48 results on '"van Walderveen, M. A."'
Search Results
2. Minocycline for sporadic and hereditary cerebral amyloid angiopathy (BATMAN): study protocol for a placebo-controlled randomized double-blind trial
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Voigt, S., primary, Koemans, E. A., additional, Rasing, I., additional, van Etten, E. S., additional, Terwindt, G. M., additional, Baas, F., additional, Kaushik, K., additional, van Es, A. C. G. M., additional, van Buchem, M. A., additional, van Osch, M. J. P., additional, van Walderveen, M. A. A., additional, Klijn, C. J. M., additional, Verbeek, M. M., additional, van der Weerd, L., additional, and Wermer, M. J. H., additional
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- 2023
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3. Additional file 1 of Minocycline for sporadic and hereditary cerebral amyloid angiopathy (BATMAN): study protocol for a placebo-controlled randomized double-blind trial
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Voigt, S., Koemans, E. A., Rasing, I., van Etten, E. S., Terwindt, G. M., Baas, F., Kaushik, K., van Es, A. C. G. M., van Buchem, M. A., van Osch, M. J. P., van Walderveen, M. A. A., Klijn, C. J. M., Verbeek, M. M., van der Weerd, L., and Wermer, M. J. H.
- Abstract
Additional file 1: Supplementary Table 1. BATMANR1.
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- 2023
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4. The prognostic value of extracranial vascular characteristics on procedural duration and revascularization success in endovascularly treated acute ischemic stroke patients
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Holswilder, G., Stuart, M. P. M. E., Dompeling, T., Kruyt, N. D., Goeman, J. J., van der Lugt, A., Schonewille, W. J., Lycklama à Nijeholt, G. J., Majoie, C. B. L. M., Yo, L. S. F., Meijer, F. J. A., Marquering, H. A., Wermer, M. J. H., van Walderveen, M. A. A., Holswilder, G., Stuart, M. P. M. E., Dompeling, T., Kruyt, N. D., Goeman, J. J., van der Lugt, A., Schonewille, W. J., Lycklama à Nijeholt, G. J., Majoie, C. B. L. M., Yo, L. S. F., Meijer, F. J. A., Marquering, H. A., Wermer, M. J. H., and van Walderveen, M. A. A.
- Abstract
Introduction: Vascular anatomy might affect endovascular treatment success in acute ischemic stroke patients with large vessel occlusion. We investigated the prognostic value of extracranial vascular characteristics on procedural time and revascularization success in patients with large vessel occlusion in the anterior cerebral circulation. Patients and methods: We included 828 patients endovascularly treated within 6.5 hours of symptom onset from the Dutch MR CLEAN-Registry. We evaluated aortic arch configuration, stenosis and tortuosity of supra-aortic arteries, and internal carotid arteries (ICAs) on pre-intervention CTA. We constructed logistic prediction models for outcome variables procedural duration (≥60 minutes) and non-successful revascularization (extended thrombolysis in cerebral infarction (eTICI) of 0–2A) using baseline characteristics and assessed the effect of extracranial vascular characteristics on model performance. Results: Cervical ICA tortuosity and stenosis ≥99% improved prediction of long procedural duration compared with baseline characteristics from area under the curve of 0.61 (95% CI: 0.57–0.65) to 0.66 (95% CI: 0.62–0.70) (P < 0.001). Cervical ICA tortuosity was significantly associated with non-successful recanalization. Prediction of non-successful revascularization did not improve after including aortic arch elongation, acute take-off angle, aortic variant, origin stenosis of supra-aortic arteries, and cervical ICA tortuosity, with an area under the curve of 0.63 (95% CI: 0.59–0.67) compared with 0.59 (95% CI: 0.55–0.63) (P = 0.11). Conclusion: Extracranial vascular characteristics have additional prognostic value for procedural duration, but not for revascularization success, compared with baseline characteristics. Performance of both prediction models is limited in patients treated for large vessel occlusion.
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- 2022
5. Whole brain CT perfusion in acute anterior circulation ischemia: coverage size matters
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Emmer, B. J., Rijkee, M., Niesten, J. M., Wermer, M. J. H., Velthuis, B. K., and van Walderveen, M. A. A.
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- 2014
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6. Evolutionary algorithms and decision trees for predicting poor outcome after endovascular treatment for acute ischemic stroke
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Kappelhof, N., Ramos, L. A., Kappelhof, M, van Os, H. J.A., Chalos, V., van Kranendonk, K. R., Kruyt, N. D., Roos, Y. B.W.E.M., van Zwam, W. H., van der Schaaf, I. C., van Walderveen, M. A.A., Wermer, M. J.H., van Oostenbrugge, R. J., Lingsma, Hester, Dippel, Diederik, Majoie, C. B.L.M., Marquering, H. A., Kappelhof, N., Ramos, L. A., Kappelhof, M, van Os, H. J.A., Chalos, V., van Kranendonk, K. R., Kruyt, N. D., Roos, Y. B.W.E.M., van Zwam, W. H., van der Schaaf, I. C., van Walderveen, M. A.A., Wermer, M. J.H., van Oostenbrugge, R. J., Lingsma, Hester, Dippel, Diederik, Majoie, C. B.L.M., and Marquering, H. A.
- Abstract
Despite the large overall beneficial effects of endovascular treatment in patients with acute ischemic stroke, severe disability or death still occurs in almost one-third of patients. These patients, who might not benefit from treatment, have been previously identified with traditional logistic regression models, which may oversimplify relations between characteristics and outcome, or machine learning techniques, which may be difficult to interpret. We developed and evaluated a novel evolutionary algorithm for fuzzy decision trees to accurately identify patients with poor outcome after endovascular treatment, which was defined as having a modified Rankin Scale score (mRS) higher or equal to 5. The created decision trees have the benefit of being comprehensible, easily interpretable models, making its predictions easy to explain to patients and practitioners. Insights in the reason for the predicted outcome can encourage acceptance and adaptation in practice and help manage expectations after treatment. We compared our proposed method to CART, the benchmark decision tree algorithm, on classification accuracy and interpretability. The fuzzy decision tree significantly outperformed CART: using 5-fold cross-validation with on average 1090 patients in the training set and 273 patients in the test set, the fuzzy decision tree misclassified on average 77 (standard deviation of 7) patients compared to 83 (±7) using CART. The mean number of nodes (decision and leaf nodes) in the fuzzy decision tree was 11 (±2) compared to 26 (±1) for CART decision trees. With an average accuracy of 72% and much fewer nodes than CART, the developed evolutionary algorithm for fuzzy decision trees might be used to gain insights into the predictive value of patient characteristics and can contribute to the development of more accurate medical outcome prediction methods with improved clarity for practitioners and patients.
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- 2021
7. Evolutionary algorithms and decision trees for predicting poor outcome after endovascular treatment for acute ischemic stroke
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MS Radiologie, Circulatory Health, Kappelhof, N., Ramos, L. A., Kappelhof, M., van Os, H. J.A., Chalos, V., van Kranendonk, K. R., Kruyt, N. D., Roos, Y. B.W.E.M., van Zwam, W. H., van der Schaaf, I. C., van Walderveen, M. A.A., Wermer, M. J.H., van Oostenbrugge, R. J., Lingsma, Hester, Dippel, Diederik, Majoie, C. B.L.M., Marquering, H. A., MS Radiologie, Circulatory Health, Kappelhof, N., Ramos, L. A., Kappelhof, M., van Os, H. J.A., Chalos, V., van Kranendonk, K. R., Kruyt, N. D., Roos, Y. B.W.E.M., van Zwam, W. H., van der Schaaf, I. C., van Walderveen, M. A.A., Wermer, M. J.H., van Oostenbrugge, R. J., Lingsma, Hester, Dippel, Diederik, Majoie, C. B.L.M., and Marquering, H. A.
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- 2021
8. Intracranial Cerebrospinal Fluid Volume as a Predictor of Malignant Middle Cerebral Artery Infarction
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Kauw, Frans, Bennink, Edwin, de Jong, Hugo W. A. M., Kappelle, L. Jaap, Horsch, Alexander D., Velthuis, Birgitta K., Dankbaar, Jan W., Majoie, C. B., Roos, Y. B., Duijm, L. E., Keizer, K., van der Lugt, A., Dippel, D. W., Droogh-de Greve, K. E., Bienfait, H. P., van Walderveen, M. A., Wermer, M. J., Nijeholt, Lycklama A. G. J., Boiten, J., Duyndam, D., Kwa, V., I, Meijer, F. J., van Dijk, E. J., Kesselring, F. O., Hofmeijer, J., Vos, J. A., Schonewille, W. J., van Rooij, W. J., de Kort, P. L., Pleiter, C. C., Bakker, S. L., Bot, J., Visser, M. C., Velthuis, B. K., van der Schaaf, I. C., Dankbaar, J. W., Mali, W. P., van Seeters, T., Horsch, A. D., Niesten, J. M., Biessels, G. J., Kappelle, L. J., Luitse, M. J., van der Graaf, Y., Radiology & Nuclear Medicine, Neurology, Physics and medical technology, Radiology and nuclear medicine, VU University medical center, Dermatology, Surgery, Public and occupational health, Human genetics, Radiation Oncology, Amsterdam Neuroscience - Neurovascular Disorders, and ACS - Atherosclerosis & ischemic syndromes
- Subjects
medicine.medical_specialty ,Original Contributions ,infarction ,Clinical Sciences ,Clinical Neurology ,Infarction ,Perfusion scanning ,All institutes and research themes of the Radboud University Medical Center ,Midline shift ,Internal medicine ,medicine.artery ,Journal Article ,Medicine ,odds ratio ,cardiovascular diseases ,Advanced and Specialised Nursing ,humans ,Stroke ,Advanced and Specialized Nursing ,brain edema ,middle cerebral artery ,infarction, middle cerebral artery ,Receiver operating characteristic ,medicine.diagnostic_test ,business.industry ,Odds ratio ,medicine.disease ,Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3] ,Angiography ,Middle cerebral artery ,Cardiology ,ComputingMethodologies_DOCUMENTANDTEXTPROCESSING ,Neurology (clinical) ,prognosis ,business ,Cardiology and Cardiovascular Medicine ,Rare cancers Radboud Institute for Health Sciences [Radboudumc 9] - Abstract
Supplemental Digital Content is available in the text., Background and Purpose— Predicting malignant middle cerebral artery (MCA) infarction can help to identify patients who may benefit from preventive decompressive surgery. We aimed to investigate the association between the ratio of intracranial cerebrospinal fluid (CSF) volume to intracranial volume (ICV) and malignant MCA infarction. Methods— Patients with an occlusion proximal to the M3 segment of the MCA were selected from the DUST (Dutch Acute Stroke Study). Admission imaging included noncontrast computed tomography (CT), CT perfusion, and CT angiography. Patient characteristics and CT findings were collected. The ratio of intracranial CSF volume to ICV (CSF/ICV) was quantified on admission thin-slice noncontrast CT. Malignant MCA infarction was defined as a midline shift of >5 mm on follow-up noncontrast CT, which was performed 3 days after the stroke or in case of clinical deterioration. To test the association between CSF/ICV and malignant MCA infarction, odds ratios and 95% CIs were calculated for 3 multivariable models by using binary logistic regression. Model performances were compared by using the likelihood ratio test. Results— Of the 286 included patients, 35 (12%) developed malignant MCA infarction. CSF/ICV was independently associated with malignant MCA infarction in 3 multivariable models: (1) with age and admission National Institutes of Health Stroke Scale (odds ratio, 3.3; 95% CI, 1.1–11.1), (2) with admission National Institutes of Health Stroke Scale and poor collateral score (odds ratio, 7.0; 95% CI, 2.6–21.3), and (3) with terminal internal carotid artery or proximal M1 occlusion and poor collateral score (odds ratio, 7.7; 95% CI, 2.8–23.9). The performance of model 1 (areas under the receiver operating characteristic curves, 0.795 versus 0.824; P=0.033), model 2 (areas under the receiver operating characteristic curves, 0.813 versus 0.850; P
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- 2019
