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Mofrad RB, Schoonenboom NS, Tijms BM, Knol DL, Scheltens P, Flier WM, Visser PJ, Teunissen CE. [P1–250]: DECISION TREE ANALYSIS REVEALS TWO CUT‐OFF LEVELS FOR AMYLOID BETA IN EARLY AD DIAGNOSIS. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Rosha Babapour Mofrad
- Neurochemistry Laboratory and Biobank, Dept. of Clinical Chemistry, Neuroscience Campus AmsterdamVU University Medical CenterAmsterdamNetherlands
- Alzheimer Center and Department of Neurology, Amsterdam NeuroscienceVU University Medical CenterAmsterdamNetherlands
| | | | - Betty M. Tijms
- Alzheimer Center and Department of Neurology, Amsterdam NeuroscienceVU University Medical CenterAmsterdamNetherlands
| | - Dirk L. Knol
- Department of Epidemiology and BiostatisticsVU University Medical CenterAmsterdamNetherlands
| | - Philip Scheltens
- Alzheimer Center and Department of Neurology, Amsterdam NeuroscienceVU University Medical CenterAmsterdamNetherlands
| | - Wiesje M. Flier
- Department of Epidemiology and BiostatisticsVU University Medical CenterAmsterdamNetherlands
| | - Pieter Jelle Visser
- Alzheimer Center and Department of Neurology, Amsterdam Neuroscience CampusVU University Medical CenterAmsterdamNetherlands
- Maastricht UniversityMaastrichtNetherlands
| | - Charlotte E. Teunissen
- Neurochemistry Laboratory and Biobank, Dept. of Clinical Chemistry, Neuroscience Campus AmsterdamVU University Medical CenterAmsterdamNetherlands
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Apeldoorn AT, Kamper SJ, Kalter J, Knol DL, van Tulder MW, Ostelo RW. Rigid shoulder taping with physiotherapy in patients with subacromial pain syndrome: A randomized controlled trial. J Rehabil Med 2017; 49:347-353. [PMID: 28352939 DOI: 10.2340/16501977-2214] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To assess the effectiveness of individualized physiotherapy in combination with rigid taping compared with individualized physiotherapy alone in patients with subacromial pain syndrome. DESIGN A prospective randomized trial with concealed allocation. PATIENTS A total of 140 patients between 18 and 65 years of age from primary physiotherapy settings. METHODS The intervention group received individualized physiotherapy and shoulder taping. The control group received individualized physiotherapy only. Primary outcomes were: pain intensit (numerical rating scale) and functioning (Simple Shoulder Test). Secondary outcomes were: global perceived effect and patient-specific complaints. Data were collected at baseline, and at 4, 12 and 26 weeks' follow-up. RESULTS During the 6-month follow-up period multilevel analysis showed a significant difference between groups favouring the control group on pain intensity (p = 0.02), but not on functioning. Regarding secondary outcomes, a significant difference between groups was found favouring the intervention group for global perceived effect (p = 0.02), but not for patient-specific complaints. CONCLUSION Rigid shoulder taping, as used in this study, cannot be recommended for improving physiotherapy outcomes in people with subacromial pain syndrome.
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Affiliation(s)
- Adri T Apeldoorn
- Rehabilitation department, Noordwest Ziekenhuisgroep, NL-1815 JD Alkmaar, The Netherlands.
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Burggraaff J, Knol DL, Uitdehaag BMJ. Regression-Based Norms for the Symbol Digit Modalities Test in the Dutch Population: Improving Detection of Cognitive Impairment in Multiple Sclerosis? Eur Neurol 2017; 77:246-252. [PMID: 28319952 DOI: 10.1159/000464405] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 02/21/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND/AIMS Appropriate and timely screening instruments that sensitively capture the cognitive functioning of multiple sclerosis (MS) patients are the need of the hour. We evaluated newly derived regression-based norms for the Symbol Digit Modalities Test (SDMT) in a Dutch-speaking sample, as an indicator of the cognitive state of MS patients. METHODS Regression-based norms for the SDMT were created from a healthy control sample (n = 96) and used to convert MS patients' (n = 157) raw scores to demographically adjusted Z-scores, correcting for the effects of age, age2, gender, and education. Conventional and regression-based norms were compared on their impairment-classification rates and related to other neuropsychological measures. RESULTS The regression analyses revealed that age was the only significantly influencing demographic in our healthy sample. Regression-based norms for the SDMT more readily detected impairment in MS patients than conventional normalization methods (32 patients instead of 15). Patients changing from an SDMT-preserved to -impaired status (n = 17) were also impaired on other cognitive domains (p < 0.05), except for visuospatial memory (p = 0.34). CONCLUSIONS Regression-based norms for the SDMT more readily detect abnormal performance in MS patients than conventional norms, identifying those patients at highest risk for cognitive impairment, which was supported by a worse performance on other neuropsychological measures.
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Affiliation(s)
- Jessica Burggraaff
- Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands
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Voorman JM, Dallmeijer AJ, Schuengel C, Knol DL, Lankhorst GJ, Becher JG. Activities and participation of 9- to 13-year-old children with cerebral palsy. Clin Rehabil 2016; 20:937-48. [PMID: 17065537 DOI: 10.1177/0269215506069673] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To describe the activities and participation of children with cerebral palsy and to examine the relationship with personal factors and disease characteristics. Design: Cross-sectional study. Setting: Department of Rehabilitation Medicine of a University Medical Center in The Netherlands. Subjects: One hundred and ten children: 70 boys, 40 girls, mean (SD) age 11 years and 3 months (20 months). Outcome measures: Activities and participation, described in the domains of mobility, self-care, domestic life, social life and communication, measured with the Gross Motor Function Measure, the Pediatric Evaluation of Disability Inventory and the Vineland Adaptive Behavior Scales. Results: Multiple linear regression models showed that the Gross Motor Function Classification System (GMFCS) was strongly associated with mobility (explained variance 87-92%), self-care and domestic life. Apart from the GMFCS, cognitive impairment and limb distribution were less important but also significantly associated with self-care and domestic life (explained variance 65-81%). Cognitive impairment and epilepsy were the most important factors associated with social life and communication (explained variance 54-75%). Conclusion: Activities and participation can, to a large extent, be explained by only a few associated factors.
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Affiliation(s)
- Jeanine M Voorman
- Department of Rehabilitation Medicine and Institute for Research in Extramural Medicine (EMGO Institute), VU University Medical Center, Amsterdam, The Netherlands.
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Abstract
OBJECTIVE The aim was to evaluate the effect of the implementation of an information handover form regarding patients receiving palliative care. Outcome was the information available for the out-of-hours GP co-operative. DESIGN We conducted a controlled trial. SETTING All GPs in Amsterdam, The Netherlands. INTERVENTION The experimental group (N = 240) received an information handover form and an invitation for a one-hour training, the control group (N = 186) did not receive a handover form or training. We studied contacts with the GP co-operative concerning patients in palliative care for the presence and quality of information transferred by the patient's own GP. MAIN OUTCOME MEASURES Proportion of contacts in which information was available and proportion of adequate information transfer. RESULTS Overall information was transferred by the GPs in 179 of the 772 first palliative contacts (23.2%). The number of contacts in the experimental group in which information was available increased significantly after intervention from 21% to 30%, compared to a decrease from 23% to 19% in the control group. The training had no additional effect. The content of the transferred information was adequate in 61.5%. There was no significant difference in the quality of the content between the groups. CONCLUSION The introduction of a handover form resulted in a moderate increase of information transfers to the GP co-operative. However, the total percentage of contacts in which this information was present remained rather low. GP co-operatives should develop additional policies to improve information transfer. Key points The out-of-hours period is potentially problematic for the delivery of optimal palliative care, often due to inadequate information transfer. Introduction of a handover form resulted in a moderate increase of transferred information. The percentage of palliative contacts remained low in cases where information was available. Adequate information was transferred in more than half of the cases.
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Affiliation(s)
- Bart Schweitzer
- Department of General Practice and Elderly Care Medicine, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands;
- CONTACT Bart P. M. Schweitzer Department of General Practice, and EMGO + Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Nettie Blankenstein
- Department of General Practice and Elderly Care Medicine, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands;
| | - Willemjan Slort
- Department of General Practice and Elderly Care Medicine, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands;
| | - Dirk L. Knol
- Department of Epidemiology and Biostatistics, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands;
| | - Luc Deliens
- Department of Public and Occupational Health, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands;
- End-of-Life Care Research Group, Ghent University & Vrije Universiteit Brussel, Brussels, Belgium
| | - Henriette Van Der Horst
- Department of General Practice and Elderly Care Medicine, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands;
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van Helvoirt H, Apeldoorn AT, Knol DL, Arts MP, Kamper SJ, van Tulder MW, Ostelo RW. Transforaminal epidural steroid injections influence Mechanical Diagnosis and Therapy (MDT) pain response classification in candidates for lumbar herniated disc surgery. J Back Musculoskelet Rehabil 2016; 29:351-359. [PMID: 26837014 DOI: 10.3233/bmr-160662] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
STUDY DESIGN Prospective cohort study. BACKGROUND Although lumbar radiculopathy is regarded as a specific diagnosis, the most effective treatment strategy is unclear. Commonly used treatments include transforaminal epidural steroid injections (TESIs) and Mechanical Diagnosis & Therapy (MDT), but no studies have investigated the effectiveness of this combination. MDT differentiates pain centralization (C) from non-centralization (NC), which indicates good vs. poor prognostic validity respectively. OBJECTIVE The main aims were 1) to determine changes in Mechanical Diagnosis and Therapy (MDT) pain response classifications after transforaminal epidural steroid injections (TESIs) in candidates for lumbar herniated disc surgery and 2) to evaluate differences in short and long term outcomes for patients with different pain response classifications. METHODS Candidates for lumbar herniated disc surgery were assessed with a MDT protocol and their pain response classified as centralizing or peripheralizing. For this study,only patients were eligible who showed a peripheralizing pain response at intake. All patients then received TESIs and were reassessed and classified using the MDT protocol, into groups according to pain response (resolved, centralizing, peripheralizing with less pain and peripheralising with severe pain). After receiving targeted treatment based on pain response after TESIs, ranging from advice, MDT or surgery, follow-up assessments were completed at discharge and at 12 months. The primary outcomes were disability (Roland-Morris Disability Questionnaire [RMDQ] for Sciatica), pain severity in leg (visual analogue scale [VAS], 0-100) and global perceived effect (GPE). Linear mixed-models were used to determine between-groups differences in outcome. RESULTS A total of 77 patients with lumbar disc herniation and peripheralizing symptoms were included. Patients received an average of 2 (SD 0.7) TESIs. After TESIs, 17 patients (22%) were classified as peripheralizing with continuing severe pain.These patients underwent surgery and were not further evaluated. Eleven (14%) patients were classified as resolved, 37 (48%) as centralizing with significant less pain, and 12 (16%) as peripheralizing with significant less pain. None of these patients underwent surgery. Resolved and centralizer subgroups had better outcomes in terms of VAS and RMDQ than the non-operated peripheralizers at discharge and at 12 months. The succes rates (GPE) for the resolved, centralizing, and peripheralizing with less pain patients were 100%, 100% and 33% respectively at short term, and 100%, 92% and 50% respectively at long term. CONCLUSION After TESIs, a peripheralizing pain pattern changed to resolved or centralizing in 62% of the patients. For the non-operated patients, those with a centralising pattern after TESIs reported better pain and disability outcomes than those with peripheralizing pattern at short and long term.
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Affiliation(s)
- Hans van Helvoirt
- Medical Back Neck Centre, The Hague and Rugpoli Brabant Tilburg, the Netherlands
| | - Adri T Apeldoorn
- Department of Rehabilitation, Medical Centre Alkmaar, Alkmaar, the Netherlands
| | - Dirk L Knol
- Department of Epidemiology and Biostatistics and the EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands
| | - Mark P Arts
- Department of Neurosurgery, Medical Center Haaglanden, Gravenhage, the Netherlands
| | - Steven J Kamper
- Department of Epidemiology and Biostatistics and the EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands.,The George Institute for Global Health, University of Sydney, Australia
| | - Maurits W van Tulder
- Department of Epidemiology and Biostatistics and the EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands.,Department of Health Sciences and the EMGO+ Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University Amsterdam, the Netherlands
| | - Raymond W Ostelo
- Department of Epidemiology and Biostatistics and the EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands.,Department of Health Sciences and the EMGO+ Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University Amsterdam, the Netherlands
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Geytenbeek JJ, Oostrom KJ, Harlaar L, Becher JG, Knol DL, Barkhof F, Pinto PS, Vermeulen RJ. Language comprehension in nonspeaking children with severe cerebral palsy: Neuroanatomical substrate? Eur J Paediatr Neurol 2015; 19:510-20. [PMID: 26112263 DOI: 10.1016/j.ejpn.2015.06.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 05/19/2015] [Accepted: 06/07/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS To identify relations between brain abnormalities and spoken language comprehension, MRI characteristics of 80 nonspeaking children with severe CP were examined. METHODS MRI scans were analysed for patterns of brain abnormalities and scored for specific MRI measures: white matter (WM) areas; size of lateral ventricles, WM abnormality/reduction, cysts, subarachnoid space, corpus callosum thinning and grey matter (GM) areas; cortical GM abnormalities, thalamus, putamen, globus pallidus and nucleus caudatus and cerebellar abnormalities. Language comprehension was assessed with a new validated instrument (C-BiLLT). RESULTS MRI scans of 35 children were classified as a basal ganglia necrosis (BGN) pattern, with damage to central GM areas; in 60% of these children damage to WM areas was also found. MRI scans of 13 children were classified as periventricular leukomalacia (PVL) with little concomitant damage to central GM areas, 13 as malformations and 19 as miscellaneous. Language comprehension was best in children with BGN, followed by malformations and miscellaneous, and was poorest in PVL. Linear regression modelling per pattern group (malformations excluded), with MRI measures as independent variables, revealed that corpus callosum thinning in BGN and parieto-occipital WM reduction in PVL were the most important explanatory factors for poor language comprehension. No MRI measures explained outcomes in language comprehension in the miscellaneous group. CONCLUSIONS Comprehension of spoken language differs between MRI patterns of severe CP. In children with BGN and PVL differences in language comprehension performance is attributed to damage in the WM areas. Language comprehension was most affected in children with WM lesions in the subcortical and then periventricular areas, most characteristic for children with PVL.
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Affiliation(s)
- Joke J Geytenbeek
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands; The EMGO+ Institute for Health and Care Research, VU University, Amsterdam, The Netherlands; Neuroscience Campus Amsterdam, Amsterdam, The Netherlands.
| | - Kim J Oostrom
- Neuroscience Campus Amsterdam, Amsterdam, The Netherlands; Department of Pediatric Psychology, VU University Medical Center, Amsterdam, The Netherlands
| | - Laurike Harlaar
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Jules G Becher
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands; The EMGO+ Institute for Health and Care Research, VU University, Amsterdam, The Netherlands
| | - Dirk L Knol
- The EMGO+ Institute for Health and Care Research, VU University, Amsterdam, The Netherlands
| | - Frederik Barkhof
- Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands
| | - Pedro S Pinto
- Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands; Department of Neuroradiology, Centro Hospitalar do Porto, Portugal
| | - R Jeroen Vermeulen
- Department of Child Neurology, Maastricht University Medical Center, Maastricht, The Netherlands; Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
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Bui HN, Sluss PM, Hayes FJ, Blincko S, Knol DL, Blankenstein MA, Heijboer AC. Testosterone, free testosterone, and free androgen index in women: Reference intervals, biological variation, and diagnostic value in polycystic ovary syndrome. Clin Chim Acta 2015; 450:227-32. [PMID: 26327459 DOI: 10.1016/j.cca.2015.08.019] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 08/21/2015] [Accepted: 08/21/2015] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The objective of our study was to determine reference intervals and biologic variation for testosterone (T), free testosterone (fT), and free androgen index (FAI) in women with accurate methods and to test the discriminative value of these parameters in a polycystic ovary syndrome (PCOS)-population. METHODS Serum was obtained daily during a normal menstrual cycle from 25 healthy women (677 data-points). A single serum sample was obtained from 44 PCOS-patients. T was measured by LC–MS/MS and by Architect® 2nd generation T Immunoassay. Sex hormone-binding globulin was measured to calculate fT and FAI. Results: Reference intervals which were established in healthy women with an ovulatory menstrual cycle were T = 0.3-1.6 nmol/L and 0.5-2.0 nmol/L, fT = 5.2-26 pmol/L and 7.2-33 pmol/L, and FAI = 0.4-2.9 and 0.6-4.4, by LC-MS/MS and immunoassay, respectively. T, fT and FAI were higher in PCOS patients than in controls (p b 0.0001). The areas under the curve of receiver operator characteristic (ROC) plots were not different for T, fT, or FAI when T was measured by LC–MS/MS versus immunoassay based on prediction of PCOS. FAI and fT were the strongest predictors of PCOS. CONCLUSIONS When based upon the appropriate reference intervals and ROC analysis, LC-MS/MS and second generation immunoassay have equivalent clinical utility for the diagnosis of PCOS.
