Michiel de Ruiter - Academia.edu (original) (raw)

Papers by Michiel de Ruiter

BackgroundCognitive problems in breast cancer patients are common after systemic treatment, parti... more BackgroundCognitive problems in breast cancer patients are common after systemic treatment, particularly chemotherapy. An increasing number of fMRI studies show altered brain activation in breast cancer patients after treatment, suggestive of neurotoxicity. Previous prospective fMRI studies administered a single cognitive task. The current study employed two task paradigms to evaluate whether treatment-induced changes depend on the probed cognitive domain.<br>MethodsParticipants were breast cancer patients scheduled to receive systemic treatment (anthracycline-based chemotherapy +/- endocrine treatment, n=28), or no systemic treatment (n=24) and no-cancer controls (n=31). Assessment took place before adjuvant treatment and six months after chemotherapy, or at similar intervals. Blood oxygen level dependent (BOLD) activation and performance were measured during an executive functioning task and an episodic memory task. Group-by-time interactions were analyzed using a flexible f...

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Breast Cancer Research and Treatment

Purpose This longitudinal study aimed to disentangle the impact of chemotherapy on fatigue and hy... more Purpose This longitudinal study aimed to disentangle the impact of chemotherapy on fatigue and hypothetically associated functional brain network alterations. Methods In total, 34 breast cancer patients treated with chemotherapy (BCC +), 32 patients not treated with chemotherapy (BCC −), and 35 non-cancer controls (NC) were included. Fatigue was assessed using the EORTC QLQ-C30 fatigue subscale at two time points: baseline (T1) and six months after completion of chemotherapy or matched intervals (T2). Participants also underwent resting-state functional magnetic resonance imaging (rsfMRI). An atlas spanning 90 cortical and subcortical brain regions was used to extract time series, after which Pearson correlation coefficients were calculated to construct a brain network per participant per timepoint. Network measures of local segregation and global integration were compared between groups and timepoints and correlated with fatigue. Results As expected, fatigue increased over time in ...

SSRN Electronic Journal

Purpose: To compare neurocognitive functioning in Small Cell Lung Cancer patients(SCLC) who recei... more Purpose: To compare neurocognitive functioning in Small Cell Lung Cancer patients(SCLC) who received prophylactic cranial irradiation(PCI) with or without hippocampus avoidance (HA). Material and Methods: In a multicenter randomized phase III trial (NCT01780675) patients with SCLC were randomized to standard PCI (25 Gy /10 fractions) or HA-PCI. Neuropsychological tests were performed at baseline and 4, 8, 12, 18 and 24 months after PCI. The primary endpoint was total recall on the Hopkins Verbal Learning Test- Revised(HVLT-R) at 4 months; a decline of at least 5 points from baseline was considered a failure. Secondary endpoints included other cognitive outcomes, evaluation of the incidence and location of brain metastases and overall survival(OS). Results: From April 2013 until March 2018 a total of 168 patients were randomized. The median follow-up time was 26 .6 months. In both treatment arms 70% of patients had limited disease and baseline characteristics were well balanced. Decline on the HVLT-R total recall score at 4 months was not significantly different between the arms: 29% of PCI patients dropped ≥5 points and 28% of HA-PCI patients (p=1.000). Performance on other cognitive tests measuring memory, executive function, attention, motor function and processing speed did not change significantly different over time between the groups. The OS was not significantly different. The cumulative incidence of brain metastases at 2 years was 20% (95% CI: 12% - 29%) for the PCI arm and 16% (95% CI: 7% - 24%) for the HA-PCI arm. Conclusion: This randomized phase III trial did not show lower probability of cognitive decline in SCLC patients receiving hippocampus avoidance PCI compared to conventional PCI. No increase in brain metastases at 2 years was observed in the HA- PCI arm. Trial Registration: NCT01780675 Funding Statement: Maarten Lambrecht Speaker’s fee AstraZeneca, all others No Funding. Declaration of Interests: YL reports personal fees from Astra-Zeneca and RaySearch outside the context of the submitted work. All other authors have nothing to declare. Ethics Approval Statement: This trial (NCT01780675) was conducted according to the Declaration of Helsinki and approved by the Medical Ethics Committee of the Netherlands Cancer Institute.