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9. Fourth meeting of the European Neurological Society 25–29 June 1994 Barcelona, Spain: Abstracts of Symposia and free communications
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Harms, L., Bock, A., JÄnisch, W., Valdueza, J., Weber, J., Link, I., De Keyser, J., Goossens, A., Wilczak, N., Vedeler, C., Bjorge, L., Uvestad, E., Conti, G., Williams, K., Ginsberg, L., Rafique, S., Rapoport, S. I., Gershfeld, N. L., De La Meilleure, G., Crevits, L., Faiss, J. H., Heye, N., Blanke, J., Sackmann, A., Kastrup, O., Doornbos, R., van der Worp, H. B., Kappelle, L. J., Bar, P. R., Davie, C. A., Barker, G. J., Brenton, D., Miller, D. H., Thompson, A. J., Block, F., Schwarz, M., Delodovici, L., Baruzzi, F., Bonaldi, G., Dario, A., Marra, A., Mercuri, A., Dworzak, F., Cavallari, P., Confalonieri, P., Zuffi, M., Antozzi, C., Cornelio, F., Baldissera, F., Chassande, B., Ameri, A., Eymard, B., Poisson, M., Vérier, A., Brunet, P., Congia, S., Murgia, P. L., Cannas, A., Borghero, G., Uselli, S., Mellino, G., Ferrai, R., Lampis, R., Massa, R., Muzzetto, B., Giannini, F., Rossi, S., Cioni, R., d'Aniello, C., Guarneri, A., Battistini, N., Ceriani, F., Del Santo, A., Poloni, M., Campo, J. F., Iglesias, F., Guitera, M. V., Farinas, C., Pascual, J., Leno, C., Berciano, J., Thorpe, I. W., Kendall, B. E., McDonald, W. I., Moulignier, A., Dromer, F., Baudrimont, M., Dupont, B., Gozlan, J., El Amrani, M., Petit, J. C., Roullet, E., Sterzi, R., Causaran, R., Protti, A., Riva, M., Erminio, F., Arena, O., Villa, F., Maccagnano, E., Miletta, M., Spinelli, F., Ben-Hur, T., Weidenfeldl, J., Rao, N. S., Chari, C. C., Laforet, P., Matheron, S., Adams, D., Chemouilli, Ph., Desi, M., Said, G., Davous, P., Lionnet, F., Pulik, M., Genet, P., Rozenberg, F., Cartier, L. M., Castillo, J. L., Cea, J. G., Villagra, R., de Saint Martin, L., Mahieux, F., Manifacier, M. J., Mattos, K., Queiros, C., Publio, L., Vinhas, V., PeÇanha-Martins, A. C., Melo, A., Liska, U., Zifko, U., Budka, H., Drlicek, M., Grisold, W., Kaufmann, R., Kaiser, R., Czygan, M., Gomes, I., Jones, N., Cunha, S., EmbiruÇu, E. Katiane, Vieira, V., Araujo, I., Alexandra, M., Ferreira, A., Goes, J., Chemouilli, P., Israel-Biet, Masson, H., Lacroix, C., Gasnault, J., Hildebrandt-Müller, B., Oschmann, P., Krack, P., Willems, W. R., Dorndorf, W., Freitas, V., Bittencourt, A., Fernandes, D., Nascimento, M. H., Severo, M., Moraes, D., Muller, M., Hasert, K., Merkelbach, S., Schimrigk, K., van Oosten, B. W., Lai, M., Polman, C. H., Bertelsmann, F. W., Hodgkinson, S., Cabre, P. H., Volpe, L., Smadja, D., Vernant, J. P., Villaroya, H., Violleau, K., Younes-Chennoufi, A. Ben, Baumann, N., Villanueva-Hemandez, P., Ballabriga, J., Basart, E., Arbizu, T. X., Perez-Serra, J., Vinuels, F., Giron, J. M., Castilla, J. M., Redondo, L., Izquierdo, G., Lauer, K., Henneberg, A., Bittmann, N., Link, D., Wollinsky, K. H., Mobner, R., Fassbender, K., Kuhnen, J., Schwartz, A., Hennerici, M., Miller, A., Lider, O., Abramsky, O., Weiner, H. L., Offner, H., Vanderbark, A. A., Paoino, E., Fainardi, E., Addonizio, M. C., Ruppi, P., Tola, M. R., Granieri, E., Carreras, M., Sazdovitch, V., Joutel, A., Verdier-taillefer, M. H., Heinzlef, O., Radder, C., Tournier-Lasserve, E., Brenner, R. E., Munro, P. M. G., Williams, S. C. R., Bell, J. D., Hawkins, C. P., Filippi, M., Campi, A., Dousset, V., Canal, N., Comi, G., Zhu, J., Weber, F., Retska, R., List, J., Zhang, L., Brock, M., Taphoorn, M. J. B., Heimans, J. J., van der Veen, E. A., Karim, A. B. M. F., Sarazin, M., Argentino, N., Delattre, J. Y., Derkinderen, P., Buchwald, B., Schroter, G., Serve, G., Franke, C. H., Conrad, B., Kitchen, N. D., Thomas, D. G. T., Forman, A. D., Ang, Kie- Kian, Price, R., Stephens, C., Salmaggi, A., Nermni, R., Silvani, A., Forno, M. G., Luksch, R., Boiardi, A., Grzelec, H., Fryze, C., Nowacki, P., Zdziarska, B., Sanson, M., Merel, P., Richard, S., Rouleau, G., Thomas, G., Olsen, N. K., Pfeiffer, P., Egund, N., Bentzen, S. M., Johannesen, L., Mondrup, K., Rose, C., Zyluk, B., Wondrusch, E., Berger, O., Fast, N., Jellinger, K., Lindner, K., Urman, A., Thibault, J. L., Duyckaerts, Ch., Strik, H., Muller, B., Richter, E., Krauseneck, P., Steinbrecher, A., Schabet, M., Hess, C., Bamberg, M., Dichgans, J., Counsell, C. E., McLeod, M., Grant, R., Creel, G. B., Claus, D., Sieber, E., Engelhardt, A., Rechlin, T., Thierauf, P., Neubauer, U., Peresson, M., Di Giovacchino, G., Romani, G. L., Di Silverio, F., Danek, A., Kuffner, M., Hoermann, R., Schopohl, J., Laska, M., Heye, B., Zangaladze, A. T., Valls-SoIè, J., Cammarota, A., Alvarez, R., Tolosa, E., Hallett, M., Ulbricht, D., Ganslandt, O., Kober, H., Vieth, J., Grummich, P., Pongratz, H., Brigel, C., Fahlbusch, R., Serra, F. P., Palma, V., Nolfe, G., Buscaino, G. A., Rothstein, T. L., Gibson J. M., Morrison P. M., Collins A. D., Eiselt, M., Wagnur, H., Zwiener, U., Schindler, T., Efendi, H., Ertekin, C., Erfas, M., Larsson, L. E., Sirin, H., AraÇ, N., Toygar, A., Demir, Y., Seddigh, S., Vogt, T. H., Hundemer, H., Visbeck, A., Pastena, L., Faralli, F., Mainardi, G., Gagliardi, R., Linden, D., Berlit, P., Lopez, O. L., Becker, J. T., Jungreis, C., Brenner, R., Rezek, D., Dekesky, S. T., Estol, C., Boller, F., Fernandez, J. M., Mederer, S., Batlle, J., Turon, A., Codina, A., Hitzenberger, P., Vila, N., Valls-SolÇ, J., Chamorro, A., Pouget, J., Schmied, A., Morin, D., Azulay, J. Ph., Vedel, J. P., Montalt, J., Escudero, J., Barona, R., Campos, A., Varli, K., Ertem, E., Uludag, B., Yagiz, A., Privorkin, Z., Steinvil, Y., Kott, E., Combarros, O., Sanchez-Pernaute, R., Orizaola, P., Mokrusch, Th., Kutluaye, E., Selcuki, D., Ertikin, C., Zettl, U., Gold, R., Harvey, G. K., Hartung, H. P., Toyka, K. V., Wokke, J. H. J., Oey, P. L., Ippel, P. F., Jansen, G. H., Franssen, H., Toyooka, K., Fujimura, H., Ueno, S., Yoshikawa, H., Yorifuji, S., Yanagihara, T., Talamon, C., Tzourio, C., Kiefer, R., Jung, S., Toyka, K., Ruolt, I., Tranchant, C., Mohr, M., Warter, J. M., Younger, D. S., Rosoklija, G., Hays, A. P., Kurita, R., Hasegawa, O., Matsumto, M., Komiyama, A., Nara, Y., Oueslati, S., Belal, S., Turki, I., Ben Hamida, C., Hentati, F., Ben Hamida, M., Kwiecinski, H., Krolicki, L., Domzal-Stryga, A., Dellemijn, P. L. I., van Deventer, P., van Moll, B., Drogendijk, T., Vecht, Ch. J., Nemni S., Amadio, Fazio, R., Galardin, G., Delodovici, M. L., Peghi, E., Monticelli, M. L., Sessa, A., Viguera, M. L., Palomar, M., Gamez, J., Cervera, C., Navarro, C., Serena, J., Duran, I., Fernandez, A. L., Comabella, M., Nos, C., Rio, J., Montalban, J., Navarro, X., Verdu, E., Darbra, S., Buti, M., Mrabet, A., Fredj, M., Gouider, R., Tounsi, H., Khalfallah, N., Haddad, A., Dbaiss, T., Ghnassia, R., Rouillet, E., Chedru, F., Porsche, H., Strenge, H., Li, S. W., Young, Y. P., Garcia, A. A., Baron, P., Scarpini, E., Bianchi, R., Conti, A., Livraghi, S., Rees, J. H., Gregson, N. A., Hughes, R. A. C., Sedano, M. J., Calleja, J., Canga, E., Bahou, Y., Biary, N., Al Deeb, S. M., Guern, E. L. E., Gugenheim, M., Tardieu, S., Aisonobe, T. M., Agid, Y., Bouche, P., Brice, A., Rautenstrauss, B., Nelis, E., Grehl, H., Van Broeckhoven, C., Pfeiffer, R. A., Liehr, T., Ganzmann, E., Gehring, C., Neundörfer, B., Geremia, L., Doronzo, R., Sacilotto, G., Sergi, P., Pastorino, G. C., Scarlato, G., Planté-Bordeneuve, V., Mantel, A., Baas, F., Moser, H., Antonini, A., Psylla, M., Günther, I., Vontobell, P., Beer, H. F., Leenders, K. L., Chaudhuri, K. Ray, Parker, J., Pye, I. F., Millac, P. A. H., Abbott, R. J., Sutter, M., Albani, C., de Rijk, M. C., Breteler, M. M. B., Graveland, G. A., van der Mechè, F. G. A., Hofman, A., Keipes, M., Hilger, Ch., Diederich, N., Metz, H., Hentges, F., Pollak, P., Benabid, A. L., Limousin, P., Hoffmann, D., Benazzouz, A., Perret, J., Laihinen, A., Rinne, J. O., Ruottinen, H., Nagren, K., Lehikoinen, P., Oikonen, V., Ruotsalainen, U., Rinne, U. K., Cocozza, S., Pizzuti, A., Cavalcanti, F., Monticelli, A., Pianese, L., Redolfi, E., Paiau, F., Di Donato, S., Pandolfo, M., Palau, F., Monros, E., De Michele, G., Smeyers, P., Lopez-ArLandis, J., Uilchez, J., Filla, A., Genis, D., Matilla, T., Volpini, V., Blanchs, M. I., Davalos, A., Molins, A., Rosell, J., Estivill, X., De Jonghe, P., Smeyers, G., Krols, L., Mercelis, R., Hazan, J., Weissenbach, J., Martin, J. J., Warner, T. A. T., Williams, L., Orb, A. S., Harding, A. E., Giunti, P., Sweeney, M. G., Spadaro, M., Jodice, C., Novelletto, A., Malaspina, P., Frontali, M., Salmon, E., Gregoire, Del Fiore, Comar, Franck, G., Scheltens, P. H., Siegfried, K., Dartigues, E., De Deyn, P., Horn, R., Nelson, I., Hanna, M. G., Morgan-Hughes, J. A., Collinge, J., Palmer, M. S., Campbell, T., Mahal, S., Sidle, K., Humphreys, C., Tavitian, B., Pappata, S., Jobert, A., Crouzel, A. M., DiGiamberardino, L., Steimetz, G., Barbanti, P., Fabbrini, G., Salvatore, M., Buzzi, M. G., Di Piero, V., Petraroli, R., Sbriccoli, A., Pocchiari, M., Macchi, G., Lenzi, G. L., Spiegel, R., Maguire, P., Schmid, W., Ott, A., Bots, M. L., Grobbe, D. E., Hofman, A., Howard, R. S., Russell, S., Losseff, N., Hirsch, N. P., Couderc, R., Bailleul, S., Nargeot, M. C., Touchon, J., Picot, M. C., Rizzo, M., Watson, G., McGehee, D., Dingus, T., Kappos, L., Radü, E. W., Haas, J., Hartard, C. H., Spuler, S., Yousry, T., Voltz, R., Scheller, A., Holler, E., Hohlfeld, R., Scolding, N. J., Sussman, J., Kolar, O. J., Farlow, M. R., Rice, P. H., Zipp, F., Sotgiu, S., Weiss, E. H., Wekerle, H., Chalmers, R., Robertson, N., Compston, D. A. S., Martino, G., Clementi, E., Brambilla, E., Moiola, L., Martinelli, V., Colombo, B., Poggi, A., Rovaris, M., Grimaldi, L. M. E., Roth, M. P., Descoins, P., Ballivet, S., Ruidavets, J. B., Waubant, E., Nogueira, L., Cambon-Thomsen, A., Clanet, M., Leppert, D., Hauser, S., Lugaresi, A., Tartaro, A., D'aurelio, P., Befalo, L. L. O., Thomas, A., Malatesta, G., Gambi, D., Benedikz, J. E. G., Magnusson, H., Poser, C. M., Guomundsson, G., Bates, T. E., Davies, S. E. C., Clark, J. B., Landon, D. N., ùther, J. R., Rautenberg, W., Overgaard, K., Sereghy, T., Pedersen, H., Boysen, G., Diez-Tejedor, E., Carceller, F., Gutierrez, M., Lopez-Pajares, R., Roda, J. M., Chandra, B., Ricart, W., Gonzalez-Huix, F., Molina, A., Rundek, T., Demarin, V., De Reuck, J., Boon, P., Decoq, D., Strijckmans, K., Goethals, P., Lemahieu, I., Nibbio, A., Chabriat, H., Vahedi, K., Nagy, T., Verin, M., Mas, J. L., Julien, J., Ducrocq, X., Iba-Zizen, M. T., Cabanis, E. A., Bousser, M. G., Rolland, Y., Landgraf, F., Bompais, B., Lemaitre, M. H., Edan, G., Vorstrup, S., Knudsen, L., Olsen, K. Skovgaard, Videbaek, C., Schroeder, T., van Gijn, J., Jansen, H. M. L., Pruim, J., Paans, A. M. J., Willemsen, A. T. M., Hew, J. M., vd Vliet, A. M., Haaxma, R., Vaalburg, W., Minderhoud, J. M., Korf, J., Soudain, S. E., Ho, T. W., Mishu, B., Li, C. Y., Nachainkin, I., Gao, C. Y., Cornblath, D. R., Griffin, J. W., Asbury, A. K., Blaser, M. J., McKhann, G. M., Ho, T., Macko, C., Xue, P., Stadlan, E. M., Ramos-Alvarez, M., Valenciano, L., Visser, L. H., van der Meché, F. G. A., van Darn, P. A., Meulstee, J., Schmitz, P. I. M., Jacobs, B., Oomes, P. G., Kleyweg, R. P., Jacobs, B. C., Endtz, H. P., van Doorn, P. A., van der Mech, F. G. A., Van den Berg, L. H., Mollee, I., Logtenberg, T., Thomas, P. K., Plant, G., Baxter, P. J., Luis, R. Santiago, Matsumoto, M., Notermans, N. C., Wokke, J. H. J., Lokhorst, H. M., van der Graaf, Y., Jennekens, F. G. I., Azulay, J. P., Bille-Turg, F., Valentin, P., Farnarier, G. G., Pellissier, J. F., Serratrice, G., Quasthoff, S., Schneider, U., Grafe, P., Hilkens, P. H. E., Moll, J. W. B., van der Burg, M. E. L., Planting, A. S. T., van Putten, W. L. J., van den Bent, M. J., Birklein, F., Spitzer, A., Lang, E., Neundorfer, B., Diehl, R. R., Lücke, D., Smith, G. D. P., Mathias, C. J., Serra, J., Campera, M., Ochoa, J. L., Ray Chaudhuri, K., Pavitt, D., Alam, M., Handwerker, H. O., Bleasdale-Barr, K., Smith, G., Murray, N. M. F., Hawkins, P., Pepys, M., Gellera, C., DiDonato, S., Taroni, F., Uncini, A., Di