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Affiliation(s)
- H N Bui
- Dept. of Clinical Chemistry, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - P M Sluss
- Clinical Pathology Core Laboratory, Massachusetts General Hospital, Boston, MA, USA
| | - F J Hayes
- Reproductive Endocrine Unit, Massachusetts General Hospital, Boston, MA, USA
| | - S Blincko
- Abbott Diagnostics, Wiesbaden, Germany
| | - D L Knol
- Dept. of Epidemiology and Biostatistics, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - M A Blankenstein
- Dept. of Clinical Chemistry, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - A C Heijboer
- Dept. of Clinical Chemistry, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
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Stekelenburg CM, Jaspers ME, Niessen FB, Knol DL, van der Wal MB, de Vet HC, van Zuijlen PP. In a clinimetric analysis, 3D stereophotogrammetry was found to be reliable and valid for measuring scar volume in clinical research. J Clin Epidemiol 2015; 68:782-7. [DOI: 10.1016/j.jclinepi.2015.02.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Revised: 12/21/2014] [Accepted: 02/24/2015] [Indexed: 11/15/2022]
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Geytenbeek JJM, Heim MJM, Knol DL, Vermeulen RJ, Oostrom KJ. Spoken language comprehension of phrases, simple and compound-active sentences in non-speaking children with severe cerebral palsy. Int J Lang Commun Disord 2015; 50:499-515. [PMID: 25703269 DOI: 10.1111/1460-6984.12151] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2014] [Accepted: 11/03/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND Children with severe cerebral palsy (CP) (i.e. 'non-speaking children with severely limited mobility') are restricted in many domains that are important to the acquisition of language. AIMS To investigate comprehension of spoken language on sentence type level in non-speaking children with severe CP. METHODS & PROCEDURES From an original sample of 87 non-speaking children with severe CP, 68 passed the pre-test (i.e. they matched at least five spoken words to the corresponding objects) of a specifically developed computer-based instrument for low motor language testing (C-BiLLT), admitting them to the actual C-BiLLT computer test. As a result, the present study included 68 children with severe CP (35 boys, 33 girls; mean age 6;11 years, SD 3;0 years; age range 1;9-11;11 years) who were investigated with the C-BiLLT for comprehension of different sentence types: phrases, simple active sentences (with one or two arguments) and compound sentences. The C-BiLLT provides norm data of typically developing (TD) children (1;6-6;6 years). Binomial logistic regression analyses were used to compare the percentage correct of each sentence type in children with severe CP with that in TD children (subdivided into age groups) and to compare percentage correct within the CP subtypes. OUTCOMES & RESULTS Sentence comprehension in non-speaking children with severe CP followed the developmental trajectory of TD children, but at a much slower rate; nevertheless, they were still developing up to at least age 12 years. Delays in sentence type comprehension increased with sentence complexity and showed a large variability between individual children and between subtypes of CP. Comprehension of simple and syntactically more complex sentences were significantly better in children with dyskinetic CP than in children with spastic CP. Of the children with dyskinetic CP, 10-13% showed comprehension of simple and compound sentences within the percentage correct of TD children, as opposed to none of the children with spastic CP. CONCLUSION & IMPLICATIONS In non-speaking children with severe CP sentence comprehension is delayed rather than deviant. Results indicate the importance of following comprehension skills across all age groups, even beyond age 12 years. Moreover, the subtype of CP should be considered when establishing an educational programme for sentence comprehension, and augmentative and alternative communication support. In addition, educational programmes for children with severe CP should take into account the linguistic hierarchy of sentence comprehension when focusing on the input and understanding of spoken language comprehension.
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Affiliation(s)
- Joke J M Geytenbeek
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, the Netherlands
- The EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
- Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
| | | | - Dirk L Knol
- University of Amsterdam, Amsterdam, the Netherlands
| | - R Jeroen Vermeulen
- Department of Paediatric Neurology, VU University Medical Center, Amsterdam, the Netherlands
- Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
| | - Kim J Oostrom
- Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
- Department of Pediatric Psychology, VU University Medical Center, Amsterdam, the Netherlands
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Ossenkoppele R, Jansen WJ, Rabinovici GD, Knol DL, van der Flier WM, van Berckel BNM, Scheltens P, Visser PJ, Verfaillie SCJ, Zwan MD, Adriaanse SM, Lammertsma AA, Barkhof F, Jagust WJ, Miller BL, Rosen HJ, Landau SM, Villemagne VL, Rowe CC, Lee DY, Na DL, Seo SW, Sarazin M, Roe CM, Sabri O, Barthel H, Koglin N, Hodges J, Leyton CE, Vandenberghe R, van Laere K, Drzezga A, Forster S, Grimmer T, Sánchez-Juan P, Carril JM, Mok V, Camus V, Klunk WE, Cohen AD, Meyer PT, Hellwig S, Newberg A, Frederiksen KS, Fleisher AS, Mintun MA, Wolk DA, Nordberg A, Rinne JO, Chételat G, Lleo A, Blesa R, Fortea J, Madsen K, Rodrigue KM, Brooks DJ. Prevalence of amyloid PET positivity in dementia syndromes: a meta-analysis. JAMA 2015; 313:1939-49. [PMID: 25988463 PMCID: PMC4517678 DOI: 10.1001/jama.2015.4669] [Citation(s) in RCA: 428] [Impact Index Per Article: 47.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
IMPORTANCE Amyloid-β positron emission tomography (PET) imaging allows in vivo detection of fibrillar plaques, a core neuropathological feature of Alzheimer disease (AD). Its diagnostic utility is still unclear because amyloid plaques also occur in patients with non-AD dementia. OBJECTIVE To use individual participant data meta-analysis to estimate the prevalence of amyloid positivity on PET in a wide variety of dementia syndromes. DATA SOURCES The MEDLINE and Web of Science databases were searched from January 2004 to April 2015 for amyloid PET studies. STUDY SELECTION Case reports and studies on neurological or psychiatric diseases other than dementia were excluded. Corresponding authors of eligible cohorts were invited to provide individual participant data. DATA EXTRACTION AND SYNTHESIS Data were provided for 1359 participants with clinically diagnosed AD and 538 participants with non-AD dementia. The reference groups were 1849 healthy control participants (based on amyloid PET) and an independent sample of 1369 AD participants (based on autopsy). MAIN OUTCOMES AND MEASURES Estimated prevalence of positive amyloid PET scans according to diagnosis, age, and apolipoprotein E (APOE) ε4 status, using the generalized estimating equations method. RESULTS The likelihood of amyloid positivity was associated with age and APOE ε4 status. In AD dementia, the prevalence of amyloid positivity decreased from age 50 to 90 years in APOE ε4 noncarriers (86% [95% CI, 73%-94%] at 50 years to 68% [95% CI, 57%-77%] at 90 years; n = 377) and to a lesser degree in APOE ε4 carriers (97% [95% CI, 92%-99%] at 50 years to 90% [95% CI, 83%-94%] at 90 years; n = 593; P < .01). Similar associations of age and APOE ε4 with amyloid positivity were observed in participants with AD dementia at autopsy. In most non-AD dementias, amyloid positivity increased with both age (from 60 to 80 years) and APOE ε4 carriership (dementia with Lewy bodies: carriers [n = 16], 63% [95% CI, 48%-80%] at 60 years to 83% [95% CI, 67%-92%] at 80 years; noncarriers [n = 18], 29% [95% CI, 15%-50%] at 60 years to 54% [95% CI, 30%-77%] at 80 years; frontotemporal dementia: carriers [n = 48], 19% [95% CI, 12%-28%] at 60 years to 43% [95% CI, 35%-50%] at 80 years; noncarriers [n = 160], 5% [95% CI, 3%-8%] at 60 years to 14% [95% CI, 11%-18%] at 80 years; vascular dementia: carriers [n = 30], 25% [95% CI, 9%-52%] at 60 years to 64% [95% CI, 49%-77%] at 80 years; noncarriers [n = 77], 7% [95% CI, 3%-18%] at 60 years to 29% [95% CI, 17%-43%] at 80 years. CONCLUSIONS AND RELEVANCE Among participants with dementia, the prevalence of amyloid positivity was associated with clinical diagnosis, age, and APOE genotype. These findings indicate the potential clinical utility of amyloid imaging for differential diagnosis in early-onset dementia and to support the clinical diagnosis of participants with AD dementia and noncarrier APOE ε4 status who are older than 70 years.
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Affiliation(s)
- Rik Ossenkoppele
- Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, the Netherlands 2Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands 3Memory and Aging Center, University of Californ
| | - Willemijn J Jansen
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, the Netherlands
| | - Gil D Rabinovici
- Memory and Aging Center, University of California, San Francisco4Helen Wills Neuroscience Institute, University of California, Berkeley
| | - Dirk L Knol
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands
| | - Wiesje M van der Flier
- Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, the Netherlands 6Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands
| | - Bart N M van Berckel
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands
| | - Philip Scheltens
- Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, the Netherlands
| | - Pieter Jelle Visser
- Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, the Netherlands 5Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, the Netherlan
| | | | - Sander C J Verfaillie
- Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, the Netherlands 2Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands
| | - Marissa D Zwan
- Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, the Netherlands 2Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands
| | - Sofie M Adriaanse
- Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, the Netherlands 2Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands
| | - Adriaan A Lammertsma
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands
| | - William J Jagust
- Helen Wills Neuroscience Institute, University of California, Berkeley7Lawrence Berkeley National Laboratory, University of California, Berkeley
| | - Bruce L Miller
- Memory and Aging Center, University of California, San Francisco
| | - Howard J Rosen
- Memory and Aging Center, University of California, San Francisco
| | - Susan M Landau
- Helen Wills Neuroscience Institute, University of California, Berkeley7Lawrence Berkeley National Laboratory, University of California, Berkeley
| | - Victor L Villemagne
- Department of Nuclear Medicine and Centre for PET, Austin Health, Melbourne, Australia
| | - Christopher C Rowe
- Department of Nuclear Medicine and Centre for PET, Austin Health, Melbourne, Australia
| | - Dong Y Lee
- Department of Neuropsychiatry, College of Medicine, Seoul National University, South Korea
| | - Duk L Na
- Department of Neurology, Sungkyunkwan University, Seoul, South Korea
| | - Sang W Seo
- Department of Neurology, Sungkyunkwan University, Seoul, South Korea
| | - Marie Sarazin
- Neurologie de la Mémoire et du Langage, Sorbonne Paris Cité, INSERM UMR S894, Centre Hospitalier Sainte Anne, Université Paris Descartes, France
| | - Catherine M Roe
- Department of Neurology, Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, Missouri
| | - Osama Sabri
- Department of Nuclear Medicine, University of Leipzig, Germany
| | - Henryk Barthel
- Department of Nuclear Medicine, University of Leipzig, Germany
| | | | - John Hodges
- Neuroscience Research Australia, Sydney, Australia
| | | | - Rik Vandenberghe
- Laboratory for Cognitive Neurology and Alzheimer Research Center, Katholieke Universiteit Leuven, Catholic University Leuven, Belgium
| | - Koen van Laere
- Laboratory for Cognitive Neurology and Alzheimer Research Center, Katholieke Universiteit Leuven, Catholic University Leuven, Belgium
| | | | - Stefan Forster
- Department of Nuclear Medicine, Technische Universitaet Muenchen, Munich, Germany
| | - Timo Grimmer
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technische Universitaet Muenchen, Munich, Germany
| | - Pascual Sánchez-Juan
- IFIMAV and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Marqués de Valdecilla University Hospital, Cantabria, Spain
| | - Jose M Carril
- Department of Nuclear Medicine, Marqués de Valdecilla University Hospital, University of Cantabria, Spain
| | - Vincent Mok
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Shatin, China
| | - Vincent Camus
- INSERM U930 and Université François Rabelais de Tours, Centre Hospitalier Régional Universitaire Hôpitaux de Tours, France
| | - William E Klunk
- Alzheimer's Disease Research Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Ann D Cohen
- Alzheimer's Disease Research Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Philipp T Meyer
- Department of Nuclear Medicine, University Hospital Freiburg, Germany
| | - Sabine Hellwig
- Centre for Geriatrics and Gerontology, University Hospital Freiburg, Germany
| | - Andrew Newberg
- Myrna Brind Center of Integrative Medicine, Thomas Jefferson University and Hospital, Philadelphia, Pennsylvania
| | - Kristian S Frederiksen
- Danish Dementia Research Center, Department of Neurology, Righospitalet, University of Copenhagen, Denmark
| | | | - Mark A Mintun
- Avid Radiopharmaceuticals, Philadelphia, Pennsylvania
| | - David A Wolk
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Agneta Nordberg
- Center for Alzheimer Research, Translational Alzheimer Neurobiology, Karolinska Institutet, Stockholm, Sweden
| | - Juha O Rinne
- Turku PET Centre and Division of Clinical Neuroscience, Turku University Hospital, University of Turku, Finland
| | - Gaël Chételat
- Institut National de la Santé et de la Recherche Medicale, Caen, France
| | - Alberto Lleo
- Department of Neurology, Universitat Autònoma de Barcelona, Spain
| | - Rafael Blesa
- Department of Neurology, Universitat Autònoma de Barcelona, Spain
| | - Juan Fortea
- Department of Neurology, Universitat Autònoma de Barcelona, Spain
| | - Karine Madsen
- Neurobiology Research Unit, Copenhagen University Hospital, Denmark, Germany
| | | | - David J Brooks
- University of Texas Southwestern Medical Center, Dallas39Division of Neuroscience and Medical Research Council Clinical Sciences Centre, Imperial College London, United Kingdom
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12
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Jansen WJ, Ossenkoppele R, Knol DL, Tijms BM, Scheltens P, Verhey FRJ, Visser PJ, Aalten P, Aarsland D, Alcolea D, Alexander M, Almdahl IS, Arnold SE, Baldeiras I, Barthel H, van Berckel BNM, Bibeau K, Blennow K, Brooks DJ, van Buchem MA, Camus V, Cavedo E, Chen K, Chetelat G, Cohen AD, Drzezga A, Engelborghs S, Fagan AM, Fladby T, Fleisher AS, van der Flier WM, Ford L, Förster S, Fortea J, Foskett N, Frederiksen KS, Freund-Levi Y, Frisoni GB, Froelich L, Gabryelewicz T, Gill KD, Gkatzima O, Gómez-Tortosa E, Gordon MF, Grimmer T, Hampel H, Hausner L, Hellwig S, Herukka SK, Hildebrandt H, Ishihara L, Ivanoiu A, Jagust WJ, Johannsen P, Kandimalla R, Kapaki E, Klimkowicz-Mrowiec A, Klunk WE, Köhler S, Koglin N, Kornhuber J, Kramberger MG, Van Laere K, Landau SM, Lee DY, de Leon M, Lisetti V, Lleó A, Madsen K, Maier W, Marcusson J, Mattsson N, de Mendonça A, Meulenbroek O, Meyer PT, Mintun MA, Mok V, Molinuevo JL, Møllergård HM, Morris JC, Mroczko B, Van der Mussele S, Na DL, Newberg A, Nordberg A, Nordlund A, Novak GP, Paraskevas GP, Parnetti L, Perera G, Peters O, Popp J, Prabhakar S, Rabinovici GD, Ramakers IHGB, Rami L, Resende de Oliveira C, Rinne JO, Rodrigue KM, Rodríguez-Rodríguez E, Roe CM, Rot U, Rowe CC, Rüther E, Sabri O, Sanchez-Juan P, Santana I, Sarazin M, Schröder J, Schütte C, Seo SW, Soetewey F, Soininen H, Spiru L, Struyfs H, Teunissen CE, Tsolaki M, Vandenberghe R, Verbeek MM, Villemagne VL, Vos SJB, van Waalwijk van Doorn LJC, Waldemar G, Wallin A, Wallin ÅK, Wiltfang J, Wolk DA, Zboch M, Zetterberg H. Prevalence of cerebral amyloid pathology in persons without dementia: a meta-analysis. JAMA 2015; 313:1924-38. [PMID: 25988462 PMCID: PMC4486209 DOI: 10.1001/jama.2015.4668] [Citation(s) in RCA: 1010] [Impact Index Per Article: 112.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
IMPORTANCE Cerebral amyloid-β aggregation is an early pathological event in Alzheimer disease (AD), starting decades before dementia onset. Estimates of the prevalence of amyloid pathology in persons without dementia are needed to understand the development of AD and to design prevention studies. OBJECTIVE To use individual participant data meta-analysis to estimate the prevalence of amyloid pathology as measured with biomarkers in participants with normal cognition, subjective cognitive impairment (SCI), or mild cognitive impairment (MCI). DATA SOURCES Relevant biomarker studies identified by searching studies published before April 2015 using the MEDLINE and Web of Science databases and through personal communication with investigators. STUDY SELECTION Studies were included if they provided individual participant data for participants without dementia and used an a priori defined cutoff for amyloid positivity. DATA EXTRACTION AND SYNTHESIS Individual records were provided for 2914 participants with normal cognition, 697 with SCI, and 3972 with MCI aged 18 to 100 years from 55 studies. MAIN OUTCOMES AND MEASURES Prevalence of amyloid pathology on positron emission tomography or in cerebrospinal fluid according to AD risk factors (age, apolipoprotein E [APOE] genotype, sex, and education) estimated by generalized estimating equations. RESULTS The prevalence of amyloid pathology increased from age 50 to 90 years from 10% (95% CI, 8%-13%) to 44% (95% CI, 37%-51%) among participants with normal cognition; from 12% (95% CI, 8%-18%) to 43% (95% CI, 32%-55%) among patients with SCI; and from 27% (95% CI, 23%-32%) to 71% (95% CI, 66%-76%) among patients with MCI. APOE-ε4 carriers had 2 to 3 times higher prevalence estimates than noncarriers. The age at which 15% of the participants with normal cognition were amyloid positive was approximately 40 years for APOE ε4ε4 carriers, 50 years for ε2ε4 carriers, 55 years for ε3ε4 carriers, 65 years for ε3ε3 carriers, and 95 years for ε2ε3 carriers. Amyloid positivity was more common in highly educated participants but not associated with sex or biomarker modality. CONCLUSIONS AND RELEVANCE Among persons without dementia, the prevalence of cerebral amyloid pathology as determined by positron emission tomography or cerebrospinal fluid findings was associated with age, APOE genotype, and presence of cognitive impairment. These findings suggest a 20- to 30-year interval between first development of amyloid positivity and onset of dementia.