PLOS ONE

The objective is to present a proof-of-concept of a semi-automatic method to reduce hippocampus s... more The objective is to present a proof-of-concept of a semi-automatic method to reduce hippocampus segmentation time on magnetic resonance images (MRI). Materials and methods FAst Segmentation Through SURface Fairing (FASTSURF) is based on a surface fairing technique which reconstructs the hippocampus from sparse delineations. To validate FAS-TSURF, simulations were performed in which sparse delineations extracted from full manual segmentations served as input. On three different datasets with different diagnostic groups, FASTSURF hippocampi were compared to the original segmentations using Jaccard overlap indices and percentage volume differences (PVD). In one data set for which back-toback scans were available, unbiased estimates of overlap and PVD were obtained. Using longitudinal scans, we compared hippocampal atrophy rates measured by manual, FAS-TSURF and two automatic segmentations (FreeSurfer and FSL-FIRST). Results With only seven input contours, FASTSURF yielded mean Jaccard indices ranging from 72 (±4.3)% to 83(±2.6)% and PVDs ranging from 0.02(±2.40)% to 3.2(±3.40)% across the three datasets. Slightly poorer results were obtained for the unbiased analysis, but the performance was still considerably better than both tested automatic methods with only five contours.

NeuroImage. Clinical, 2018

Several diffusion tensor imaging (DTI) studies in attention deficit hyperactivity disorder (ADHD)... more Several diffusion tensor imaging (DTI) studies in attention deficit hyperactivity disorder (ADHD) have shown a delay in brain white matter (WM) development. Because these studies were mainly conducted in children and adolescents, these WM abnormalities have been assumed, but not proven to progress into adulthood. To provide further insight in the natural history of WM maturation delay in ADHD, we here investigated the modulating effect of age on WM in children and adults. 120 stimulant-treatment naive male ADHD children (10-12 years of age) and adults (23-40 years of age) with ADHD (according to DSM-IV; all subtypes) were included, along with 23 age and gender matched controls. Fractional anisotropy (FA) values were compared throughout the WM by means of tract-based spatial statistics (TBSS) and in specific regions of interest (ROIs). On both TBSS and ROI analyses, we found that stimulant-treatment naive ADHD children did not differ in FA values from control children, whereas adult ...

Brain Imaging and Behavior

An increasing number of studies suggest chemotherapy for breast cancer may be neurotoxic. Cross-s... more An increasing number of studies suggest chemotherapy for breast cancer may be neurotoxic. Cross-sectional MRI diffusion tensor imaging (DTI) studies suggest a vulnerability of brain white matter to various chemotherapeutic regimens. Up till now, this was confirmed in one prospective DTI study: Deprez et al. (2012) showed a widespread decline in fractional anisotropy (FA) of breast cancer patients after chemotherapy consisting of 5-fluorouracil (5-FU), epirubicin and cyclophosphamide (FEC) +/- taxanes +/- endocrine treatment. Our aim was to evaluate whether similar detrimental effects on white matter integrity would be observed with the currently widely prescribed anthracycline-based chemotherapy for breast cancer (predominantly doxorubicin and cyclophosphamide +/- taxanes +/- endocrine treatment (=BC + SYST; n = 26) compared to no systemic treatment (BC; n = 23) and no-cancer controls (NC; n = 30). Assessment took place before and six months after chemotherapy, and matched intervals for the unexposed groups. DTI data were analyzed using voxel-based tract-based spatial statistics and region of interest (ROI) analysis. Voxel-based analysis did not show an effect of chemotherapy +/- endocrine treatment on white matter integrity. ROI analysis however indicated subtle detrimental effects of chemotherapy +/- endocrine treatment by showing a larger decline in WM integrity in the superior longitudinal fasciculus and corticospinal tract in BC + SYST than BC. Indications for relatively mild neurotoxicity in our study might be explained by patient characteristics and specific aspects of data analysis. The omission of 5-FU in current treatment regimens or the administration of doxorubicin instead of epirubicin is also discussed as an explanation for the observed effects.

PLOS ONE

Background Cognitive problems in breast cancer patients are common after systemic treatment, part... more Background Cognitive problems in breast cancer patients are common after systemic treatment, particularly chemotherapy. An increasing number of fMRI studies show altered brain activation in breast cancer patients after treatment, suggestive of neurotoxicity. Previous prospective fMRI studies administered a single cognitive task. The current study employed two task paradigms to evaluate whether treatment-induced changes depend on the probed cognitive domain. Methods Participants were breast cancer patients scheduled to receive systemic treatment (anthracycline-based chemotherapy +/-endocrine treatment, n = 28), or no systemic treatment (n = 24) and no-cancer controls (n = 31). Assessment took place before adjuvant treatment and six months after chemotherapy, or at similar intervals. Blood oxygen level dependent (BOLD) activation and performance were measured during an executive functioning task and an episodic memory task. Group-by-time interactions were analyzed using a flexible factorial design. Results Task performance did not differ between patient groups and did not change over time. Breast cancer patients who received systemic treatment, however, showed increased parietal activation compared to baseline with increasing executive functioning task load compared to breast cancer patients who did not receive systemic treatment. This hyperactivation was accompanied by worse physical functioning, higher levels of fatigue and more cognitive complaints. In contrast, in breast cancer patients who did not receive systemic treatment, parietal activation normalized over time compared to the other two groups.