Muzio, A., Servidei, S., Silvestri, G., Lodi, R., Iotti, S., Barbiroli, B., Morrissey, S. P., Borruat, F. X., Francis, D., Mosely, I., Hansen, H. C., Helmke, K., Kunze, K., Sadzot, B., Maquet, P., Lemaire, Plenevaux, Damhaut, Sommer, C., Myers, R. R., Berta, E., Mantegazza, R., Argov, Z., Shapira, Y., Wirguin, I., Beuuer, J., Franke, C., Roberts, M., Willison, H., Vincent, A., Newsom-Davis, J., Morrison, K. E., Damels, R., Francis, M., Campbell, L., Davies, K. E., Kohler, W., Bucka, C., Hertel, G., Kanovsky, P., Auer, D., Ackermann, H., Klose, U., Naegele, Th., Bien, S., Voigt, K., Fink, G. R., Stephan, K. M., Wise, R. J. S., Mullatti, N., Hewer, L., Frackowiak, R. S. J., Weiller, C. S., Rijnites, M., Jueptner, M., Bauermann, T., Krams, M., Diener, H. C., van Walderveen, M. A. A., Barkhof, F., Hommes, O. R., Valk, J., Willmer, J. P., Guzman, D. A., Passingham, R. E., Silbersweig, D., Ceballos-Baumann, A., Frith, C. D., Frackowiak, R., Lucas, C. H., Goullard, L., Marchau, M. J., Godefroy, O., Rondepierre, P. H., Chamas, E., Mounier-Vehier, F., Leys, D., Renato, J., Verdugo, M. S. C., Campero, M., Jose, L., Ochoa, D. S. C., Vivancos, F., Tejedor, E. Diez, Martinez, N., Roda, J., Frank, A., Barreiro, P., Satoh, Y., Nagata, K., Maeda, T., Hirata, Y., YalÇinerner, B., Ozkara, C., Ozer, F., Ozer, S., Hanoglu, L., Zunker, P., Pozo, J. L., Oberwittler, C., Schick, A., Buschmann, H. -Ch., Ringelstein, E. Bernd, Lara, M., Anzola, G. P., Magoni, M., Volta, G. Dalla, Tarasov, A., Feigin, V., Beaudry, M. G., Carrier, S., Chicoutimi, Henriques, I. L., Bogoussslavsky, J., van Melle, G., Mathieu, J., Perusse, L., Allard, P., Prevost, C., Cantin, L., Bouchard, J. M., De Braekeleer, M., Agbo, C., Neau, J. P., Tantot, A. M., Dary-Auriol, M., Ingrand, P., Gil, R., Baltadjiev, D., Zekin, D., Sabey, K., Gennaula, C. P., Pope, B. A., Caparros-Lefebvre, D., Girard-Buttaz, I., Pruvo, J. P., Petit, H., Hipola, D., Martin, M., Giménez-Roldan, S., Ivanez, V., Japaridze, G., Carrasco, J. L., Picomell, I., Herranz, J. L., Macias, J. A., Nieto, M., Noya, M., Oller, L., Kiteva-Trencevska, G., Delgado, M. R., Liu, H., Luengo, A., Parra, J., Colas, J., Fernandez, M. J., Manzanares, R., Kornhuber, M. E., Malashkhia, V., Orkodashili, G., Martinez, M., Bonaventura, I., Porta, G., Martinez, I., Fernandez, A., Aguilar, M., Masnou, P., Drouet, A., Dreyfus, M., Cartron, J., Morel-Kopp, M. C., Tchernia, G., Kaplan, C., Lammers, M. W., Hekster, Y. A., Keyser, A., Meinardi, H., Renier, W. O., Boon, P. A. J. M., Have, M. D., Kint, B., Cruz, P., Cadilha, A., Almeida, R., Goncalves, M., Pimenta, M., Ramos, L. M. P., Polder, T. W., Broere, C. A., Polman, L., Rother, I., Rother, M., Schlaug, G., Arnold, S., Holthausen, H., Wunderlich, G., Ebner, A., Luders, H., Witte, O. W., Seitz, R. J., Serra, L. L., Gallicchio, B., Rotondi, F., Wieshmann, U., Meierkord, H., Sabev, K., Di Carlo, V., Gueguen, B., Derouesné, Ch., Ancri, D., Bourdel, M. C., Guillou, S., Aliaga, R., Chornet, M. A., Rodrigo, A., Pascual, A. Pascual -Leone, Catala, M. D., Pascual-Leone, A., Benbadis, S. R., Dinner, D. S., Chelune, G. J., Lüders, H. O., Piedmonte, M. R., Blanco, T., Lopez, M. P., Romero, B., Deltoro, A., Pascual, A., Pascual, Leone, Bolgert, F., Josse, M. O., Tassan, P., Touze, E., Laplane, D., Godenberg, F., Brizioli, E., Del Gobbo, M., Pelliccioni, G., Scarpino, O., Durak, H., Damlacik, G., Tunca, Z., Fidaner, H., Yurekli, Y., Yemez, B., Kaygisiz, A., Anllo, E. A., Esperet, E., Giovagnoli, A. R., Casazza, M., Spreafico, R., Avanzini, G., Mascheroni, S., Vecchio, I., Tornali, C., Antonuzzo, A., Grasso, A. A., Bella, R., Pennisi, G., Raffaele, R., Broeckx, J., Schildermans, F., Hospers, W., Deberdt, W., Carney, J. M., Aksenova, M., Chen, M. S., Juncadella, M., Busquets, N., De la Fuente, I., Rodriguez, A., Rubio, F., Soler, R., Khati, C., Pillon, B., Deweer, B., Malapani, C., Malichard, N., Dubois, B., Rancurel, G., Lopez, D. L., Jungreia, G., DeKosky, S. T., Boiler, F., Weiller, C., Rijntjes, M., Mueller, S. P., Maguire, E. A., Burke, E. T., Staunton, H., Phillips, J., Rousseaux, M., Pena, J., Bertran, I., Santacruz, P., Lopez, R., Catafau, A., Lomena, F., Blesa, R., Rampello, L., Nicoletti, A., Cabaret, M., Lesoin, F., Steinling, M., Tournev, I., Maier-Hauff, K., Schroeder, M., Wolf, A., Cochin, J. P., Noel, I., Augustin, P., Auzou, P., Hannequin, D., Maria, V., Lopez-Bresnahan, Danielle, D. M., Antin-Ozerkis B. A., Bartels, E., Rodiek, S. O., Flugel, K. A., Campos, D. M., Salas-Puig, J., Del Rio, J. Sanhez, Vidal, J. A., Lahoz, C. H., Eraksoy, M., Barlas, O., Barlas, M., Bayindir, C., Ozcan, H., Birbamer, G., Gerstenbrand, F., Felber, S., Luz, G., Aichner, F., Seidel, G., Kaps, M., Hutzelmann, A., Gerriets, T., Kruggel, F., Martin, P. J., Gaunt, M. E., Abbot, R. J., Naylor, A. R., Meary, E., Dilouya, A., Meder, J. F., De Recondo, J., Lebtahi, R., Neff, K. W., Meairs, S., Viola, S., Matta, E., Aquilone, L., Rise, I. R., Authier, F. J., Kondo, H., Ghnassia, R. T., Degos, J. D., Gherardi, R. K., Bardoni A., Ciafaloni E., Comi G. P., Bresolin N., Robotti M., Moggio M., Rigoletto C., Roses A., Scarlato G., Castelli, E., Turconi, A., Bresolin, N., Perani, D., Felisari, G., Chariot, P., de Pinieux, G., Astier, A., Jacotot, B., Gherardi, R., Fischer-Gagnepain, V., Louboutin, J. P., Crespo, F., Florea-Strat, A., Fromont, G., Sabourin, J. -C., Gonano, E. -F., Moroni, I., Prelle, A., Iannaccone, S., Quattrini, A., deRino, F., Sessa, M., Golzi, V., Smirne, S., Nemni, R., Turpin, J. C., Lucotte, G., Jacobs, S. C. J. M., Willems, P. W. A., Bootsma, A. L., Lasa, A., Calaf, M., Baiget, M., Gallano, B., Fichter-Gagnepain, V., Mazzucchelli, F., D'Angelo, M. G., Velicogna, M., Bet, L., Comi, G. P., Bordoni, A., Gonano, E. F., Bazzi, P., Rapuzzi, S., Moggio, M., Fagiolari, G., Ciscato, P., Messina, A., Battistel, A., Ryniewicz, B., Sangla, I., Desnuelle, C., Paquis, V., Cozzone, P. J., Bendahan, D., Sturenburg, H. J., Kohncke, G., Castellli, E., Linssen, W., Stegeman, D., Binkhorst, R., Notermans, S., Jaspert, A., Fahsold, R., de Munain, A. Lopez, Cobo, A., Martorell, L., Poza, J. J., Navarrete Palau, D., Emparanza, J. I., Sanchez-Roy, R., Vilchez, J. J., Hernandez, M., Tena, J. Garcia, Perla, C., Koutroumanidis, M., Papathanasopoulos, P., Papadimitriou, A., Papapetropoulos, T. H., Divari, R., Hadjigeorgiou, G. M., Anastasopoulos, I., Sansone, V., Rotondo, G., Meola, G., Rigoletto, C., Messina, S., Szwabowska-Orzeszko, E., Jozwiak, S., Michalowicz, R., Szaplyko, W., Petrella, M. A., Della Marca, G., Masullo, G., Mennuni, G. F., Kompf, D., Wascher, E., Verleger, R., Kaido, M., Soga, F., Toyooka, H., Bayon, C., Rubio, J., Carlomagno, S., Parlato, V., Santoro, A., Lavarone, A., Bonavita, V., Pentore, R., Venneri, A., Pasquier, F., Lebert, F., Grymonprez, L., Lefebvre, C., Van der Linden, M., Derouesné, C., Renault, B., Lacomblez, L., Homeyer, P., Ouss, L., Neuman, E., Malbezin, M., Barrandon, S., Guez, D., Stevens, M., van Swieten, J. C., Franke, C. L., Sanchez, A., Castellvirel, S., Mila, M., Jimenez, D., Pallesta, F., Ruiz, P. J. Garcia, Barrio, A., Barroso, T., Benitez, J., de Yebenes, J. Garcia, Manubens, J. M., Martinez-Lage, J. M., Larumbe, R., Muruzabal, J., Lacruz, F., Quesada, Pedro, Gallego, J., Ferini-Strambi, L., Marcone, A., Garancini, P., Tedesi, B., Jacob, B., Rozewicz, L., Langdon, D., Davie, C., Ron, M., Thompson, A., Koepp, M. J., Hansen, M. L., Guldin, B., Pressler, R. M., Ried, S., Scholz, C., Monaco, F., Gianelli, M., Schiavalla, M. P., Naldi, P., Cantello, R., Torta, R., Verze, L., Mutani, R., Knott, H., Ferbert, A., Schulze-Bonhage, A., Aust, W., Di Mascio, R., Marchioli, R., Vitullo, F., Di Pasquale, A., Sciulli, L., Kramer, V., Tognoni, G., Santacruz, P., Lopez, R., Marti, M. J., Charques, I., Catafau, A., Lomeila, F., Peila, J., Bertran, I., Blesa, R., Krendel, D. A., Costiga, D. A., Koeppen, S., Korn, W. M., Brugge, S., Schmitz, D., Scheulen, M. E., King, R. H. M., Robertson, A. M., Thomas, P. K., Kerkhofs, A., Vermersch, P., Dereeper, O., Daems Monpeun, C., Parent, M., Deplanque, D., Petit, H., Campero, M., Serra, J., Ochoa, J. L., Martinez-Matos, J. A., Montero, J., Olivé, M., Rene, R., Vidaller, A., Gugenheim, M., Gouider, R., Le Guern, E., Brice, A., Agid, Y., Bouche, P., Grisold, W., Ziflo, U., Drlicek, M., Budka, H., Jellinger, K., Zielinski, C. H., Ginsberg, L., King, R. H. M., Workman, J., Platts, A. D., Thomas, P. K., Gherardi, R. K., Florea-Strat, A., Poron, F., Sabourin, J. -C., Fazio, R., Nemni, R., Franceschi, M., Lorenzetti, I., Rinaldi, L., Canal, N., Weilbach, F. X., Sennlaub, A., Jung, S., Gold, R., Toyka, K. V., Hartung, H. P., Giegerich, G., Ellie, E., Vital, A., Steck, A. J., Vital, C., Julien, J., Doneda, P., Pizzul, S., Scarpini, E., Chiodi, P., Ramacci, M. T., Livraghi, S., Maimone, D., Annunziata, P., Salvadori, C., Guazzi, G. C., Arne-Bes, M. C., Delisle, M. B., Fabre, N., Hurtevent, J. F., Bes, A., Baudoin-Martin, D., Laborde, E., Viallet, F., Creisson, C., Crespi, V., Bogliun, G., Marzorati, L., Zincone, A., D'Angelo, L., Liberani, A., Merlini, M., Rivolta, R., Creange, A., Sabourin, J. -C., Theodorou, I., Gherardi, R. K., Conti, A. M., Malosio, M. L., Baron, P. L., Scarlato, G., Chorao, R., Rosas, M. J., Leite, I., Callea, L., Donati, E., Bargnani, C., Bud, M., Verdu, E., Navarro, X., Braun, S., Einius, S., Poindron, P., Warier, J. M., Bradley, J., Bekkelund, S. I., Torbergsen, T., Mellgren, S. I., Carlomagno, S., Parlato, V., Santoro, A., Lavarone, A., Boller, F., Bonavita, V., Engelhardt, A., Lörler, H., Robeck, S., Kluglein, C., Comi, G., Avoledo, V., Locatelli, T., Leocani, L., Galardi, G., Magnani, G., Medaglini, S., Chkhikvishvili, T. S., Zangaladze, A., Bratoeva, M., Kovachev, P., Chavdarov, D., Artemis, N., Karacostas, D., Milonas, I., Arpa, J., Lopez-Pajares, R., Cruz-Matinez, A., Sarria, J., Palomo, F., Alonso, M., Rodriguez-Al-barino, A., Lacasa, T., Nos, J., Barreiro, P., Martinez, A. Cruz, Villoslada, C., Alons, M., Taghavy, A., Hamer, H., Kratzer, A., Dethy, S., Pauwels, T., Monclus, M., Luxen, A., Goldman, S., Ziegler, M., Crambes, O., Ragueneau, I., Arnaud, F., Zappia, M., Montesanti, R., Colao, R., Palmieri, A., Branca, D., Nicoletti, G., Rizzo, M., Parlato, G., Quattrone, A., Vanacore, N., Zuchegna, P., Bonifati, V., Meco, G., Scholz, J., Friedrich, H. -J., Rohl, A., Ulm, G., Vieregge, P., Savettieri, G., Rocca, W. A., Meneghini, F., Grigoletto, F., Morgante, L., Reggio, A., Salemi, G., Di Pierri, R., OzckmekÇi, S., Ertan, S., Yeni, N., Apaydin, H., Erkol, G., Kiziltan, G., Denktas, F., Ranoux, D., de Recondo, J., Ostergaard, L., Werdelin, L., Odin, P., Lindvall, O., Dupont, E., Christensen, P. B., Boisen, E., Jensen, N. B., Schmiegelow, M., Ingwersen, S. H., Matias-Guiu, J., Canet, T., Falip, R., Martin, R., Galiano, L., Voloshin, M. Y., Burchinskaya, L. F., Cabrera-Valdivia, F., Jimenez-Jimenez, F. J., Molina, J. A., Fernandez-Calle, P., Vazquez, A., Canizares-Liebana, F., Larumbe-Lobalde, S., Ayuso-Peralta, L., Rabasa, M., Codoceo, R., Arrieta, F. J., Aguilar, M. V., Jorge-Santamaria, A., Martinez-Para, M. C., Alarcon, J., Mateo, D., Gimenez-Roldan, S., Gencheva, E., Tzonev, T. z., Georgiev, G., Petkova, P., Gasparini, M., Vanacore, N., Meco, N. G., de la Sierra, G., Aguado, F., Revilla, M., Varela, L., Rico, H., Feve, A., N'Guyen, J. P., Bathien, N., Fenelon, G., Veroust, J., Cesaro, P., Egersbach, G., Hattig, H., Schelosky, L., Wissel, J., Poewe, W., Durif, F., Albuisson, E., Debilly, B., Tournilhac, M., Magnani, C., Mocellini, C., Soffietti, R., Schiffer, D., Cardozo, A., Cruz-Sanchez, F. F., Falip, L., Potagas, G., Ziegler, M., Rondot, P., Bonifati, V., Fabrizio, E., Meco, G., Bostantjopoulou, S., Katsarou, Z., Kyriazis, G., Baas, H., Demisch, L., Esser, A., Zoeller, F., Burklin, F., Harder, S., Fischer, P. A., Arcusa, M. J., Hermandez, S., Claramonte, F. J., Pascual, A. Pascual- Leone, Alonso, M. D., Catata, M. D., Alessandri, A., Giustini, P., Dufour, A., Ciusani, E., Nespolo, A., Roelcke U., Radu E. W., von Ammon K., Maguire R. P., Leenders K. L., Radionova, M., Chavdarov, D., Bratoeva, M., Tzekov, Ch., Pietrangeli, A., Bove, L., Pace, A., Falqui, L., Jandolo, B., Potemkowski, A., Muller B., Reinhard I., Krone A., Warmuth M., Brocker E. 