
Cleo L CrunelleVrije Universiteit Brussel | VUB · KLIW
Cleo L Crunelle
MD PhD PhD
About
118
Publications
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Introduction
I am a professor at the Vrije Universiteit Brussel and neuroscientist specialized in neuroimaging (MRI, SPECT) and neurocognition in the psychiatric field, with a keen interest in addiction and translational studies. Since 2012, I extended my field of research towards finding suitable biomarkers to detect chronic drug use through hair analyses, and I am currently working at the Vrije Universiteit Brussel and the University Hospital Brussels (Psychiatry department).
Additional affiliations
May 2012 - July 2015
March 2013 - present
December 2012 - present
Education
October 2007 - July 2012
September 2003 - September 2007
Publications
Publications (118)
Background: Treatment of attention-deficit/ hyperactivity disorder (ADHD) in patients with a substance use disorder (SUD) and comorbid ADHD (SUD +ADHD) may have positive effects on the outcome of both conditions, but controversy exists regarding the preferred ADHD treatment in these patients. Little is known about the treatments that are provided f...
The COVID-19 pandemic had a major worldwide impact resulting in more than 7 million deaths due to COVID-19. Mental health issues, including anxiety, depression, and post-traumatic stress disorder (PTSD) have been observed in COVID-19 survivors worldwide. This study aimed to investigate the psychological impact of COVID-19 survivors three months aft...
Introduction
Patient‐centred care has become increasingly important in health care. Patient‐reported experience measures (PREM) are used to measure patient experiences in health care, but the availability of psychometrically validated PREMs is limited. The Patient Reported Experience Measure in Addiction Treatment (PREMAT) is a PREM developed with...
BACKGROUND
Traditionally, treatment outcomes in patients with a substance use disorder (SUD) are measured using objective and provider-reported indicators. Recently, there has been a shift towards incorporating Patient-Reported Outcome Measures (PROMs) and Patient-Reported Experience Measures (PREMs) to capture service users' perspectives on treatm...
In this scientific advisory report, which offers guidance to public health policy-makers, the Superior Health Council of Belgium provides recommendations of digital interventions
and apps for mental health. Available in English, French and Dutch (https://www.health.belgium.be/en/report-9745-apps-mental-health).
To be cited as SHC - Superior Health...
Objective
An early description, possibly the earliest, of attention deficit disorder in a 1753 Dutch medical book by Cornelius Kloekhof is presented.
Method
The author of this text is briefly introduced and contextualized. The text is translated from Latin and afterwards, its impact on later scientific literature is discussed.
Results and Conclus...
Baclofen may reduce the symptoms of alcohol withdrawal, as an alternative or as an adjuvant for benzodiazepines, but the available data are insufficient to support baclofen-assisted alcohol withdrawal. This study investigated the need for diazepam during acute alcohol withdrawal in patients receiving baclofen. In a single-blind, dose-dependent rand...
Introduction
There is a variety of specialized outpatient and residential Alcohol and Other Drugs (AOD) services, but research on outcomes of these services is limited. Given the chronic, relapsing nature of AOD problems, there is a need for longitudinal research on outcomes after treatment in various AOD services.
Patient-Reported Outcome Measures...
Attention deficit/hyperactivity disorder (ADHD) often co-occurs with substance use disorders (SUD). Together, these disorders are associated with significantly more burden for patients and society, than each alone. Patients with SUD and underlying ADHD have more complex SUD and have more poly-substance use compared with SUD patients without ADHD. A...
Background:
Substance use disorders (SUD) are among the most prevalent psychiatric disorders, with high illness costs. A disturbed balance between frontostriatal and stress brain circuitry influences the development of SUD, its continuation, and vulnerability for relapse.
Aim:
To provide a concise overview of neural networks in SUD, and discuss...
Objective
An exponential implementation of remote mental health care has been observed, but little data is available on experiences and barriers of remote health from a patient’s perspective. This study investigated experiences associated with several forms of remote consultations (both telephone and online video) for mental health care during the...
Résumé
Introduction
Le trouble du déficit de l’attention/hyperactivité chez l’enfant (TDAH) est un facteur de risque de mésusage et de troubles de l’usage de substances (TUS) chez l’adolescent et le jeune adulte. Le TDAH et le TUS coexistent également fréquemment chez les adolescents en demande de soins, compliquant le diagnostic et le traitement...
