miguel Á A, Chappell, Francesca M, Chen, Christopher P L H, Dichgans, Martin, Duering, Marco, Georgakis, Marios K, van der Giessen, Ruben S, Gyanwali, Bibek, Hamilton, Olivia K L, Hilal, Saima, Vom Hofe, Elise M, de Kort, Paul L M, Koudstaal, Peter J, Lam, Bonnie Y K, Lim, Jae-Sung, Makin, Stephen D J, Mok, Vincent C T, Shi, Lin, Valdés Hernández, Maria C, Venketasubramanian, Narayanaswamy, Wardlaw, Joanna M, Wollenweber, Frank A, Wong, Adrian, Xin, Xu, Meta VCI Map consortium, and Biessels, Geert Jan

Published
2019

28. Extent to Which Network Hubs Are Affected by Ischemic Stroke Predicts Cognitive Recovery

Author

Projectafdeling VCI, Zorglijn AN/AAN Medisch, Brain, Circulatory Health, RF&S Team 1 Medisch, Revalidatie/Sportgeneeskunde Medisch, 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., Projectafdeling VCI, Zorglijn AN/AAN Medisch, Brain, Circulatory Health, RF&S Team 1 Medisch, Revalidatie/Sportgeneeskunde Medisch, 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., and Jansen, Ben P. W.

Published
2019

29. The Meta VCI Map consortium for meta-analyses on strategic lesion locations for vascular cognitive impairment using lesion-symptom mapping: Design and multicenter pilot study

Author

ZL Algemene Neurologie Medisch, Opleiding Neurologie, Brain, Beeldverwerking ISI, Circulatory Health, Weaver, Nick A, Zhao, Lei, Biesbroek, J Matthijs, Kuijf, Hugo J, Aben, Hugo P, Bae, Hee-Joon, Caballero, Miguel Á A, Chappell, Francesca M, Chen, Christopher P L H, Dichgans, Martin, Duering, Marco, Georgakis, Marios K, van der Giessen, Ruben S, Gyanwali, Bibek, Hamilton, Olivia K L, Hilal, Saima, Vom Hofe, Elise M, de Kort, Paul L M, Koudstaal, Peter J, Lam, Bonnie Y K, Lim, Jae-Sung, Makin, Stephen D J, Mok, Vincent C T, Shi, Lin, Valdés Hernández, Maria C, Venketasubramanian, Narayanaswamy, Wardlaw, Joanna M, Wollenweber, Frank A, Wong, Adrian, Xin, Xu, Meta VCI Map consortium, Biessels, Geert Jan, ZL Algemene Neurologie Medisch, Opleiding Neurologie, Brain, Beeldverwerking ISI, Circulatory Health, Weaver, Nick A, Zhao, Lei, Biesbroek, J Matthijs, Kuijf, Hugo J, Aben, Hugo P, Bae, Hee-Joon, Caballero, Miguel Á A, Chappell, Francesca M, Chen, Christopher P L H, Dichgans, Martin, Duering, Marco, Georgakis, Marios K, van der Giessen, Ruben S, Gyanwali, Bibek, Hamilton, Olivia K L, Hilal, Saima, Vom Hofe, Elise M, de Kort, Paul L M, Koudstaal, Peter J, Lam, Bonnie Y K, Lim, Jae-Sung, Makin, Stephen D J, Mok, Vincent C T, Shi, Lin, Valdés Hernández, Maria C, Venketasubramanian, Narayanaswamy, Wardlaw, Joanna M, Wollenweber, Frank A, Wong, Adrian, Xin, Xu, Meta VCI Map consortium, and Biessels, Geert Jan

Published
2019

30. Safety and Outcome of Endovascular Treatment for Minor Ischemic Stroke: Results From the Multicenter Clinical Registry of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands

Author

Goldhoorn, Robert-Jan B., Mulder, Maxim J. H. L., Jansen, Ivo G. H., van Zwam, Wim H., Staals, Julie, van der Lugt, Aad, Dippel, Diederik W. J., Lingsma, Hester F., Vos, Jan Albert, Boiten, Jelis, van den Wijngaard, Ido R., Majoie, Charles B. L. M., Roos, Yvo B. W. E. M., van Oostenbrugge, Robert J., Schonewille, Wouter J., Coutinho, Jonathan M., Wermer, Marieke J. H., van Walderveen, Marianne A. A., Hofmeijer, Jeannette, Martens, Jasper M., Nijeholt, Geert J. Lycklama A., Roozenbeek, Bob, Emmer, Bart J., de Bruijn, Sebastiaan F., van Dijk, Lukas C., van der Worp, H. Bart, Lo, Rob H., van Dijk, Ewoud J., Boogaarts, Hieronymus D., de Kort, Paul L. M., Peluso, Jo J. P., van den Berg, Jan S. P., van Hasselt, Boudewijn A. A. M., Aerden, Leo A. M., Dallinga, Rene J., Uyttenboogaart, Maarten, Eshghi, Omid, Schreuder, Tobien H. C. M. L., Heijboer, Roel J. J., Keizer, Koos, Yo, Lonneke S. F., den Hertog, Heleen M., Sturm, Emiel J. C., Sprengers, Marieke E. S., Jenniskens, Sjoerd F. M., Postma, Alida, Hinsenveld, Wouter, Groot, P. F. C., MR CLEAN Registry Investigators, Goldhoorn, Robert-Jan B., Mulder, Maxim J. H. L., Jansen, Ivo G. H., van Zwam, Wim H., Staals, Julie, van der Lugt, Aad, Dippel, Diederik W. J., Lingsma, Hester F., Vos, Jan Albert, Boiten, Jelis, van den Wijngaard, Ido R., Majoie, Charles B. L. M., Roos, Yvo B. W. E. M., van Oostenbrugge, Robert J., Schonewille, Wouter J., Coutinho, Jonathan M., Wermer, Marieke J. H., van Walderveen, Marianne A. A., Hofmeijer, Jeannette, Martens, Jasper M., Nijeholt, Geert J. Lycklama A., Roozenbeek, Bob, Emmer, Bart J., de Bruijn, Sebastiaan F., van Dijk, Lukas C., van der Worp, H. Bart, Lo, Rob H., van Dijk, Ewoud J., Boogaarts, Hieronymus D., de Kort, Paul L. M., Peluso, Jo J. P., van den Berg, Jan S. P., van Hasselt, Boudewijn A. A. M., Aerden, Leo A. M., Dallinga, Rene J., Uyttenboogaart, Maarten, Eshghi, Omid, Schreuder, Tobien H. C. M. L., Heijboer, Roel J. J., Keizer, Koos, Yo, Lonneke S. F., den Hertog, Heleen M., Sturm, Emiel J. C., Sprengers, Marieke E. S., Jenniskens, Sjoerd F. M., Postma, Alida, Hinsenveld, Wouter, Groot, P. F. C., and MR CLEAN Registry Investigators

Abstract

Goal: Insufficient data is available about safety and efficacy of endovascular treatment (EVT) in patients with minor stroke symptoms because these patients were excluded from most randomized trials. We aimed to compare characteristics, functional outcome, and complications in patients with minor ischemic stroke National Institutes of Health Stroke Scale score = 6) due to intracranial proximal artery occlusion of the anterior circulation who underwent EVT. Materials and Methods: We report patients with an anterior circulation occlusion who were included between March 2014 and June 2016 in the multicenter randomized clinical trial of EVT of acute ischemic stroke in the Netherlands Registry, a prospective, multicenter, observational study for stroke centers that perform EVT in the Netherlands. Minor ischemic stroke was defined as baseline NIHSS score of 5 or less. Primary outcome is the modified Rankin Scale (mRS) score at 90 days. Secondary outcomes include symptomatic intracranial hemorrhage (sICH) and mortality. Findings: Seventy-one (5.5%) patients had a NIHSS score of 5 or less. Functional independence (mRS 0-2 at 90 days) was reached in 75% of these patients, compared to 40% of patients with NIHSS score of 6 or more. sICH occurred in 4% of patients, of which 1% occurred peri-interventionally. Death occurred in 6% of patients. Conclusions: Patients with minor ischemic stroke with an intracranial proximal arterial occlusion of the anterior circulation who underwent EVT have a high chance of favorable outcome and appear to have low occurrence of treatment-related sICH. Therefore, our results encourage the use of EVT for minor ischemic stroke in the absence of effect estimates from controlled studies.