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Oliveras, Alameda, F., Alfonso, S., Podobnik-Sarkanji, S., Pniewski, J., Torbicki, A., Mieszkowski, J., Plaza, I., Petrunjashev, V., Velcheva, I., Hadjiev, D., Yancheva, S., Petrov, L., Karakaneva, S., Petkov, A., Nikolov, E., Niehaus, L., Sacchetti, M. L., Toni, D., Fiorelli, M., Gori, C., Argentino, C., Lyrer, Ph., Radu, E. W., Gratzl, O., Rondepierre, Ph., Leclerc, X., Marchau, Jr, M., Scheltens, Ph., Hamon, M., Janssens, E., Henon, H., Lucas, C., KuÇukoglu, H., Baybas, S., Dervis, A., YalÇiner, B., Yilmaz, N., Ozturk, M., Arpaci, B., Navarro, J. A., Arenas, J., Perez-Sempere, A., Egido, J. A., Soriano-Soriano, C., Beau, P., Gergaud, J. -M., Coudero, C., Dierckx, R. A., Dobbeleir, A., Timmermans, E., Vandevivere, J., Lucas, C. H., Gomez, M., Aguirre, J., Berenguer, A., Duran, C., Parrilla, J., Gonzalez, F., Gironell, A., Rey, A., Marti-Vilalta, J. L., de Lecinana, M. Alonso, Federico, F., Conte, C., Simone, I. L., Giannini, P., Liguori, M., Lucivero, V., Picciola, E., Tortorella, C., Drislane, F., Wang, A. Ming, Di Mascio, R., Marchioli, R., Vitullo, F., Di Pasquale, A., Sciulli, L., Kramer, V., Tognoni, G., Levivier, M., del Olmo, A., Caballero, E., Degaey, I., de Bruijn, S. F. T. M., Tchaoussoglou, I., Bastianello, S., Pozzilli, C., Cervello, A., Catala, N., Koskas, F., Kieffer, E., Botia, E., Vivancos, J., Leon, T., Segura, T., Ramo, C., Lopez, F., Karepov, V. G., Gur, A. J., Berlanga, B., Gracia, V., Fiol, C., Kurtel, H., Ozkutlu, U., Yegen, B., Grau, A. J., Buggle, F., Heindle, S., Steichen-Wiehn, C., Banerjee, T., Maiwald, M., Becher, H., Villafana, W., Medina, F., Fernandez-Real, J. M., Soler, S., Planas, E., Iceman, E., Doganer, I., Badlan, G., Genc, B., Yulug, K., Ideman, E., Dural, H., Kutlul, K., Damalik, G., Baklan, Y., Metin, B., Tekinsoy, E., Iriarte, I., Subira, M. L., Crockar, A. D., Treacy, M., McNell, T. A., Grazzi, L., Ediboglu, N., Bilgin, H., Ertas, S., Goument, J. -P., Basset, C., Campos, Y., Garcia-Silva, T., Cabello, A., Bussaglia, E., Tizzano, E., Colomer, J., Gimbergues, P., Campagne, D., Bommelaer, C., Delaguillaume, B., Ramtami, H., Ait-Kaci-Ahmed, M., Pascual L. F., Fernandez T., Hortells M., Sanz C., Morales F., Lauritzen, L., Picard, F., Sellal, F., Collard, M., Avramidis, T., Alexiou, E., Anastopoulos, T., Frongillo, D., Delfino, F. A., Cannata, M., Calo, L., Vichi, R., Antonini, G., Fragola, V., Cannata, D., Salas, M., Ruiz, C., Angelard, B., Lacau, J., Guily, St., Sendtner, M., Goadsby, Peter J., Quin, N. P., Gadian, D. G., Roland, P. E., Seitz, Rudiger J., Frackowiak, Richard S. J., Becker, G., Krone, A., Schmidt, K., Hofmann, E., Bogdahn, U., Rosenfeld, M. R., Meneses, P., Kaplitt, M. G., Dalmau, J., Posner, J., Cordon-Cardon, C., Hoang-Xuan, K., Vega, F., Nishisho, I., Moisan, J. P., Theillet, C., Delattre, O., Zhu, Jiahong, Walther, W., Posner, J. B., Roelcke, U., von Ammon, K., Pellikka, R., Lucking, C. H., Walon, C., Boucquey, D., -Van Rijckevorsel, K. Harmant, Lannoy, N., Verellen-Dunoulin, Ch., Liszka, U., Cavaletti, G., Casati, B., Kolig, C., Bogliun, G., Marzorati, L., Johannsen, L., Chio, A., Ruda, R., Vigliani, M. C., Sciolla, R., Seliak, D., Hoang-Xuang, K., Villanueva, J. A., Montalban, X., Arboix, A., Colosimo, C., Albanese, A., Hughes, A. J., de Bruin, V., Lees, A. J., Kowalski, J. W., Banfi, S., Santoro, L., Perretti, A., Castaldo, I., Barbieri, F., Campanella, G., Bhatia, K. P., Mardsen, C. D., de Bruin, V. S., Machedo, C., Ceballos-Baumann, D., Marsden, C. D., Brooks, D. B. J., Wennlng, G. K., Quinn, N., McDonald, W. l., Warner, T. T., Bain, P. C., Davis, M. B., Conway, D., Shaunak, S., O'Sullivan, E., Crawford, T., Lawden, M., Blunt, S., Rapoport, A., Sarova-Pinchas, I., de Beyl, D. Zegers, Mavroudakis, N., Blanc, S., Godinot, C., Lenoir, G., Barkhof, M. S. F., Tas, M. W., Baron, P. L., Constantin, C., Cassatella, M. A., Langdon, D. W., Webb, S., Gasparini, P., Zeviani, A., Kidd, D., Mammi, S., Cahalon, L., Hershkoviz, R., Lahat, N., Wallach, D., Annunziata, P., Martino, T., Maimone, D., Guazzi, G. C., Porrini, A. M., Dell'Arciprete, L., Rothwell, P. M., Stewart, R. R. C., Cull, R. E., Willmes, K., Poeck, K., Russell, D., Braekken, S. K., Brucher, R., Svennevig, J., Hermesl, M., Bruckmann, H., Biraben, A., Sliwka, U., Meyer, B., Schondube, F., Noth, J., Lavenu, I., Lammers, C., Waldecker, B., Haberbosch, W., Stam, J., Schneider, R., Gautier, J. C., Berlit, T. P., Fauser, B., Kuhne, D., Geraud, G., Danielli, A., Larrue, V., Bes, A., Timmerman, E., Bono, F., Bruni, A. C., Valalentino, P., Montesi, M. P., Talerico, G., Zappia, M., Sabatelli, M., Quattrone, A., Pareyson, D., Lorenzetti, D., Sghirlanzoni, A., Castellotti, B., Lupski, J. R., Archidiacono, N., Antonacci, R., Marzella, R., Rocchi, M., Samuel, D., Goulon-Goeau, C., Costa, P. P., Bismuth, H., Said, G., De Jongh P., Lofgren A., Timmerman V., Vance J. M., Van Broeckhoven C., Martin J. -J., Martinez, A. Cruz, Bort, S., Arpa, J., Misra, P., King, R. H. M., Badhia, K., Anderson, M., Caballo, A., Vichez, J., Gabriel, J. M., Erne, B., Miescher, G. C., Ulrich, J., Vital, A., Vital, C., Steck, A., Petry, K., Labatut, I., Hilmi, S., Ellie, E., Ferrini-Strambi, L., Zucconl, M., Marchettini, P., Palazzi, S., Oehlschlager, M., Pepinsky, R. B., Gemignani, F., Marbini, A., Pavesi, G., Di Vittorio, S., Manganelli, P., Mancia, D., Vermersh, P., Roche, J., Durocher, A. M., Dewailly, Ph., Dettmers, C., Fink, G., Lemon, R., Stephan, K., Passingham, D., Weder, B., Knorr, U., Huang, Y., Butterfield, D. A., Peris, M. L., Peiro, C., Pascual, A. Pascual-Leone, Bottini, G., Folnegovic-Smalc, V., Knezevic, S., Bokonjic, R., Ersmark, B., Torres, M. Gonzalez, Guiraud-Chaumeil, B., Haugaard, K., Jovicic, A., Chr, Lang, Levic, Z., Parra, C. Martinez, Ochoa, J. Patrignani, Titlbach, O., Wikkelso, C., Caparros-Lefevre, D., Debachy, B., Verier, A., Cantinho, G., Santos, A. I., Godinho, F., Bagunya, J., Roig, T., Ensenyat, A., Santiag, O., Trabucchi, H., De Leo, D., Koch, Ch., Zeumer, H., Matkovic, Z., Morris, P., Donaghy, M., Köhler, W., Kammer, T., Röther, J., Navon, R., Fontaine, B., Wu, Y., Capdevila, A., Guardiola, M. J., van Dijk, G. W., Notermans, N. C., Kruize, A. A., Kater, L., Bertelt, C., Hesse, S., Friedrich, H., Mauritz, K. -H., Giron, L. T., Watanabe, I. S., Ewing, D., Koepp, M., Lempert, T., Sander, B., Kauerz, U., Mehdorn, H. M., Hezel, J., Eickhoff, W., Kryst, T., Timsit, S., Gardeur, D., Reis, Mitermayer Galvao dos, Secor, E., Filho, A. Andrade, Silva, M. Cardoso, Santos, S. R. Silveira, Vasilaski, G., Reis, E. A. dos, Velupillai, P., Harn, D. A., Tigera, J. Garcia, Dreke, R. Martinez, Crespo, R. Piedra, Besses, C., Acin, P., Massons, J., Florensa, L., Oliveres, M., Sans-Sabrafen, J., Wicklein, E. M., Pleiffer, G., Kunre, K., Dieterich, M., Brandt, Th., Guarino, M., Stracciari, A., Pazzaglia, P., D'Alessandro, R., Santilli, I., Donato, M., The European Velnacrine Study Group, The Dutch Guillain-Barré study group, The COP-1 Multicenter Clinical and Research Group Study, and European Study Group
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- 1994
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10. Variation in arterial input function in a large multicenter computed tomography perfusion study.
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Peerlings, Daan, Bennink, Edwin, Dankbaar, Jan W., Velthuis, Birgitta K., de Jong, Hugo W. A. M., On behalf of the DUtch acute STroke (DUST) study investigators, Majoie, C. B., Roos, Y. B., Duijm, L. E., Keizer, K., van der Lugt, A., Dippel, D. W., Droogh - de Greeve, K. E., Bienfait, H. P., van Walderveen, M. A., Wermer, M. J., Lycklama à Nijeholt, G. J., Boiten, J., Duyndam, D., and Kwa, V. I.
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COMPUTED tomography ,PERFUSION imaging ,CONTRAST media ,STROKE ,SINGULAR value decomposition ,PERFUSION - Abstract
Objectives: To report the variation in computed tomography perfusion (CTP) arterial input function (AIF) in a multicenter stroke study and to assess the impact this has on CTP results. Methods: CTP datasets from 14 different centers were included from the DUtch acute STroke (DUST) study. The AIF was taken as a direct measure to characterize contrast bolus injection. Statistical analysis was applied to evaluate differences in amplitude, area under the curve (AUC), bolus arrival time (BAT), and time to peak (TTP). To assess the clinical relevance of differences in AIF, CTP acquisitions were simulated with a realistic anthropomorphic digital phantom. Perfusion parameters were extracted by CTP analysis using commercial software (IntelliSpace Portal (ISP), version 10.1) as well as an in-house method based on block-circulant singular value decomposition (bSVD). Results: A total of 1422 CTP datasets were included, ranging from 6 to 322 included patients per center. The measured values of the parameters used to characterize the AIF differed significantly with approximate interquartile ranges of 200–750 HU for the amplitude, 2500–10,000 HU·s for the AUC, 0–17 s for the BAT, and 10–26 s for the TTP. Mean infarct volumes of the phantom were significantly different between centers for both methods of perfusion analysis. Conclusions: Although guidelines for the acquisition protocol are often provided for centers participating in a multicenter study, contrast medium injection protocols still vary. The resulting volumetric differences in infarct core and penumbra may impact clinical decision making in stroke diagnosis. Key Points: • The contrast medium injection protocol may be different between stroke centers participating in a harmonized multicenter study. • The contrast medium injection protocol influences the results of X-ray computed tomography perfusion imaging. • The contrast medium injection protocol can impact stroke diagnosis and patient selection for treatment. [ABSTRACT FROM AUTHOR]
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- 2021
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11. Risk factors for atherosclerotic and medial arterial calcification of the intracranial internal carotid artery
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Vos, Annelotte, Kockelkoren, Remko, de Vis, Jill B., van der Schouw, Yvonne T., van der Schaaf, I. C., Velthuis, B. K., Mali, W. P., de Jong, Pim A., Majoie, C. B., Roos, Y. B., Duijm, L. E., Keizer, K., van der Lugt, A., Dippel, D. W., Droogh-de Greve, K. E., Bienfait, H. P., van Walderveen, M. A., Wermer, M. J.H., Lycklama à Nijeholt, G. J., Boiten, J., Duyndam, D., Kwa, V. I., Meijer, F. J., van Dijk, E. J., Kesselring, F. O., Hofmeijer, J., Vos, J. A., Schonewille, W. J., van Rooij, W. J., de Kort, P. L., Pleiter, C. C., Bakker, S. L., Bot, J., Visser, M. C., Dankbaar, J. W., van Seeters, T., Horsch, A. D., Niesten, J. M., Biessels, G. J., Kappelle, L. J., Luitse, M. J., van der Graaf, Y., and the DUST study group
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Medial arterial calcification ,Cardiovascular disease risk factors ,Atherosclerosis ,Intracranial carotid artery ,Cardiology and Cardiovascular Medicine - Abstract
Background and aims: Calcifications of the intracranial internal carotid artery (iICA) are an important risk factor for stroke. The calcifications can occur both in the intimal and medial layer of the vascular wall. The aim of this study is to assess whether medial calcification in the iICA is differently related to risk factors for cardiovascular disease, compared to intimal calcification. Methods: Unenhanced thin slice computed tomography (CT) scans from 1132 patients from the Dutch acute stroke study cohort were assessed for dominant localization of calcification (medial or intimal) by one of three observers based on established methodology. Associations between known cardiovascular risk factors (age, gender, body mass index, pulse pressure, eGFR, smoking, hypertension, diabetes mellitus, hyperlipidemia, previous vascular disease, and family history) and the dominant localization of calcifications were assessed via logistic regression analysis. Results: In the 1132 patients (57% males, mean age 67.4 years [SD 13.8]), dominant intimal calcification was present in 30.9% and dominant medial calcification in 46.9%. In 10.5%, no calcification was seen. Age, pulse pressure and family history were risk factors for both types of calcification. Multivariably adjusted risk factors for dominant intimal calcification only were smoking (OR 2.09 [CI 1.27–3.44]) and hypertension (OR 2.09 [CI 1.29–3.40]) and for dominant medial calcification diabetes mellitus (OR 2.39 [CI 1.11–5.14]) and previous vascular disease (OR 2.20 [CI 1.30–3.75]). Conclusions: Risk factors are differently related to the dominant localizations of calcifications, a finding that supports the hypothesis that the intimal and medial calcification represents a distinct etiology.
