Donders Institute for Brain, Cognition and Behaviour
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Kevin van den Berg

Date of news: 1 November 2022

kevin-novWhat's your name, nationality, current function, and department?
Hi everyone! My name is Kevin van den Berg and I was born in Amersfoort, which is a city in the province of Utrecht here in the Netherlands. In February 2022, I obtained my medical degree and as of March 2022 I started working as a PhD-candidate.

I am affiliated with two centers within the Donders Institute, namely the Donders Centre for Cognitive Neuroimaging (DCCN) and the Donders Centre for Medical Neuroscience (DCMN). I do most of my work at the Systems Neurology group of dr. Rick Helmich at the DCCN. My promotion team consists of prof. dr. Bas Bloem, dr. Rick Helmich, and dr. Michiel Dirkx.

What is the topic of your PhD project and how does your work look like in practice?
My current focus is on the cerebral mechanisms underlying tremor in Parkinson’s disease. Parkinson’s disease is a neurological disorder, which is caused by loss of dopamine-producing cells in the substantia nigra within the brainstem. The cardinal motor symptoms include bradykinesia (slowness of movement), rigidity (stiffness), postural imbalance, and tremor (trembling).

First, we are investigating how tremor progresses in a Parkinson’s disease patient cohort consisting of more than 500 subjects with a baseline, 1-year and 2-year follow-up visit. Data from these patients were all obtained as part of the Parkinson Op Maat study (English: Personalized Parkinson Project). At each annual visit, clinical scores were acquired. Moreover, both structural and functional MRI (fMRI) scans were acquired at baseline and 2-year follow-up visits. This allows us to look at tremor progression from both a clinical and neuroimaging standpoint. This first study involves the more known Parkinsonian resting tremor of the hands. However, most patients with resting tremor also have an action tremor, which occurs when the muscles are not at rest (e.g., holding a posture or during activities). This action tremor behaves quite differently from resting tremor and responds less well to dopaminergic medication. As action tremor interferes with daily activities, it can be quite burdensome for patients. Therefore, we will also investigate the cerebral mechanisms of action tremor (specifically re-emergent tremor) in Parkinson’s disease in two new upcoming studies, which will involve both fMRI and non-invasive brain stimulation. We expect the cerebellum to be particularly involved in re-emergent tremor in Parkinson’s disease. Utilizing both fMRI and brain stimulation techniques, we hope we will gain insights in what this exact role might be.

I am currently not involved in the data collection itself of the Parkinson Op Maat study. My work within this project is primarily related to data analysis. At this time, almost every participant within the Parkinson Op Maat study has completed the 2-year follow-up visit. Therefore, I have already started analyzing the currently available data. We are quite far with the clinical progression and have already started looking at the baseline fMRI data. So far, the preliminary results are very interesting. After rounding up the fMRI analysis, we will start with the structural MRI analysis. We hope to be able to explain why tremor progresses in some patients and why it regresses in others.

For the upcoming studies regarding re-emergent tremor, I will be involved in both data collection and analysis. In the first study we will use a task in the MRI scanner to evoke re-emergent tremor in order to find the underlying cerebral network. Then, after having identified this network, we will use non-invasive brain stimulation to perturb this network and (hopefully) diminish tremor. This could potentially lead to novel therapies for patients who do not benefit from currently available therapies, such as dopaminergic medication.

What has your career path been so far and how did you come to your current position?
In 2015, I started studying medicine at the Radboud university medical center (Radboudumc). During the first year of my Bachelor’s, I realized that I wanted to delve deeper into neuroscience. Therefore, for my second and third year I applied for the Medical Sciences Program of the Radboud Honours Academy. It was during this program where I met Rick Helmich, who is both a neurologist at the Radboudumc and principal investigator of the Systems Neurology group at the DCCN. As part of this Honours Program, you got the opportunity to do a research internship abroad. Rick had connections with the Human Motor Control lab at the National Institutes of Health (NIH) in Bethesda, Maryland, USA. He helped me setup an internship at the NIH from April until August 2018. At the NIH, I applied transcranial magnetic stimulation (TMS) over the motor cortex and cerebellum to investigate their individual roles in rest and re-emergent tremor in Parkinson’s disease. This amazing experience made me realize that I not only wanted to become a physician, but also a neuroscientist. After finishing this internship, I returned to Rick’s lab for my Master’s internship to learn about using fMRI in tremor-research. Somewhere around summer or autumn of 2020, Rick and I applied for a MSc-PhD grant at the Radboudumc. We successfully made it through each round and eventually obtained this grant, which enabled me to follow a PhD-trajectory for 4 years after finishing my MSc. In February 2022, I obtained my medical degree and as of March 2022 I started working as a PhD-candidate at the DCCN and DCMN.

What did you want to be when you were younger?
When I was younger I wanted to either be a musician (guitarist), physicist or physician. When I was 16 or 17 years old, I realized that making a living in music would be very difficult. I always looked up to my great-uncles, who were accomplished musicians. At some point, I learned that most of them had an academic degree and did music as a hobby. I wanted to do the same thing. I wasn’t exactly sure what I wanted to do as a job, but I did know that I was interested in natural science (physics in particular) and medicine (neurology in particular). For me, the perfect combination would entail something where I could combine the two. At this moment, I can happily say that I was somewhat able to make this happen. Moreover, I still make music to this day and perform in a pop/rock cover band called Dwayne & The Johnsons.

Who are you working with and what do these collaborations look like?
Even though I only started working as of March 2022, I have already collaborated with the ENIGMA Consortium. This consortium brings together researchers from all over the world to participate in meta-analysis of neuroimaging. With a small group within our lab, we have participated in a Parkinson’s disease sub-study. The way it works is that we receive an analysis pipeline with a manual and we provide our outputs to the leading researcher of that specific study within the ENIGMA Consortium. As this is done on a global scale with numerous research groups, the leading researcher ends up with thousands of participants from all over the world on which they then perform their meta-analysis. The preliminary results of the Parkinson’s disease sub-study are already very interesting and it is scheduled to be published very soon (perhaps already published when you read this). I hope that we can continue working in such international collaborations. Our lab also receives researchers from abroad, such as Israel and Germany. Such collaborations are very exciting, as we get to learn from and help with a variety of different studies.

What is the most important piece of advice you want to share with Donders PhD candidates?
Don’t be too hard on yourself. Doing the things you love does not mean that it will always be a lot of fun. There are good and bad days. When you feel that you’re not in a good place mentally, be open about it with your friends, parents, colleagues, and/or supervisor. Learning and understanding how the world influences you is part of growing as a person and researcher, which will most likely result in you becoming more resilient!

What do you wish you would have known when you started your PhD project?
Doing research involves a lot of coding! From my previous internships, I only had experience with MATLAB. Some statistical packages and simulation software require R and Python. Therefore, I wish I also invested some time in learning how to code in R and Python.

What are you looking forward to in life?
After finishing my PhD, I would like to become a neurologist specialized in movement disorders. My wish is to be able to pursue this career path and still have time to make music as well as perform live on a regular basis!