Background
Substance use disorders (SUD) often co-occur with attention deficit hyperactivity disorder (ADHD). Although the short-term effects of some specific interventions have been investigated in randomized clinical trials, little is known about the long-term clinical course of treatment-seeking SUD patients with comorbid ADHD.
Aims
This paper...
An increase of psychopathology such as post-traumatic stress disorder (PTSD) is described in patients affected with COVID-19 that stayed at an intensive care unit (ICU). However, data on follow-up and on impact of contextual factors are limited. In a single-center, observational study, PTSD symptomatology was prevalent among 38% of participants (n=...
Résumé
Contexte
Le trouble du déficit de l’attention avec ou sans hyperactivité (TDAH) de l’adulte est souvent associé aux troubles de l’usage de substances (TUS), qui ont alors un début précoce et un développement plus sévère, avec une efficacité moindre du traitement. Il n’existe pas de recommandation en langue française sur le repérage, le diag...
Introduction
Excessive use of alcohol increases the risk to be involved in a road traffic accident. According to many legislations, certain maximal blood-alcohol-concentrations (BAC) have to be respected to be allowed to drive on public roads. Acute alcohol intoxication is evaluated by blood analysis or analysis of the exhaled alveolar air. In many...
Gamma hydroxyboterzuur (GHB) werd in de jaren zestig ontwikkeld als anestheticum, maar vanwege de onvoorspelbare werkingsduur raakte het voor deze indicatie spoedig in onbruik. Tegenwoordig wordt GHB (onder de merknaam Xyrem®) voornamelijk toegepast bij narcolepsie, kataplexie, alcoholverslaving en voor de ontwenning van GHB ('taperen') bij patiënt...
Recent advances in social neuroscience have highlighted the critical role of the cerebellum in social cognition, and especially the posterior cerebellum. Studies have supported the view that the posterior cerebellum builds internal action models of our social interactions to predict how other people’s actions will be executed and what our most like...
Zusammenfassung. Hintergrund: Eine Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) im Kindesalter stellt einen Risikofaktor für Substanzmissbrauch und Störungen durch Substanzgebrauch (Substance Use Disorder, SUD) in der Pubertät und dem (frühen) Erwachsenenalter dar. ADHS und SUD treten auch häufig bei therapiesuchenden Jugendlichen auf, was...
Background: GHB (gamma-hydroxybutyric acid; sodium oxybate) is a general anaesthetic that is clinically used for the treatment of narcolepsy, cataplexy, alcohol withdrawal and alcohol relapse prevention. In addition, GHB is recreationally used. Most clinical and recreational users regard GHB as an innocent drug devoid of adverse effects, despite it...
Background: Misconceptions about ADHD stigmatize affected people, reduce credibility of providers, and prevent/delay treatment. To challenge misconceptions, we curated findings with strong evidence base.
Methods: We reviewed studies with more than 2,000 participants or meta-analyses from five or more studies or 2,000 or more participants. We exclu...
Background:
In the coming years, mental health care may come into contact with patients who developed psychological complaints related to their critical illness and stay in the intensive care unit (ICU) as a result of COVID-19. However, the experiences of these patients are to date rarely documented.
Aim:
Gaining insight into the experiences of...
Background:
Prader-Willi syndrome (PWS) is a genetic syndrome characterized by dysmorphic features and endocrine, cognitive and psychiatric problems. Psychiatric problems interfere with the transition from pediatric to adult care. Psychiatric expertise is needed to facilitate this transition.
Aim:
To provide a literature review on the prevalence...
Background:
Substance use disorder (SUD) is common among youths with attention-deficit/hyperactivity disorder (ADHD). Co-morbid ADHD and SUD in youths complicates screening, diagnosis, and treatment of both disorders and is associated with worse treatment prognosis. Limited research in youths with SUD and co-morbid ADHD provides insufficient basis...
Background and Aims
Alcohol‐related liver disease is the most frequent cause of cirrhosis and a major indication for liver transplantation. Several alcohol use biomarkers have been developed in recent years and are already in use in several centers. However, in patients with liver disease their diagnostic performance might be influenced by altered...
Background: The outbreak of coronavirus disease 19 (COVID-19) has led to measures of social distancing and quarantine worldwide. This stressful period may lead to psychological problems, including increases in substance use. Objective: To investigate changes in alcohol, tobacco, and cannabis consumption before and during COVID-19 lockdown and motiv...