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Affiliation(s)
- Willemijn J Jansen
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | - Rik Ossenkoppele
- Department of Neurology and Alzheimer Center, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands3Department of Radiology and Nuclear Medicine, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the
| | - Dirk L Knol
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands
| | - Betty M Tijms
- Department of Neurology and Alzheimer Center, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
| | - Philip Scheltens
- Department of Neurology and Alzheimer Center, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
| | - Frans R J Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | - Pieter Jelle Visser
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands2Department of Neurology and Alzheimer Center, VU University Medical Center, Neuroscience
| | | | - Pauline Aalten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | - Dag Aarsland
- Center for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Daniel Alcolea
- Neurology Department, Hospital de Sant Pau, Barcelona, Spain
| | | | - Ina S Almdahl
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | - Steven E Arnold
- Department of Neurology, University of Pennsylvania, Philadelphia
| | - Inês Baldeiras
- Center for Neuroscience and Cell Biology, Faculty of Medicine, Hospital Center University of Coimbra, Portugal
| | - Henryk Barthel
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Bart N M van Berckel
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
| | - Kristen Bibeau
- GlaxoSmithKline, Worldwide Epidemiology, Research Triangle Park, North Carolina
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
| | - David J Brooks
- Division of Neuroscience, Medical Research Council Clinical Sciences Centre, Imperial College London, London, United Kingdom
| | - Mark A van Buchem
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Vincent Camus
- CHRU de Tours, CIC INSERM 1415, INSERM U930, and Université François Rabelais de Tours, Tours, France
| | - Enrica Cavedo
- Laboratory of Epidemiology, Neuroimaging and Telemedicine, IRCCS San Giovanni di Dio Fatebenefratelli, Brescia, Italy20Sorbonne University, University Pierre et Marie Curie, Paris 06, Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A) and Institut
| | - Kewei Chen
- Banner Alzheimer's Institute, Phoenix, Arizona
| | - Gael Chetelat
- Institut National de la Santé et de la Recherche Médicale (Inserm), U1077, Caen, France
| | - Ann D Cohen
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, Pennsylvania
| | - Alexander Drzezga
- Department of Nuclear Medicine, University of Cologne, Cologne, Germany
| | - Sebastiaan Engelborghs
- Reference Center for Biological Markers of Dementia (BIODEM), University of Antwerp, Antwerp, Belgium
| | - Anne M Fagan
- Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University School of Medicine, St Louis, Missouri
| | - Tormod Fladby
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | - Adam S Fleisher
- Banner Alzheimer's Institute, Phoenix, Arizona27Eli Lilly, Indianapolis, Indiana28Department of Neurosciences, University of California, San Diego
| | - Wiesje M van der Flier
- Department of Neurology and Alzheimer Center, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands6Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands
| | - Lisa Ford
- Janssen Research and Development, Titusville, New Jersey
| | - Stefan Förster
- Department of Nuclear Medicine, Technischen Universitaet München, Munich, Germany
| | - Juan Fortea
- Neurology Department, Hospital de Sant Pau, Barcelona, Spain
| | | | - Kristian S Frederiksen
- Danish Dementia Research Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
| | - Yvonne Freund-Levi
- Department of Geriatrics, Institution of NVS, Section of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden
| | - Giovanni B Frisoni
- Laboratory of Epidemiology, Neuroimaging and Telemedicine, IRCCS San Giovanni di Dio Fatebenefratelli, Brescia, Italy88Memory Clinic and LANVIE-Laboratory of Neuroimaging of Aging, University Hospitals, and University of Geneva, Geneva, Switzerland
| | - Lutz Froelich
- Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Tomasz Gabryelewicz
- Department of Neurodegenerative Disorders, Mossakowski Medical Research Centre Polish Academy of Sciences, Warsaw, Poland
| | - Kiran Dip Gill
- Postgraduate Institute of Medical Education and Research (PGIMER), Department of Biochemistry, Research Block-A, Chandigarh, India
| | - Olymbia Gkatzima
- Third Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | | | - Timo Grimmer
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen Universitaet München, Munich, Germany
| | - Harald Hampel
- AXA Research Fund and UPMC ChairSorbonne Universités, Université Pierre et Marie Curie, Paris 06, Institut de la Mémoire et de la Maladie d'Alzheimer and INSERM U1127, Institut du Cerveau et de la Moelle épinière (ICM), Département de Neurologie, Hôpital
| | - Lucrezia Hausner
- Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Sabine Hellwig
- Center of Geriatrics and Gerontology, University Hospital Freiburg, Freiburg, Germany
| | - Sanna-Kaisa Herukka
- Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | | | - Lianna Ishihara
- GlaxoSmithKline, Worldwide Epidemiology, Epidemiology, Genetic Epidemiology and Neurology, United Kingdom
| | - Adrian Ivanoiu
- Memory Clinic and Neurochemistry Laboratory, Saint Luc University Hospital, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - William J Jagust
- Helen Wills Neuroscience Institute, University of California, Berkeley
| | - Peter Johannsen
- Memory Clinic, Danish Dementia Research Center, Rigshospitalet, Copenhagen, Denmark
| | - Ramesh Kandimalla
- Postgraduate Institute of Medical Education and Research (PGIMER), Department of Biochemistry, Research Block-A, Chandigarh, India46Radiation Oncology, Emory University, Atlanta, Georgia
| | - Elisabeth Kapaki
- First Department of Neurology, Neurochemistry Unit and Cognitive and Movement Disorders Clinic, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece
| | | | - William E Klunk
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, Pennsylvania
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | | | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Milica G Kramberger
- Center for Cognitive Impairments, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Koen Van Laere
- Department of Imaging and Pathology, Catholic University Leuven, Leuven, Belgium
| | - Susan M Landau
- Helen Wills Neuroscience Institute, University of California, Berkeley
| | - Dong Young Lee
- Department of Neuropsychiatry, Seoul National University, College of Medicine, Seoul, South Korea
| | - Mony de Leon
- School of Medicine, Center for Brain Health, New York University, New York
| | - Viviana Lisetti
- Section of Neurology, Center for Memory Disturbances, University of Perugia, Perugia, Italy
| | - Alberto Lleó
- Neurology Department, Hospital de Sant Pau, Barcelona, Spain
| | - Karine Madsen
- Neurobiology Research Unit, Copenhagen University Hospital, Copenhagen, Denmark
| | - Wolfgang Maier
- Department of Psychiatry and Psychotherapy, University of Bonn, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Jan Marcusson
- Geriatric Medicine, Department of Clinical and Experimental Medicine, University of Linköping, Linköping, Sweden
| | - Niklas Mattsson
- Clinical Memory Research Unit, Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Alexandre de Mendonça
- Institute of Molecular Medicine and Faculty of Medicine, University of Lisbon, Portugal
| | - Olga Meulenbroek
- Department of Geriatric Medicine, Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Philipp T Meyer
- Department of Nuclear Medicine, University Hospital Freiburg, Freiburg, Germany
| | - Mark A Mintun
- Avid Radiopharmaceuticals, Philadelphia, Pennsylvania
| | - Vincent Mok
- Lui Che Woo Institute of Innovative Medicine, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - José Luis Molinuevo
- Alzheimer's Disease and Other Cognitive Disorders Unit, IDIBAPS, Clinic University Hospital, Barcelona, Spain
| | - Hanne M Møllergård
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | - John C Morris
- Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University School of Medicine, St Louis, Missouri
| | - Barbara Mroczko
- Department of Neurodegeneration Diagnostics, Leading National Research Centre in Bialystok (KNOW), Medical University of Bialystok, Bialystok, Poland
| | - Stefan Van der Mussele
- Reference Center for Biological Markers of Dementia (BIODEM), University of Antwerp, Antwerp, Belgium
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Andrew Newberg
- Myrna Brind Center of Integrative Medicine, Thomas Jefferson University and Hospital, Philadelphia, Pennsylvania
| | - Agneta Nordberg
- Dept NVS, Center for Alzheimer, Translational Alzheimer Neurobiology, Karolinska Institutet, and Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Arto Nordlund
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
| | - Gerald P Novak
- Janssen Research and Development, Titusville, New Jersey
| | - George P Paraskevas
- First Department of Neurology, Neurochemistry Unit and Cognitive and Movement Disorders Clinic, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece
| | - Lucilla Parnetti
- Section of Neurology, Center for Memory Disturbances, University of Perugia, Perugia, Italy
| | - Gayan Perera
- Roche Products, Welwyn Garden City, United Kingdom69Department of Psychological Medicine, Institute of Psychiatry, Kings College London, London, United Kingdom
| | - Oliver Peters
- Department of Psychiatry and Psychotherapy, Charité Berlin, German Center for Neurodegenrative Diseases (DZNE), Berlin, Germany
| | - Julius Popp
- Department of Psychiatry, Service of Old Age Psychiatry and Department of Clinical Neurosciences, Leenaards Memory Centre, University Hospital of Lausanne, Lausanne, Switzerland
| | - Sudesh Prabhakar
- Postgraduate Institute of Medical Education and Research (PGIMER), Department of Neurology, Nehru Hospital, Chandigarh, India
| | - Gil D Rabinovici
- Department of Neurology, Memory and Aging Center, University of California, San Francisco
| | - Inez H G B Ramakers
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | - Lorena Rami
- Alzheimer's Disease and Other Cognitive Disorders Unit, IDIBAPS, Clinic University Hospital, Barcelona, Spain
| | | | - Juha O Rinne
- Turku PET Centre and Division of Clinical Neurosciences Turku, University of Turku and Turku University Hospital, Turku, Finland
| | | | | | - Catherine M Roe
- Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University School of Medicine, St Louis, Missouri
| | - Uros Rot
- Center for Cognitive Impairments, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Christopher C Rowe
- Department of Nuclear Medicine and Centre for PET, Austin Health, Melbourne, Australia
| | - Eckart Rüther
- Department of Psychiatry and Psychotherapy, University Medical Center, Georg-August University, Göttingen, Germany
| | - Osama Sabri
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Páscual Sanchez-Juan
- Neurology Service, Universitary Hospital Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - Isabel Santana
- Center for Neuroscience and Cell Biology, Faculty of Medicine, Hospital Center University of Coimbra, Portugal
| | - Marie Sarazin
- Neurologie de la Mémoire et du Langage, Centre Hospitalier Sainte-Anne, Université Paris 5, Paris, France
| | - Johannes Schröder
- Sektion Gerontopsychiatrie, Universität Heidelberg, Heidelberg, Germany
| | | | - Sang W Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Femke Soetewey
- Reference Center for Biological Markers of Dementia (BIODEM), University of Antwerp, Antwerp, Belgium
| | - Hilkka Soininen
- Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Luiza Spiru
- Department of Geriatrics-Gerontology-Gerontopsychiatry, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Hanne Struyfs
- Reference Center for Biological Markers of Dementia (BIODEM), University of Antwerp, Antwerp, Belgium
| | - Charlotte E Teunissen
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Magda Tsolaki
- Third Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology and Alzheimer Research Centre KU Leuven, Catholic University Leuven, Leuven, Belgium
| | - Marcel M Verbeek
- Departments of Neurology and Laboratory Medicine, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Victor L Villemagne
- Department of Nuclear Medicine and Centre for PET, Austin Health, Melbourne, Australia
| | - Stephanie J B Vos
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | - Linda J C van Waalwijk van Doorn
- Departments of Neurology and Laboratory Medicine, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Gunhild Waldemar
- Danish Dementia Research Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
| | - Anders Wallin
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
| | - Åsa K Wallin
- Clinical Memory Research Unit, Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center, Georg-August University, Göttingen, Germany
| | - David A Wolk
- Department of Neurology, University of Pennsylvania, Philadelphia
| | - Marzena Zboch
- Alzheimer Center, Wroclaw Medical University, Scinawa, Poland
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden87UCL Institute of Neurology, Queen Square, London, United Kingdom
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van Vilsteren M, Boot CRL, Knol DL, van Schaardenburg D, Voskuyl AE, Steenbeek R, Anema JR. Productivity at work and quality of life in patients with rheumatoid arthritis. BMC Musculoskelet Disord 2015; 16:107. [PMID: 25940578 PMCID: PMC4425924 DOI: 10.1186/s12891-015-0562-x] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 04/24/2015] [Indexed: 02/08/2023] Open
Abstract
Background The aim of this study was to determine which combination of personal, disease-related and environmental factors is best associated with at-work productivity loss in patients with rheumatoid arthritis (RA), and to determine whether at-work productivity loss is associated with the quality of life for these patients. Methods This study is based on cross-sectional data. Patients completed a questionnaire with personal, disease-related and environmental factors (related to the work environment), and clinical characteristics were obtained from patient medical records. At-work productivity loss was measured with the Work Limitations Questionnaire, and quality of life with the RAND 36. Using linear regression analyses, a multivariate model was built containing the combination of factors best associated with at-work productivity loss. This model was cross-validated internally. We furthermore determined whether at-work productivity loss was associated with quality of life using linear regression analyses. Results We found that at-work productivity loss was associated with workers who had poorer mental health, more physical role limitations, were ever treated with a biological therapeutic medication, were not satisfied with their work, and had more work instability (R2 = 0.50 and R2 following cross-validation was 0.32). We found that at-work productivity loss was negatively associated with health-related quality of life, especially with dimensions of mental health, physical role limitations, and pain. Conclusions We found that at-work productivity loss was associated with personal, work-related, and clinical factors. Although our study results should be interpreted with caution, they provide insight into patients with RA who are at risk for at-work productivity loss.
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Affiliation(s)
- Myrthe van Vilsteren
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands. .,Body@Work, Research Center Physical Activity, TNO-VU University Medical Center, Amsterdam, the Netherlands.
| | - Cecile R L Boot
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands. .,Body@Work, Research Center Physical Activity, TNO-VU University Medical Center, Amsterdam, the Netherlands.
| | - Dirk L Knol
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands.
| | | | - Alexandre E Voskuyl
- Department of Rheumatology, VU University Medical Center, Amsterdam, the Netherlands.
| | - Romy Steenbeek
- Body@Work, Research Center Physical Activity, TNO-VU University Medical Center, Amsterdam, the Netherlands. .,TNO Work, Health and Care, Leiden, The Netherlands.
| | - Johannes R Anema
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands. .,Body@Work, Research Center Physical Activity, TNO-VU University Medical Center, Amsterdam, the Netherlands. .,Research Center for Insurance Medicine AMC-UMCG-UWV-VU University Medical Center, Amsterdam, the Netherlands.
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14
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Brussee T, van Nispen RMA, Klerkx EMFJ, Knol DL, van Rens GHMB. Comparison of reading performance tests concerning difficulty of sentences and paragraphs and their reliability. Ophthalmic Physiol Opt 2015; 35:324-35. [DOI: 10.1111/opo.12204] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 02/17/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Tamara Brussee
- Department of Ophthalmology; VU University Medical Center; Amsterdam The Netherlands
- EMGO+ Institute for Health and Care Research; VU University Medical Center; Amsterdam The Netherlands
- Department of Ophthalmology; Elkerliek Hospital; Helmond The Netherlands
| | - Ruth M. A. van Nispen
- Department of Ophthalmology; VU University Medical Center; Amsterdam The Netherlands
- EMGO+ Institute for Health and Care Research; VU University Medical Center; Amsterdam The Netherlands
| | - Edwin M. F. J. Klerkx
- Department of Ophthalmology; VU University Medical Center; Amsterdam The Netherlands
| | - Dirk L. Knol
- Department of Epidemiology and Biostatistics; VU University Medical Center; Amsterdam The Netherlands
| | - Ger H. M. B. van Rens
- Department of Ophthalmology; VU University Medical Center; Amsterdam The Netherlands
- EMGO+ Institute for Health and Care Research; VU University Medical Center; Amsterdam The Netherlands
- Department of Ophthalmology; Elkerliek Hospital; Helmond The Netherlands
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15
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Holla JFM, van der Leeden M, Knol DL, Roorda LD, Hilberdink WKHA, Lems WF, Steultjens MPM, Dekker J. Predictors and outcome of pain-related avoidance of activities in persons with early symptomatic knee osteoarthritis: a five-year followup study. Arthritis Care Res (Hoboken) 2015; 67:48-57. [PMID: 24905958 DOI: 10.1002/acr.22381] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 06/03/2014] [Indexed: 11/07/2022]
Abstract
OBJECTIVE It has been hypothesized that pain and low vitality lead to an increase in avoidance of activities in persons with early symptomatic knee osteoarthritis (OA), and that avoidance of activities leads to an increase in activity limitations. The present study aimed to evaluate these hypotheses. METHODS Baseline, 2-year, and 5-year followup data of 828 participants from the Cohort Hip and Cohort Knee Study with early symptomatic knee OA were used. Autoregressive generalized estimating equations and linear regression models were used to analyze the longitudinal and cross-sectional associations between self-reported knee pain, vitality, pain-related avoidance of activities, and activity limitations. The models were adjusted for the covariates age, sex, education level, body mass index, comorbidity, radiographic severity, and hip pain. RESULTS In longitudinal analyses, knee pain and vitality predicted a subsequent increase in avoidance of activities. Pain-related avoidance of activities predicted a subsequent increase in activity limitations; however, this relationship lost statistical significance (P = 0.089) after adjustment for covariates. Cross-sectional analyses showed strong relationships between knee pain, low vitality, pain-related avoidance of activities, and activity limitations at all time points. CONCLUSIONS In persons with early symptomatic knee OA, knee pain and low vitality lead to a subsequent increase in avoidance of activities. Pain-related avoidance of activities is related to activity limitations at inception of symptoms, but also years later. Therefore, it can be recommended to monitor and target avoidance of activities at various stages of the disease.
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Affiliation(s)
- Jasmijn F M Holla
- Amsterdam Rehabilitation Research Center/Reade, Amsterdam, The Netherlands
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van der Esch M, Knoop J, van der Leeden M, Roorda LD, Lems WF, Knol DL, Dekker J. Clinical phenotypes in patients with knee osteoarthritis: a study in the Amsterdam osteoarthritis cohort. Osteoarthritis Cartilage 2015; 23:544-9. [PMID: 25596322 DOI: 10.1016/j.joca.2015.01.006] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Revised: 01/05/2015] [Accepted: 01/08/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To identify and validate previously established phenotypes of knee osteoarthritis (OA) based on similarities in clinical patient characteristics. METHODS Knee OA patients (N = 551) from the Amsterdam OA (AMS-OA) cohort provided data. Four clinical patient characteristics were assessed: upper leg muscle strength, body mass index (BMI), radiographic severity (Kellgren/Lawrence [KL] grade), and depressive mood (the Hospital Anxiety and Depression Scale [HADS] questionnaire). Cluster analysis was performed to identify the optimal number of phenotypes. Differences in clinical characteristics between the phenotypes were analyzed with ANOVA. RESULTS Cluster analysis identified five phenotypes of knee OA patients: "minimal joint disease phenotype", "strong muscle strength phenotype", "severe radiographic OA phenotype", "obese phenotype", and "depressive mood phenotype". CONCLUSIONS Among patients with knee OA, five phenotypes were identified based on four clinical characteristics. To a high degree, the results are a replication of earlier findings in the OA Initiative, indicating that these five phenotypes seem a stable, valid, and clinically relevant finding.