International Journal of Radiation Oncology*Biology*Physics

To the Editor: With interest we read the article by Redmond et al (1) reporting on a prospective ... more To the Editor: With interest we read the article by Redmond et al (1) reporting on a prospective study of hippocampal-sparing prophylactic cranial irradiation (HSPCI) in limited stage small cell lung cancer (SCLC). Within this trial, 20 patients with limited-stage SCLC showing a complete response to chemoradiation therapy and no brain metastases received HS-PCI up to 25 Gy in 10 fractions. At baseline and at 6 and 12 months, magnetic resonance imaging and a battery of neuropsychological tests were performed. The authors conclude that their study “suggests a potential benefit of HS-PCI in limiting the neuropsychological sequelae of brain radiation with rates of brain and hippocampal metastases consistent with standard PCI.” There are some important considerations to mention. First, the authors compare their patients receiving HSPCI with a group of limited-stage SCLC patients from another study (2) receiving identical PCI but without HS using the Delayed Recall measure of the Hopkins Verbal Learning TestdRevised. The authors conclude that in comparison with these historical control patients, the current patients had less cognitive decline on the memory measure. In addition, there was no evidence for cognitive decline on any of the other neuropsychological tests covering a much wider spectrum of functions than memory alone, either 6 months or 12 months after PCI. This finding is in contrast to the authors’ own expectation and also opposite to the cognitive decline that was observed in the historical control group receiving PCI without HS. Without a direct comparison of patients receiving PCI with and without HS in a randomized design, the absence of cognitive decline on measures irrespective of their hippocampal dependency should be interpreted with caution. Although the authors tried to control for normal fluctuations with repeated testing by applying a reliable change index, it is questionable whether this is sufficient, inasmuch as for each test a different reference population was used, with a different test-retest interval compared with the

Psychiatry Research: Neuroimaging

Age-dependent effects of acute methylphenidate on amygdala reactivity in stimulant treatment-naiv... more Age-dependent effects of acute methylphenidate on amygdala reactivity in stimulant treatment-naive patients with Attention Deficit/Hyperactivity Disorder.

Journal of pain and symptom management, Jan 17, 2016

Studies indicate adverse effects of breast cancer (BC) and cancer treatment on cognitive function... more Studies indicate adverse effects of breast cancer (BC) and cancer treatment on cognitive function. To investigate the effects of systemic treatment on cognitive performance in BC patients. Participants were BC patients scheduled to receive systemic treatment (BC+SYST; n=31), or no systemic treatment (BC; n=24) and no-cancer controls (NC; n=33). Neuropsychological examinations were used to study cognitive performance on 18 tests grouped into 8 cognitive domains, before adjuvant treatment (T1) and six months after chemotherapy (T2), or at similar intervals. We also assessed health-related quality of life, anxiety and depression, mood, stress, and cognitive problems. ANOVA was used to assess group differences of cognitive performance and multivariate normative comparison (MNC) to classify impairment, comparing scores of each participant against the distribution of the scores of NCs. Of BC+SYST, 16% were cognitively impaired at T2, compared to 4% in BC and 6% in NC. Although not signifi...