Published
2019

31. Clinical and Imaging Markers Associated With Hemorrhagic Transformation in Patients With Acute Ischemic Stroke

Author

van Kranendonk, Katinka R., Treumiet, Kilian M., Boers, Anna M. M., Berkhemer, Olvert A., van den Berg, Lucie A., Chalos, Vicky, Lingsma, Hester F., van Zwam, Wim H., van der Lugt, Aad, van Oostenbrugge, Robert J., Dippel, Diederik W. J., Roos, Yvo B. W. E. M., Marquering, Henk A., Majoie, Charles B. L. M., Fransen, Puck S. S., Beumer, Debbie, Yoo, Albert J., Schonewille, Wouter J., Vos, Jan Albert, Nederkoorn, Paul J., Wenner, Marieke J. H., van Walderveen, Marianne A. A., Staals, Julie, Hofmeijer, Jeannette, van Oostayen, Jacques A., Nijeholt, Geert J. Lycklama a, Boiten, Jells, Brouwer, Patrick A., Emmet, 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 Rooij, Willem Jan J., van den Berg, Jan S. P., van Hassell, Boudewijn A. A. M., Aerden, Leo A. M., Dallinga, Rene 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, den Hertog, Heleen M., MR CLEAN Investigators, van Kranendonk, Katinka R., Treumiet, Kilian M., Boers, Anna M. M., Berkhemer, Olvert A., van den Berg, Lucie A., Chalos, Vicky, Lingsma, Hester F., van Zwam, Wim H., van der Lugt, Aad, van Oostenbrugge, Robert J., Dippel, Diederik W. J., Roos, Yvo B. W. E. M., Marquering, Henk A., Majoie, Charles B. L. M., Fransen, Puck S. S., Beumer, Debbie, Yoo, Albert J., Schonewille, Wouter J., Vos, Jan Albert, Nederkoorn, Paul J., Wenner, Marieke J. H., van Walderveen, Marianne A. A., Staals, Julie, Hofmeijer, Jeannette, van Oostayen, Jacques A., Nijeholt, Geert J. Lycklama a, Boiten, Jells, Brouwer, Patrick A., Emmet, 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 Rooij, Willem Jan J., van den Berg, Jan S. P., van Hassell, Boudewijn A. A. M., Aerden, Leo A. M., Dallinga, Rene 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, den Hertog, Heleen M., and MR CLEAN Investigators

Abstract

Background and Purpose- Hemorrhagic transformation (HT) after acute ischemic stroke may cause severe neurological deterioration and affects functional outcome. Identifying patients most likely to suffer from this complication could potentially be used for future treatment selection. Reperfusion after endovascular therapy could be associated with different risk factors for HT than intravenous thrombolytics as these treatments largely differ. In this study, we aimed to identify clinical and imaging markers that are associated with HT subtypes in the MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) population.Methods- In this post hoc analysis, all patients with follow-up imaging were included. HT was classified according to ECASS II (European Cooperative Acute Stroke Study). Variables with an association of PResults- Of the 478 out of 500 included patients in this subanalysis, 46% had HT (n=222). Of these, 66% had hemorrhagic infarction (n=147) and 34% PH (n=75). Symptomatic intracranial hemorrhage was observed in 7.3% (n=35) of all patients. Baseline National Institutes of Health Stroke Scale (odds ratio [OR], 1.05,95% CI, 1.01-1.09 per point) and absent/poor collaterals (OR, 1.90; 95% CI, 1.05-3.42) were significantly associated with hemorrhagic infarction. Increased systolic blood pressure (OR, 1.17; 95% CI, 1.05-1.31 per 10 mmHg) and atrial fibrillation (OR, 1.94; 95% CI, 1.08-3.48) were associated with PH. Increased systolic blood pressure (OR, 1.28; 95% CI, 1.12-1.48) and antiplatelet use (OR, 2.6; 95% CI, 1.08-6.3) were associated with symptomatic intracranial hemorrhage.Conclusions- Clinical and imaging stroke severity parameters were associated with HT, both in hemorrhagic infarction and PH, whereas baseline patients characteristics like systolic blood pressure, atrial fibrillation, and antiplatelet use were only associated with PH or symptomatic intracranial hemorr