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Affiliation(s)
- M van der Esch
- Amsterdam Rehabilitation Research Center, Reade, Amsterdam, The Netherlands.
| | - J Knoop
- Amsterdam Rehabilitation Research Center, Reade, Amsterdam, The Netherlands
| | - M van der Leeden
- Amsterdam Rehabilitation Research Center, Reade, Amsterdam, The Netherlands; VU University Medical Center, Department of Rehabilitation Medicine, Amsterdam, The Netherlands; VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
| | - L D Roorda
- Amsterdam Rehabilitation Research Center, Reade, Amsterdam, The Netherlands
| | - W F Lems
- VU University Medical Center, Department of Rheumatology, Amsterdam, The Netherlands; Reade, Department of Rheumatology, Amsterdam, The Netherlands
| | - D L Knol
- VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands; VU University Medical Center, Department of Epidemiology and Biostatistics, Amsterdam, The Netherlands
| | - J Dekker
- VU University Medical Center, Department of Rehabilitation Medicine, Amsterdam, The Netherlands; VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands; VU University Medical Center, Department of Psychiatry, Amsterdam, The Netherlands
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17
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Lukas C, Knol DL, Sombekke MH, Bellenberg B, Hahn HK, Popescu V, Weier K, Radue EW, Gass A, Kappos L, Naegelin Y, Uitdehaag BMJ, Geurts JJG, Barkhof F, Vrenken H. Cervical spinal cord volume loss is related to clinical disability progression in multiple sclerosis. J Neurol Neurosurg Psychiatry 2015; 86:410-8. [PMID: 24973341 DOI: 10.1136/jnnp-2014-308021] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To examine the temporal evolution of spinal cord (SC) atrophy in multiple sclerosis (MS), and its association with clinical progression in a large MS cohort. METHODS A total of 352 patients from two centres with MS (relapsing remitting MS (RRMS): 256, secondary progressive MS (SPMS): 73, primary progressive MS (PPMS): 23) were included. Clinical and MRI parameters were obtained at baseline, after 12 months and 24 months of follow-up. In addition to conventional brain and SC MRI parameters, the annualised percentage brain volume change and the annualised percentage upper cervical cord cross-sectional area change (aUCCA) were quantified. Main outcome measure was disease progression, defined by expanded disability status scale increase after 24 months. RESULTS UCCA was lower in SPMS and PPMS compared with RRMS for all time points. aUCCA over 24 months was highest in patients with SPMS (-2.2% per year) and was significantly higher in patients with disease progression (-2.3% per year) than in stable patients (-1.2% per year; p=0.003), while annualised percentage brain volume change did not differ between subtypes (RRMS: -0.42% per year; SPMS -0.6% per year; PPMS: -0.46% per year) nor between progressive and stable patients (p=0.055). Baseline UCCA and aUCCA over 24 months were found to be relevant contributors of expanded disability status scale at month-24, while baseline UCCA as well as number of SC segments involved by lesions at baseline but not aUCCA were relevant contributors of disease progression. CONCLUSIONS SC MRI parameters including baseline UCCA and SC lesions were significant MRI predictors of disease progression. Progressive 24-month upper SC atrophy occurred in all MS subtypes, and was faster in patients exhibiting disease progression at month-24.
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Affiliation(s)
- Carsten Lukas
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Dirk L Knol
- Department of Epidemiology and Biostatistics, VU University Medical Center & Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - Madeleine H Sombekke
- Department of Neurology, MS Center Amsterdam, VU University Medical Center & Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - Barbara Bellenberg
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Horst K Hahn
- Fraunhofer MEVIS, Institute for Medical Image Computing, Bremen, Germany
| | - Veronica Popescu
- Department of Radiology, Nuclear Medicine and PET Research, MS Center Amsterdam, VU University Medical Center & Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - Katrin Weier
- Department of Neurology, University Hospital Basel, Basel, Switzerland
| | - Ernst W Radue
- Medical Image Analysis Center (MIAC), University Hospital Basel, Basel, Switzerland
| | - Achim Gass
- Medical Image Analysis Center (MIAC), University Hospital Basel, Basel, Switzerland
| | - Ludwig Kappos
- Medical Image Analysis Center (MIAC), University Hospital Basel, Basel, Switzerland
| | - Yvonne Naegelin
- Medical Image Analysis Center (MIAC), University Hospital Basel, Basel, Switzerland
| | - Bernard M J Uitdehaag
- Department of Neurology, MS Center Amsterdam, VU University Medical Center & Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - Jeroen J G Geurts
- Department of Radiology, Nuclear Medicine and PET Research, MS Center Amsterdam, VU University Medical Center & Neuroscience Campus Amsterdam, Amsterdam, The Netherlands. Department of Anatomy and Neurosciences, section of Clinical Neuroscience, VU University Medical Center & Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - Frederik Barkhof
- Department of Radiology, Nuclear Medicine and PET Research, MS Center Amsterdam, VU University Medical Center & Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - Hugo Vrenken
- Department of Radiology, Nuclear Medicine and PET Research, MS Center Amsterdam, VU University Medical Center & Neuroscience Campus Amsterdam, Amsterdam, The Netherlands. Department of Physics and Medical Technology, MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
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18
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Mokkink LB, Knol DL, van der Linden FH, Sonder JM, D'hooghe M, Uitdehaag BMJ. The Arm Function in Multiple Sclerosis Questionnaire (AMSQ): development and validation of a new tool using IRT methods. Disabil Rehabil 2015; 37:2445-2451. [PMID: 25801923 DOI: 10.3109/09638288.2015.1027005] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE We developed the Arm Function in Multiple Sclerosis Questionnaire (AMSQ) to measure arm and hand function in MS, based on existing scales. We aimed at developing a unidimensional scale containing enough items to be used as an itembank. In this study, we investigated reliability and differential item functioning of the Dutch version. METHOD Patients were recruited from two MS Centers and a Dutch website for MS patients. We performed item factor analysis on the polychoric correlation matrix, using multiple fit-indices to investigate model fit. The graded response model, an item response theory model, was used to investigate item goodness-of-fit, reliability of the estimated trait levels (θ), differential item functioning, and total information. Differential item functioning was investigated for type of MS, gender, administration version, and test length. RESULTS Factor analysis results suggested one factor. All items showed p-values of the item goodness-of-fit statistic above 0.0016. The reliability was 0.95, and no items showed differential item functioning on any of the investigated variables. CONCLUSION AMSQ is a unidimensional 31-item questionnaire for measuring arm function in MS. Because of a well fit in a graded response model, it is suitable for further development as a computer adaptive test. Implications for Rehabilitation A new questionnaire for arm and hand function recommended in people with multiple sclerosis (AMSQ). Scale characteristics make the questionnaire suitable for use in clinical practice and research. Good reliability. Further development as a computer adaptive test to reduce burden of (repetitive) testing in patients is feasible.
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Affiliation(s)
| | - Dirk L Knol
- a Department of Epidemiology and Biostatistics and
| | - Femke H van der Linden
- a Department of Epidemiology and Biostatistics and.,b Department of Neurology , VU University Medical Center , Amsterdam , The Netherlands , and
| | - Judith M Sonder
- a Department of Epidemiology and Biostatistics and.,b Department of Neurology , VU University Medical Center , Amsterdam , The Netherlands , and
| | | | - Bernard M J Uitdehaag
- b Department of Neurology , VU University Medical Center , Amsterdam , The Netherlands , and
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Popescu V, Klaver R, Voorn P, Galis-de Graaf Y, Knol DL, Twisk JWR, Versteeg A, Schenk GJ, Van der Valk P, Barkhof F, De Vries HE, Vrenken H, Geurts JJG. What drives MRI-measured cortical atrophy in multiple sclerosis? Mult Scler 2015; 21:1280-90. [PMID: 25583833 DOI: 10.1177/1352458514562440] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 11/07/2014] [Indexed: 01/31/2023]
Abstract
BACKGROUND Cortical atrophy, assessed with magnetic resonance imaging (MRI), is an important outcome measure in multiple sclerosis (MS) studies. However, the underlying histopathology of cortical volume measures is unknown. OBJECTIVE We investigated the histopathological substrate of MRI-measured cortical volume in MS using combined post-mortem imaging and histopathology. METHODS MS brain donors underwent post-mortem whole-brain in-situ MRI imaging. After MRI, tissue blocks were systematically sampled from the superior and inferior frontal gyrus, anterior cingulate gyrus, inferior parietal lobule, and superior temporal gyrus. Histopathological markers included neuronal, axonal, synapse, astrocyte, dendrite, myelin, and oligodendrocyte densities. Matched cortical volumes from the aforementioned anatomical regions were measured on the MRI, and used as outcomes in a nested prediction model. RESULTS Forty-five tissue blocks were sampled from 11 MS brain donors. Mean age at death was 68±12 years, post-mortem interval 4±1 hours, and disease duration 35±15 years. MRI-measured regional cortical volumes varied depending on anatomical region. Neuronal density, neuronal size, and axonal density were significant predictors of GM volume. CONCLUSIONS In patients with long-standing disease, neuronal and axonal pathology are the predominant pathological substrates of MRI-measured cortical volume in chronic MS.
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Affiliation(s)
- V Popescu
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Neuroscience Campus Amsterdam, The Netherlands
| | - R Klaver
- Department of Anatomy and Neurosciences, VU University Medical Center, Neuroscience Campus Amsterdam, The Netherlands
| | - P Voorn
- Department of Anatomy and Neurosciences, VU University Medical Center, Neuroscience Campus Amsterdam, The Netherlands
| | - Y Galis-de Graaf
- Department of Anatomy and Neurosciences, VU University Medical Center, Neuroscience Campus Amsterdam, The Netherlands
| | - D L Knol
- Department of Epidemiology and Biostatistics, VU University Medical Center, Neuroscience Campus Amsterdam, The Netherlands
| | - J W R Twisk
- Department of Epidemiology and Biostatistics, VU University Medical Center, Neuroscience Campus Amsterdam, The Netherlands
| | - A Versteeg
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Neuroscience Campus Amsterdam, The Netherlands
| | - G J Schenk
- Department of Anatomy and Neurosciences, VU University Medical Center, Neuroscience Campus Amsterdam, The Netherlands
| | - P Van der Valk
- Department of Pathology, VU University Medical Center, Neuroscience Campus Amsterdam, The Netherlands
| | - F Barkhof
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Neuroscience Campus Amsterdam, The Netherlands
| | - H E De Vries
- Department of Molecular Cell Biology and Immunology, VU University Medical Center, Neuroscience Campus Amsterdam, The Netherlands
| | - H Vrenken
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Neuroscience Campus Amsterdam, The Netherlands/Department of Physics and Medical Technology, VU University Medical Center, Neuroscience Campus Amsterdam, The Netherlands
| | - J J G Geurts
- Department of Anatomy and Neurosciences, VU University Medical Center, Neuroscience Campus Amsterdam, The Netherlands
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Bruijning JE, van Rens G, Fick M, Knol DL, van Nispen R. Longitudinal observation, evaluation and interpretation of coping with mental (emotional) health in low vision rehabilitation using the Dutch ICF Activity Inventory. Health Qual Life Outcomes 2014; 12:182. [PMID: 25539603 PMCID: PMC4308065 DOI: 10.1186/s12955-014-0182-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Accepted: 12/01/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Since there is evidence that mental health aspects (such as depression) may inhibit an optimal rehabilitation outcome, there is growing interest in the psychosocial aspects of vision loss as part of rehabilitation. The purpose of this study is to provide more insight into the construct validity and (longitudinal) interpretation of goals related to 'Coping with mental (emotional) health aspects' which are part of the recently developed 'Dutch ICF Activity Inventory (D-AI). Moreover, the data allowed to provide some insight in the outcome in this domain in relation to rehabilitation programs followed in Dutch Multidisciplinary Rehabilitation Centers at baseline and follow-up. METHODS In a cohort of 241 visually impaired persons, the D-AI was assessed at baseline (enrollment), 4 and 12 months, The importance and difficulty of the D-AI goals 'Handle feelings', 'Acceptance', and 'Feeling fit' and difficulty scores of underlying tasks were further analyzed, together with similar or related standardized questionnaires. At baseline, Spearman correlations were determined between D-AI goals and task and additional questionnaires to investigate the construct validity. Corrected and uncorrected linear mixed models were used to determine longitudinal rehabilitation outcomes in relation to rehabilitation programs followed. RESULTS Baseline correlations indicated that the difficulty of tasks and the umbrella goal 'Acceptance' were not similar. Longitudinal analyses provided insight in some subtle differences in concepts measured at the goal and task level of the D-AI, as well as similar validated questionnaires. After correcting for confounding variables, none of the underlying task difficulty scales changed over time. For goal difficulty scores only 'Acceptance' was reported to be significantly less difficult at 4 and 12 months follow-up. Importance scores of goals were stable from baseline to follow-up. CONCLUSION With respect to the constructs measured, results support the formulation of the new goal question 'Emotional life' which replaces the goals 'Handle feelings' and 'Acceptance'. Results indicate that MRCs should pay more attention to problems related to mental health. They have started to use the D-AI as it seems a promising tool to investigate and evaluate rehabilitation needs (including those related to mental health) over time and to clearly define rehabilitation goals from the very start.
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21
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Oosterwerff MM, Meijnen R, Schoor NMV, Knol DL, Kramer MHH, Poppel MNMV, Lips P, Eekhoff EMW. Effect of vitamin D supplementation on physical performance and activity in non-western immigrants. Endocr Connect 2014; 3:224-32. [PMID: 25351444 PMCID: PMC4240903 DOI: 10.1530/ec-14-0096] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Vitamin D deficiency is highly prevalent among non-western immigrants in The Netherlands and associated with poor physical performance. The aim of this study was to assess the effect of vitamin D supplementation on physical performance, exercise capacity, and daily physical activity in vitamin D-deficient, overweight non-western immigrants. A randomized double-blind, placebo-controlled trial was conducted to assess the effect of vitamin D on physical performance. A total of 130 participants were included. Eligibility criteria included overweight (BMI >27 kg/m(2)), 25-hydroxy vitamin D (25(OH)D) ≤50 nmol/l, and an age range of 20-65 years. The intervention group received 1200 IU vitamin D3 daily for 4 months; the control group received placebo. Both groups received 500 mg calcium daily. Outcome measures included physical performance (physical performance score), exercise capacity (a 6-min walk test (6-MWT)), and daily physical activity (questionnaire and accelerometer). There was no significant effect on physical performance, exercise capacity, or physical activity in the intention to treat analysis. In an explorative post hoc analysis restricted to participants reaching a serum 25(OH)D concentration of >60 nmol/l after intervention, there was an improvement of 19 m in the 6-MWT compared with the control group (P=0.053). Moderate dose vitamin D supplementation did not significantly improve physical performance, exercise capacity, or physical activity. However, when 25(OH)D concentrations reached >60 nmol/l after intervention, there was a borderline significant improvement in exercise capacity. Although the clinical relevance is not clear, this is a promising result, as all participants were overweight and did not improve their overall activity levels.