European Neuropsychopharmacology, 2014

ABSTRACT Purpose: Children and adults diagnosed with attention-deficit hyperactivity disorder (AD... more ABSTRACT Purpose: Children and adults diagnosed with attention-deficit hyperactivity disorder (ADHD) show deficits in their ability to accurately recognize facial expressions of emotions [1,2]. Emotion recognition is particularly associated with activity in the amygdala and connected prefrontal areas are modulated by dopamine (DA) [3]. In children suffering from ADHD, treatment with stimulants such as methylphenidate (MPH), a drug that targets the DA system, has been shown to normalize increased activity in the amygdala during emotional processing [1]. However, in children the brain is still in development, and the effects of stimulants may therefore differ from adult ADHD patients. To this end, we assessed the effect of MPH on emotional processing in children and adults suffering from ADHD using functional magnetic resonance imaging (fMRI) during an emotion recognition task. We expected to find a reduction in activation following MPH administration in the amygdala. In addition, we expected that these effects are modulated by age. Methods: fMRI data was collected as part of a randomized clinical trial (Netherlands Trial Register no NTR3103) in which medication-naive children and adults with ADHD (any subtype) were enrolled. Present preliminary analysis was conducted on participant's first visit data, as they performed a facial emotion- (fear and anger) and shape-recognition task in a 3.0T scanner, before and 90 minutes after an oral MPH challenge (0.5mg/kg with a maximum of 20mg in children and 40mg in adults). 12 children (aged 10–12 years, all male) and 16 adults (aged 23–30, all male) were included in the analysis. fMRI data was pre-processed using FSL-FEAT (standard pre-processing) and regressors were modelled per participant according to facial emotion vs. shapes, per participant, per session. First level contrast images were analysed with a FEAT higher level analysis using whole-brain and region-of-interest (ROI on amygdala) statistics with cluster p=0.05 FDR corrected. Results: In both children and adults, recognition of fearful and angry faces induced reliable activation in bilateral amygdala and visual processing areas compared to the control task (viewing shapes). MPH administration in children led to a decrease in activation in the right fusiform gyrus. In adult patients, MPH induced a decrease in brain activity in bilateral fusiform gyrus, bilateral amygdala and various cortical regions. Although children and adults differed in the extent the amygdala was activated by MPH, the interaction effect was not significant. However, we did observe significant interaction effects in the left lateral occipital cortex and precentral gyrus: these brain structures were less active in children, but more active in adult ADHD patients following the challenge with MPH. Conclusions: In line with previous studies, acute MPH administration reduced brain activation to emotional stimuli in children and adults with ADHD in various brain areas. Interestingly, we found that MPH induced small but opposite effects in specific brain regions of children when compared to adults during emotional processing. These findings suggest that the acute effects of DA agents such as MPH are dependent on age. In our ongoing trail we will obtain evidence whether chronic treatment with MPH also affects the developing brain differently than the developed adult brain. 1. Posner, J., Maia, T.V., Fair, D., Peterson, B.S., Sonuga-Barke, E.J., Nagel, B.J., 2011 The attenuation of dysfunctional emotional processing with stimulant medication: an fMRI study of adolescents with ADHD. Psychiatry Research: Neuroimaging 193, 151–60. 2. Rapport, L.J., Friedman, S.L., Tzelepis, A., Van Voorhis, A., 2002. Experienced emotion and affect recognition in adult attention-deficit hyperactivity disorder. Neuropsychology 16, 102–110. 3. Salgado-Pineda, P., Delaveau, P., Blin, O., Nieoullon, A., 2005. Dopaminergic contribution to the regulation of emotional perception. Clinical Neuropharmacology 28, 228–237.

Progress in Brain Research, 2015

Since the sample size of a typical neuroimaging study lacks sufficient statistical power to explo... more Since the sample size of a typical neuroimaging study lacks sufficient statistical power to explore unknown genomic associations with brain phenotypes, several international genetic imaging consortia have been organized in recent years to pool data across sites. The challenges and achievements of these consortia are considered here with the goal of leveraging these resources to study addiction. The authors of this review have joined together to form an Addiction working group within the framework of the ENIGMA project, a meta-analytic approach to multisite genetic imaging data. Collectively, the Addiction working group possesses neuroimaging and genomic data obtained from over 10,000 subjects. The deadline for contributing data to the first round of analyses occurred at the beginning of May 2015. The studies performed on this data should significantly impact our understanding of the genetic and neurobiological basis of addiction.

Journal of pain and symptom management, Jan 4, 2015

While cognitive impairments have been identified in patients with non-central nervous system canc... more While cognitive impairments have been identified in patients with non-central nervous system cancer, especially breast cancer, the respective roles of cancer and therapies, and the mechanisms involved in cognitive dysfunction remain unclear. To report a state of the art update from the International Cognitive and Cancer Task Force (ICCTF) conference held in 2012. A report of the meeting and recent new perspectives are presented. Recent clinical data support that non-central nervous system cancer per se may be involved in cognitive dysfunctions associated with inflammation parameters. The role of chemotherapy on cognitive decline was confirmed in colorectal and testicular cancers. Whereas the impact of hormone therapy remains debatable, some studies support a negative impact of targeted therapies on cognition. Regarding interventions, preliminary results of cognitive rehabilitation showed encouraging results. The methodology of future longitudinal studies has to be optimized by a pri...