Published
2019

32. Impact of single phase CT angiography collateral status on functional outcome over time: results from the MR CLEAN Registry

Author

Jansen, Ivo G. H., Mulder, Maxim J. H. L., Goldhoorn, Robert-Jan B., Boers, Anna M. M., van Es, Adriaan C. G. M., Yo, Lonneke S. F., Hofmeijer, Jeannette, Martens, Jasper M., van Walderveen, Marianne A. A., van der Kallen, Bas F. W., Jenniskens, Sjoerd F. M., Treurniet, Kilian M., Marqueriny, Henk A., Sprengers, Marieke E. S., Schonewille, Wouter J., Bot, Joost, Lycklama A Nijeholt, Geert J., Lingsma, Hester F., Liebeskind, David S., Boiten, Jelis, Vos, Jan-Albert, Roos, Yvo B. W. E. M., van Oostenbrugge, Robert J., van der Lugt, Aad, van Zwam, Wim H., Dippel, Diederik W. J., van den Wijngaard, Ido R., Majoie, Charles B. L. M., Coutinho, Jonathan M., Wermern, Marieke J. H., Staals, Julie, Roozenbeek, Bob, Emmer, Bart J., de Bruijn, Sebastiaan F., van Dijk, Lukas C., van der Worp, H. Bart, Lo, Rob H., van Dijk, Ewoud J., Boogaarts, Hieronymus D., de Kort, Paul L. M., Peluso, Jo J. P., van den Berg, Jan S. P., van Hasselt, Boudewijn A. A. M., Aerden, Leo A. M., Dallinga, Rene J., Uyttenboogaart, Maarten, Eshghi, Omid, Schreuder, Tobien H. C. M. L., Heijboer, Roel J. J., Groot, P. F. C., MR CLEAN Registry Investigators, Jansen, Ivo G. H., Mulder, Maxim J. H. L., Goldhoorn, Robert-Jan B., Boers, Anna M. M., van Es, Adriaan C. G. M., Yo, Lonneke S. F., Hofmeijer, Jeannette, Martens, Jasper M., van Walderveen, Marianne A. A., van der Kallen, Bas F. W., Jenniskens, Sjoerd F. M., Treurniet, Kilian M., Marqueriny, Henk A., Sprengers, Marieke E. S., Schonewille, Wouter J., Bot, Joost, Lycklama A Nijeholt, Geert J., Lingsma, Hester F., Liebeskind, David S., Boiten, Jelis, Vos, Jan-Albert, Roos, Yvo B. W. E. M., van Oostenbrugge, Robert J., van der Lugt, Aad, van Zwam, Wim H., Dippel, Diederik W. J., van den Wijngaard, Ido R., Majoie, Charles B. L. M., Coutinho, Jonathan M., Wermern, Marieke J. H., Staals, Julie, Roozenbeek, Bob, Emmer, Bart J., de Bruijn, Sebastiaan F., van Dijk, Lukas C., van der Worp, H. Bart, Lo, Rob H., van Dijk, Ewoud J., Boogaarts, Hieronymus D., de Kort, Paul L. M., Peluso, Jo J. P., van den Berg, Jan S. P., van Hasselt, Boudewijn A. A. M., Aerden, Leo A. M., Dallinga, Rene J., Uyttenboogaart, Maarten, Eshghi, Omid, Schreuder, Tobien H. C. M. L., Heijboer, Roel J. J., Groot, P. F. C., and MR CLEAN Registry Investigators