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Affiliation(s)
- Mirjam M Oosterwerff
- Departments of Internal MedicineEndocrine SectionEpidemiology and BiostatisticsEMGO Institute for Health and Care ResearchPublic and Occupational HealthEMGO Institute for Health and Care Research, VU University Medical Center, PO Box 7057, Amsterdam 1007 MB, The Netherlands
| | - Rosa Meijnen
- Departments of Internal MedicineEndocrine SectionEpidemiology and BiostatisticsEMGO Institute for Health and Care ResearchPublic and Occupational HealthEMGO Institute for Health and Care Research, VU University Medical Center, PO Box 7057, Amsterdam 1007 MB, The Netherlands
| | - Natasja M Van Schoor
- Departments of Internal MedicineEndocrine SectionEpidemiology and BiostatisticsEMGO Institute for Health and Care ResearchPublic and Occupational HealthEMGO Institute for Health and Care Research, VU University Medical Center, PO Box 7057, Amsterdam 1007 MB, The Netherlands
| | - Dirk L Knol
- Departments of Internal MedicineEndocrine SectionEpidemiology and BiostatisticsEMGO Institute for Health and Care ResearchPublic and Occupational HealthEMGO Institute for Health and Care Research, VU University Medical Center, PO Box 7057, Amsterdam 1007 MB, The Netherlands
| | - Mark H H Kramer
- Departments of Internal MedicineEndocrine SectionEpidemiology and BiostatisticsEMGO Institute for Health and Care ResearchPublic and Occupational HealthEMGO Institute for Health and Care Research, VU University Medical Center, PO Box 7057, Amsterdam 1007 MB, The Netherlands
| | - Mireille N M Van Poppel
- Departments of Internal MedicineEndocrine SectionEpidemiology and BiostatisticsEMGO Institute for Health and Care ResearchPublic and Occupational HealthEMGO Institute for Health and Care Research, VU University Medical Center, PO Box 7057, Amsterdam 1007 MB, The Netherlands
| | - Paul Lips
- Departments of Internal MedicineEndocrine SectionEpidemiology and BiostatisticsEMGO Institute for Health and Care ResearchPublic and Occupational HealthEMGO Institute for Health and Care Research, VU University Medical Center, PO Box 7057, Amsterdam 1007 MB, The Netherlands
| | - E Marelise W Eekhoff
- Departments of Internal MedicineEndocrine SectionEpidemiology and BiostatisticsEMGO Institute for Health and Care ResearchPublic and Occupational HealthEMGO Institute for Health and Care Research, VU University Medical Center, PO Box 7057, Amsterdam 1007 MB, The Netherlands
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van der Meer EWC, Boot CRL, van der Gulden JWJ, Knol DL, Jungbauer FHW, Coenraads PJ, Anema JR. Hands4U: the effects of a multifaceted implementation strategy on hand eczema prevalence in a healthcare setting. Results of a randomized controlled trial. Contact Dermatitis 2014; 72:312-24. [DOI: 10.1111/cod.12313] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 09/18/2014] [Accepted: 09/23/2014] [Indexed: 12/01/2022]
Affiliation(s)
- Esther W. C. van der Meer
- Department of Public and Occupational Health EMGO Institute for Health and Care Research, VU University Medical Centre van der Boechorststraat 7 1081 BT Amsterdam The Netherlands
| | - Cécile R. L. Boot
- Department of Public and Occupational Health EMGO Institute for Health and Care Research, VU University Medical Centre van der Boechorststraat 7 1081 BT Amsterdam The Netherlands
- Body©Work, Research Centre Physical Activity, Work and Health, TNO‐VU University Medical Centre van der Boechorststraat 7 1081 BT Amsterdam The Netherlands
| | - Joost W. J. van der Gulden
- Department of Primary and Community Care Centre for Family Medicine, Geriatric care and Public Health, Radboud University Nijmegen Medical Centre PO Box 9101 6500 HB Nijmegen The Netherlands
| | - Dirk L. Knol
- Department of Epidemiology and Biostatistics EMGO Institute for Health and Care Research, VU University Medical Centre De Boelelaan 1118 1081 HZ Amsterdam The Netherlands
| | - Frank H. W. Jungbauer
- Department of Occupational Health University Medical Centre Groningen, University of Groningen Hanzeplein 1 9713GZ, Groningen The Netherlands
| | - Pieter Jan Coenraads
- Dermatology Department University Medical Centre Groningen, University of Groningen Hanzeplein 1 9713GZ, Groningen The Netherlands
| | - Johannes R. Anema
- Department of Public and Occupational Health EMGO Institute for Health and Care Research, VU University Medical Centre van der Boechorststraat 7 1081 BT Amsterdam The Netherlands
- Body©Work, Research Centre Physical Activity, Work and Health, TNO‐VU University Medical Centre van der Boechorststraat 7 1081 BT Amsterdam The Netherlands
- Research Centre for Insurance Medicine AMC‐UWV‐VU University Medical Centre van der Boechorststraat 7 1081 BT Amsterdam The Netherlands
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de Vet HCW, Foumani M, Scholten MA, Jacobs WCH, Stiggelbout AM, Knol DL, Peul WC. Minimally important change values of a measurement instrument depend more on baseline values than on the type of intervention. J Clin Epidemiol 2014; 68:518-24. [PMID: 25544741 DOI: 10.1016/j.jclinepi.2014.07.008] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Revised: 07/08/2014] [Accepted: 07/13/2014] [Indexed: 01/16/2023]
Abstract
OBJECTIVES Multi-item questionnaires are frequently used to measure outcomes in randomized controlled trials (RCTs) in patients with sciatica. Knowing the minimaly important change (MIC) values for these instruments will facilitate interpretation of change scores. MIC values have been shown to be dependent on baseline values. The question is whether they also depend on the type of intervention. To estimate the MIC of the Roland Morris Disability Questionnaire (modified 23 item version) (RMDQ) and of intensity of leg pain measured by a Visual Analogue Scale (VAS) in patients with sciatica and to assess to what extent MIC values depend on type of intervention and on baseline values. STUDY DESIGN AND SETTING This is a secondary analysis of RCT data of the effects of early surgery vs. prolonged conservative treatment in patients with sciatica. Baseline and 8-week data were used to assess MIC of the RMDQ-23 and VAS leg pain. We used the receiver operator characteristic (ROC) method to assess the MIC. Global Perceived Recovery (rated 8 weeks after baseline) was used as anchor. Subgroups were created based on type of treatment and baseline severity. RESULTS The MIC value of the RMDQ-23 for the total group of sciatica patients was 7.5. The values were 8.1 and 6.9 for surgery and conservative treatment, respectively. For high and low baseline values, the MICs were 9.0 and 4.9, respectively, irrespective of treatment received. The MIC values of the VAS leg pain were 34.4 for the total group. For surgery and conservative treatment, the MIC values were 38.5 and 30.4, respectively, whereas for groups with high and low baseline values, MIC values of 53.5 and 17.2 were found. CONCLUSION The MIC values of the RMDQ-23 and VAS leg pain were found to be highly dependent on their baseline values, although the type of intervention appeared to influence the MIC value only slightly.
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Affiliation(s)
- Henrica C W de Vet
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7 1081 BT Amsterdam, The Netherlands.
| | - Mahrouz Foumani
- Department of Neurosurgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Marjolein A Scholten
- Department of Neurosurgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Wilco C H Jacobs
- Department of Neurosurgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Anne M Stiggelbout
- Department of Medical Decision Making, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Dirk L Knol
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7 1081 BT Amsterdam, The Netherlands
| | - Wilco C Peul
- Department of Neurosurgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands; Department of Neurosurgery, Medical Center Haaglanden, Lijnbaan 32, 2512 VA, The Hague, The Netherlands
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Noij DP, Pouwels PJW, Ljumanovic R, Knol DL, Doornaert P, de Bree R, Castelijns JA, de Graaf P. Predictive value of diffusion-weighted imaging without and with including contrast-enhanced magnetic resonance imaging in image analysis of head and neck squamous cell carcinoma. Eur J Radiol 2014; 84:108-116. [PMID: 25467228 DOI: 10.1016/j.ejrad.2014.10.015] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 10/09/2014] [Accepted: 10/13/2014] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To assess disease-free survival (DFS) in head and neck squamous cell carcinoma (HNSCC) treated with (chemo)radiotherapy ([C]RT). METHODS Pretreatment MR-images of 78 patients were retrospectively studied. Apparent diffusion coefficients (ADC) were calculated with two sets of two b-values: 0-750s/mm(2) (ADC750) and 0-1000s/mm(2) (ADC1000). One observer assessed tumor volume on T1-WI. Two independent observers assessed ADC-values of primary tumor and largest lymph node in two sessions (i.e. without and with including CE-T1WI in image analysis). Interobserver and intersession agreement were assessed with intraclass correlation coefficients (ICC) separately for ADC750 and ADC1000. Lesion volumes and ADC-values were related to DFS using Cox regression analysis. RESULTS Median follow-up was 18 months. Interobserver ICC was better without than with CE-T1WI (primary tumor: 0.92 and 0.75-0.83, respectively; lymph node: 0.81-0.83 and 0.61-0.64, respectively). Intersession ICC ranged from 0.84 to 0.89. With CE-T1WI, mean ADC-values of primary tumor and lymph node were higher at both b-values than without CE-T1WI (P<0.001). Tumor volume (sensitivity: 73%; specificity: 57%) and lymph node ADC1000 (sensitivity: 71-79%; specificity: 77-79%) were independent significant predictors of DFS without and with including CE-T1WI (P<0.05). CONCLUSIONS Pretreatment primary tumor volume and lymph node ADC1000 were significant independent predictors of DFS in HNSCC treated with (C)RT. DFS could be predicted from ADC-values acquired without and with including CE-T1WI in image analysis. The inclusion of CE-T1WI did not result in significant improvements in the predictive value of DWI. DWI without including CE-T1WI was highly reproducible.
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Affiliation(s)
- Daniel P Noij
- Department of Radiology and Nuclear Medicine, VU University Medical Center, De Boelelaan 1117, Amsterdam, Noord-Holland, The Netherlands.
| | - Petra J W Pouwels
- Department of Physics and Medical Technology, VU University Medical Center, De Boelelaan 1117, Amsterdam, Noord-Holland, The Netherlands.
| | - Redina Ljumanovic
- Department of Radiology and Nuclear Medicine, VU University Medical Center, De Boelelaan 1117, Amsterdam, Noord-Holland, The Netherlands.
| | - Dirk L Knol
- Department of Epidemiology and Biostatistics, VU University Medical Center, De Boelelaan 1117, Amsterdam, Noord-Holland, The Netherlands.
| | - Patricia Doornaert
- Department of Radiation Oncology, VU University Medical Center, De Boelelaan 1117, Amsterdam, Noord-Holland, The Netherlands.
| | - Remco de Bree
- Department of Otolaryngology - Head and Neck Surgery, VU University Medical Center, De Boelelaan 1117, Amsterdam, Noord-Holland, The Netherlands.
| | - Jonas A Castelijns
- Department of Radiology and Nuclear Medicine, VU University Medical Center, De Boelelaan 1117, Amsterdam, Noord-Holland, The Netherlands.
| | - Pim de Graaf
- Department of Radiology and Nuclear Medicine, VU University Medical Center, De Boelelaan 1117, Amsterdam, Noord-Holland, The Netherlands.
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Cover KS, van Schijndel RA, Popescu V, van Dijk BW, Redolfi A, Knol DL, Frisoni GB, Barkhof F, Vrenken H. The SIENA/FSL whole brain atrophy algorithm is no more reproducible at 3T than 1.5 T for Alzheimer's disease. Psychiatry Res 2014; 224:14-21. [PMID: 25089020 DOI: 10.1016/j.pscychresns.2014.07.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 07/03/2014] [Accepted: 07/04/2014] [Indexed: 11/28/2022]
Abstract
The back-to-back (BTB) acquisition of MP-RAGE MRI scans of the Alzheimer׳s Disease Neuroimaging Initiative (ADNI1) provides an excellent data set with which to check the reproducibility of brain atrophy measures. As part of ADNI1, 131 subjects received BTB MP-RAGEs at multiple time points and two field strengths of 3T and 1.5 T. As a result, high quality data from 200 subject-visit-pairs was available to compare the reproducibility of brain atrophies measured with FSL/SIENA over 12 to 18 month intervals at both 3T and 1.5 T. Although several publications have reported on the differing performance of brain atrophy measures at 3T and 1.5 T, no formal comparison of reproducibility has been published to date. Another goal was to check whether tuning SIENA options, including -B, -S, -R and the fractional intensity threshold (f) had a significant impact on the reproducibility. The BTB reproducibility for SIENA was quantified by the 50th percentile of the absolute value of the difference in the percentage brain volume change (PBVC) for the BTB MP-RAGES. At both 3T and 1.5 T the SIENA option combination of "-B f=0.2", which is different from the default values of f=0.5, yielded the best reproducibility as measured by the 50th percentile yielding 0.28 (0.23-0.39)% and 0.26 (0.20-0.32)%. These results demonstrated that in general 3T had no advantage over 1.5 T for the whole brain atrophy measure - at least for SIENA. While 3T MRI is superior to 1.5 T for many types of measurements, and thus worth the additional cost, brain atrophy measurement does not seem to be one of them.
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Affiliation(s)
- Keith S Cover
- Department of Physics and Medical Technology, VU University medical center, Amsterdam, The Netherlands.
| | | | - Veronica Popescu
- Department of Radiology, VU University medical center, Amsterdam, The Netherlands
| | - Bob W van Dijk
- Department of Physics and Medical Technology, VU University medical center, Amsterdam, The Netherlands
| | - Alberto Redolfi
- Laboratory of Epidemiology & Neuroimaging, IRCCS San Giovanni di Dio Fatebenefratelli, Via Pilastroni 4, 25125 Brescia, Italy
| | - Dirk L Knol
- Department of Epidemiology and Biostatistics, VU University medical center, Amsterdam, The Netherlands
| | - Giovanni B Frisoni
- Laboratory of Epidemiology & Neuroimaging, IRCCS San Giovanni di Dio Fatebenefratelli, Via Pilastroni 4, 25125 Brescia, Italy
| | - Frederik Barkhof
- Department of Radiology, VU University medical center, Amsterdam, The Netherlands; MS Center Amsterdam and Alzheimer Center, VU University medical center, Amsterdam, The Netherlands
| | - Hugo Vrenken
- Department of Physics and Medical Technology, VU University medical center, Amsterdam, The Netherlands; Department of Radiology, VU University medical center, Amsterdam, The Netherlands; MS Center Amsterdam and Alzheimer Center, VU University medical center, Amsterdam, The Netherlands
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Kolff-Gart AS, Pouwels PJW, Noij DP, Ljumanovic R, Vandecaveye V, de Keyzer F, de Bree R, de Graaf P, Knol DL, Castelijns JA. Diffusion-weighted imaging of the head and neck in healthy subjects: reproducibility of ADC values in different MRI systems and repeat sessions. AJNR Am J Neuroradiol 2014; 36:384-90. [PMID: 25258365 DOI: 10.3174/ajnr.a4114] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND PURPOSE DWI is typically performed with EPI sequences in single-center studies. The purpose of this study was to determine the reproducibility of ADC values in the head and neck region in healthy subjects. In addition, the reproducibility of ADC values in different tissues was assessed to identify the most suitable reference tissue. MATERIALS AND METHODS We prospectively studied 7 healthy subjects, with EPI and TSE sequences, on 5 MR imaging systems at 3 time points in 2 institutions. ADC maps of EPI (with 2 b-values and 6 b-values) and TSE sequences were compared. Mean ADC values for different tissues (submandibular gland, sternocleidomastoid muscle, spinal cord, subdigastric lymph node, and tonsil) were used to evaluate intra- and intersubject, intersystem, and intersequence variability by using a linear mixed model. RESULTS On 97% of images, a region of interest could be placed on the spinal cord, compared with 87% in the tonsil. ADC values derived from EPI-DWI with 2 b-values and calculated EPI-DWI with 2 b-values extracted from EPI-DWI with 6 b-values did not differ significantly. The standard error of ADC measurement was the smallest for the tonsil and spinal cord (standard error of measurement = 151.2 × 10(-6) mm/s(2) and 190.1 × 10(-6) mm/s(2), respectively). The intersystem difference for mean ADC values and the influence of the MR imaging system on ADC values among the subjects were statistically significant (P < .001). The mean difference among examinations was negligible (ie, <10 × 10(-6) mm/s(2)). CONCLUSIONS In this study, the spinal cord was the most appropriate reference tissue and EPI-DWI with 6 b-values was the most reproducible sequence. ADC values were more precise if subjects were measured on the same MR imaging system and with the same sequence. ADC values differed significantly between MR imaging systems and sequences.
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Affiliation(s)
- A S Kolff-Gart
- From the Departments of Radiology and Nuclear Medicine (A.S.K.-G., D.P.N., R.L., P.d.G., J.A.C.)
| | | | - D P Noij
- From the Departments of Radiology and Nuclear Medicine (A.S.K.-G., D.P.N., R.L., P.d.G., J.A.C.)
| | - R Ljumanovic
- From the Departments of Radiology and Nuclear Medicine (A.S.K.-G., D.P.N., R.L., P.d.G., J.A.C.)
| | - V Vandecaveye
- Department of Radiology (V.V., F.d.K.), University Hospitals Leuven, Leuven, Belgium
| | - F de Keyzer
- Department of Radiology (V.V., F.d.K.), University Hospitals Leuven, Leuven, Belgium
| | - R de Bree
- Otolaryngology-Head and Neck Surgery (R.d.B.)
| | - P de Graaf
- From the Departments of Radiology and Nuclear Medicine (A.S.K.-G., D.P.N., R.L., P.d.G., J.A.C.)
| | - D L Knol
- Clinical Epidemiology and Biostatistics (D.L.K.), VU University Medical Center, Amsterdam, the Netherlands
| | - J A Castelijns
- From the Departments of Radiology and Nuclear Medicine (A.S.K.-G., D.P.N., R.L., P.d.G., J.A.C.)
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Slort W, Blankenstein AH, Schweitzer BPM, Knol DL, van der Horst HE, Aaronson NK, Deliens L. Effectiveness of the palliative care 'Availability, Current issues and Anticipation' (ACA) communication training programme for general practitioners on patient outcomes: a controlled trial. Palliat Med 2014; 28:1036-45. [PMID: 24951633 PMCID: PMC4230538 DOI: 10.1177/0269216314538302] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although communicating effectively with patients receiving palliative care can be difficult, it may contribute to maintaining or enhancing patients' quality of life. Little is known about the effect of training general practitioners in palliative care-specific communication. We hypothesized that palliative care patients of general practitioners exposed to the 'Availability, Current issues and Anticipation' communication training programme would report better outcomes than patients of control general practitioners. AIM To evaluate the effectiveness of the Availability, Current issues and Anticipation training programme for general practitioners on patient-reported outcomes. DESIGN In a controlled trial, general practitioners followed the Availability, Current issues and Anticipation programme or were part of the control group. Patients receiving palliative care of participating general practitioners completed the Palliative Care Outcome Scale, the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 Palliative, the Rest & Peace Scale, the Patient Satisfaction Questionnaire-III and the Availability, Current issues and Anticipation Scale, at baseline and 12 months follow-up. We analysed differences between groups using linear mixed models. TRIAL REGISTRATION ISRCTN56722368. SETTING/PARTICIPANTS General practitioners who attended a 2-year Palliative Care Training Course in the Netherlands. RESULTS Questionnaire data were available for 145 patients (89 in intervention and 56 in control group). We found no significant differences over time between the intervention and control groups in any of the five outcome measures. Ceiling effects were observed for the Rest & Peace Scale, Patient Satisfaction Questionnaire-III and Availability, Current issues and Anticipation Scale. CONCLUSION General practitioner participation in the Availability, Current issues and Anticipation training programme did not have a measurable effect on any of the outcomes investigated. Patients reported high levels of satisfaction with general practitioner care, regardless of group assignment. Future research might focus on general practitioners without special interest in palliative care.