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- 2018
12. Risk factors for atherosclerotic and medial arterial calcification of the intracranial internal carotid artery
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AvL-U, Circulatory Health, Onderzoek Beeld, Cardiovasculaire Epidemiologie, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, MS Radiologie, Researchgr. Hart-brein as., Brain, Cancer, Researchgr. Systems Radiology, Infection & Immunity, Public Health Practice, Externen Hematologie, Affectieve & Psychotische Med., Pathologie Pathologen staf, Arts-Assistenten Onderwijs Radiologie, ZL Algemene Neurologie Medisch, ZL Cerebrovasculaire Ziekten Medisch, Opleiding Neurologie, Vos, Annelotte, Kockelkoren, Remko, de Vis, Jill B., van der Schouw, Yvonne T., van der Schaaf, I. C., Velthuis, B. K., Mali, W. P., de Jong, Pim A., Majoie, C. B., Roos, Y. B., Duijm, L. E., Keizer, K., van der Lugt, A., Dippel, D. W., Droogh-de Greve, K. E., Bienfait, H. P., van Walderveen, M. A., Wermer, M. J.H., Lycklama à Nijeholt, G. J., Boiten, J., Duyndam, D., Kwa, V. I., Meijer, F. J., van Dijk, E. J., Kesselring, F. O., Hofmeijer, J., Vos, J. A., Schonewille, W. J., van Rooij, W. J., de Kort, P. L., Pleiter, C. C., Bakker, S. L., Bot, J., Visser, M. C., Dankbaar, J. W., van Seeters, T., Horsch, A. D., Niesten, J. M., Biessels, G. J., Kappelle, L. J., Luitse, M. J., van der Graaf, Y., the DUST study group, AvL-U, Circulatory Health, Onderzoek Beeld, Cardiovasculaire Epidemiologie, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, MS Radiologie, Researchgr. Hart-brein as., Brain, Cancer, Researchgr. Systems Radiology, Infection & Immunity, Public Health Practice, Externen Hematologie, Affectieve & Psychotische Med., Pathologie Pathologen staf, Arts-Assistenten Onderwijs Radiologie, ZL Algemene Neurologie Medisch, ZL Cerebrovasculaire Ziekten Medisch, Opleiding Neurologie, Vos, Annelotte, Kockelkoren, Remko, de Vis, Jill B., van der Schouw, Yvonne T., van der Schaaf, I. C., Velthuis, B. K., Mali, W. P., de Jong, Pim A., Majoie, C. B., Roos, Y. B., Duijm, L. E., Keizer, K., van der Lugt, A., Dippel, D. W., Droogh-de Greve, K. E., Bienfait, H. P., van Walderveen, M. A., Wermer, M. J.H., Lycklama à Nijeholt, G. J., Boiten, J., Duyndam, D., Kwa, V. I., Meijer, F. J., van Dijk, E. J., Kesselring, F. O., Hofmeijer, J., Vos, J. A., Schonewille, W. J., van Rooij, W. J., de Kort, P. L., Pleiter, C. C., Bakker, S. L., Bot, J., Visser, M. C., Dankbaar, J. W., van Seeters, T., Horsch, A. D., Niesten, J. M., Biessels, G. J., Kappelle, L. J., Luitse, M. J., van der Graaf, Y., and the DUST study group
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- 2018
13. Predicting the presence of macrovascular causes in non-traumatic intracerebral haemorrhage: the DIAGRAM prediction score
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Hilkens, Nina A., van Asch, Charlotte J. J., Werring, David J., Wilson, Duncan, Rinkel, Gabriël J. E., Algra, Ale, Velthuis, Birgitta K., de Kort, 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
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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.
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- 2017
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14. Temporal profile of body temperature in acute ischemic stroke : Relation to infarct size and outcome
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Geurts, Marjolein, Scheijmans, Féline E V, van Seeters, Tom, Biessels, Geert J., Kappelle, L. Jaap, Velthuis, Birgitta K., van der Worp, H. Bart, Majoie, C. B., Roos, Y. B., Duijm, L. E., Keizer, K., van der Lugt, A., Dippel, D. W., Greve, Droogh de, Bienfait, H. P., van Walderveen, M. A., Wermer, M. J., Lycklama à Nijeholt, G. J., Boiten, J., Duyndam, D., Kwa, V. I., Meijer, F. J., van Dijk, E. J., Kesselring, F. O., Hofmeijer, J., Vos, J. A., Schonewille, W. J., van Rooij, W. J., de Kort, P. L., Pleiter, C. C., Bakker, S. L., Bot, J., Visser, M. C., Velthuis, B. K., van der Schaaf, I. C., Dankbaar, J. W., Mali, W. P., van Seeters, T., Horsch, A. D., Niesten, J. M., Biessels, G. J., Kappelle, L. J., Luitse, M. J., van der Graaf, Y., Geurts, Marjolein, Scheijmans, Féline E V, van Seeters, Tom, Biessels, Geert J., Kappelle, L. Jaap, Velthuis, Birgitta K., van der Worp, H. Bart, Majoie, C. B., Roos, Y. B., Duijm, L. E., Keizer, K., van der Lugt, A., Dippel, D. W., Greve, Droogh de, Bienfait, H. P., van Walderveen, M. A., Wermer, M. J., Lycklama à Nijeholt, G. J., Boiten, J., Duyndam, D., Kwa, V. I., Meijer, F. J., van Dijk, E. J., Kesselring, F. O., Hofmeijer, J., Vos, J. A., Schonewille, W. J., van Rooij, W. J., de Kort, P. L., Pleiter, C. C., Bakker, S. L., Bot, J., Visser, M. C., Velthuis, B. K., van der Schaaf, I. C., Dankbaar, J. W., Mali, W. P., van Seeters, T., Horsch, A. D., Niesten, J. M., Biessels, G. J., Kappelle, L. J., Luitse, M. J., and van der Graaf, Y.
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- 2016
15. Assessment of collateral status by dynamic ct angiography in acute mca stroke : Timing of acquisition and relationship with final infarct volume
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Van Den Wijngaard, I. R., Holswilder, G., Wermer, M. J H, Boiten, J., Algra, A., Dippel, D. W J, Dankbaar, J. W., Velthuis, B. K., Boers, A. M M, Majoie, C. B L M, Van Walderveen, M. A A, Van Den Wijngaard, I. R., Holswilder, G., Wermer, M. J H, Boiten, J., Algra, A., Dippel, D. W J, Dankbaar, J. W., Velthuis, B. K., Boers, A. M M, Majoie, C. B L M, and Van Walderveen, M. A A
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- 2016
16. Temporal profile of body temperature in acute ischemic stroke: Relation to infarct size and outcome
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Opleiding Neurologie, Brain, Arts-assistenten Radiologie, ZL Algemene Neurologie Medisch, Circulatory Health, ZL Cerebrovasculaire Ziekten Medisch, MS Radiologie, Cancer, Onderzoek Beeld, Cardiovasculaire Epi Team 7, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Geurts, Marjolein, Scheijmans, Féline E V, van Seeters, Tom, Biessels, Geert J., Kappelle, L. Jaap, Velthuis, Birgitta K., van der Worp, H. Bart, Majoie, C. B., Roos, Y. B., Duijm, L. E., Keizer, K., van der Lugt, A., Dippel, D. W., Greve, Droogh de, Bienfait, H. P., van Walderveen, M. A., Wermer, M. J., Lycklama à Nijeholt, G. J., Boiten, J., Duyndam, D., Kwa, V. I., Meijer, F. J., van Dijk, E. J., Kesselring, F. O., Hofmeijer, J., Vos, J. A., Schonewille, W. J., van Rooij, W. J., de Kort, P. L., Pleiter, C. C., Bakker, S. L., Bot, J., Visser, M. C., Velthuis, B. K., van der Schaaf, I. C., Dankbaar, J. W., Mali, W. P., van Seeters, T., Horsch, A. D., Niesten, J. M., Biessels, G. J., Kappelle, L. J., Luitse, M. J., van der Graaf, Y., Opleiding Neurologie, Brain, Arts-assistenten Radiologie, ZL Algemene Neurologie Medisch, Circulatory Health, ZL Cerebrovasculaire Ziekten Medisch, MS Radiologie, Cancer, Onderzoek Beeld, Cardiovasculaire Epi Team 7, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Geurts, Marjolein, Scheijmans, Féline E V, van Seeters, Tom, Biessels, Geert J., Kappelle, L. Jaap, Velthuis, Birgitta K., van der Worp, H. Bart, Majoie, C. B., Roos, Y. B., Duijm, L. E., Keizer, K., van der Lugt, A., Dippel, D. W., Greve, Droogh de, Bienfait, H. P., van Walderveen, M. A., Wermer, M. J., Lycklama à Nijeholt, G. J., Boiten, J., Duyndam, D., Kwa, V. I., Meijer, F. J., van Dijk, E. J., Kesselring, F. O., Hofmeijer, J., Vos, J. A., Schonewille, W. J., van Rooij, W. J., de Kort, P. L., Pleiter, C. C., Bakker, S. L., Bot, J., Visser, M. C., Velthuis, B. K., van der Schaaf, I. C., Dankbaar, J. W., Mali, W. P., van Seeters, T., Horsch, A. D., Niesten, J. M., Biessels, G. J., Kappelle, L. J., Luitse, M. J., and van der Graaf, Y.
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- 2016
17. Assessment of collateral status by dynamic ct angiography in acute mca stroke: Timing of acquisition and relationship with final infarct volume
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ZL Cerebrovasculaire Ziekten Medisch, Cardiovasculaire Epi Team 6, Circulatory Health, Brain, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, MS Radiologie, Van Den Wijngaard, I. R., Holswilder, G., Wermer, M. J H, Boiten, J., Algra, A., Dippel, D. W J, Dankbaar, J. W., Velthuis, B. K., Boers, A. M M, Majoie, C. B L M, Van Walderveen, M. A A, ZL Cerebrovasculaire Ziekten Medisch, Cardiovasculaire Epi Team 6, Circulatory Health, Brain, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, MS Radiologie, Van Den Wijngaard, I. R., Holswilder, G., Wermer, M. J H, Boiten, J., Algra, A., Dippel, D. W J, Dankbaar, J. W., Velthuis, B. K., Boers, A. M M, Majoie, C. B L M, and Van Walderveen, M. A A
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- 2016
18. Prediction of outcome in patients with suspected acute ischaemic stroke with CT perfusion and CT angiography: the Dutch acute stroke trial (DUST) study protocol
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Van Seeters, Tom, Biessels, Geert J., van der Schaaf, Irene C., Dankbaar, Jan W., Horsch, Alexander D., Luitse, Merel J.A., Niesten, Joris M., Mali, Willem P.T.M., Kappelle, L. J., van der Graaf, Yolanda, Velthuis, Birgitta K., Majoie, C. B., Roos, Y. B., Duijm, L. E., Keizer, K., van der Lugt, A., Dippel, D. W., Droogh-de Greeve, K. E., Bienfait, H. P., van Walderveen, M. A., Wermer, M. J., Lycklamaà Nijeholt, G. J., Boiten, J., Duyndam, D., Kwa, V. I., Meijer, F. J., van Dijk, E. J., Kesselring, F. O., Hofmeijer, J., Vos, J. A., Schonewille, W. J., van Rooij, W. J., de Kort, P. L., Pleiter, C. C., Bakker, S. L., Bot, J., Visser, M. C., ACS - Amsterdam Cardiovascular Sciences, ANS - Amsterdam Neuroscience, Radiology and Nuclear Medicine, Neurology, Public Health, Radiology and nuclear medicine, and Public and occupational health
- Subjects
medicine.medical_specialty ,Infarct ,Clinical Neurology ,Perfusion scanning ,Ischaemia ,Brain Ischemia ,Cohort Studies ,Study Protocol ,Modified Rankin Scale ,Predictive Value of Tests ,medicine ,Humans ,Prospective Studies ,Stage (cooking) ,Prospective cohort study ,Stroke ,Netherlands ,Receiver operating characteristic ,medicine.diagnostic_test ,business.industry ,General Medicine ,Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3] ,medicine.disease ,Cerebral Angiography ,Perfusion ,Treatment Outcome ,CT angiography ,Predictive value of tests ,Angiography ,CT perfusion ,Neurology (clinical) ,Radiology ,business ,Prediction ,Tomography, X-Ray Computed ,Follow-Up Studies - Abstract
Contains fulltext : 136571.pdf (Publisher’s version ) (Open Access) BACKGROUND: Prediction of clinical outcome in the acute stage of ischaemic stroke can be difficult when based on patient characteristics, clinical findings and on non-contrast CT. CT perfusion and CT angiography may provide additional prognostic information and guide treatment in the early stage. We present the study protocol of the Dutch acute Stroke Trial (DUST). The DUST aims to assess the prognostic value of CT perfusion and CT angiography in predicting stroke outcome, in addition to patient characteristics and non-contrast CT. For this purpose, individualised prediction models for clinical outcome after stroke based on the best predictors from patient characteristics and CT imaging will be developed and validated. METHODS/DESIGN: The DUST is a prospective multi-centre cohort study in 1500 patients with suspected acute ischaemic stroke. All patients undergo non-contrast CT, CT perfusion and CT angiography within 9 hours after onset of the neurological deficits, and, if possible, follow-up imaging after 3 days. The primary outcome is a dichotomised score on the modified Rankin Scale, assessed at 90 days. A score of 0-2 represents good outcome, and a score of 3-6 represents poor outcome. Three logistic regression models will be developed, including patient characteristics and non-contrast CT (model A), with addition of CT angiography (model B), and CT perfusion parameters (model C). Model derivation will be performed in 60% of the study population, and model validation in the remaining 40% of the patients. Additional prognostic value of the models will be determined with the area under the curve (AUC) from the receiver operating characteristic (ROC) curve, calibration plots, assessment of goodness-of-fit, and likelihood ratio tests. DISCUSSION: This study will provide insight in the added prognostic value of CTP and CTA parameters in outcome prediction of acute stroke patients. The prediction models that will be developed in this study may help guide future treatment decisions in the acute stage of ischaemic stroke.