Human Brain Mapping, 2015

Chemotherapy (CT) is associated with adverse effects on cognition. Only few studies have investig... more Chemotherapy (CT) is associated with adverse effects on cognition. Only few studies have investigated cognition in testicular cancer (TC) patients and studies on very late effects of CT on cognition are absent. Further, brain changes in relation to treatment have not been investigated in TC. The objective of the present study is to compare psychosocial functioning, cognitive performance and brain (micro)structure following surgery and CT for TC, against surgery (S)-only. Twenty-eight CT (43.1 ± 7.5 y) and 23 S-only (48.2 ± 9.5y) TC survivors on average 14 yr post-treatment were examined using questionnaires, neurocognitive tests, and 3T-MRI [Diffusion Kurtosis Imaging (DKI), T1-weighted and Fluid Attenuated Inversion Recovery]. A multivariate cognitive performance score (Mahalanobis distance) was calculated to indicate the grade of cognitive performance. Kurtosis parameters, gray matter, and white matter (WM) volume were calculated from MRI data. Overall, the CT group showed lower cognitive performance (5.35 ± 1.7) compared with the S-only group (4.4 ± 0.9; P =0.03; d = 0.70). Further, TC patients reported more memory problems after CT. DKI revealed a significantly higher radial kurtosis after CT in several anterior and posterior brain areas (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05, corrected), but this was unrelated to cognitive performance. This cross-sectional study suggests that men receiving CT for TC are at risk for long-term lower cognitive performance. Although CT affected WM microstructure, this was unrelated to cognitive performance. More extensive, preferably prospective studies are warranted to confirm these results and to provide more insight into the possible mechanisms behind the observed cognitive sequelae after treatment for TC. Hum Brain Mapp, 2015. © 2015 Wiley Periodicals, Inc.

The findings from laboratory studies on caffeine (the research of flavour under more natural cond... more The findings from laboratory studies on caffeine (the research of flavour under more natural conditions (ESN, 1996) may be summarised as follows. The evidence suggests that both caffeine and the research on coffee flavour exert a similar beneficial effect on the early stages of information processing, that is leads to greater perceptional sensitivity. Apparently, caffeine as a substance as well coffee odour induces similar effects. These similarity of effects is supported by observations and questionnaire data that effects of coffee are dependent in particular on psychological factors such as expectancy on the effects of caffeine and its beverage coffee, contextual factors in which coffee normally is consumed and the pleasure people have when they drink their cup of coffee. For these reasons it is argued and some suggestions are given to do more ecologically valid reasearch that is studying the effects of coffee as it is enjoyed in daily life by the regular consumer.

Our findings suggest different neurotoxicity profiles for CT and RT-only, with HI-CT being more n... more Our findings suggest different neurotoxicity profiles for CT and RT-only, with HI-CT being more neurotoxic than CON-CT. We found a CT associaDon with late cogniDve impairment and the presence of late sustained cogniDve decline. fMRI measures show a possible mechanism of gradual hypoacDvaDon aGer CT combined with worse performance, depending on intensity type of CT. However, RT-only survivors are able to perform at a similar level as HC while showing hyperacDvaDon. This gives rise to the idea that paDents who received CT may be unable to compensate for their worse performance as a result of impaired brain funcDoning due to the late effects of CT, whereas RT-only paDents need to devote greater corDcal resources for good performance, thereby performing less efficient. Adjuvant chemotherapy (CT) for breast cancer (BC) is associated with cogniDve problems and brain funcDon alteraDons (Wefel & Schagen, 2012). In our previous mulDmodality study (de Ruiter et al., 2011, 2012), we assessed BC survivors who received high-dose CT (HI-CT) or radiotherapy (RT-only) 10 years earlier. In the current study, we examined neurotoxicity profiles of different treatment strategies by extending our measurements to BC survivors who received convenDonal-dose CT (CON-CT) ≥10 years earlier and healthy controls (HC). The BC survivors treated with CT were randomized to HI-CT or CON-CT. We aim at inves+ga+ng the late effects of cancer treatment and its possible underlying mechanisms by comparing CT groups, and by comparing CT to RT-only and RT-only to HCs on neuropsychological and fMRI measurements. Study popula+on: Study populaDon characterisDcs are summarized in Table 1.

Breast Cancer Research and Treatment

SSRN Electronic Journal

PLOS ONE

NeuroImage. Clinical, 2018

Brain Imaging and Behavior

PLOS ONE

International Journal of Radiation Oncology*Biology*Physics

Psychiatry Research: Neuroimaging

Journal of pain and symptom management, Jan 17, 2016

European Neuropsychopharmacology, 2014

Progress in Brain Research, 2015

Journal of pain and symptom management, Jan 4, 2015

Human Brain Mapping, 2015