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Affiliation(s)
- Willemjan Slort
- Department of General Practice and Elderly Care Medicine, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Annette H Blankenstein
- Department of General Practice and Elderly Care Medicine, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Bart P M Schweitzer
- Department of General Practice and Elderly Care Medicine, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Dirk L Knol
- Department of Epidemiology and Biostatistics, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Henriëtte E van der Horst
- Department of General Practice and Elderly Care Medicine, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Neil K Aaronson
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Luc Deliens
- Department of Public and Occupational Health, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands End-of-Life Care Research Group, Vrije Universiteit Brussel & Ghent University, Brussels, Belgium
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28
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van der Zwaard BC, van der Horst HE, Knol DL, Vanwanseele B, Elders PJM. Treatment of forefoot problems in older people: a randomized clinical trial comparing podiatric treatment with standardized shoe advice. Ann Fam Med 2014; 12:432-40. [PMID: 25354407 PMCID: PMC4157980 DOI: 10.1370/afm.1684] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Consultations for forefoot pain are frequent in primary care, but scientific support of treatment options is scarce. The purpose of this study is to investigate the effect of podiatric treatment vs standardized advice on proper shoe characteristics and fit of shoes by means of an information leaflet for people aged 50 years and older with forefoot pain in primary care. METHODS In this randomized controlled trial, 205 participants aged 50 years and older with hindering nontraumatic forefoot pain have been recruited at their general practitioner's office. Exclusion criteria were treatment of forefoot problem of less than 6 months' duration before inclusion, rheumatoid arthritis, and diabetic neuropathy or having pain considered not to be musculoskeletal (eg, warts). Participants received shoe advice by means of an information leaflet or podiatric care. Foot pain, foot-related dysfunction, general health, and social participation were assessed by means of questionnaires every 3 months for 1 year. Using multilevel analysis, we analyzed results at the level of (1) outcome measures, (2) the individual, and (3) the general practitioner. RESULTS No differences were found between the 2 treatment groups. Both intervention groups showed an improvement over time in foot pain and foot-related dysfunction. CONCLUSION This study found that shoe advice provided to patients consulting their general practitioner for forefoot pain and symptom relief resulted in outcomes similar to treatment outcomes in patients consulting a podiatrist. Based on these results, primary care physicians should be cautious when referring a patient to a podiatrist; instead, they should start by providing advice on proper characteristics and fit of shoes.
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Affiliation(s)
- Babette C van der Zwaard
- EMGO+ Institute, Department of General Practice and Elderly Care Medicine, VU University Medical Centre, Amsterdam, The Netherlands Lectoraat, Fontys University for Applied Sciences, Eindhoven, The Netherlands
| | - Henriëtte E van der Horst
- EMGO+ Institute, Department of General Practice and Elderly Care Medicine, VU University Medical Centre, Amsterdam, The Netherlands
| | - Dirk L Knol
- EMGO+ Institute, Department of Epidemiology and Biostatistics VU University Medical Centre, Amsterdam, The Netherlands
| | - Benedicte Vanwanseele
- Lectoraat, Fontys University for Applied Sciences, Eindhoven, The Netherlands Department of Kinesiology, KU Leuven, Leuven, Belgium
| | - Petra J M Elders
- EMGO+ Institute, Department of General Practice and Elderly Care Medicine, VU University Medical Centre, Amsterdam, The Netherlands
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Bertens D, Knol DL, Scheltens P, Visser PJ. Temporal evolution of biomarkers and cognitive markers in the asymptomatic, MCI, and dementia stage of Alzheimer's disease. Alzheimers Dement 2014; 11:511-22. [PMID: 25150730 DOI: 10.1016/j.jalz.2014.05.1754] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Revised: 05/10/2014] [Accepted: 05/30/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND We investigated the pattern of disease progression in the asymptomatic, mild cognitive impairment (MCI), and dementia stage of Alzheimer's disease (AD). METHODS We selected 284 subjects with AD pathology, defined as abnormal levels of amyloid beta 1-42 (Aβ1-42) in cerebrospinal fluid (CSF). Disease outcome measures included six biomarkers and five cognitive markers. We compared differences in baseline measures and decline over 4 years between the AD stages and tested whether these changes differed from subjects, without AD pathology (N = 132). RESULTS CSF Aβ1-42 reached the maximum abnormality level in the asymptomatic stage and tau in the MCI stage. The imaging and cognitive markers started to decline in the asymptomatic stage, and decline accelerated with advancing clinical stage. CONCLUSION This study provides further evidence for a temporal evolution of AD biomarkers. Our findings may be helpful to determine stage specific outcome measures for clinical trials.
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Affiliation(s)
- Daniela Bertens
- Department of Neurology/Alzheimer Centre, VU Medical Centre, Amsterdam, The Netherlands.
| | - Dirk L Knol
- Department of Epidemiology and Biostatistics, VU Medical Centre, Amsterdam, The Netherlands
| | - Philip Scheltens
- Department of Neurology/Alzheimer Centre, VU Medical Centre, Amsterdam, The Netherlands
| | - Pieter Jelle Visser
- Department of Neurology/Alzheimer Centre, VU Medical Centre, Amsterdam, The Netherlands; Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience (MHeNS), Alzheimer Centre Limburg, University Medical Centre, Maastricht, The Netherlands
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Prins ND, van der Flier WA, Knol DL, Fox NC, Brashear HR, Nye JS, Barkhof F, Scheltens P. The effect of galantamine on brain atrophy rate in subjects with mild cognitive impairment is modified by apolipoprotein E genotype: post-hoc analysis of data from a randomized controlled trial. Alzheimers Res Ther 2014; 6:47. [PMID: 25478019 PMCID: PMC4255389 DOI: 10.1186/alzrt275] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 06/27/2014] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The aim of this investigation was to assess the effect of galantamine, an acetylcholinesterase inhibitor and allosteric modulator of nicotinic receptors, on brain atrophy in individuals with mild cognitive impairment (MCI), and to assess effect modification by apolipoprotein E (APOE) genotype. METHODS We used data from the Galantamine-International-11 (Gal-Int-11) trial, a 24-month, randomized, double blind, placebo-controlled, flexible-dose (16 to 24 mg daily) study in patients with MCI. Brain magnetic resonance imaging (MRI), including a 3-dimensional T1-weighted gradient echo volumetric sequence, was performed at screening and at 24 months. We recorded whole brain and hippocampal volumes, and calculated annual atrophy rates. Linear regression analysis was used to calculate adjusted mean differences in the rate of whole brain and hippocampal atrophy, between MCI patients treated with galantamine and with placebo. Additionally, we performed stratified analyses according to APOE genotype. RESULTS Data from 364 MCI patients with 24-month MRI data (galantamine, n = 176; placebo, n = 188) were included in the volumetric analysis. Subjects treated with galantamine demonstrated a lower rate of whole brain atrophy compared to those treated with placebo (adjusted mean difference 0.18% per year (95% confidence interval (CI) 0.04; 0.30)). Stratified analyses according to APOE genotype, showed that this effect was confined to patients who carried an APOE ϵ4 allele (adjusted mean difference 0.28% per year (95% CI 0.07; 0.50)). Rates of hippocampal atrophy did not differ significantly between study groups. CONCLUSIONS Patients with MCI who were treated with galantamine demonstrated a lower rate of whole brain atrophy, but not of hippocampal atrophy, over a 24-month treatment period, compared to those treated with placebo. This protective effect of galantamine on whole brain atrophy rate in MCI was only present in APOE ϵ4 carriers.
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Affiliation(s)
- Niels D Prins
- Alzheimer Centre, Department of Neurology, VU University Medical Centre, PO Box 7057, 1007 MB Amsterdam, the Netherlands ; Alzheimer Research Center, Gebouw Cronenburg, Cronenburg 75, 1081 GM Amsterdam, the Netherlands
| | - Wiesje A van der Flier
- Alzheimer Centre, Department of Neurology, VU University Medical Centre, PO Box 7057, 1007 MB Amsterdam, the Netherlands ; Alzheimer Research Center, Gebouw Cronenburg, Cronenburg 75, 1081 GM Amsterdam, the Netherlands
| | - Dirk L Knol
- Department of Epidemiology & Biostatistics, VU University Medical Centre, PO Box 7057, 1007 MB Amsterdam, the Netherlands
| | - Nick C Fox
- Dementia Research Centre (N.C.F.), Department of Neurodegenerative Disease, Institute of Neurology, University College London, 8-11 Queen Square, London WC1N 3BG, UK
| | - H Robert Brashear
- Janssen Alzheimer Immunotherapy Research and Development, 700 Gateway Blvd, South San Francisco, CA 94080, USA
| | - Jeffrey S Nye
- Janssen Research and Development, LLC Johnson and Johnson Innovation, One Cambridge Center, 7th Floor, Cambridge, MA 02142, USA
| | - Frederik Barkhof
- Alzheimer Centre, Department of Neurology, VU University Medical Centre, PO Box 7057, 1007 MB Amsterdam, the Netherlands ; Department of Radiology, Image Analysis Centre, VU University Medical Centre, PO Box 7057, 1007 MB Amsterdam, the Netherlands
| | - Philip Scheltens
- Alzheimer Centre, Department of Neurology, VU University Medical Centre, PO Box 7057, 1007 MB Amsterdam, the Netherlands
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Oosterwerff MM, Eekhoff EM, Van Schoor NM, Boeke AJP, Nanayakkara P, Meijnen R, Knol DL, Kramer MH, Lips P. Effect of moderate-dose vitamin D supplementation on insulin sensitivity in vitamin D-deficient non-Western immigrants in the Netherlands: a randomized placebo-controlled trial. Am J Clin Nutr 2014; 100:152-60. [PMID: 24898240 DOI: 10.3945/ajcn.113.069260] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Low serum 25-hydroxyvitamin D [25(OH)D] concentrations have been associated with insulin resistance, the metabolic syndrome, and type 2 diabetes. Because many non-Western immigrants in the Netherlands are vitamin D deficient, obese, and at high risk of diabetes, vitamin D supplementation may contribute to prevent diabetes and insulin resistance. OBJECTIVE We examined the effect of vitamin D supplementation on insulin sensitivity and β cell function in overweight, vitamin D-deficient, non-Western immigrants at high risk of diabetes. DESIGN The study was a 16-wk, randomized, placebo-controlled trial. A total of 130 non-Western immigrants with prediabetes (fasting glucose concentration >5.5 mmol/L or random glucose concentration from 7.8 to 11.1 mmol/L) and vitamin D deficiency (serum 25[OH]D concentration <50 nmol/L) were randomly assigned after stratification by sex to receive either cholecalciferol (1200 IU/d) or a placebo for 16 wk. All participants received 500 mg Ca/d as calcium carbonate. The primary outcome was the difference in the area under the curve of insulin and glucose after a 75-g oral-glucose-tolerance test after 4 mo of treatment. Secondary outcomes were insulin-sensitivity variables, β cell-function variables, and metabolic syndrome. RESULTS Mean serum 25(OH)D concentrations increased significantly in the vitamin D compared with placebo groups. After 4 mo of therapy, the mean between-group difference was 38 nmol/L (95% CI: 32.1, 43.9 nmol/L; P < 0.001). There was no significant effect on insulin sensitivity and β cell function. In a post hoc analysis, when patients with diabetes at baseline were excluded, a significant increase in the insulinogenic index was observed in participants who obtained a 25(OH)D concentration ≥60 nmol/L (P = 0.040). CONCLUSIONS Vitamin D supplementation in non-Western vitamin D-deficient immigrants with prediabetes did not improve insulin sensitivity or β cell function or change the incidence of metabolic syndrome. However, after the exclusion of diabetic subjects, an improvement in the insulinogenic index was observed in participants who obtained a 25(OH)D concentration ≥60 nmol/L. This trial was registered at trialregister.nl as NTR1827.
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Affiliation(s)
- Mirjam M Oosterwerff
- From the Department of Internal Medicine, Section of Endocrinology ZH4A65 (MMO, EMWE, PN, RM, MHHK, and PL), the EMGO Institute for Health and Care Research (NMVS), and the Department of Epidemiology and Biostatistics (DLK), VU University Medical Center, Amsterdam, Netherlands, and General Practice, Postjesweg, Amsterdam (AJPB)
| | - Elisabeth Mw Eekhoff
- From the Department of Internal Medicine, Section of Endocrinology ZH4A65 (MMO, EMWE, PN, RM, MHHK, and PL), the EMGO Institute for Health and Care Research (NMVS), and the Department of Epidemiology and Biostatistics (DLK), VU University Medical Center, Amsterdam, Netherlands, and General Practice, Postjesweg, Amsterdam (AJPB)
| | - Natasja M Van Schoor
- From the Department of Internal Medicine, Section of Endocrinology ZH4A65 (MMO, EMWE, PN, RM, MHHK, and PL), the EMGO Institute for Health and Care Research (NMVS), and the Department of Epidemiology and Biostatistics (DLK), VU University Medical Center, Amsterdam, Netherlands, and General Practice, Postjesweg, Amsterdam (AJPB)
| | - A Joan P Boeke
- From the Department of Internal Medicine, Section of Endocrinology ZH4A65 (MMO, EMWE, PN, RM, MHHK, and PL), the EMGO Institute for Health and Care Research (NMVS), and the Department of Epidemiology and Biostatistics (DLK), VU University Medical Center, Amsterdam, Netherlands, and General Practice, Postjesweg, Amsterdam (AJPB)
| | - Prabath Nanayakkara
- From the Department of Internal Medicine, Section of Endocrinology ZH4A65 (MMO, EMWE, PN, RM, MHHK, and PL), the EMGO Institute for Health and Care Research (NMVS), and the Department of Epidemiology and Biostatistics (DLK), VU University Medical Center, Amsterdam, Netherlands, and General Practice, Postjesweg, Amsterdam (AJPB)
| | - Rosa Meijnen
- From the Department of Internal Medicine, Section of Endocrinology ZH4A65 (MMO, EMWE, PN, RM, MHHK, and PL), the EMGO Institute for Health and Care Research (NMVS), and the Department of Epidemiology and Biostatistics (DLK), VU University Medical Center, Amsterdam, Netherlands, and General Practice, Postjesweg, Amsterdam (AJPB)
| | - Dirk L Knol
- From the Department of Internal Medicine, Section of Endocrinology ZH4A65 (MMO, EMWE, PN, RM, MHHK, and PL), the EMGO Institute for Health and Care Research (NMVS), and the Department of Epidemiology and Biostatistics (DLK), VU University Medical Center, Amsterdam, Netherlands, and General Practice, Postjesweg, Amsterdam (AJPB)
| | - Mark Hh Kramer
- From the Department of Internal Medicine, Section of Endocrinology ZH4A65 (MMO, EMWE, PN, RM, MHHK, and PL), the EMGO Institute for Health and Care Research (NMVS), and the Department of Epidemiology and Biostatistics (DLK), VU University Medical Center, Amsterdam, Netherlands, and General Practice, Postjesweg, Amsterdam (AJPB)
| | - Paul Lips
- From the Department of Internal Medicine, Section of Endocrinology ZH4A65 (MMO, EMWE, PN, RM, MHHK, and PL), the EMGO Institute for Health and Care Research (NMVS), and the Department of Epidemiology and Biostatistics (DLK), VU University Medical Center, Amsterdam, Netherlands, and General Practice, Postjesweg, Amsterdam (AJPB)
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van der Esch M, Holla JF, van der Leeden M, Knol DL, Lems WF, Roorda LD, Dekker J. Decrease of muscle strength is associated with increase of activity limitations in early knee osteoarthritis: 3-year results from the cohort hip and cohort knee study. Arch Phys Med Rehabil 2014; 95:1962-8. [PMID: 24977932 DOI: 10.1016/j.apmr.2014.06.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 05/29/2014] [Accepted: 06/09/2014] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To determine whether a decrease in muscle strength over 3 years is associated with an increase in activity limitations in persons with early symptomatic knee osteoarthritis (OA), and to examine whether the longitudinal association between muscle strength and activity limitations is moderated by knee joint proprioception and laxity. DESIGN A longitudinal cohort study with 3-year follow-up. Measurements were performed at the second (t0) and fifth (t1) year of the Cohort Hip and Cohort Knee (CHECK) study. Statistical analyses included paired t tests, chi-square tests, and regression analyses. In regression analyses, the association between muscle strength and activity limitations was adjusted for confounders. SETTING A rehabilitation and rheumatology center. PARTICIPANTS Subjects (N=146) with early symptomatic knee OA from the CHECK study. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Muscle strength, proprioception, and laxity were assessed using specifically designed measurement devices. Self-reported and performance-based activity limitations were measured with the Western Ontario and McMaster Universities Osteoarthritis Index, the Get Up and Go test, the walk test, and the stair-climb test. RESULTS A total of 116 women (79.5%) and 30 men (20.5%), with a mean age ± SD of 58.4±4.9 years and a mean body mass index ± SD of 25.5±3.6, were included in the study. Overall, small 3-year changes in muscle strength and activity limitations were observed. At the group level, the average muscle strength increased by 10% (1.0±0.3 to 1.1±0.3Nm/kg) over the 3 years. The 3-year decrease in muscle strength was independently associated with an increase in performance-based activity limitations on all 3 measures (B=-1.12, B=-5.83, and B=-1.25, respectively). Proprioception and laxity did not moderate this association. CONCLUSIONS In patients with early knee OA, decreased muscle strength is associated with an increase in activity limitations. Our results are a step toward understanding the role of muscle weakness in the development of activity limitations in knee OA. Further well-designed experimental studies are indicated to establish the causal role of muscle weakness in activity limitations.
