At the moment, it is not yet possible to predict which patient will develop a cognitive disorder immediately after a stroke and which not. A clear prognosis is key to a successful rehabilitation process. In order to better predict the impact of a cerebral infarction, international research groups are working together on a vulnerability map of the brain. The consortium is coordinated by Professor Geert Jan Biessels of the UMC Utrecht Brain Center. An article about the pilot study for this multicenter research has been published in Alzheimer's & Dementia: Diagnosis, Assessment and Disease Monitoring.

A significant proportion of patients who have suffered a cerebral infarction develop cognitive impairments, including problems with memory, concentration, orientation or language. At the moment it is not yet possible to predict who will continue to suffer from a cognitive disorder immediately after the cerebral infarction. Researcher Nick Weaver explains: “It is known that the nature and severity of cognitive symptoms are related to the location of the cognitive infarction. By linking the location to cognitive measurements in the short and long term, we can develop "vulnerability maps" that indicate critical areas for damage and the potential cognitive outcomes. Until now, these vulnerability maps have been incomplete because brain areas with fewer infarctions could not be studied. In order to map all potential locations, data from thousands of patients is required. Such a large-scale study cannot be conducted from an individual research center, so we have set up a large international partnership.”

The pilot study was conducted with 6 international research centers, using data from 878 patients. This was coordinated by researchers from the group of Prof. Biessels: Drs. Nick Weaver, Dr. Matthijs Biesbroek And Dr. Hugo Kuijf. The data was successfully integrated into a uniform dataset. Nick Weaver says, “The largest individual study so far comprised 410 participants, so the number has more than doubled in the pilot study. We were able to map a much larger part of the brain. First we had charted 20% of the brain, now we have 46%. This confirms our idea that combining cohorts is feasible and clearly has added value. This allows us to create a more complete vulnerability map of the brain.” For the follow-up project, 43 research groups are already interested in taking part, which means data from more than 3,500 patients.

These are good developments for patients who suffer a cerebral infarction. Initiator and coordinator Prof. Geert Jan Biessels explains: “The vulnerability maps resulting from these international projects can be applied in clinical practice to better predict cognitive disorders after a cerebral infarction, giving patients more certainty about their prognosis. The sooner patients are given more certainty and if possible the right therapy, for example through cognitive rehabilitation, the better!”