Brain disorders may be acquired (such as in stroke, traumatic brain injury, brain tumors, and MS), perinatal (cerebral palsy) or neurodegenerative diseases and often lead to severe and long term problems in motor control, cognition and communication.
The objective of BrainMotion is to optimize diagnosis and personalized treatment of motor disabilities caused by brain disorders by means of excellent research, education and patient care.
Research Activities
This ACE covers fundamental, translational, clinical, and epidemiological research. Fundamental neuroscience research studies how the brain controls movement and how this is disrupted in brain disorders.
Translational research is performed, for example, on using brain stimulation to improve motor learning and to understand the functional, health and participation consequences. Clinical and epidemiological studies include trials investigating innovative interventions to improve the treatment of motor deficits, as well as large nationwide cohorts initiated from our ACE on stroke, traumatic brain injury, cerebral palsy, and intellectual disability.
These cohorts, for example, includes studies on training for improving cardiovascular risk, gait and physical strain during walking in adults with cerebral palsy or intellectual disabilities, and autonomic dysfunction.
Other examples include studies on Parkinson disease, paraneoplastic ataxia, calcium channelopathies, and eye-movement disorders. BrainMotion is a founding partner of the national consortium IMDI NeuroControl collaborates national consortia Learn2Move, PERRIN, and Healthy Ageing and Intellectual Disabilities (GOUD in Dutch). International collaborations include McMaster University, Canada, University of Michigan, Ann Arbor, USA, Lund University, Sweden, University of Illinois Chicago, University of Glasgow, and the ISPRM-WHO Liaison (prof Stucki), Uni Essen (prof Timmann), BGU (prof Donchin), Gladstone institutes for neurological disorders (UCSF), Baylor College of Medicine (Tx, USA), Okinawa Institute of Science and technology (Japan).
Collaborations
BrainMotion is a founding partner of the national consortium IMDI NeuroControl collaborates national consortia Learn2Move, PERRIN, and Healthy Ageing and Intellectual Disabilities (GOUD in Dutch). International collaborations include McMaster University, Canada, University of Michigan, Ann Arbor, USA, Lund University, Sweden, University of Illinois Chicago, University of Glasgow, and the ISPRM-WHO Liaison (prof Stucki), Uni Essen (prof Timmann), BGU (prof Donchin), Gladstone institutes for neurological disorders (UCSF), Baylor College of Medicine (Tx, USA), Okinawa Institute of Science and technology (Japan).
Contributions
BrainMotion educates students from different programs on mechanisms, diagnosis and treatment of motor deficits that result from brain disorders through participation in the Bachelor and Master education of Medicine, Clinical Technology and Nano-Biology and the education of medical specialist from a number of different specialties (Ophthalmology, Rehabilitation Medicine, Neurology, Intellectual Disability Medicine).
Amongst others, we organize all Anatomy and Physiology courses for the Medicine bachelor (highlighting motor systems), minors 'Revalidatie & Sport' and 'De werking van onze Hersenen: Van Neuron tot Vrije Wil". We participate in the research master of Medicine and in the new MSc Clinical Technology. In addition, we host students from e.g. biomedical engineering, human movement sciences, human movement engineering, physical therapy (TU Delft, Medical Delta, the Hague University of Applied Sciences, University of Applied Science Leiden, University of Applied Science Rotterdam) both at the BSc and MSc level.
For the education of medical specialists, partners provide both clinical training and research training. The department of Neuroscience hosts the Neuroscience research master. For continuous professional education we teach on state of the art knowledge on these topics in instructional courses, among others at multidisciplinary congresses of the European and American Academies of Childhood Disability and Rehabilitation Medicine.
Care Activities
BrainMotion's multidisciplinary approach is founded on the philosophy that integrated, interdisciplinary care is the most effective approach for patients with movement disorders. It takes into consideration patients' whole lives, including but not limited to the out-of-control movement of muscles.