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Affiliation(s)
- Martin van der Esch
- Amsterdam Rehabilitation Research Center, Reade, Amsterdam, The Netherlands.
| | - Jasmijn F Holla
- Amsterdam Rehabilitation Research Center, Reade, Amsterdam, The Netherlands
| | - Marike van der Leeden
- Amsterdam Rehabilitation Research Center, Reade, Amsterdam, The Netherlands; Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands; EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Dirk L Knol
- EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Willem F Lems
- Department of Rheumatology, VU University Medical Center, Amsterdam, The Netherlands; Jan van Breemen Research Institute, Reade, Amsterdam, The Netherlands
| | - Leo D Roorda
- Amsterdam Rehabilitation Research Center, Reade, Amsterdam, The Netherlands
| | - Joost Dekker
- Amsterdam Rehabilitation Research Center, Reade, Amsterdam, The Netherlands; Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands; EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands; Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
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Geytenbeek JJ, Mokkink LB, Knol DL, Vermeulen RJ, Oostrom KJ. Reliability and validity of the C-BiLLT: a new instrument to assess comprehension of spoken language in young children with cerebral palsy and complex communication needs. Augment Altern Commun 2014; 30:252-66. [PMID: 24948533 DOI: 10.3109/07434618.2014.924992] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In clinical practice, a variety of diagnostic tests are available to assess a child's comprehension of spoken language. However, none of these tests have been designed specifically for use with children who have severe motor impairments and who experience severe difficulty when using speech to communicate. This article describes the process of investigating the reliability and validity of the Computer-Based Instrument for Low Motor Language Testing (C-BiLLT), which was specifically developed to assess spoken Dutch language comprehension in children with cerebral palsy and complex communication needs. The study included 806 children with typical development, and 87 nonspeaking children with cerebral palsy and complex communication needs, and was designed to provide information on the psychometric qualities of the C-BiLLT. The potential utility of the C-BiLLT as a measure of spoken Dutch language comprehension abilities for children with cerebral palsy and complex communication needs is discussed.
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Affiliation(s)
- Joke J Geytenbeek
- Department of Paediatric Rehabilitation Medicine, The EMGO Institute for Health and Care Research, VU University Medical Center , Amsterdam , The Netherlands
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Stekelenburg CM, Sonneveld PMDG, Bouman MB, van der Wal MBA, Knol DL, de Vet HCW, van Zuijlen PPM. The hand held Doppler device for the detection of perforators in reconstructive surgery: what you hear is not always what you get. Burns 2014; 40:1702-6. [PMID: 24953858 DOI: 10.1016/j.burns.2014.04.018] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 04/23/2014] [Accepted: 04/24/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Perforator-based flaps have become indispensable in the treatment of burn scars. Pre-operative perforator mapping is often performed by use of the hand held Doppler device, partly due to its convenience and the low costs. We expected to find sufficient evidence in literature to support the use of the device, however available literature showed a distinct lack of clinimetric studies that adequately tested the reliability. METHODS To assess reliability, perforator locations were mapped independently by two clinicians using an 8MHz Doppler device. In healthy volunteers the elbow region or the peri-umbilical region were randomly chosen to be the measurement areas of predefined squares (7cm×7cm). Subsequently, the perforators within the area were mapped with Duplex to establish the validity by means of the positive predictive value. RESULTS 20 volunteers were included. The hand held Doppler technique showed moderate reliability with a mean Dice coefficient of 0.56. Also, poor validity was found expressed by a mean positive predictive value of 55%. CONCLUSIONS Surprisingly, this study has shown that performance of the hand held Doppler device was moderate. The Doppler should not be used alone for the detection of perforators.
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Affiliation(s)
- Carlijn M Stekelenburg
- Association of Dutch Burn Centers, Beverwijk, The Netherlands; Burn Center and Department of Plastic, Reconstructive and Hand Surgery, Red Cross Hospital, Beverwijk, The Netherlands; MOVE Research Institute, VU University of Amsterdam, The Netherlands; Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | - Pia M D G Sonneveld
- Burn Center and Department of Plastic, Reconstructive and Hand Surgery, Red Cross Hospital, Beverwijk, The Netherlands
| | - Mark-Bram Bouman
- Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | - Martijn B A van der Wal
- Burn Center and Department of Plastic, Reconstructive and Hand Surgery, Red Cross Hospital, Beverwijk, The Netherlands
| | - Dirk L Knol
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Henrica C W de Vet
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands; EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Paul P M van Zuijlen
- Association of Dutch Burn Centers, Beverwijk, The Netherlands; Burn Center and Department of Plastic, Reconstructive and Hand Surgery, Red Cross Hospital, Beverwijk, The Netherlands; MOVE Research Institute, VU University of Amsterdam, The Netherlands; Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam, The Netherlands.
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Bouwsma EV, Anema JR, Vonk Noordegraaf A, Knol DL, Bosmans JE, Schraffordt Koops SE, van Kesteren PJ, van Baal WM, Lips JP, Emanuel MH, Scholten PC, Mozes A, Adriaanse AH, Brölmann HA, Huirne JA. The cost effectiveness of a tailored, web-based care program to enhance postoperative recovery in gynecologic patients in comparison with usual care: protocol of a stepped wedge cluster randomized controlled trial. JMIR Res Protoc 2014; 3:e30. [PMID: 24943277 PMCID: PMC4090379 DOI: 10.2196/resprot.3236] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 05/21/2014] [Indexed: 11/13/2022] Open
Abstract
Background The length of recovery after benign gynecological surgery and return to work frequently exceeds the period that is recommended or expected by specialists. A prolonged recovery is associated with a poorer quality of life. In addition, costs due to prolonged sick leave following gynecological surgery cause a significant financial burden on society. Objective The objective of our study was to present the protocol of a stepped wedge cluster randomized controlled trial to evaluate the cost effectiveness of a new care program for patients undergoing hysterectomy and/or adnexal surgery for benign disease, compared to the usual care. Methods The care program under study, designed to improve convalescence and to prevent delayed return to work, targets two levels. At the hospital level, guidelines will be distributed among clinical staff in order to stimulate evidence-based patient education. At the patient level, additional perioperative guidance is provided by means of an eHealth intervention, equipping patients with tailored convalescence advice, and an occupational intervention is available for those patients at risk of prolonged sick leave. Due to the stepped wedge design of the trial, the care program will be sequentially rolled out among the 9 participating hospitals, from which the patients are recruited. Eligible for this study are employed women, 18-65 years of age, who are scheduled for hysterectomy and/or laparoscopic adnexal surgery. The primary outcome is full sustainable return to work. The secondary outcomes include general recovery, quality of life, self-efficacy, coping, and pain. The data will be collected by means of self-reported electronic questionnaires before surgery and at 2, 6, 12, 26, and 52 weeks after surgery. Sick leave and cost data are measured by monthly sick leave calendars, and cost diaries during the 12 month follow-up period. The economic evaluation will be performed from the societal perspective. All statistical analyses will be conducted according to the intention-to-treat principle. Results The enrollment of the patients started October 2011. The follow-up period will be completed in August 2014. Data cleaning or analysis has not begun as of this article’s submission. Conclusions We hypothesize the care program to be effective by means of improving convalescence and reducing costs associated with productivity losses following gynecological surgery. The results of this study will enable health care policy makers to decide about future implementation of this care program on a broad scale. Trial Registration Netherlands Trial Register: NTR2933; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2933 (Archived by WebCite at http://www.webcitation.org/6Q7exPG84).
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Affiliation(s)
- Esther Va Bouwsma
- Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, Netherlands
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van Helvoirt H, Apeldoorn AT, Ostelo RW, Knol DL, Arts MP, Kamper SJ, van Tulder MW. Transforaminal epidural steroid injections followed by mechanical diagnosis and therapy to prevent surgery for lumbar disc herniation. Pain Med 2014; 15:1100-8. [PMID: 24800697 DOI: 10.1111/pme.12450] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
STUDY DESIGN Prospective cohort study. OBJECTIVE To report the clinical course of patients with MRI-confirmed lumbar disc herniation-related radicular noncentralizing pain who received transforaminal epidural steroid injections (TESIs) and mechanical diagnosis and therapy (MDT). SUMMARY OF BACKGROUND DATA Noncentralizing symptoms in patients with lumbar disc herniation are associated with poor outcome. Commonly used treatments for these patients include TESIs and MDT. No study has evaluated the outcome of combining both strategies. METHODS Consecutive candidates for herniated lumbar disc surgery with noncentralizing chronic pain were eligible. Patients received TESIs followed by MDT. The primary outcomes were pain severity in the leg, disability (Roland-Morris Disability Questionnaire for Sciatica), and global perceived effect (GPE). Outcomes were measured at baseline, discharge, and 12 months. Linear mixed-models and McNemar's tests were used to analyze outcome data. RESULTS Sixty-nine patients receive TESIs. After TESIs, symptoms were resolved completely in 11 patients (16%). In these patients, symptom resolution was maintained at 12 months. A second subgroup of 32 patients (46%) reported significantly less pain after TESIs and showed centralization with MDT reassessment (significant reductions in leg pain and disability [P < 0.001]) and a satisfaction rate of 90% at 12 months. A third subgroup of 11 patients (16%) reported significantly less pain after TESIs but still showed noncentralization with MDT reassessment (significant reductions in leg pain and disability [P < 0.05] and a satisfaction rate of 50% at 12 months). A fourth subgroup of 15 patients (22%) did not respond on TESIs and received an operative intervention. CONCLUSION The results indicate that a course of TESIs followed by MDT may be able to avoid surgery in a substantial proportion of candidates for herniated lumbar disc surgery.
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Affiliation(s)
- Hans van Helvoirt
- Medical Back Neck Centre, The Hague and Rugpoli Brabant Tilburg, The Netherlands
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van Schoor NM, Knol DL, Deeg DJH, Peters FPAMN, Heijboer AC, Lips P. Longitudinal changes and seasonal variations in serum 25-hydroxyvitamin D levels in different age groups: results of the Longitudinal Aging Study Amsterdam. Osteoporos Int 2014; 25:1483-91. [PMID: 24570295 DOI: 10.1007/s00198-014-2651-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Accepted: 02/05/2014] [Indexed: 11/25/2022]
Abstract
UNLABELLED Vitamin D levels remained fairly stable during ageing with increasing levels in persons aged 55-65 years old and decreasing levels in persons aged 65-88 years old. The seasonal variation was larger than the longitudinal change. Our findings implicate that vitamin D supplementation becomes more important in older age groups and during wintertime. INTRODUCTION Longitudinal changes in serum 25-hydroxyvitamin D (25-OHD) levels during aging have not been studied extensively. Two studies showed increasing serum 25-OHD levels. One of these studies suggested that there might be decreasing levels in persons aged 65 years and older. The objectives of the current study are the following: (1) to examine longitudinal changes in serum 25-OHD levels in different age groups and (2) to describe the seasonal variation in different age groups. METHODS Data of the Longitudinal Aging Study Amsterdam (LASA), an ongoing cohort study, were used. Two different cohorts were included: (1) younger cohort: aged 55-65 years old at baseline, n = 738, follow-up of 6 years and (2) older cohort: aged 65-88 years old at baseline, n = 1,320, follow-up of 13 years. RESULTS At baseline, average levels were 56.5 nmol/L in the younger cohort and 51.1 nmol/L in the older cohort. In the younger cohort, a longitudinal increase in the mean serum 25-OHD levels of 4 nmol/L in 6 years was observed; in the older cohort, a longitudinal decrease in the mean serum 25-OHD levels of 4 nmol/L in 13 years was observed. The seasonal variation was ±12 nmol/L in the younger cohort and ±7 nmol/L in the older cohort. CONCLUSIONS Long-term serum 25-OHD levels remained fairly stable during aging with slightly increasing levels in persons aged 55-65 years old and slightly decreasing levels in persons aged 65-88 years old. On average, the seasonal variation was larger than the longitudinal change. Our findings implicate that vitamin D supplementation becomes more important in older age groups and during wintertime.
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Affiliation(s)
- N M van Schoor
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands,
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Bakkum AJ, Janssen TW, Rolf MP, Roos JC, Burcksen J, Knol DL, de Groot S. A reliable method for measuring proximal tibia and distal femur bone mineral density using dual-energy X-ray absorptiometry. Med Eng Phys 2014; 36:387-90. [DOI: 10.1016/j.medengphy.2013.08.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 07/17/2013] [Accepted: 08/14/2013] [Indexed: 01/15/2023]
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Tijdink JK, Smulders YM, Vergouwen ACM, de Vet HCW, Knol DL. The assessment of publication pressure in medical science; validity and reliability of a Publication Pressure Questionnaire (PPQ). Qual Life Res 2014; 23:2055-62. [PMID: 24522963 DOI: 10.1007/s11136-014-0643-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2014] [Indexed: 11/24/2022]
Abstract
PURPOSE To determine content validity, structural validity, construct validity and reliability of an internet-based questionnaire designed for assessment of publication pressure experienced by medical scientists. METHODS The Publication Pressure Questionnaire (PPQ) was designed to assess psychological pressure to publish scientific papers. Content validity was evaluated by collecting independent comments from external experts (n = 7) on the construct, comprehensiveness and relevance of the PPQ. Structural validity was assessed by factor analysis and item response theory (IRT) using the generalized partial credit model. Pearson's correlation coefficients were calculated to assess potential correlations with the emotional exhaustion and depersonalization subscales of the Maslach Burnout Inventory (MBI). Single test reliability (lambda2) was obtained from the IRT analysis. RESULTS Content validity was satisfactory. Confirmatory factor analysis did not support the presence of three initially assumed separate domains of publication pressure (i.e., personally experienced publication pressure, publication pressure in general, pressure on position of scientist). After exclusion of the third domain (six items), we performed exploratory factor analysis and IRT. The goodness-of-fit statistics for the IRT assuming a single dimension were satisfactory when four items were removed, resulting in 14 items of the final PPQ. Correlations with the emotional exhaustion and depersonalization scales of the MBI were 0.34 and 0.31, respectively, supporting construct validity. Single test administration reliability lambda2 was 0.69 and 0.90 on the test scores and expected a posteriori scores, respectively. CONCLUSION The PPQ seems a valid and reliable instrument to measure publication pressure among medical scientists.
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Affiliation(s)
- J K Tijdink
- Department of Internal Medicine, VU University Medical Centre, PO Box 7057, 1007 MB, Amsterdam, The Netherlands,
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Vonk Noordegraaf A, Anema JR, van Mechelen W, Knol DL, van Baal WM, van Kesteren PJM, Brölmann HAM, Huirne JAF. A personalised eHealth programme reduces the duration until return to work after gynaecological surgery: results of a multicentre randomised trial. BJOG 2014; 121:1127-35; discussion 1136. [PMID: 24511914 DOI: 10.1111/1471-0528.12661] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2013] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of an eHealth intervention on recovery and return to work, after gynaecological surgery. DESIGN Randomised multicentre trial that ran from March 2010 until September 2011. SETTING Secondary care in seven general and university hospitals in The Netherlands. POPULATION A cohort of 215 women (aged 18-65 years) who had a hysterectomy and/or laparoscopic adnexal surgery for a benign indication. METHODS The women were randomly assigned to the intervention group (n = 110) or the control group (n = 105). The intervention group received an eHealth programme that provided personalised tailor-made pre- and postoperative instructions on the resumption of daily activities, including work, and tools to improve self-empowerment and to identify recovery problems. The control group was provided with access to a control website. MAIN OUTCOME MEASURES The primary outcome was the duration of sick leave until a full sustainable return to work. Secondary outcome measures were quality of life, general recovery, and pain intensity. RESULTS In intention-to-treat analysis the eHealth intervention was effective on time to return to work (hazard ratio 1.43; 95% confidence interval 1.003-2.040; P = 0.048). The median duration of sick leave until a full sustainable return to work was 39 days (interquartile range 20-67 days) in the intervention group and 48 days (interquartile range 21-69 days) in the control group. After 26 weeks pain intensity was lower (visual analogue scale, cumulative odds ratio 1.84; 95% confidence interval 1.04-3.25; P = 0.035) and quality of life was higher (Rand-36 health survey, between-group difference 30, 95% confidence interval 4-57; P = 0.024) in the intervention group, compared with the control group. CONCLUSIONS The use of the eHealth intervention by women after gynaecological surgery results in a faster return to work, with a higher quality of life and less pain.
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Affiliation(s)
- A Vonk Noordegraaf
- Department of Obstetrics and Gynaecology, & EMGO Institute for Health and Care Research, AMC-UMCG-UWV-VUmc, Amsterdam, the Netherlands; Department of Public and Occupational Health, & EMGO Institute for Health and Care Research, AMC-UMCG-UWV-VUmc, Amsterdam, the Netherlands
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Mulder ER, de Jong RA, Knol DL, van Schijndel RA, Cover KS, Visser PJ, Barkhof F, Vrenken H. Hippocampal volume change measurement: quantitative assessment of the reproducibility of expert manual outlining and the automated methods FreeSurfer and FIRST. Neuroimage 2014; 92:169-81. [PMID: 24521851 DOI: 10.1016/j.neuroimage.2014.01.058] [Citation(s) in RCA: 101] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Revised: 01/23/2014] [Accepted: 01/31/2014] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND To measure hippocampal volume change in Alzheimer's disease (AD) or mild cognitive impairment (MCI), expert manual delineation is often used because of its supposed accuracy. It has been suggested that expert outlining yields poorer reproducibility as compared to automated methods, but this has not been investigated. AIM To determine the reproducibilities of expert manual outlining and two common automated methods for measuring hippocampal atrophy rates in healthy aging, MCI and AD. METHODS From the Alzheimer's Disease Neuroimaging Initiative (ADNI), 80 subjects were selected: 20 patients with AD, 40 patients with mild cognitive impairment (MCI) and 20 healthy controls (HCs). Left and right hippocampal volume change between baseline and month-12 visit was assessed by using expert manual delineation, and by the automated software packages FreeSurfer (longitudinal processing stream) and FIRST. To assess reproducibility of the measured hippocampal volume change, both back-to-back (BTB) MPRAGE scans available for each visit were analyzed. Hippocampal volume change was expressed in μL, and as a percentage of baseline volume. Reproducibility of the 1-year hippocampal volume change was estimated from the BTB measurements by using linear mixed model to calculate the limits of agreement (LoA) of each method, reflecting its measurement uncertainty. Using the delta method, approximate p-values were calculated for the pairwise comparisons between methods. Statistical analyses were performed both with inclusion and exclusion of visibly incorrect segmentations. RESULTS Visibly incorrect automated segmentation in either one or both scans of a longitudinal scan pair occurred in 7.5% of the hippocampi for FreeSurfer and in 6.9% of the hippocampi for FIRST. After excluding these failed cases, reproducibility analysis for 1-year percentage volume change yielded LoA of ±7.2% for FreeSurfer, ±9.7% for expert manual delineation, and ±10.0% for FIRST. Methods ranked the same for reproducibility of 1-year μL volume change, with LoA of ±218 μL for FreeSurfer, ±319 μL for expert manual delineation, and ±333 μL for FIRST. Approximate p-values indicated that reproducibility was better for FreeSurfer than for manual or FIRST, and that manual and FIRST did not differ. Inclusion of failed automated segmentations led to worsening of reproducibility of both automated methods for 1-year raw and percentage volume change. CONCLUSION Quantitative reproducibility values of 1-year microliter and percentage hippocampal volume change were roughly similar between expert manual outlining, FIRST and FreeSurfer, but FreeSurfer reproducibility was statistically significantly superior to both manual outlining and FIRST after exclusion of failed segmentations.