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- 2014
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19. Assessment of Collateral Status by Dynamic CT Angiography in Acute MCA Stroke: Timing of Acquisition and Relationship with Final Infarct Volume
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van den Wijngaard, I. R., primary, Holswilder, G., additional, Wermer, M. J. H., additional, Boiten, J., additional, Algra, A., additional, Dippel, D. W. J., additional, Dankbaar, J. W., additional, Velthuis, B. K., additional, Boers, A. M. M., additional, Majoie, C. B. L. M., additional, and van Walderveen, M. A. A., additional
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- 2016
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20. Patterns of lesion development in multiple sclerosis:longitudinal observations with T1-weighted spin-echo and magnetization transfer MR
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van Waesberghe, J H, van Walderveen, M A, Castelijns, J A, Scheltens, P, Lycklama à Nijeholt, G J, Polman, C H, and Barkhof, F
- Abstract
PURPOSE: We evaluated the appearance of enhancing multiple sclerosis (MS) lesions on unenhanced T1-weighted MR images and the natural course of enhancing MS lesions on serial unenhanced T1-weighted and magnetization transfer (MT) MR images.METHODS: One hundred twenty-six enhancing lesions were followed up monthly for 6 to 12 months to determine their signal intensity on unenhanced T1-weighted and MT MR images. At the time of initial enhancement, the size of the lesion and the contrast ratio of enhancement were calculated for each enhancing lesion. During follow-up, the contrast ratio on the corresponding unenhanced T1-weighted image was measured, and an MT ratio (MTR) was calculated.RESULTS: Twenty-five enhancing lesions (20%) appeared isointense and 101 lesions (80%) appeared hypointense relative to normal-appearing white matter on unenhanced T1-weighted images. During 6 months of follow-up, four MR patterns of active lesions were detected: initially isointense lesions remained isointense (15%); initially isointense lesions became hypointense (5%, most of which reenhanced); initially hypointense lesions became isointense (44%); and initially hypointense lesions remained hypointense (36%). MTR was significantly lower for hypointense lesions as compared with isointense lesions at the time of initial enhancement. For lesions that changed from hypointense to isointense, MTR increased significantly during 6 months of follow-up. Multiple regression analysis showed that strongly decreased MTR at the time of initial enhancement and enhancement duration of more than one scan were predictive of a hypointense appearance on unenhanced T1-weighted images at 6 months' follow-up. Ring enhancement was found to be the only (weak) predictor of persistently hypointense signal intensity.CONCLUSION: Most enhancing lesions appear slightly to significantly hypointense on unenhanced T1-weighted images. Although most hypointensities are reversible, only those lesions that fail to recover on unenhanced T1-weighted and MT images may have considerable irreversible structural changes.
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- 1998
21. Effect of covalent antithrombin-heparin on activated protein C inactivation by protein C inhibitor
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Van Walderveen, M. C., primary, Berry, L. R., additional, and Chan, A. K. C., additional
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- 2010
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22. Axonal loss in multiple sclerosis lesions: magnetic resonance imaging insights into substrates of disability.
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Van Waesberghe, J. H. T. M., Kamphorst, W., De Groot, C. J. A., Van Walderveen, M. A. A., Castelijns, J. A., Ravid, R., Lycklama à Nijeholt, G. J., Van Der Valk, P., Polman, C. H., Thompson, A. J., Barkhof, F., van Waesberghe, J H, De Groot, C J, van Walderveen, M A, and Lycklama à Nijeholt, G J
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- 1999
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23. Optimizing the association between disability and biological markers in MS
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Kalkers, N. F., primary, Bergers, E., additional, Castelijns, J. A., additional, van Walderveen, M. A. A., additional, Bot, J. C. J., additional, Ader, H. J., additional, Polman, C. H., additional, and Barkhof, F., additional
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- 2001
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24. Giant Intracranial Aneurysm in a Ten-Year-Old Boy with Parry Romberg Syndrome.
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BOSMAN, T., VAN BEIJNUM, J., VAN WALDERVEEN, M. A. A., and BROUWER, P. A.
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INTRACRANIAL aneurysms ,CEREBROVASCULAR disease ,VASCULAR diseases ,CALCIFICATION ,BIOMINERALIZATION ,TOMOGRAPHY ,DIAGNOSTIC imaging ,NEURORADIOLOGY ,SYNDROMES in children - Abstract
Parry-Romberg syndrome (PRS) is a rare acquired syndrome consisting of progressive hemiatrophy of the face. We present a child with PRS and progressive neurological deficit caused by a giant intracranial aneurysm and reviewed the literature concerning all intracranial abnormalities in patients with PRS. A literature search identified 27 articles reporting on 88 patients with PRS and intracranial abnormalities. Ipsilateral brain calcification and hemiatrophy are the most prominent features on CT scan and hyperintense white matter lesions are most frequently seen on T2-weighted MRI. Although lacking precise prevalence data, intracranial abnormalities are not uncommon in patients with PRS. We found three other PRS patients with intracranial aneurysms. Our case and literature search suggests a possible association between PRS and intracranial aneurysms. We consider this association important for clinical practice and recommend including intracranial vascular diseases in the differential diagnosis when dealing with a PRS patient with neurological symptoms. [ABSTRACT FROM AUTHOR]
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- 2009
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25. Association between MRI parameters and the MS severity scale: a 12 year follow-up study.
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Minneboo, A., Uitdehaag, B. M. J., Jongen, P., Vrenken, H., Knol, D. L., van Walderveen, M. A. A., Polman, C. H., Castelijns, J. A., and Barkhof, F.
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MAGNETIC resonance imaging ,MEDICAL imaging systems ,DIAGNOSTIC imaging ,VIRUS diseases ,PROGNOSIS - Abstract
Background Several magnetic resonance imaging (MRI) parameters are known to be associated with short-term outcome in multiple sclerosis (MS) patients. MS-related disability typically progresses over decades, stressing the need for longer follow-up studies. Until now, these studies are relatively sparse and, therefore, the predictive value of MRI parameters for clinical disability remains largely unknown. Objective To assess the predictive value of brain MRI parameters, which are obtained during the first 3.3 years of the study for overall disease severity as measured by the MS Severity Score (MSSS) after 12.2 years follow-up. Methods Forty-six MS patients were included in the study. MRI parameters included both lesion loads and atrophy measures. Average and change parameters were calculated for MRI parameters and subsequently used as independent variables in regression models, while MSSS was the dependent variable. Results Follow-up (FU) was obtained in 43/46 patients (94%) and median expanded disability status scale (EDSS) score increased significantly from 2.5 to 4.0. At last FU median MSSS was 4.3 (range 2.2-6.9). In univariate analyses, both change and cross-sectional T1-hypointense lesion load and ventricular atrophy measures were associated with MSSS. A multiple regression model included the change parameter of hypointense T1-lesion load (BHLL). This model explained 20% of variance in MSSS, which increased to 34% when type of disease (relapsing remitting or secondary progressive), age, and sex were entered additionally. Conclusion MRI measures of axonal loss are associated with higher overall disease severity in MS patients. [ABSTRACT FROM AUTHOR]
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- 2009
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26. Concurrent validity of the MS Functional Composite using MRI as a biological disease marker.
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Kalkers, N F, Bergers, L, de Groot, V, Lazeron, R H, van Walderveen, M A, Uitdehaag, B M, Polman, C H, and Barkhof, F
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- 2001
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27. Neuronal damage in T1-hypointense multiple sclerosis lesions demonstrated in vivo using proton magnetic resonance spectroscopy.
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Van Walderveen, Marianne A. A., Barkhof, Frederik, Pouwels, Petra J. W., Van Schijndel, Ronald A., Polman, Chris H., Castelijns, Jonas A., van Walderveen, M A, Barkhof, F, Pouwels, P J, van Schijndel, R A, Polman, C H, and Castelijns, J A
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- 1999
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28. Histopathologic correlate of hypointense lesions on T1-weighted spin-echo MRI in multiple sclerosis.
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Van Walderveen, M.A.A., Kamphorst, W., Scheltens, P., van Waesberghe, J. H. T. M., Ravid, R., Valk, J., Polman, C. H., Barkhof, F., van Walderveen, M A, and van Waesberghe, J H
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- 1998
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29. Magnetic resonance evaluation of disease activity during pregnancy in multiple sclerosis.
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van Walderveen, M. A.A., Tas, M. W., Barkhof, F., Polman, C. H., Frequin, S. T.F.M., Hommes, O. R., and Valk, J.
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- 1994
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30. A Randomized Trial of Intraarterial Treatment for Acute Ischemic Stroke.
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Berkhemer, O. A., Fransen, P. S. S., Beumer, D., van den Berg, L. A., Lingsma, H. F., Yoo, A. J., Schonewille, W. J., Vos, J. A., Nederkoorn, P. J., Wermer, M. J. H., van Walderveen, M. A. A., Staals, J., Hofmeijer, J., van Oostayen, J. A., Lycklama à Nijeholt, G. J., Boiten, J., Brouwer, P. A., Emmer, B. J., de Bruijn, S. F., and van Dijk, L. C.
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- *
STROKE treatment , *ARTERIAL occlusions , *ARTERIAL diseases , *CEREBRAL hemorrhage , *TREATMENT effectiveness - Abstract
The article presents a study on the intraarterial treatment for acute ischemic stroke caused by a proximal intracranial occlusion of the anterior circulation in the Netherlands. A randomized trial was conducted for 500 patients at 16 medical centers who were treated with intravenous alteplase before randomization. The study found no difference in mortality or the occurrence of symptomatic intracerebral haemorrhage, and the treatment was effective if given within six hours after stroke.
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- 2015
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31. Quantitative measurement of cortical superficial siderosis in cerebral amyloid angiopathy.
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van Harten TW, Koemans EA, Voigt S, Rasing I, van Osch MJP, van Walderveen MAA, and Wermer MJH
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- Humans, Reproducibility of Results, Brain, Cerebral Hemorrhage diagnostic imaging, Cerebral Hemorrhage etiology, Magnetic Resonance Imaging, Siderosis complications, Siderosis diagnostic imaging, Cerebral Amyloid Angiopathy complications, Cerebral Amyloid Angiopathy diagnostic imaging
- Abstract
Cerebral amyloid angiopathy (CAA) is a cerebrovascular disease affecting the small arteries in the brain with hallmark depositions of amyloid-β in the vessel wall, leading to cognitive decline and intracerebral hemorrhage (ICH). An emerging MRI marker for CAA is cortical superficial siderosis (cSS) as it is strongly related to the risk of (recurrent) ICH. Current assessment of cSS is mainly done on T2*- weighted MRI using a qualitative score consisting of 5 categories of severity which is hampered by ceiling effects. Therefore, the need for a more quantitative measurement is warranted to better map disease progression for prognosis and future therapeutic trials. We propose a semi-automated method to quantify cSS burden on MRI and investigated it in 20 patients with CAA and cSS. The method showed excellent inter-observer (Pearson's 0.991, P < 0.001) and intra-observer reproducibility (ICC 0.995, P < 0.001). Furthermore, in the highest category of the multifocality scale a large spread in the quantitative score is observed, demonstrating the ceiling effect in the traditional score. We observed a quantitative increase in cSS volume in two of the 5 patients who had a 1 year follow up, while the traditional qualitative method failed to identify an increase because these patients were already in the highest category. The proposed method could therefore potentially be a better way of tracking progression. In conclusion, semi-automated segmenting and quantifying cSS is feasible and repeatable and may be used for further studies in CAA cohorts., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)
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- 2023
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32. Evolutionary algorithms and decision trees for predicting poor outcome after endovascular treatment for acute ischemic stroke.
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Kappelhof N, Ramos LA, Kappelhof M, van Os HJA, Chalos V, van Kranendonk KR, Kruyt ND, Roos YBWEM, van Zwam WH, van der Schaaf IC, van Walderveen MAA, Wermer MJH, van Oostenbrugge RJ, Lingsma H, Dippel D, Majoie CBLM, and Marquering HA
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- Algorithms, Decision Trees, Humans, Brain Ischemia therapy, Ischemic Stroke, Stroke therapy
- Abstract
Despite the large overall beneficial effects of endovascular treatment in patients with acute ischemic stroke, severe disability or death still occurs in almost one-third of patients. These patients, who might not benefit from treatment, have been previously identified with traditional logistic regression models, which may oversimplify relations between characteristics and outcome, or machine learning techniques, which may be difficult to interpret. We developed and evaluated a novel evolutionary algorithm for fuzzy decision trees to accurately identify patients with poor outcome after endovascular treatment, which was defined as having a modified Rankin Scale score (mRS) higher or equal to 5. The created decision trees have the benefit of being comprehensible, easily interpretable models, making its predictions easy to explain to patients and practitioners. Insights in the reason for the predicted outcome can encourage acceptance and adaptation in practice and help manage expectations after treatment. We compared our proposed method to CART, the benchmark decision tree algorithm, on classification accuracy and interpretability. The fuzzy decision tree significantly outperformed CART: using 5-fold cross-validation with on average 1090 patients in the training set and 273 patients in the test set, the fuzzy decision tree misclassified on average 77 (standard deviation of 7) patients compared to 83 (±7) using CART. The mean number of nodes (decision and leaf nodes) in the fuzzy decision tree was 11 (±2) compared to 26 (±1) for CART decision trees. With an average accuracy of 72% and much fewer nodes than CART, the developed evolutionary algorithm for fuzzy decision trees might be used to gain insights into the predictive value of patient characteristics and can contribute to the development of more accurate medical outcome prediction methods with improved clarity for practitioners and patients., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)
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- 2021
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33. Comparison of CTA- and DSA-Based Collateral Flow Assessment in Patients with Anterior Circulation Stroke.