Background:
The International Collaboration on ADHD and Substance Abuse (ICASA) is a network of 28 centers from 16 countries initiated to investigate the link between attention deficit-hyperactivity disorder (ADHD) and substance use disorder (SUD). In this article, we present the mission, the results of finished studies, and the current and future...
Background:
Childhood attention-deficit/hyperactivity disorder (ADHD) is a risk factor for substance misuse and substance use disorder (SUD) in adolescence and (early) adulthood. ADHD and SUD also frequently co-occur in treatment-seeking adolescents, which complicates diagnosis and treatment and is associated with poor treatment outcomes. Research...
Objective
This study aims to assess the validity of the ADHD module of the Mini-International Neuropsychiatric Interview (MINI-Plus) in patients with substance use disorders (SUD), using the Conners’ Adult ADHD Diagnostic Interview for DSM-IV (CAADID) as the external criterion.
Method
A cross sectional international multi-center study in 10 countr...
Among patients with substance use disorders (SUD), adult attention deficit hyperactivity disorder (ADHD) is one of the most frequently co-occuring disorder. Those SUD patients with comorbid ADHD show earlier onset of substance use, more severe SUD and poor treatment outcomes. Therefore, early recognition of ADHD is highly rele - vant within this pa...
Objective:
The importance of protein glycosylation in regulating lipid metabolism is becoming increasingly apparent. We set out to further investigate this by studying the effects of defective glycosylation on plasma lipids in patients with B4GALT1-CDG, caused by a mutation in B4GALT1 with defective N-linked glycosylation.
Approach:
We studied p...
Ruptured anterior communicating artery aneurysms are commonly associated with deficits in memory and executive functions. However, little studies are available on the effect of surgical clipping (SC) and endovascular coiling (EC) on cognitive functioning. This study evaluates cognitive functioning in 35 patients with subarachnoid hemorrhage after r...
Background: A reformation of psychiatry was set up in Belgium with the establishment of mobile crisis teams. Subjects and methods: We performed a retrospective analysis of the patients referred to the mobile team "Pharos" in the period between December 2013 and December 2018. Results: The number of patients is growing over the years and the most co...
Animal models of alcohol dependence and relapse demonstrate an important role of the glutamatergic system, in particular the cerebral metabotropic glutamate receptor 5 (mGluR5). Using [18F]FPEB positron emission tomography, it was found that chronic alcohol use leads to decreased limbic mGluR5 availability, where lower mGluR5 was associated with le...
This cross-sectional study aims to determine the prevalence of metabolic syndrome (MetS) in patients with severe mental illness (SMI) on a Caribbean island, Curaçao, using the modified National Cholesterol Education Program Adult Treatment Panel III criteria. Among 350 patients (240 men and 110 women) with a mean age of 51.9 years (S.D.=13.5) MetS...
Oculogyre crisis als enige extrapiramidaal symptoom bij auto-intoxicatie met risperidon klinische praktijk op het dopaminemetabolisme uitoefenen, wordt OGC waargenomen, bijvoorbeeld bij het syndroom van Rett (mutatie slc18a2 coderend voor de vesiculaire mono-ami-netransporter), syndroom van Kufor Rakeb (mutatie van atp13a2) en neuronale intranuclea...
Background:
A reformation of psychiatry was set up in Belgium with the establishment of mobile crisis teams.
Subjects and methods:
We performed a retrospective analysis of the patients referred to the mobile team "Pharos" in the period between December 2013 and December 2018.
Results:
The number of patients is growing over the years and the mo...
Attention-deficit/hyperactivity disorder (ADHD) is a risk factor for the development and persistence of substance use disorders (SUD). The prevalence of ADHD in patients with SUD varies across countries and cultures. So far, cross-cultural variance in ADHD prevalence rates among SUD patients was mainly ascribed to methodological differences between...
Purpose of review:
Attention-deficit and hyperactivity disorder (ADHD) often presents with comorbid substance use disorders (SUD). Due to similarities in key symptoms of both disorders and suboptimal efficacy of the available treatments, clinicians are faced with difficulties in the diagnosis and treatment of these patients with both disorders. Th...
Body mass index (BMI) is a variable that complicates the interpretation of the alcohol metabolite ethyl glucuronide (EtG) in hair. However, direction on how EtG should currently be interpreted within individuals consuming moderate and excessive daily amounts of alcohol related to their BMI is lacking. In light of interpretation of EtG in individual...