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Affiliation(s)
- Emma R Mulder
- Image Analysis Center, VU University Medical Center, Amsterdam, The Netherlands; Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands
| | - Remko A de Jong
- Image Analysis Center, VU University Medical Center, Amsterdam, The Netherlands; Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands
| | - Dirk L Knol
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Ronald A van Schijndel
- Image Analysis Center, VU University Medical Center, Amsterdam, The Netherlands; Department of Information and Communication Technology, VU University Medical Center, Amsterdam, The Netherlands
| | - Keith S Cover
- Department of Physics and Medical Technology, VU University Medical Center, Amsterdam, The Netherlands
| | - Pieter J Visser
- Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands
| | - Frederik Barkhof
- Image Analysis Center, VU University Medical Center, Amsterdam, The Netherlands; Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands
| | - Hugo Vrenken
- Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands; Department of Physics and Medical Technology, VU University Medical Center, Amsterdam, The Netherlands.
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Prins ND, van der Flier WM, Brashear HR, Knol DL, van de Pol LA, Barkhof F, Scheltens P. Predictors of progression from mild cognitive impairment to dementia in the placebo-arm of a clinical trial population. J Alzheimers Dis 2013; 36:79-85. [PMID: 23563246 DOI: 10.3233/jad-122233] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We studied the predictive value of cognitive performance, vascular risk factors, apolipoprotein E (APOE) genotype, and structural brain changes on MRI, on progression to dementia in post hoc analyses of 426 placebo patients (mean age 71 years; 55% women) with mild cognitive impairment (MCI) who participated in a previously published large multi-center clinical trial (Gal-Int-11). The ADAS-cog/MCI test, the New York University Paragraph Recall Test, and the Digit Symbol Coding Test were available at baseline, as were vascular risk factors and APOE genotype. Medial temporal lobe atrophy (MTA), white matter hyperintensities (WMH) and lacunes were assessed on MRI. Over two years of follow-up, 81 patients (19%) converted to dementia, while 345 patients (81%) remained stable. Results of Cox proportional-hazards regression analysis showed that higher age, worse cognitive test performance, presence of an APOE ε4 allele, and higher MTA scores on MRI increased the risk of progression to dementia in univariate analyses. Vascular risk factors, and WMH and lacunes on MRI, were not associated with progression to dementia. Lower performance on the ADAS-cog/MCI test (HR 1.08 per point increase; 95% CI 1.06-1.10) and Delayed recall test (HR 0.76 per point increase; 95% CI 0.68-0.85), as well as higher MTA scores on MRI (HR 1.33 per point increase; 95% CI 1.00-1.77) were independent predictors of progression to dementia in a step-wise Cox proportional-hazards model with age and gender forced into the model. We conclude that global cognitive function, episodic memory performance, and MTA on MRI independently predict progression to dementia in patients with MCI.
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Affiliation(s)
- Niels D Prins
- Alzheimer Centre and Department of Neurology, VU University Medical Centre, Amsterdam, The Netherlands.
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Sikkes SAM, Pijnenburg YAL, Knol DL, de Lange-de Klerk ESM, Scheltens P, Uitdehaag BMJ. Assessment of instrumental activities of daily living in dementia: diagnostic value of the Amsterdam Instrumental Activities of Daily Living Questionnaire. J Geriatr Psychiatry Neurol 2013; 26:244-50. [PMID: 24212244 DOI: 10.1177/0891988713509139] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Measuring impairments in "instrumental activities of daily living" (IADL) is important in dementia, but challenging due to the lack of reliable and valid instruments. We recently developed the Amsterdam Instrumental Activities of Daily Living Questionnaire (A-IADL-Q; note 1). We aim to investigate the diagnostic accuracy of the A-IADL-Q for dementia in a memory clinic setting. METHODS Patients visiting the Alzheimer Center of the VU University Medical Center with their informants between 2009 and 2011 were included (N = 278). Diagnoses were established in a multidisciplinary consensus meeting, independent of the A-IADL-Q scores. An optimal A-IADL-Q cutoff point was determined, and sensitivity and specificity were calculated. Area under the curves (AUCs) were compared between A-IADL-Q and "disability assessment of dementia" (DAD). The additional diagnostic value of the A-IADL-Q to Mini-Mental State Examination (MMSE) was examined using logistic regression analyses. RESULTS Dementia prevalence was 50.5%. Overall diagnostic accuracy based on the AUC was 0.75 (95% confidence interval [CI]: 0.70-0.81) for the A-IADL-Q and 0.70 (95% CI: 0.63-0.77) for the DAD, which did not differ significantly. The optimal cutoff score for the A-IADL-Q was 51.4, resulting in sensitivity of 0.74 and specificity of 0.64. Combining the A-IADL-Q with the MMSE improved specificity (0.94), with a decline in sensitivity (0.55). Logistic regression models showed that adding A-IADL-Q improved the diagnostic accuracy (Z = 2.55, P = .011), whereas the DAD did not. CONCLUSIONS In this study, we showed a fair diagnostic accuracy for A-IADL-Q and an additional value in the diagnosis of dementia. These results support the role of A-IADL-Q as a valuable diagnostic tool.
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Affiliation(s)
- Sietske A M Sikkes
- Alzheimer Center, VU University Medical Center, Amsterdam, the Netherlands
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van der Esch M, Knol DL, Schaffers IC, Reiding DJ, van Schaardenburg D, Knoop J, Roorda LD, Lems WF, Dekker J. Osteoarthritis of the knee: multicompartmental or compartmental disease? Rheumatology (Oxford) 2013; 53:540-6. [PMID: 24292347 DOI: 10.1093/rheumatology/ket393] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Knee OA has been conceptualized as a multicompartmental disease, as a compartmental disease or as a combination of these two disease processes. The aim of this study was to determine the associations between four radiographic features (joint space narrowing, osteophyte formation, sclerosis and cysts) across and within the three knee compartments (medial tibiofemoral, lateral tibiofemoral and patellofemoral compartment) in knee OA. METHODS Data from the Amsterdam OA Cohort were used. In 298 patients diagnosed with knee OA, radiographic features were examined in three knee joint compartments. Radiographic features were scored according to standardized scoring methods. Factor analysis was used to examine associations between the four radiographic features across and within compartments. RESULTS A bifactor model showed a general multicompartmental factor: 10 of 12 radiographic features across the entire joint were associated with the general factor. The bifactor model also showed three compartmental factors-one for each compartment: joint space narrowing, sclerosis and to a lesser extent osteophyte formation were associated with these compartmental factors. CONCLUSION These findings suggest a multicompartmental disease process in the knee, characterized by associations among features across the entire joint, as well as compartmental disease processes in each knee compartment, characterized by associations among features within specific compartments. Longitudinal studies are needed to explore the possibility of the development from a compartmental disease to a multicompartmental disease and the impact of contributing factors on the development.
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Affiliation(s)
- Martin van der Esch
- Amsterdam Rehabilitation Research Centre Reade, Dr Jan van Breemenstraat 2, PO 58271, 1040 HG Amsterdam, The Netherlands.
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Hermsen LAH, Leone SS, Smalbrugge M, Knol DL, van der Horst HE, Dekker J. Exploring the aggregation of four functional measures in a population of older adults with joint pain and comorbidity. BMC Geriatr 2013; 13:119. [PMID: 24192234 PMCID: PMC3827990 DOI: 10.1186/1471-2318-13-119] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Accepted: 10/29/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In clinical settings, it is important for health care providers to measure different aspects of functioning in older adults with joint pain and comorbidity. Besides the use of distinct measures, it could also be attractive to have one general measure of functioning that incorporates several distinct measures, but provides one summary score to quantify overall level of functioning, for example for the identification of older adults at risk of poor functional outcome. Therefore, we selected four measures of functioning: Physical Functioning (PF), Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL) and participation, and tested the possibility to aggregate these measures into one general measure of functioning. METHODS A prospective cohort study of older adults (≥65 years) with joint pain and comorbidity provided baseline data (n = 407) consisting of PF (PF subscale, RAND-36; 10 items), ADL (KATZ index; 6 items), IADL (Lawton index; 7 items) and participation (KAP; 6 items). We tested two models with confirmatory factor analysis: first, a bifactor model with all four measures and second, a bifactor model with PF, ADL and IADL and a correlated but distinct subgroup factor for participation. Several model fit indexes and reliability coefficients, such as explained common variance (ECV) and omegas were computed for both models. RESULTS The first model fitted the data well, but the reliability analysis indicated multidimensionality and unique information in the subgroup factor participation. The second model showed similar model fits, but better reliability; ECV = 0.67, omega-t = 0.94, low omega-s = 0.18-0.22 on the subgroup factors and high omega of 0.82 on participation, which all were in favour of the second model. CONCLUSIONS The results indicate that PF, ADL and IADL could be aggregated into one general measure of functioning, whereas participation should be considered as a distinct measure.
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Affiliation(s)
- Lotte A H Hermsen
- Department of General Practice and Elderly Care Medicine and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, Netherlands.
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Lukas C, Sombekke MH, Bellenberg B, Hahn HK, Popescu V, Bendfeldt K, Radue EW, Gass A, Borgwardt SJ, Kappos L, Naegelin Y, Knol DL, Polman CH, Geurts JJG, Barkhof F, Vrenken H. Relevance of Spinal Cord Abnormalities to Clinical Disability in Multiple Sclerosis: MR Imaging Findings in a Large Cohort of Patients. Radiology 2013. [DOI: 10.1148/radiol.13122566] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Holla JFM, van der Leeden M, Knol DL, Roorda LD, van der Esch M, Voorneman RE, Lems WF, Dekker J. The association of body-mass index and depressed mood with knee pain and activity limitations in knee osteoarthritis: results from the Amsterdam osteoarthritis cohort. BMC Musculoskelet Disord 2013; 14:296. [PMID: 24131757 PMCID: PMC3852795 DOI: 10.1186/1471-2474-14-296] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Accepted: 10/14/2013] [Indexed: 11/16/2022] Open
Abstract
Background Body-mass index (BMI) and depressed mood are both positively associated with pain and activity limitations in knee osteoarthritis (OA), and are interrelated. The aims of the present study were: 1) to assess whether BMI and depressed mood are independently associated with knee pain and activity limitations; and 2) to compare the relative contributions of BMI and depressed mood to knee pain and activity limitations. Methods A cross-sectional study in 294 patients with clinical knee OA. Regression analyses were performed with knee pain or activity limitations (self-reported and performance-based) as dependent variables, and BMI and depressed mood as independent variables. All analyses were adjusted for age, gender, marital status, education level, radiographic OA and comorbidity. Dominance analyses were performed to examine the relative contributions of BMI and depressed mood to knee pain and activity limitations. Results BMI and depressed mood were positively and independently associated with knee pain and activity limitations. BMI and depressed mood explained small parts (3.0% and 2.3%, respectively) of variance in knee pain. BMI explained a substantial part of variance in both self-reported (9.8%) and performance-based (20.4%) activity limitations, while depressed mood explained a small part of variance (3.1% in self-reported and 2.6% in performance-based activity limitations). Conclusions In patients with knee OA both BMI and depressed mood seem to be independently associated with knee pain and activity limitations. The contribution of BMI to activity limitations is most substantial, thereby offering a relevant target for interventions.
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Affiliation(s)
- Jasmijn F M Holla
- Amsterdam Rehabilitation Research Centre
- Reade, PO Box 58271, 1040 HG Amsterdam, The Netherlands.
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Popescu V, Agosta F, Hulst HE, Sluimer IC, Knol DL, Sormani MP, Enzinger C, Ropele S, Alonso J, Sastre-Garriga J, Rovira A, Montalban X, Bodini B, Ciccarelli O, Khaleeli Z, Chard DT, Matthews L, Palace J, Giorgio A, De Stefano N, Eisele P, Gass A, Polman CH, Uitdehaag BMJ, Messina MJ, Comi G, Filippi M, Barkhof F, Vrenken H. Brain atrophy and lesion load predict long term disability in multiple sclerosis. J Neurol Neurosurg Psychiatry 2013; 84:1082-91. [PMID: 23524331 DOI: 10.1136/jnnp-2012-304094] [Citation(s) in RCA: 227] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To determine whether brain atrophy and lesion volumes predict subsequent 10 year clinical evolution in multiple sclerosis (MS). DESIGN From eight MAGNIMS (MAGNetic resonance Imaging in MS) centres, we retrospectively included 261 MS patients with MR imaging at baseline and after 1-2 years, and Expanded Disability Status Scale (EDSS) scoring at baseline and after 10 years. Annualised whole brain atrophy, central brain atrophy rates and T2 lesion volumes were calculated. Patients were categorised by baseline diagnosis as primary progressive MS (n=77), clinically isolated syndromes (n=18), relapsing-remitting MS (n=97) and secondary progressive MS (n=69). Relapse onset patients were classified as minimally impaired (EDSS=0-3.5, n=111) or moderately impaired (EDSS=4-6, n=55) according to their baseline disability (and regardless of disease type). Linear regression models tested whether whole brain and central atrophy, lesion volumes at baseline, follow-up and lesion volume change predicted 10 year EDSS and MS Severity Scale scores. RESULTS In the whole patient group, whole brain and central atrophy predicted EDSS at 10 years, corrected for imaging protocol, baseline EDSS and disease modifying treatment. The combined model with central atrophy and lesion volume change as MRI predictors predicted 10 year EDSS with R(2)=0.74 in the whole group and R(2)=0.72 in the relapse onset group. In subgroups, central atrophy was predictive in the minimally impaired relapse onset patients (R(2)=0.68), lesion volumes in moderately impaired relapse onset patients (R(2)=0.21) and whole brain atrophy in primary progressive MS (R(2)=0.34). CONCLUSIONS This large multicentre study points to the complementary predictive value of atrophy and lesion volumes for predicting long term disability in MS.
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Affiliation(s)
- Veronica Popescu
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands.
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Sonder JM, Burggraaff J, Knol DL, Polman CH, Uitdehaag BMJ. Comparing long-term results of PASAT and SDMT scores in relation to neuropsychological testing in multiple sclerosis. Mult Scler 2013; 20:481-8. [DOI: 10.1177/1352458513501570] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background and objectives: The Symbol Digit Modalities Test (SDMT) shows advantages over the Paced Auditory Serial Addition Test (PASAT) as a cognitive test in patients with multiple sclerosis (MS). To determine which of these tests is most valid and reliable over time as an indicator of the cognitive state of MS patients, long-term test results of both tests were compared in relation to scores of the Brief Repeatable Battery of Neuropsychological tests (BRBN). Methods: For 485 MS patients visiting the VU University Medical Center Amsterdam for different research projects, a total number of 1078 visits with BRBN (including PASAT and SDMT) was planned. Observed and model-based correlations were used to calculate the construct validity of the SDMT and PASAT 3 seconds test (PASAT3) by comparing correlations with the BRBN-sumscore. The test-retest reliability of each test was also computed. Results: For the construct validity, higher correlations were found between SDMT and BRBN compared to PASAT3 and BRBN, especially for the model-based correlations at baseline. The reliability of the measurements was good for all instruments, with the highest coefficients for the SDMT. Conclusion: As a single assessment tool for cognition in MS, the SDMT is more valid and reliable compared to PASAT3.
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Affiliation(s)
- Judith M Sonder
- Department of Epidemiology and Biostatistics, The Netherlands
- Department of Neurology, VU University Medical Center, The Netherlands
| | | | - Dirk L Knol
- Department of Epidemiology and Biostatistics, The Netherlands
| | - Chris H Polman
- Department of Neurology, VU University Medical Center, The Netherlands
| | - Bernard MJ Uitdehaag
- Department of Epidemiology and Biostatistics, The Netherlands
- Department of Neurology, VU University Medical Center, The Netherlands
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Vreeken HL, van Rens GHMB, Knol DL, van Reijen NA, Kramer SE, Festen JM, van Nispen RMA. Dual sensory loss: A major age-related increase of comorbid hearing loss and hearing aid ownership in visually impaired adults. Geriatr Gerontol Int 2013; 14:570-6. [PMID: 23992434 DOI: 10.1111/ggi.12136] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2013] [Indexed: 11/30/2022]
Abstract
AIM Despite increasing interest in visual and hearing impairment in the older population, little attention has been paid to concurrent hearing and vision loss, also known as dual sensory loss. The aim of the present study was to investigate the prevalence of comorbid hearing disability and hearing aid ownership in visually impaired older adults. METHODS In a cross-sectional survey, a self-report hearing disability screener was administered to 1396 visually impaired patients (aged ≥ 50 years) of outpatient low vision rehabilitation centers in the Netherlands and Belgium. RESULTS Of all participants, 44.8% (95% CI 42.2-47.5) had insufficient or poor hearing; the prevalence increased quadratically with age. Of all dual sensory impaired participants, 31.2% in the Netherlands and 55.7% in Belgium did not own hearing aids. CONCLUSIONS The high prevalence of dual sensory loss calls for more awareness of related problems in these patients. Differences between the Netherlands and Belgium regarding hearing aid ownership might be due to different criteria used for hearing aid referral and insurance policies. For patients with dual sensory loss, specialized care implemented in low vision rehabilitation seems warranted.
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Affiliation(s)
- Hilde L Vreeken
- Department of Ophthalmology, VU University Medical Center, Amsterdam, the Netherlands; EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
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