PhD Defense: Cognitive impact of lesion location in cerebrovascular disease: Expanding the boundaries of lesion-symptom mapping

PhD Defense of Nicholas Alexander Weaver

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Cerebrovascular disease is a major cause of cognitive impairment and dementia. Brain lesion location is considered a key determinant of cognitive impairment. Lesion-symptom mapping (LSM) is a powerful approach to studying the relationship between clinical symptoms and lesion location.

The overarching aim of this thesis was to gain further insight into the cognitive impact of lesion location using LSM. We focused on vascular brain lesions, specifically infarcts resulting from acute ischemic stroke, and white matter hyperintensities in memory clinic patients. Prior to this thesis, a comprehensive map of locations that put patients at risk of developing cognitive problems after vascular brain injury was lacking. An important limiting factor in previous studies was that only a small part of the brain could be analyzed (approximately 20%), even with data from several hundred patients. We proposed that large-scale multicenter studies might overcome this challenge. In this thesis we established an international collaborative research network: the Meta-VCI-Map consortium. We successfully implemented multicenter data processing, harmonization and analysis procedures to enable large-scale studies. Upscaling of sample sizes resulted in clear improvement of brain lesion coverage, allowing us to include up to 87% of the brain. Furthermore, we identified which infarct locations put a patient at risk of developing cognitive problems, and developed a risk score for clinical use. Finally, we found that white matter hyperintensity location was linked to cognitive impairment in memory clinic patients. In conclusion, this thesis put brain lesion location better on the map as key determinant of cognitive impairment.

Start date and time
End date and time
Location
Academiegebouw, Domplein 29 & online (livestream link)
PhD candidate
N.A. Weaver
Dissertation
Cognitive impact of lesion location in cerebrovascular disease: Expanding the boundaries of lesion-symptom mapping
PhD supervisor(s)
prof. dr. G.J. Biessels
Co-supervisor(s)
dr. J.M. Biesbroek
dr. H.J. Kuijf