Abstract

Background Collateral status modified the effect of endovascular treatment (EVT) for stroke in several randomized trials. We assessed the association between collaterals and functional outcome in EVT treated patients and investigated if this association is time dependent.Methods We included consecutive patients from the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in The Netherlands (MR CLEAN) Registry (March 2014-June 2016) with an anterior circulation large vessel occlusion undergoing EVT. Functional outcome was measured on the modified Rankin Scale (mRS) at 90 days. We investigated the association between collaterals and mRS in the MR CLEAN Registry with ordinal logistic regression and if this association was time dependent with an interaction term. Additionally, we determined modification of EVT effect by collaterals compared with MR CLEAN controls, and also investigated if this was time dependent with multiplicative interaction terms.Results 1412 patients were analyzed. Functional independence (mRS score of 0-2) was achieved in 13% of patients with grade 0 collaterals, in 27% with grade 1, in 46% with grade 2, and in 53% with grade 3. Collaterals were significantly associated with mRS (adjusted common OR 1.5 (95% CI 1.4 to 1.7)) and significantly modified EVT benefit (P=0.04). None of the effects were time dependent. Better collaterals corresponded to lower mortality (PConclusion In routine clinical practice, better collateral status is associated with better functional outcome and greater treatment benefit in EVT treated acute ischemic stroke patients, independent of time to treatment. Within the 6 hour time window, a substantial proportion of patients with absent and poor collaterals can still achieve functional independence.

Published
2019

33. Predicting the presence of macrovascular causes in non-traumatic intracerebral haemorrhage: the DIAGRAM prediction score

Author

Hilkens, Nina A., van Asch, Charlotte J. J., Werring, David J., Wilson, Duncan, Rinkel, Gabriël J. E., Algra, Ale, Velthuis, Birgitta K., de Kort, G. rard 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, Bronner, Irene M., Remmers, Michel J. M., Bienfait, Henri Paul, Witjes, Ron J. G. M., Jäger, H. Rolf, Greving, Jacoba P., Klijn, Catharina J. M., Boogaarts, H. B., van Dijk, E. J., Schonewille, W. J., Pellikaan, W. M. J., Puppels-de Waard, C., de Kort, P. L. M., Peluso, J. P., van Tuijl, J. H., Hofmeijer, J., Joosten, F. B. M., Dippel, D. W., Khajeh, L., Raaijmakers, T. W. M., Wermer, M. J., van Walderveen, M. A., Kerkhoff, H., Zock, E., Jellema, K., Lycklama, G. J., Bronner, I. M., Remmers, M. J. M., Witjes, R. J. G. M., Bienfait, H. P., Droogh-Greve, K. E., Donders, R. C. J. M., Kwa, V. I. H., Schreuder, T. H., Franke, C. L., Straver, J. S., Jansen, C., Bakker, S. L. M., Pleiter, C. C., Visser, M. C., van Asch, C. J. J., Velthuis, B. K., Rinkel, G. J. E., van Nieuwenhuizen, K. M., Klijn, C. J. M., Neurology, and Amsterdam Neuroscience - Neurovascular Disorders

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Computed Tomography Angiography, Clinical Neurology, Logistic regression, Magnetic resonance angiography, 03 medical and health sciences, Young Adult, 0302 clinical medicine, All institutes and research themes of the Radboud University Medical Center, Predictive Value of Tests, Risk Factors, Internal medicine, Non traumatic, medicine, Humans, 030212 general & internal medicine, cardiovascular diseases, Prospective Studies, Aged, Cerebral Hemorrhage, Netherlands, Central Nervous System Vascular Malformations, Prediction score, medicine.diagnostic_test, business.industry, Arteriovenous malformation, Digital subtraction angiography, Middle Aged, medicine.disease, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], nervous system diseases, Cerebral Angiography, Psychiatry and Mental health, Logistic Models, Cohort, Angiography, Cardiology, Surgery, Female, Neurology (clinical), business, 030217 neurology & neurosurgery, Magnetic Resonance Angiography
Abstract

ObjectiveA 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.MethodsThe 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%).ResultsIndependent 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.ConclusionThe 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.

Published
2017
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35. Predicting the presence of macrovascular causes in non-traumatic intracerebral haemorrhage : The DIAGRAM prediction score

Author

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, Bronner, Irene M., Remmers, Michel J M, Bienfait, Henri Paul, Witjes, Ron J G M, Jäger, H Rolf, Greving, Jacoba P, Klijn, Catharina J M, DIAGRAM study group, 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, Bronner, Irene M., Remmers, Michel J M, Bienfait, Henri Paul, Witjes, Ron J G M, Jäger, H Rolf, Greving, Jacoba P, Klijn, Catharina J M, and DIAGRAM study group