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Jansen IGH, Berkhemer OA, Yoo AJ, Vos JA, Lycklama À Nijeholt GJ, Sprengers MES, van Zwam WH, Schonewille WJ, Boiten J, van Walderveen MAA, van Oostenbrugge RJ, van der Lugt A, Marquering HA, and Majoie CBLM
- Abstract
Background and Purpose: Collateral flow is associated with clinical outcome after acute ischemic stroke and may serve as a parameter for patient selection for intra-arterial therapy. In clinical trials, DSA and CTA are 2 imaging modalities commonly used to assess collateral flow. We aimed to determine the agreement between collateral flow assessment on CTA and DSA and their respective associations with clinical outcome., Materials and Methods: Patients randomized in MR CLEAN with middle cerebral artery occlusion and both baseline CTA images and complete DSA runs were included. Collateral flow on CTA and DSA was graded 0 (absent) to 3 (good). Quadratic weighted κ statistics determined agreement between both methods. The association of both modalities with mRS at 90 days was assessed. Also, association between the dichotomized collateral score and mRS 0-2 (functional independence) was ascertained., Results: Of 45 patients with evaluable imaging data, collateral flow was graded on CTA as 0, 1, 2, 3 for 3, 10, 20, and 12 patients, respectively, and on DSA for 12, 17, 10, and 6 patients, respectively. The κ-value was 0.24 (95% CI, 0.16-0.32). The overall proportion of agreement was 24% (95% CI, 0.12-0.38). The adjusted odds ratio for favorable outcome on mRS was 2.27 and 1.29 for CTA and DSA, respectively. The relationship between the dichotomized collateral score and mRS 0-2 was significant for CTA ( P = .01), but not for DSA ( P = .77)., Conclusions: Commonly applied collateral flow assessment on CTA and DSA showed large differences, indicating that these techniques are not interchangeable. CTA was significantly associated with mRS at 90 days, whereas DSA was not., (© 2016 by American Journal of Neuroradiology.)
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- 2016
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34. Assessment of Collateral Status by Dynamic CT Angiography in Acute MCA Stroke: Timing of Acquisition and Relationship with Final Infarct Volume.
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van den Wijngaard IR, Holswilder G, Wermer MJ, Boiten J, Algra A, Dippel DW, Dankbaar JW, Velthuis BK, Boers AM, Majoie CB, and van Walderveen MA
- Subjects
- Aged, Cerebral Angiography, Computed Tomography Angiography, Female, Follow-Up Studies, Humans, Image Processing, Computer-Assisted, Male, Middle Aged, Treatment Outcome, Collateral Circulation, Infarction, Middle Cerebral Artery diagnostic imaging, Infarction, Middle Cerebral Artery physiopathology, Stroke diagnostic imaging, Stroke physiopathology
- Abstract
Background and Purpose: Dynamic CTA is a promising technique for visualization of collateral filling in patients with acute ischemic stroke. Our aim was to describe collateral filling with dynamic CTA and assess the relationship with infarct volume at follow-up., Materials and Methods: We selected patients with acute ischemic stroke due to proximal MCA occlusion. Patients underwent NCCT, single-phase CTA, and whole-brain CT perfusion/dynamic CTA within 9 hours after stroke onset. For each patient, a detailed assessment of the extent and velocity of arterial filling was obtained. Poor radiologic outcome was defined as an infarct volume of ≥70 mL. The association between collateral score and follow-up infarct volume was analyzed with Poisson regression., Results: Sixty-one patients with a mean age of 67 years were included. For all patients combined, the interval that contained the peak of arterial filling in both hemispheres was between 11 and 21 seconds after ICA contrast entry. Poor collateral status as assessed with dynamic CTA was more strongly associated with infarct volume of ≥70 mL (risk ratio, 1.9; 95% CI, 1.3-2.9) than with single-phase CTA (risk ratio, 1.4; 95% CI, 0.8-2.5). Four subgroups (good-versus-poor and fast-versus-slow collaterals) were analyzed separately; the results showed that compared with good and fast collaterals, a similar risk ratio was found for patients with good-but-slow collaterals (risk ratio, 1.3; 95% CI, 0.7-2.4)., Conclusions: Dynamic CTA provides a more detailed assessment of collaterals than single-phase CTA and has a stronger relationship with infarct volume at follow-up. The extent of collateral flow is more important in determining tissue fate than the velocity of collateral filling. The timing of dynamic CTA acquisition in relation to intravenous contrast administration is critical for the optimal assessment of the extent of collaterals., (© 2016 by American Journal of Neuroradiology.)
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- 2016
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35. Dynamic 320-section CT angiography in cranial arteriovenous shunting lesions.
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Brouwer PA, Bosman T, van Walderveen MA, Krings T, Leroux AA, and Willems PW
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- Adult, Contrast Media administration & dosage, Equipment Design, Female, Humans, Male, Middle Aged, Radiation Dosage, Angiography, Digital Subtraction instrumentation, Cerebral Angiography instrumentation, Image Enhancement instrumentation, Image Processing, Computer-Assisted instrumentation, Intracranial Arteriovenous Malformations diagnostic imaging, Tomography, X-Ray Computed instrumentation
- Abstract
Novel 320-section CT scanning equipment enables dynamic noninvasive angiographic imaging of the entire cranial vasculature (4D-CTA). We describe this technique and demonstrate its potential in arteriovenous shunting lesions. 4D-CTA imaging resulted in a correct diagnosis, lesion classification, and treatment-strategy selection in 3 patients, compared with CA. We think that 4D-CTA can further reduce the need for CA, sparing the patient the discomfort and risk associated with an invasive procedure.
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- 2010
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36. Diagnostic accuracy of CT angiography with matched mask bone elimination for detection of intracranial aneurysms: comparison with digital subtraction angiography and 3D rotational angiography.
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Romijn M, Gratama van Andel HA, van Walderveen MA, Sprengers ME, van Rijn JC, van Rooij WJ, Venema HW, Grimbergen CA, den Heeten GJ, and Majoie CB
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- Adult, Aged, Aged, 80 and over, Algorithms, Female, Humans, Male, Middle Aged, Radiographic Image Enhancement methods, Reproducibility of Results, Rotation, Sensitivity and Specificity, Subtraction Technique, Angiography, Digital Subtraction methods, Cerebral Angiography methods, Imaging, Three-Dimensional methods, Intracranial Aneurysm diagnostic imaging, Radiographic Image Interpretation, Computer-Assisted methods, Skull diagnostic imaging, Tomography, X-Ray Computed methods
- Abstract
Background and Purpose: Our aim was to determine the diagnostic accuracy of multisection CT angiography combined with matched mask bone elimination (CTA-MMBE) for detection of intracranial aneurysms compared with digital subtraction angiography (DSA) and 3D rotational angiography (3DRA)., Materials and Methods: Between January 2004 and February 2006, 108 patients who presented with clinically suspected subarachnoid hemorrhage underwent both CTA-MMBE and DSA for diagnosis of an intracranial aneurysm. Two neuroradiologists, independently, evaluated 27 predefined vessel locations in the CTA-MMBE images for the presence of an aneurysm. After consensus, diagnostic accuracy of CTA was calculated per predefined location and per patient. Interobserver agreement was calculated with kappa statistics., Results: In 88 patients (81%), 117 aneurysms (82 ruptured, 35 unruptured) were present on DSA. CTA-MMBE detected all ruptured aneurysms except 1. Overall specificity, sensitivity, positive predictive value, and negative predictive value of CTA-MMBE were 0.99, 0.90, 0.98, and 0.95 per patient and 0.91, 1.00, 0.97, and 0.99 per location, respectively. Sensitivity was 0.99 for aneurysms >/=3 mm and 0.38 for aneurysms <3 mm. Interobserver agreement for aneurysm detection was excellent (kappa value of 0.92 per location and 0.80 per patient)., Conclusion: CTA-MMBE is accurate in detecting intracranial aneurysms in any projection without overprojecting bone. CTA-MMBE has limited sensitivity in detecting very small aneurysms. Our data suggest that DSA and 3DRA can be limited to the vessel harboring the ruptured aneurysm before endovascular treatment, after detection of a ruptured aneurysm with CTA.
- Published
- 2008
- Full Text
- View/download PDF
37. Hypointense lesions on T1-weighted spin-echo magnetic resonance imaging: relation to clinical characteristics in subgroups of patients with multiple sclerosis.
- Author
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van Walderveen MA, Lycklama A Nijeholt GJ, Adèr HJ, Jongen PJ, Polman CH, Castelijns JA, and Barkhof F
- Subjects
- Adult, Age Factors, Axons pathology, Contrast Media, Cross-Sectional Studies, Disability Evaluation, Disease Progression, Female, Gadolinium DTPA, Humans, Linear Models, Male, Middle Aged, Severity of Illness Index, Sex Factors, Surveys and Questionnaires, Brain pathology, Echo-Planar Imaging methods, Multiple Sclerosis, Chronic Progressive diagnosis, Multiple Sclerosis, Relapsing-Remitting diagnosis
- Abstract
Context: Hypointense lesions on T1-weighted spin-echo magnetic resonance images (T1 lesions) represent destructive multiple sclerosis (MS) lesions, consisting of axonal loss and matrix destruction. These lesions are being used as a secondary outcome measure in phase III clinical trials. Clinical determinants of T1 lesions may differ between subgroups of patients with MS and subsequently may have implications for the selection of patients for clinical trials., Objective: To determine if clinical characteristics of patients with MS are related to T1 lesion volume., Design: A survey of 138 patients with MS (52 with relapsing-remitting MS, 44 with secondary progressive MS, and 42 with primary progressive MS)., Setting: The Magnetic Resonance Center for Multiple Sclerosis Research, University Hospital "Vrije Universiteit," Amsterdam, the Netherlands., Main Outcome Measures: Type of MS, Expanded Disability Status Scale (EDSS) score, sex, age at first symptoms, and T1 lesion volume., Results: Patients with secondary progressive MS have the highest T1 lesion volume. Patients with relapsing-remitting MS have a lower T1/T2 ratio than patients with secondary progressive MS and patients with primary progressive MS. In patients with relapsing-remitting MS and secondary progressive MS, T1 lesion volume relates to disease duration and EDSS score, while in patients with primary progressive MS sex is important. A trend toward higher T1 lesion volume was shown for male patients with primary progressive MS when compared with female patients with primary progressive MS (1.0 cm(3) vs 0.3 cm(3), P=.03); a trend toward higher T1 lesion volume was found with age at onset in patients with relapsing-remitting MS and in patients with primary progressive MS., Conclusions: In patients with MS different clinical characteristics associate with T1 lesion volume, suggesting a more destructive type of lesions in certain subgroups. A possible sex difference in (destructive) lesion development on magnetic resonance imaging should be evaluated in more detail, preferably in a cohort.
- Published
- 2001
- Full Text
- View/download PDF
38. T1 hypointensities and axonal loss.
- Author
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Barkhof F, Karas GB, and van Walderveen MA
- Subjects
- Axons pathology, Brain pathology, Diagnosis, Differential, Disability Evaluation, Echo-Planar Imaging, Humans, Image Enhancement, Magnetic Resonance Spectroscopy, Multiple Sclerosis pathology, Multiple Sclerosis, Chronic Progressive diagnosis, Multiple Sclerosis, Chronic Progressive pathology, Retrograde Degeneration pathology, Magnetic Resonance Imaging, Multiple Sclerosis diagnosis, Retrograde Degeneration diagnosis
- Abstract
T1 hypointensities are lesions that are hypointense on moderately T1-weighted conventional spin-echo sequences and serve as markers of matrix destruction and axonal loss. They correlate better with clinical disability than T2-weighted images, are found in patients with progressive multiple sclerosis, and can be used as surrogate outcome measures in treatment trials.
- Published
- 2000
39. MR venography of multiple sclerosis.
- Author
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Tan IL, van Schijndel RA, Pouwels PJ, van Walderveen MA, Reichenbach JR, Manoliu RA, and Barkhof F
- Subjects
- Adult, Brain pathology, Contrast Media, Humans, Magnetic Resonance Imaging, Middle Aged, Cerebral Veins pathology, Magnetic Resonance Angiography, Multiple Sclerosis diagnosis
- Abstract
Background and Purpose: The distribution of multiple sclerosis (MS) lesions in the brain follows a specific pattern, with most lesions in the periventricular regions and in the deep white matter; histopathologic studies have shown a perivenous distribution. The aim of this study was to illustrate these distribution patterns in vivo using high-resolution MR venography., Methods: Seventeen MS patients underwent MR imaging at 1.5 T. Venographic studies were obtained with a 3D gradient-echo technique. MS lesions were identified on T2-weighted images, and their shape, orientation, and location were compared with the venous anatomy on the venograms., Results: The use of contrast material facilitated the visualization of small veins and increased the number of veins seen. A total of 95 MS lesions could be identified on both the T2-weighted series and the venograms; a central vein was visible in all 43 periventricular lesions and in all but one of the 52 focal deep white matter lesions. The typical ovoid shape and orientation of the long axis of the MS lesions correlated well with the course of these veins., Conclusion: With MR venography, the perivenous distribution of MS lesions in the brain can be visualized in vivo. The venous anatomy defines the typical form and orientation of these lesions.
- Published
- 2000
40. Development of hypointense lesions on T1-weighted spin-echo magnetic resonance images in multiple sclerosis: relation to inflammatory activity.
- Author
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van Walderveen MA, Truyen L, van Oosten BW, Castelijns JA, Lycklama à Nijeholt GJ, van Waesberghe JH, Polman C, and Barkhof F
- Subjects
- Adult, Female, Follow-Up Studies, Gadolinium, Humans, Inflammation, Magnetic Resonance Imaging, Male, Middle Aged, Prognosis, Brain pathology, Multiple Sclerosis pathology
- Abstract
Objective: To evaluate whether degree of inflammatory activity in multiple sclerosis, expressed by frequency of gadolinium enhancement, has prognostic value for development of hypointense lesions on T1-weighted spin-echo magnetic resonance images, a putative marker of tissue destruction., Design: Cohort design with long-term follow-up. Thirty-eight patients with multiple sclerosis who in the past had been monitored with monthly gadolinium-enhanced magnetic resonance imaging for a median period of 10 months (range, 6-12 months) were reexamined after a median period of 40.5 months (range, 33-80 months)., Setting: Magnetic Resonance Center for Multiple Sclerosis Research, Amsterdam, the Netherlands, referral center., Main Outcome Measures: The new enhancing lesion rate (median number of gadolinium-enhancing lesions per monthly scan) during initial monthly follow-up; hypointense T1 and hyperintense T2 lesion load at first and last visit., Results: The number of enhancing lesions on entry scan correlated with the new enhancing lesions rate (r = 0.64; P<.001, Spearman rank correlation coefficient). The new enhancing lesion rate correlated with yearly increase in T1 (r = 0.42; P<.01, Spearman rank correlation coefficient) and T2 (r = 0.47; P<.01, Spearman rank correlation coefficient) lesion load. Initial T1 lesion load correlated more strongly with yearly increase in T1 lesion load (r = 0.68; P<.01, Spearman rank correlation coefficient)., Conclusions: Degree of inflammatory activity only partially predicted increase in T1 (and T2) lesion load at long-term follow-up. Initial T1 lesion load strongly contributed to subsequent increase in hypointense T1 lesion load, suggesting that there is a subpopulation of patients with multiple sclerosis who are prone to develop destructive lesions.
- Published
- 1999
- Full Text
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41. Cardiovascular autonomic function in patients with relapsing remitting multiple sclerosis: a new surrogate marker of disease evolution?
