The brain on screen The brain is our most complicated and least understood organ. This makes it almost surprising that it functions so well in most people. But there is a lot that can go wrong. Luckily, we now have MRI scanners with which we can examine the brain in detail.
MRI scans are essential when uncovering whether Alzheimer’s, capillary damage or a combination of the two is behind dementia symptoms. BRAM BELLONI
By Joris Janssen
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t is located in a special wing of UMC Utrecht: one of the most powerful MRI scanners in the world in a clinical environment – an environment in which it can help patients directly, as opposed to an environment focused solely on research. For two neurologists, this machine is a blessing for their research. Geert Jan Biessels uses it to study patients with dementia due to damage to small blood vessels in the brain. Kees Braun uses the scanner to treat children and adults with epilepsy that is difficult to control. Two different disciplines with something in common: technological progress promises improved treatment by visualizing the brain. Anyone thinking of dementia, often thinks of Alzheimer’s disease. This disease causes pathogenic protein to damage the brain, leading to memory problems, among other things. However, this is often only part of the story. Nine out of ten people who develop Alzheimer’s in later life have another problem: damage to small capillaries in the brain. Sometimes, this type of capillary damage is even the
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main culprit behind the dementia-like symptoms. In those cases, patients are diagnosed with vascular dementia. Overall, capillary damage is responsible for roughly one third of all dementia symptoms. Half is due to Alzheimer-like processes, and the rest is caused by a catchall of other conditions. So, although it is not the most common form, many people with dementia are faced with the vascular variety, to a greater of lesser extent.
Tiny capillaries ‘The study of dementia due to capillary damage is lagging behind the study of dementia due to Alzheimer’s,’ says Geert Jan Biessels, head of general neurology and leader of the Vascular Cognitive Impairment research group at UMC Utrecht. ‘It’s a shame, because there is a very real opportunity to do something about it.’ This disadvantage is, in part, caused by lagging investments, but there is also a practical cause. Until recently, it was impossible to obtain a good visual of the culprits behind the condition: the small
Damage to small capillaries in the brain is the cause of roughly one third of all dementia symptoms. BRAM BELLONI
