University Medical Center Utrecht
Neurology and neurosurgery
Geert Jan Biessels obtained his PhD in 1997 at Utrecht University, registered as a neurologist in 2004, and was appointed Professor of Cerebrovascular Disease and Cognition in 2012. His area of expertise is vascular cognitive impairment (VCI) and small vessel disease (SVD), focusing on novel imaging markers to improve diagnosis and prognostication and to identify targets for personalized treatment and the role of diabetes. Professor Biessels is actively involved in several national and international VCI and SVD research networks, including STRIVE and HARNESS. He leads the Dutch Heart Brain Connection consortium and the international Meta VCI Map consortium (https://metavcimap.org/). He was Principal Investigator in two large randomized controlled trials in diabetes with cognitive outcomes. He participates in the H2020 programs SVDs@target and Recognised. Professor Biessels has mentored over 40 PhD students and has over 350 peer-reviewed publications. He is a Dutch Research Council Vidi and Vici laureate and received the senior investigator award of the European Stroke Organisation in 2015.

Presenter of 1 Presentation

Predicting Dementia after Stroke

Session Type
Main Theme Symposium
Date
29.10.2021, Friday
Session Time
15:15 - 16:45
Room
MAIN THEME B
Lecture Time
15:32 - 15:49

Abstract

Abstract Body

Approximately half of people with an ischemic stroke experience cognitive impairment. In my presentation I will provide an overview of known predictors of post-stroke cognitive impairment (PSCI) and I will summarize the results of a study1 in which we evaluated infarct location as a potential determinant of PSCI and used lesion location information to develop a prediction model.

For our study we pooled and harmonized individual patient data (n=2950) from 12 cohorts through the Meta-analyses on Strategic Lesion Locations for Vascular Cognitive Impairment using Lesion-Symptom Mapping consortium (https://metavcimap.org/ ). Voxel-based lesion-symptom mapping (VLSM) was used to calculate voxel-wise odds ratios for PSCI that were mapped onto a three-dimensional brain template. In the pooled sample of 2950 patients, 1286 (43.6%) had PSCI. Brain lesion coverage was 86.9%. Infarcts in the left frontotemporal lobes, left thalamus, and right parietal lobe were strongly associated with PSCI (voxel-wise ORs >20).

For prediction of PSCI risk, a location impact score on a 5-point scale was derived from the VLSM results. The location impact score showed good correspondence on cross-validation across cohorts and by itself proved to have similar performance to a combined model with other PSCI predictors, while allowing for easy visual assessment.

Next steps are to fully integrate lesion location information with other measures of brain injury and resilience and personal factors that relate to PSCI risk, to come to an optimal personalized prediction of PSCI.

1 published in The Lancet Neurology; https://doi.org/10.1016/S1474-4422(21)00060-0

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