Patients with movement disorders also can suffer from depression, anxiety, cognitive problems, and speech and sleep problems. They may need physical and speech therapy, psychiatric help or social work support. BrainMotion delivers motor, cognitive and behavioral diagnoses as well as various treatments all in one centralized location. Care is coordinated and provided by leading specialists in a comprehensive array of expertise: physiatrists, neurologists, neurosurgeons, neurophysiologists, neuroradiologists, neuropsychologists, physical and occupational therapists and speech therapists supported by a team of movement scientists involved a clinical movement laboratory and neuroscientists.
Societal Relevance to Research, Education and Patient Care
Movement pathologies impact quality of life and cause a wide range of secondary effects such as joint contractures, decreased fitness and physical inactivity, which increase for example the risk on obesity, cancer, cardiovascular disease and diabetes. About 30% of the healthcare costs in the Netherlands are spent on neurological diseases, more than on cancer and cardiovascular diseases combined, and it has been estimated that in 2010 the total European cost of brain disorders was €798 billion, which is about €5,550 per inhabitant.
The incidence of these disorders increases with age, and due to the aging of the population, it is expected that the number of patients with late-onset neurodegenerative disorders will double every 20 years in the Western countries. BrainMotion maintains structural and long-term relationships with consumer organizations such as VSN (society for muscular disorders) and BOSK (society for parents with children with spasticity). Researchers and clinicians actively contribute to the development of national guidelines, f.i. guideline for Cerebral Palsy, ALS, Stroke, etc. Besides regular contribution to the regular curriculum of Erasmus Medical School, BrainMotion organizes and contributes to several national and international post graduate courses, books and educational smartphone application.
Viability of Research, Education and Patient Care
Interdisciplinary efforts are becoming critical for scientific discovery and translational research efforts. Yet, facilitation of knowledge sharing represents one of the major challenges in interdisciplinary research. While essential, a lack of sufficient extrinsic and/or intrinsic rewards is a common barrier to share knowledge.
The ACE BrainMotion aims to be a research team with common objectives, coordinated resources, and a shared agenda of activities. In BrainMotion we will further strengthen collaboration between partners and disciplines. To achieve a high level of integration and interaction regular meetings are planned and a scientific vision is shaped in the central theme of brain motion, motor consequences related to brain disorders. Intellectual disagreement will be encouraged, data will be shared as well as credits for research accomplishments.
The participating departments participate in various EU-funded research consortia, which allows numerous international PhD-students to work in the Erasmus MC. Moreover, many PhDs visit laboratories abroad and gain individual grants and fellowships. Substantial efforts is made to retain the Top Talents. International initiatives included PhD students from Neuroscience and Rehabilitation Medicine that will visit a Summer school in Chicago in 2016 organized by IMDI NeuroControl, Northwestern University and Rehabilitation Institute of Chicago as well as an exchange program with McMaster University, Canada and the founding and present presidency of the International Society for the Measurement of Physical Behaviour.
Key and relevant publications of the last five years
- Gao Z, Proietti-Onori M, Lin Z, Ten Brinke MM, Boele HJ, Potters JW, Ruigrok TJH, Hoebeek FE, De Zeeuw CI. Excitatory cerebellar nucleocortical circuit provides internal amplification during associative conditioning. Neuron in press. [IF 15.1; rank 6 out of 255 neuroscience journals; 1st quartile; top 10%]
- Schonewille M, Gao Z, Boele HJ, Vinueza Veloz MF, Amerika WE, Simek AA, De Jeu MT, Steinberg JP, Takamiya K, Hoebeek FE, Linden DJ, Huganir RL, De Zeeuw CI. Reevaluating the Role of LTD in Cerebellar Motor Learning. Neuron 70:43-50. [IF 15.1; rank 6 out of 255; 1st quartile; top 10%]
- De Zeeuw CI*, Hoebeek FE*, Bosman LW*, Schonewille M*, Witter L*, Koekkoek SK. Spatiotemporal firing patterns in the cerebellum. Nature Rev Neurosci 12: 327-344. [IF 31.4; rank 1 out of 255; 1st quartile; top 10%]
- Olgiati S, Quadri M, Fang M, Rood JP, Saute JA, Chien HF, Bouwkamp CG, Graafland J, Minneboo M, Breedveld GJ, Zhang J; International Parkinsonism Genetics Network, Verheijen FW, Boon AJ, Kievit AJ, Jardim LB, Mandemakers W, Barbosa ER, Rieder CR, Leenders KL, Wang J, and Bonifati V. DNAJC6 Mutations Associated With Early-Onset Parkinson's Disease. Ann Neurol 2016; 79: 244-56.