- Author
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Nasseri K, Uitdehaag BM, van Walderveen MA, Ader HJ, and Polman CH
- Subjects
- Adult, Biomarkers, Brain pathology, Disease Progression, Female, Heart Rate, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Multiple Sclerosis, Relapsing-Remitting diagnosis, Posture, Respiration, Time Factors, Autonomic Nervous System physiopathology, Cardiovascular System innervation, Multiple Sclerosis, Relapsing-Remitting physiopathology
- Abstract
Twenty patients with active relapsing remitting multiple sclerosis (MS) were examined annually for 2 years with a set of autonomic function tests (AFT) consisting of heart rate variability during deep breathing (IE), standing-up, and ratios of Valsalva manoeuvre (VR). Disease characteristics, including T2-weighted magnetic resonance imaging (MRI) of the brain and the expanded disability status scale (EDSS) score were documented each year within 1 week of the AFT. The EDSS score, MRI load lesion and VR did not change significantly over the follow-up period. The IE and initial heart-rate on standing during the first 30 s (DeltaHRMAX) showed significant worsening during follow-up. No relationship was found between deterioration of AFT and EDSS score, number of exacerbations, duration of disease, gender, age, size and number of lesions on MRI. We conclude that patients with active relapsing remitting MS show progression of autonomic dysfunction over a relatively short time. Therefore, in the absence of changes in clinical disability or brain MRI lesion load, AFT might be useful as a sensitive surrogate outcome measure for demonstrating subclinical change in MS., (Copyright 1999 Lippincott Williams & Wilkins)
- Published
- 1999
- Full Text
- View/download PDF
42. Patterns of brain magnetic resonance abnormalities on T2-weighted spin echo images in clinical subgroups of multiple sclerosis: a large cross-sectional study.
- Author
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van Walderveen MA, Barkhof F, Tas MW, Polman C, Frequin ST, Hommes OR, Thompson AJ, and Valk J
- Subjects
- Adult, Atrophy pathology, Cross-Sectional Studies, Disease Progression, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Radiopharmaceuticals, Retrospective Studies, Severity of Illness Index, Technetium, Multiple Sclerosis pathology
- Abstract
To substantiate differences in magnetic resonance (MR) patterns in clinical subgroups of multiple sclerosis (MS), we analyzed T2-weighted MR images of a large regional population of MS patients (n = 188). The patients had already been classified according to recent consensus definitions regarding the clinical course of MS into relapsing-remitting (RR), secondary progressive (SP) or primary progressive (PP). Significant (p < 0.01; Spearman test) differences were present between RR and SP patients regarding total lesion load, size and location of lesions. RR and PP patients showed similar MR patterns. PP and SP patients differed in total lesion load, small and medium-sized lesions. The degree of atrophy was highest for SP patients. The clinical progression rate [Expanded Disability Status Scale (EDSS)/disease duration] was similar for various subgroups; the MR progression rate (total lesion score/disease duration) was significantly larger for SP than for PP patients. The lesions load disability quotient (total lesion load/EDSS) differed between RR and PP patients and also between SP and PP patients. In SP patients, the total lesion load correlated significantly (Spearman rank correlation coefficient of 0.52) with EDSS. We conclude that PP patients differ in MR abnormalities from SP patients, that PP and RR patients have similar MR abnormalities and that RR and SP patients are at a different end of the same spectrum of the disease. As the dynamics and clinical impact of MS lesions are different in the various clinical subgroups, they should be considered separately in clinical trials.
- Published
- 1998
- Full Text
- View/download PDF
43. Brain and spinal cord abnormalities in multiple sclerosis. Correlation between MRI parameters, clinical subtypes and symptoms.
- Author
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Nijeholt GJ, van Walderveen MA, Castelijns JA, van Waesberghe JH, Polman C, Scheltens P, Rosier PF, Jongen PJ, and Barkhof F
- Subjects
- Adult, Aged, Disease Progression, Female, Humans, Magnetic Resonance Imaging methods, Male, Middle Aged, Multiple Sclerosis classification, Recurrence, Remission, Spontaneous, Brain pathology, Multiple Sclerosis pathology, Multiple Sclerosis physiopathology, Spinal Cord pathology
- Abstract
We investigated various magnetic resonance MRI parameters for both brain and spinal cord to see if any improved the clinicoradiological correlation in multiple sclerosis. Ninety-one multiple sclerosis patients (28 relapsing-remitting, 32 secondary progressive and 31 primary progressive) were imaged using conventional T1, proton density- and T2-weighted MRI of the brain and spinal cord. Focal brain and spinal cord lesion load was scored, as were diffuse signal abnormalities, brain ventricular volume and spinal cord cross-sectional area. Clinical measures included the expanded disability status scale (EDSS), the functional systems score and a dedicated urology complaint questionnaire. Secondary progressive patients differed from relapsing-remitting and primary progressive patients by a larger number of hypointense T1 lesions in the brain, ventricular enlargement and spinal cord atrophy. Primary progressive patients more often had diffuse abnormalities in the brain and/or spinal cord than did relapsing-remitting and secondary progressive patients. In the entire study population, EDSS correlated with both brain and spinal cord MRI parameters, which were independent. The urological complaint score correlated only with spinal cord MRI parameters. In relapsing-remitting and secondary progressive multiple sclerosis, the correlation between MRI and clinical parameters was better than in the entire population. In this subgroup EDSS variance could be explained best by T1 brain lesion load, ventricle volume and spinal cord cross-sectional area. In the primary progressive subgroup the clinicoradiological correlation was weak for brain parameters but was present between spinal cord symptoms and spinal cord MRI parameters. In conclusion, the different brain and spinal cord MRI parameters currently available revealed considerable heterogeneity between clinical subtypes of multiple sclerosis. In relapsing-remitting and secondary progressive multiple sclerosis both brain and spinal cord MRI may provide a tool for monitoring patients, while in primary progressive multiple sclerosis the clinicoradiological correlation is weak for brain imaging.
- Published
- 1998
- Full Text
- View/download PDF
44. Patterns of lesion development in multiple sclerosis: longitudinal observations with T1-weighted spin-echo and magnetization transfer MR.
- Author
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van Waesberghe JH, van Walderveen MA, Castelijns JA, Scheltens P, Lycklama à Nijeholt GJ, Polman CH, and Barkhof F
- Subjects
- Adolescent, Adult, Disease Progression, Female, Follow-Up Studies, Humans, Longitudinal Studies, Male, Multiple Sclerosis classification, Multiple Sclerosis physiopathology, Recurrence, Time Factors, Brain pathology, Magnetic Resonance Imaging methods, Multiple Sclerosis pathology
- Abstract
Purpose: We evaluated the appearance of enhancing multiple sclerosis (MS) lesions on unenhanced T1-weighted MR images and the natural course of enhancing MS lesions on serial unenhanced T1-weighted and magnetization transfer (MT) MR images., Methods: One hundred twenty-six enhancing lesions were followed up monthly for 6 to 12 months to determine their signal intensity on unenhanced T1-weighted and MT MR images. At the time of initial enhancement, the size of the lesion and the contrast ratio of enhancement were calculated for each enhancing lesion. During follow-up, the contrast ratio on the corresponding unenhanced T1-weighted image was measured, and an MT ratio (MTR) was calculated., Results: Twenty-five enhancing lesions (20%) appeared isointense and 101 lesions (80%) appeared hypointense relative to normal-appearing white matter on unenhanced T1-weighted images. During 6 months of follow-up, four MR patterns of active lesions were detected: initially isointense lesions remained isointense (15%); initially isointense lesions became hypointense (5%, most of which reenhanced); initially hypointense lesions became isointense (44%); and initially hypointense lesions remained hypointense (36%). MTR was significantly lower for hypointense lesions as compared with isointense lesions at the time of initial enhancement. For lesions that changed from hypointense to isointense, MTR increased significantly during 6 months of follow-up. Multiple regression analysis showed that strongly decreased MTR at the time of initial enhancement and enhancement duration of more than one scan were predictive of a hypointense appearance on unenhanced T1-weighted images at 6 months' follow-up. Ring enhancement was found to be the only (weak) predictor of persistently hypointense signal intensity., Conclusion: Most enhancing lesions appear slightly to significantly hypointense on unenhanced T1-weighted images. Although most hypointensities are reversible, only those lesions that fail to recover on unenhanced T1-weighted and MT images may have considerable irreversible structural changes.
- Published
- 1998
45. Specific power calculations for magnetic resonance imaging (MRI) in monitoring active relapsing-remitting multiple sclerosis (MS): implications for phase II therapeutic trials.
- Author
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Truyen L, Barkhof F, Tas M, Van Walderveen MA, Frequin ST, Hommes OR, Nauta JJ, Polman CH, and Valk J
- Subjects
- Adult, Clinical Trials, Phase II as Topic, Female, Humans, Male, Middle Aged, Recurrence, Research Design, Magnetic Resonance Imaging, Multiple Sclerosis diagnosis, Multiple Sclerosis physiopathology
- Abstract
Inhomogeneous patient samples have been used in previous studies to determine the power of magnetic resonance imaging (MRI) for trial monitoring in multiple sclerosis (MS). These power-calculations might not be applicable to the active relapsing-remitting patient who is preferably included in trials. In order to reevaluate the power-calculations for MRI in the monitoring of treatment in strictly relapsing-remitting MS and to compare the power of different trial designs we studied 12 relapsing-remitting MS patients prospectively for a median period of 12 months using monthly clinical assessments and gadolinium-enhanced MRI. A median number of two clinical relapses/patient occurred of which a median of one was treated with steroids. A median of 1.59 new lesions/scan/patient was detected (range 0-8). The total number of new active lesions correlated significantly with study period relapses (SRCC = 0.72, P = 0.023). Computer simulations using the bootstrap technique yielded mostly lower power values for a parallel groups design than in previous studies except for short follow-periods in larger samples. In this-sample the open cross-over design was found to be between 20 and 40% more powerful. Results of power-calculations are clearly sample dependent implying that for treatment trial monitoring using MRI in relapsing-remitting MS conservative sample size estimates are to be used. In an active patient group open cross-over trial designs could be a very powerful alternative to parallel groups design.
- Published
- 1997
- Full Text
- View/download PDF
46. Accumulation of hypointense lesions ("black holes") on T1 spin-echo MRI correlates with disease progression in multiple sclerosis.
- Author
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Truyen L, van Waesberghe JH, van Walderveen MA, van Oosten BW, Polman CH, Hommes OR, Adèr HJ, and Barkhof F
- Subjects
- Adult, Brain pathology, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Time Factors, Multiple Sclerosis pathology
- Abstract
MRI findings are increasingly used as outcome measures in therapeutic trials in MS. The discrepancy between the extent of the lesions on conventional T2 images and the clinical condition of the patient is one of the problems encountered in such studies. This clinical-radiological paradox prevents the use of MRI data as surrogate markers of disability in MS. A recent pilot study suggested a relationship between hypointense lesions on T1 MRI and disability. To assess in more detail the correlation of changes in hypointense lesion load on T1-weighted spin-echo MR images ("black holes") with changes in disability in MS, we studied 46 patients with clinically definite MS at baseline and after a median follow-up of 40 months. There was a significant correlation between baseline disability and hypointense lesion load (Spearman rank correlation coefficient [SRCC] = 0.46, p = 0.001). In secondary progressive patients, the rate of accumulation of these "black holes" was significantly related to progression rate (SRCC = 0.81, p < 0.0001). We speculate that the appearance of hypointense lesions is the MRI equivalent of a failure of remission. Overall, T1 lesion load measurements correlated better with clinical assessments than T2 lesion load measurements. Quantification of hypointense lesion load on T1-weighted spin-echo MRI helps to resolve the clinical-radiological paradox between disability and MRI and has the potential to be a surrogate marker of disability in MS.
- Published
- 1996
- Full Text
- View/download PDF
47. Correlating MRI and clinical disease activity in multiple sclerosis: relevance of hypointense lesions on short-TR/short-TE (T1-weighted) spin-echo images.
- Author
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van Walderveen MA, Barkhof F, Hommes OR, Polman CH, Tobi H, Frequin ST, and Valk J
- Subjects
- Adult, Disability Evaluation, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Brain pathology, Multiple Sclerosis pathology
- Abstract
Magnetic resonance imaging (MRI) is being used as an outcome criterion in therapeutic trials in multiple sclerosis (MS) on the assumption that it, as a sensitive marker of biologic disease activity, could serve as a surrogate marker of disability. We evaluated the relation between MRI findings and disability in a quantitative follow-up study of 48 MS patients. Median duration of follow-up was 24 months (range, 10 to 42 months). Computer-assisted volume measurements employing a seed-growing technique yielded a standard error of measurement of 0.275 cm2. The median total area of the hyperintense lesions on the initial T2-weighted images was 8.4 cm2. The median increase was 0.76 cm2/yr (9%). In a subgroup (n = 19) with short-TR/short-TE spin-echo (SE) images, we measured the hypointense lesion load. The median total area of the lesions at entry was 0.70 cm2, with a median increase of 0.28 cm2/yr (40%). The total area of the hyperintense lesions on the initial T2-weighted images showed a weak correlation with the Expanded Disability Status Scale score at entry (Spearman rank correlation coefficient [SRCC] = 0.30; 0.02 < p < 0.05). The increase in disability showed a positive correlation (SRCC = 0.19) with the increase in hyperintense lesion load on the T2-weighted SE images, but this correlation did not reach statistical significance (p = 0.09), probably because of lack of clinical progression.(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1995
- Full Text
- View/download PDF
48. The effect of gadolinium on the sensitivity and specificity of MR in the initial diagnosis of multiple sclerosis.
- Author
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Tas MW, Barkhol F, van Walderveen MA, Polman CH, Hommes OR, and Valk J
- Subjects
- Adult, Brain pathology, Drug Combinations, Female, Gadolinium DTPA, Humans, Male, Middle Aged, Prospective Studies, Sensitivity and Specificity, Contrast Media, Magnetic Resonance Imaging, Meglumine, Multiple Sclerosis diagnosis, Organometallic Compounds, Pentetic Acid analogs & derivatives
- Abstract
Purpose: To determine whether gadolinium can improve the sensitivity and specificity of MR imaging for the initial diagnosis of multiple sclerosis., Methods: Patients (n = 57) with neurologic symptoms suggesting multiple sclerosis were studied prospectively. MR imaging consisted of T2-weighted and gadolinium-enhanced T1-weighted spin-echo images. Lumbar puncture was performed for cerebrospinal fluid analysis in 34 patients., Results: After imaging, 17 patients (35%) had clinically definite multiple sclerosis. Cerebrospinal fluid examination had a sensitivity of 69% and specificity of 38%. Using liberal criteria, the sensitivity of T2-weighted MR imaging was 94% and the specificity 55%; using more strict criteria, the specificity increased to 65% with a sensitivity of 88%. Gadopentetate dimeglumine enhancement increased the specificity further to 80% with a loss of sensitivity (59%)., Conclusion: Gadolinium enhancement increases the specificity of MR imaging in the early diagnosis of multiple sclerosis.
- Published
- 1995
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