Cerebrovascular Disease

Cerebrovascular disease (stroke) is among the leading causes of death and disability. The main interest of our research group is on causes and cognitive consequences of cerebrovascular disease in the young and elderly.

Typically, there is a broad spectrum of cerebrovascular disease ranging from acute symptomatic intracerebral hemorrhages and cerebral infarcts to the more chronic white matter lesions and microbleeds, the latter usually going clinically unnoticed. The occurrence of especially these white matter lesions and microbleeds seems inevitable during aging; virtually any person above the age of 60 years exhibits it to some extent. These vascular lesions are related to cognitive and motor decline and prospective studies have shown a relation with dementia, Parkinsonism and even depressive symptoms. However in some, seemingly comparable vascular lesions do not result in any clinical relevant deficit at all. Maybe, the typically chronic development of some of these vascular lesions allow some patients to develop compensatory mechanisms, others may have the right (genetic) make-up to overcome clinical symptoms as a consequence of the vascular lesions.

In contrast, a substantial proportion of cerebrovascular disease occurs in young people under age of 50 years. In this subpopulation of patients with cerebrovascular disease, even less is known with respect to causes and cognitive and motor consequences and recovery.

Most of our studies are embedded in large (n>500) well phenotyped participants with varying types of vascular lesions. There is a special interest in patients with small vessel disease (lacunar infarcts, white matter lesions and microbleeds) that are being investigated in the RUNDMC study, a prospective study with baseline data-collection in 2006 and a follow up in 2012. Young stroke patients are being assessed within the framework of the FUTURE study, the worlds' largest study on young stroke (n>1000) with the longest follow up ever. In addition, we recently established a cohort including patients with a transient neurological attack (CONNECT study) that aims at investigating the cognitive consequences of such attacks. The backbone of all of these cohorts include expert clinical phenotyping, neuropsychology and innovative MRI with DNA and biomaterials available.