Published
2018

36. Predicting the presence of macrovascular causes in non-traumatic intracerebral haemorrhage: The DIAGRAM prediction score

Author

Cardiovasculaire Epi Team 6, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Hersenen-Medisch 2, Neurologie, Brain, ZL Cerebrovasculaire Ziekten Medisch, Researchgr. Hart-brein as., Cancer, MS Radiologie, Opleiding Neurologie, 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, Bronner, Irene M., Remmers, Michel J M, Bienfait, Henri Paul, Witjes, Ron J G M, Jäger, H Rolf, Greving, Jacoba P, Klijn, Catharina J M, DIAGRAM study group, Cardiovasculaire Epi Team 6, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Hersenen-Medisch 2, Neurologie, Brain, ZL Cerebrovasculaire Ziekten Medisch, Researchgr. Hart-brein as., Cancer, MS Radiologie, Opleiding Neurologie, 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, Bronner, Irene M., Remmers, Michel J M, Bienfait, Henri Paul, Witjes, Ron J G M, Jäger, H Rolf, Greving, Jacoba P, Klijn, Catharina J M, and DIAGRAM study group

Published
2018

37. Impaired Emotion Recognition after Left Hemispheric Stroke: A Case Report and Brief Review of the Literature

Author

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

Subjects
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.

Published
2017
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38. Association of Reperfusion With Brain Edema in Patients With Acute Ischemic Stroke : A Secondary Analysis of the MR CLEAN Trial

Author

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

Subjects
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

Published
2018
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39. Predicting the presence of macrovascular causes in non-traumatic intracerebral haemorrhage: the DIAGRAM prediction score

Author

Hilkens, Nina A, primary, van Asch, Charlotte J J, additional, Werring, David J, additional, Wilson, Duncan, additional, Rinkel, Gabriël J E, additional, Algra, Ale, additional, Velthuis, Birgitta K, additional, de Kort, Gérard A P, additional, Witkamp, Theo D, additional, van Nieuwenhuizen, Koen M, additional, de Leeuw, Frank-Erik, additional, Schonewille, Wouter J, additional, de Kort, Paul L M, additional, Dippel, Diederik W J, additional, Raaymakers, Theodora W M, additional, Hofmeijer, Jeannette, additional, Wermer, Marieke J H, additional, Kerkhoff, Henk, additional, Jellema, Korné, additional, Bronner, Irene M, additional, Remmers, Michel J M, additional, Bienfait, Henri Paul, additional, Witjes, Ron J G M, additional, Jäger, H Rolf, additional, Greving, Jacoba P, additional, and Klijn, Catharina J M, additional

Published
2018
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40. Observer variability of absolute and relative thrombus density measurements in patients with acute ischemic stroke

Author

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

Subjects
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.

Published
2016

41. Time to Reperfusion and Treatment Effect for Acute Ischemic Stroke : A Randomized Clinical Trial

Author

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

Subjects
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.

Published
2016

42. Automated Entire Thrombus Density Measurements for Robust and Comprehensive Thrombus Characterization in Patients with Acute Ischemic Stroke

Author

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

Subjects
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

Published
2016
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45. Psychological factors and subjective cognitive complaints after stroke: Beyond depression and anxiety.

Author

van Rijsbergen, Mariëlle W. A., Mark, Ruth E., Kop, Willem J., de Kort, Paul L. M., and Sitskoorn, Margriet M.

Subjects
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]

Published
2019
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50. Advance directives, proxy opinions, and treatment restrictions in patients with severe stroke

Author

Opleiding Neurologie, Brain, Medical Humanities Onderzoek Team 1, Circulatory Health, JC onderzoeksprogramma Methodologie, ZL Cerebrovasculaire Ziekten Medisch, De Kort, Floor A.S., Geurts, Marjolein, de Kort, Paul L M, Van Tuijl, Julia H., Van Thiel, Ghislaine J.M.W., Kappelle, L. Jaap, Van Der Worp, H. Bart, Opleiding Neurologie, Brain, Medical Humanities Onderzoek Team 1, Circulatory Health, JC onderzoeksprogramma Methodologie, ZL Cerebrovasculaire Ziekten Medisch, De Kort, Floor A.S., Geurts, 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

Published
2017

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