Maarten H.T. Zwartbol

• Doctor of Medicine
• PhD Student at University Medical Center Utrecht

Background The need persists for sensitive, low‐cost, and high‐access cognitive markers to complement biomarker information in the earliest stages of Alzheimer’s disease. Sensitive cognitive markers may be derived from information at the item level of neuropsychological tests. We investigated if item‐level metrics add information beyond total score...

Specific subfields within the hippocampus have shown vulnerability to chronic stress, highlighting the importance of looking regionally within the hippocampus to understand the role of psychosocial factors in the development of neurodegenerative diseases. A systematic review on psychosocial factors and hippocampal subfield volumes was performed and...

Background Specific subfields within the hippocampus have shown vulnerability to chronic stress, highlighting the importance of looking regionally within the hippocampus to understand the role of psychosocial risk factors in the development of neurodegenerative diseases. The current study had two aims: to perform a systematic review on psychosocial...

Asymptomatic low-grade carotid artery stenosis (LGCS) is a common finding in patients with manifest arterial disease, however its relationship with brain MRI changes and cognitive decline is unclear. We included 902 patients (58 ± 10 years; 81% male) enrolled in the Second Manifestations of Arterial Disease - Magnetic Resonance (SMART-MR) study wit...

White matter hyperintensity (WMH) shape has been associated with the severity of the underlying brain pathology, suggesting it is a potential neuroimaging marker of WMH impact on brain function. In 563 patients with vascular disease (58±10 years), we examined the relationship between WMH volume, shape and cognitive functioning. WMH volume and shape...

Background and purpose: The clinical relevance of cortical microinfarcts has recently been established; however, studies on microinfarcts in the deep gray matter are lacking. We examined the risk factors and MR imaging correlates of microinfarcts in the deep gray matter on 7T MR imaging and their relation to cognitive functioning. Materials and m...

Objective Investigate associations of cognitive and brain reserve with trajectories of memory decline in mid-life and late-life, and whether the relationship of memory decline with atrophy differs as a function of reserve. Methods Participants were 989 Dutch middle-aged to older adults from the SMART-MR prospective cohort, followed up to 12 years...

We determined the occurrence and association of cortical cerebral microinfarcts (CMIs) at 7 T MRI with risk factors, neuroimaging markers of small and large vessel disease, and cognitive functioning. Within the Medea-7T study, a diverse cohort of older persons with normal cognition, patients with vascular disease, and memory clinic patients, we inc...

Background White matter hyperintensities (WMHs) are associated with cognitive decline and increased risk of dementia, including Alzheimer’s disease. However, the association between WMH and cognitive functioning is weak, presumably due to heterogeneity of the underling WMH pathology. Recently, WMH shape has been related to the severity of the under...

Background Histopathological studies suggest that microinfarcts in the deep gray matter are associated with ante‐mortem cognitive impairment, however in vivo data on subcortical microinfarcts are lacking. We examined the association of microinfarcts in the deep gray matter on 7T MRI with vascular risk factors, MRI markers of cerebrovascular disease...

Background Subjective cognitive decline is increasingly being viewed as an early cognitive marker of preclinical Alzheimer’s disease (AD). Studies have recommended including AD biomarkers to increase the specificity of subjective cognitive decline, because of its etiological heterogeneity. We studied the prevalence and burden of cerebral microbleed...

Background The hippocampal formation is considered to be one of the first brain structures affected in Alzheimer’s disease. High resolution brain MRI has made it possible to visualize the subfields of the hippocampal formation in greater detail. We estimated volumes of hippocampal subfields on 7T MRI in normal aging and early Alzheimer’s disease. W...

The etiology of cerebral small vessel disease (CSVD) is the subject of ongoing research. Although intracranial atherosclerosis (ICAS) has been proposed as a possible cause, studies on their relationship remain sparse. We used 7 T vessel wall magnetic resonance imaging (MRI) to study the association between intracranial vessel wall lesions-a neuroim...

Background Vascular risk factors have been associated with risk of Alzheimer’s disease (AD) and volume loss of the hippocampus, but the associations with subfields of the hippocampus are understudied. Knowing if vascular risk factors contribute to hippocampal subfield atrophy may improve our understanding of vascular contributions to neurodegenerat...

Global cerebral hypoperfusion may be involved in the aetiology of brain atrophy; however, long-term longitudinal studies on this relationship are lacking. We examined whether reduced cerebral blood flow was associated with greater progression of brain atrophy. Data of 1165 patients (61 ± 10 years) from the SMART-MR study, a prospective cohort study...

Objective To investigate the association between intracranial atherosclerosis (ICAS) and cognitive functioning in patients with a history of vascular disease. Methods Within the SMART-MR study cross-sectional analyses were performed in 130 patients (mean±SD age 68±9 years) with 7T vessel wall–magnetic resonance imaging data. Vessel wall lesions we...

Background and purpose: Intracranial atherosclerosis, a major risk factor for ischemic stroke, is thought to have different atherogenic mechanisms than extracranial atherosclerosis. Studies investigating their relationship in vivo are sparse and report inconsistent results. We studied the relationship between intracranial atherosclerosis and extra...

Hippocampal sulcal cavities (HSCs) are frequently observed on MRI, but their etiology and relevance is unclear. HSCs may be anatomical variations, or result from pathology. We assessed the presence of HSCs, and their cross-sectional association with demographics, vascular risk factors and cognitive functioning in two study samples. Within a random...

We estimated associations of subjective cognitive decline (SCD) with neuro-imaging markers of dementia and cognitive functioning in patients with a history of vascular disease without objective cognitive impairment. Within the SMART-Medea study, 599 patients (62±9 years) had 1.5T brain MRI and cognitive testing at baseline and after 8 years of foll...

Background and Purpose— Intracranial vessel wall lesions are a novel imaging marker of intracranial atherosclerosis (ICAS), but data on their occurrence and risk factors are lacking. Our aim was to study the frequency, distribution, and risk factors of intracranial vessel wall lesions on 7T magnetic resonance imaging in patients with a history of v...

Lacunes and white matter hyperintensities (WMHs) are features of cerebral small vessel disease (CSVD) that are associated with poor functional outcomes. However, how the two are related remains unclear. In this study, we examined the association between lacunes and several WMH features in patients with a history of vascular disease. A total of 999...

Small infarcts are among the key imaging features of cerebral small vessel disease (CSVD), but remain largely undetected on conventional MRI. We aimed to evaluate (1) imaging criteria for the detection of small infarcts in the caudate nucleus on 7T MRI, (2) intra- and inter-rater agreement, (3) frequency and (4) detection rate on 7T versus 1.5T MRI...

Stroke and related cerebrovascular diseases are a major cause of mortality and disability. Even at standard-field-strengths (1.5T), MRI is by far the most sensitive imaging technique to detect acute brain infarctions and to characterize incidental cerebrovascular lesions, such as white matter hyperintensities, lacunes and microbleeds. Arterial time...

Background: Several infectious processes of intra-abdominal origin may atypically present as skin or soft tissue infections or abscess in the thigh. Case report: We describe the case of a 73-year-old woman who presented to the emergency department with the clinical picture of a skin infection of the right leg. The patient's condition deteriorate...

Heart failure (HF) is a complex disease involving multiple changes including cardiomyocyte hypertrophy (growth). Here we performed a set of screens in different HF and hypertrophy models to identify differentially expressed genes associated with HF and/or hypertrophy. Hypertensive Ren2 rats and animals with postmyocardial infarction (post-MI) HF we...