Background:
Substance use disorders (SUD) and attention-deficit/hyperactivity disorder (ADHD) often co-occur in adults. Together, they complicate diagnosis and can negatively influence treatment outcome.
AIM: To develop a practical guide to assist professionals with the screening, diagnosis and treatment of adult patients with SUD and ADHD.
METHOD...
A 19-year-old female was seen at the emergency department following an auto-intoxication. An oculogyric crisis (ogc) was observed, in the absence of other extrapyramidal symptoms (eps). In a second anamnesis, patient indicated that she had taken risperidone 3 mg (an atypical antipsychotic). This particular case description of an isolated ogc shows...
Gamma-hydroxybutyric acid (GHB) is a short-chain fatty acid used recreationally as a drug of abuse due its strong suppressive effect on the central nervous system. The detection window of GHB in blood and urine is very narrow (t1/2=30min) but can be substantially prolonged using alternative matrices such as hair. We here present a newly developed a...
Ethyl glucuronide (EtG) and ethyl sulphate (EtS) are 2 non‐oxidative and direct metabolites of ethanol. EtG is known to accumulate in hair and has proved to be a reliable biomarker for detection of chronic alcohol consumption. EtS has been analysed in blood and urine but has never been reported in hair. This article presents the first analytical as...
Adult attention deficit/hyperactivity disorder (ADHD) often co-occurs with substance use disorders (SUD) and is associated with early onset and more severe development of SUD and with reduced treatment effectiveness. Screening tools allow for a good recognition of possible ADHD in adults with SUD and should be used routinely, followed by an ADHD di...
Introduction
Alcohol-use disorders (AUD) have a high global prevalence and about half of the patients suffering from AUD will develop withdrawal symptoms upon cessation of alcohol intake. Therefore, management of alcohol withdrawal has a significant place in medical care. The current gold standard for the prevention and treatment of the alcohol wit...
Animal studies suggest an important role for the metabotropic glutamate receptor subtype 5 (mGlu5) in the pathophysiology of alcohol dependence, but direct human evidence is lacking. The goal of this study was to investigate cerebral mGlu5 availability in alcohol-dependent patients versus controls using 18F-FPEB positron emission tomography. Method...
Keratinous matrices - hair and nails - accumulate substances over time and allow retrospective investigation of past consumption. Analysis of these matrices can provide information complementary to blood and urine analysis or can be used as standalone. So far, research has primarily focused on the detection of substances in hair, while studies in n...
Approximately one in four adults with cocaine dependence is diagnosed with an underlying attention deficit hyperactivity disorder (ADHD). ADHD is a neurodevelopmental disorder characterized by symptoms of inattention, hyperactivity, and/or impulsivity, and is an important contributing factor in the development of cocaine and other drug dependence....
Converging preclinical evidence links extrastriatal dopamine release and glutamatergic transmission via the metabotropic glutamate receptor 5 (mGluR5) to the rewarding properties of alcohol. To date, human evidence is lacking on how and where in the brain these processes occur. Mesocorticolimbic dopamine release upon intravenous alcohol administrat...
A 27-year-old male patient presented at the emergency department with a two-day history of a progressively worsening bioccipital headache. The clinical examination and laboratory results were unremarkable, besides a slightly decreased vitamin B12 level and increased homocysteine level. He had no significant medical or family history. He admitted th...
Background
Attention deficit/hyperactivity disorder (ADHD) is an important contributing factor in the pathophysiology of substance use disorders (SUD), and ADHD occurs more often in populations with SUD compared to the general population. This high prevalence rate and comorbidity may relate to a shared neurobiological vulnerability, including a der...
In this study, we evaluated persistent cognitive deficits in whiplash injury (WI) patients and compared these to cognitive functioning in mild traumatic brain injury (MTBI) patients and healthy controls (HC). Sixty-one patients suffering from a WI were compared with 57 patients suffering from a MTBI and with 30 HC. They were examined with an extens...
Ethyl glucuronide (EtG), a minor metabolite of alcohol, is present in hair and nails, and thus can be used as a maker to estimate previous alcohol consumption. Due to the low concentrations of EtG in keratinized matrices (pg/mg range), sensitive analytical methods and optimized sample preparation procedures are essential. While several methods for...
Aims:
Ethyl glucuronide in hair (hEtG) can be used to assess the retrospective consumption of alcohol. A lower cut-off of 7pg/mg hair in the 0-3cm proximal scalp hair segment has been used for repeated alcohol consumption in the previous three months. While a concentration below this cut-off is stated not to contradict self reported abstinence, it...