- Quadri M, Federico A, Zhao T, Breedveld GJ, Battisti C, Delnooz C, Severijnen LA, Di Toro Mammarella L, Mignarri A, Monti L, Sanna A, Lu P, Punzo F, Cossu G, Willemsen R, Rasi F, Oostra BA, van de Warrenburg BP and Bonifati V. Mutations in SLC30A10 cause parkinsonism and dystonia with hypermanganesemia, polycythemia, and chronic liver disease. Am J Hum Genet 2012: 90:467-77.
- Michielsen ME, Selles RW, Stam HJ, Ribbers GM, Bussmann JB. Quantifying non-use in chronic stroke patients: a study into paretic, non-paretic and bimanual upper-limb use in daily life. Arch Phys Med Rehabil. 2012 Mar 27.
- Slaman J, Roebroeck ME, van der Slot W, Twisk J, Wensink A, Stam HJ, van den Berg-Emons R, Learn2Move Research Group. Can a lifestyle intervention improve physical fitness in adolescents and young adults with spastic cerebral palsy? A randomized controlled trial. Arch Phys Med Rehabil 2014;95:1646-55.
- Slot WMA van der, Roebroeck ME, Nieuwenhuijsen C, Bergen MP, Stam HJ, Burdorf A, van den Berg-Emons RJ, MoveFit and Lifespan Research Group. Cardiovascular disease risk in adults with spastic bilateral cerebral palsy. J Rehabil Med 2013; 45: 866-72.
- Oppewal A, Hilgenkamp TI, van Wijck R, Evenhuis HM. Feasibility and outcomes of the Berg Balance Scale in older adults with intellectual disabilities. Res Dev Disabil 2014 October;34(9) :2743-2752.
- Hilgenkamp TI, van Wijck R, Evenhuis HM. Low physical fitness levels in older adults with ID: Results of the HA-ID study. Res Dev Disabil 2012 July;33(4) :1048-58.
PhD theses of the last five years
- Henk-Jan Boele (2014) Neural mechanisms underlying motor learning
- Maria Fernanda Vinueza Veloz (2015) Cerebellar control of locomotion in health and disease
- Lieke Kros (2015) Cerebellar involvement in ataxia and generalized epilepsy
- Simone Olgiati (2016). Genetics of movement disorders in the next generation sequencing era.
- Marian Michielsen (2012). Reflections on mirror therapy in stroke: Mechanisms and effectiveness for improving hand function.
- J. Slaman (2014): Promoting a healthy lifestyle. Effectiveness of an intervention on physical behaviour and physical fitness among adolescents and young adults with spastic cerebral palsy.
- W. van der Slot (2013): Health issues and participation of adults with cerebral palsy.
- M.M. Visser (2016) How to cope with stroke? The effectiveness of Problem Solving Therapy
- Thessa Hilgenkamp (2012). Physical activity and fitness in older adults with intellectual disabilities.
- Alyt Oppewal (2014). Measuring physical fitness in older adults with intellectual disabilities – moving towards practice
Non-scientific publications related to the ACE
Principal coordinator(s)
Leading investigator(s)
- H.J. Boele
- V. Bonifati
- L.W.J. Bosman
- E. Brusse
- J.B.J. Bussmann
- M.T.G. de Jeu
- C.I. de Zeeuw
- M.A. Frens
- Z. Gao
- T.I.M. Hilgenkamp
- F.E. Hoebeek
- H.L.D. Horemans
- D. Jaarsma
- C.C.W. Klaver
- G.J. Kleinrensink
- S.K.E. Koekkoek
- S.E. Loudon
- A. Oppewal
- J.J.M. Pel
- G.M. Ribbers
- M.E. Roebroeck
- T.J.H. Ruigrok
- M. Schonewille
- R.W. Selles
- H.J. Stam
- C. Strydis
- M.J. Titulaer
- H.J.G. Van den Berg-Emons
- J.N. van der Geest
- J. van der Steen