Aim:
Analysis of ethyl glucuronide (EtG) concentrations in hair is increasingly used to estimate the consumption of alcohol of the prior months. Linear correlations between the amount of alcohol consumed and the concentration of EtG in hair have been reported, and several variables that may influence this correlation have been investigated: e.g. c...
Methods:
Cross-sectional investigation of forty-four nonsmoking healthy volunteers (age=40±14 years, range 22-66 years; 22 females). Brain mGluR5 availability was quantified both voxel- and VOI-based by the total distribution volume of (18)F-FPEB using 90 min dynamic PET and arterial input function. Moreover, glutamate-glutamine concentrations in...
Objective: To examine ADHD symptom persistence and subtype stability among substance use disorder (SUD) treatment seekers. Method: In all, 1,276 adult SUD treatment seekers were assessed for childhood and adult ADHD using Conners’ Adult ADHD Diagnostic Interview for Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; CAADID). A...
Objectives:
Ethyl glucuronide in hair (hEtG) and serum carbohydrate deficient transferrin (%CDT) are valuable markers for alcohol abuse, but their diagnostic accuracy to monitor abstinence and relapse is unclear. Here, we investigate to what extent repeated measurements of hEtG and %CDT can be used to monitor relapse in alcohol-dependent patients...
(18) F-FPEB is a promising PET tracer for studying the metabotropic glutamate subtype 5 receptor (mGluR5) expression in neuropsychiatric disorders. To assess the potential of (18) F-FPEB for longitudinal mGluR5 evaluation in patient studies, we evaluated the long-term test-retest reproducibility using various kinetic models in the human brain. Nine...
Ethyl glucuronide (EtG) is a minor phase II metabolite of alcohol that accumulates in hair. It has been established as a sensitive marker to assess the retrospective consumption of alcohol over recent months using a cut-off of ≥7 pg/mg hair to assess repeated alcohol consumption. The primary aim was to assess whether amounts of alcohol consumed cor...
Hair ethyl glucuronide (hEtG) is a marker used for previous alcohol consumption. Correlations have been reported between the amount of alcohol consumed and hEtG concentration, but little has been published regarding relatively low levels of alcohol consumption and associated hEtG concentrations close to the limit of quantification (LOQ). Here, we i...
Stimulant use is associated with increased anxiety and a single administration of dexamphetamine increases amygdala activation to biologically salient stimuli in healthy individuals. Here, we investigate how current cocaine use affects amygdala activity and amygdala connectivity with the prefrontal cortex in response to biologically salient stimuli...
In Europe between 30 and 50% of all liver transplantations (LTX) are done within the context of chronic end-stage alcoholic liver disease (ALD). However, post-operatively 20-25% of these patients lapse or relapse into heavy alcohol use. Thus, assessment of alcohol relapse risk before enlisting and therapeutic follow-up during and after LTX is of ut...
Ethyl glucuronide (EtG), a minor metabolite of ethanol, accumulates in hair and is currently used as a long-term marker for the detection of chronic and excessive alcohol consumption. Sensitive methods are required to differentiate teetotalers from moderate drinkers according to the established cut-off (i.e., 7 pg/mg hair). The aim of this study wa...
Measuring antipsychotic concentrations in human matrices is important for both therapeutic drug monitoring and forensic toxicology. This review provides a critical overview of the analytical methods for detection and quantification of antipsychotics published in the last four years. Focus lies on advances in sample preparation, analytical technique...
Nails can stably accumulate substances for long periods of time, thus providing retrospective information regarding drugs of abuse and pharmaceutical use. Nails have several advantages over the conventional matrices, such as blood and urine, including a longer detection window (months to years), non-invasive sample collection, and easy storage and...
Background
Trait impulsivity is commonly associated with cocaine dependence. The few studies that have investigated the relation between trait impulsivity and cortical morphometry, have shown a distinct relation between impulsivity and cortical volume (CV) of temporal, frontal and insula cortex. As CV is the function of cortical surface area (SA) a...
We report a case of an ethanol and massive gamma-butyrolactone (GBL) intoxication, the precursor of the recreational drug gamma-hydroxybutyric acid (GHB), resulting in life-threatening metabolic acidosis (pH 6.5) with a highly increased anion- and osmolal gap. Rapid analysis using gas chromatography revealed a GHB plasma concentration of 4400 mg/L,...