We have a long history of functional imaging and neurophysiological examinations. In recent years, neurogenetics and cell biology research have also become very important. We are convinced that increasing our knowledge in these areas can strongly improve diagnostics and treatment for our patients.

Our major research themes:

  • hyperkinetic movement disorders 
  • hypokinetic movement disorders

This way, our group is continuously working on improving patient care through advanced clinical research.

Relevance

Our scientific questions arise from our daily clinical practice

Many of the scientific questions arise from the daily clinical practice.

Examples of our paediatric clinical research are detailed phenotyping of children with ataxia and dystonia, studies into the quality of life of children with dystonia and studies into the value of deep brain nucleus stimulation (DBS) for children with dystonia.

  • In adults, we focus on improving the treatment of Parkinson’s disease, creating innovative diagnostics of dystonia and myoclonus, and researching how to improve the effects of DBS in treating movement disorders.
  • Our translational research aims to discover new genes that underlie movement disorders and unravel the pathophysiology of and mechanisms behind several diseases.
  • We have close collaborations with the genetics and cell biology laboratories and with the imaging departments, for example for our fMRI and PET (positron emission tomography) studies.
  • The cell biology department is doing a lot of research into iron storage diseases such as neuro-degeneration with brain iron accumulation (NBIA). At the UMCG, everything we need for our research is right at hand.
  • We set up a database (approx. 1500 patients). At this moment, a large NEMO/ZonMW-TOP project is running with the aim to use machine learning algorithms to classify different types of movement disorders using 3D-video, sensors and EMG activity.

    In addition, good phenotyping is used to describe patients with different (rare) movement disorders, such as myoclonus dystonia, progressive myoclonus ataxia, task-specific dystonia (‘zwabberbeen’), ‘Noordzeeziekte’, and different metabolic disorders with movement disorders, such as Niemann Pieck disease. Phenotyping is focused on both motor and non-motor symptoms, such as psychiatry and cognition, and quality of life.

  • We discover new genes that underlie movement disorders and unravel the pathophysiology of and mechanisms behind several diseases. Our clinical deparment collaborates closely with the Dept. of Genetics, the Dept. of Biomedical Sciences of Cells and Systems (BSCS) and the Dept. of Nuclear Medicine & Medical Imaging (NMMI).

    BSCS is doing a lot of research into iron storage diseases such as neuro-degeneration with brain iron accumulation (NBIA). In our genetic studies, we focus on network analyses of genes involved in movement disorders to determine new candidate genes. Electrophysiological studies give insight into the pathophysiology of tremor myoclonus and dystonia.

    In collaboration with NMMI (fMRI and PET), we study the brains networks involved in different movement disorders (also part of the NEMO/ZonMW-TOP project).

  • Pathophysiology of Parkinson’s disease (PD) and personalized medicine, with a main focus on the gut-brain axis, the role of inflammation and the development of PD-related dementia and visual hallucinations. For this reason, the DUPARC cohort was started, which is a dopa-naïve de novo PD cohort with >150 participants, who are deeply phenotyped with MRI, dopaminergic- (F-DOPA PET) and cholinergic imaging (FEOBV-PET), gut microbiome analysis (16S and metagenomics), optical coherence tomography and neuropsychological examination, in combination with genotyping (GSA-MD and single cell RNA sequencing).

    Lifelines-DEEP participants serve as valuable controls in this study design. Another line of research is related to the treatment of visual hallucinations by means of rTMS, using advanced techniques to image brain network connectivity, as a basis for rTMS treatment.

  • For treatment studies, we focus on the improvement of deep brain nucleus stimulation (DBS) for dystonia using electrophysiological measurements pre-, per and post-operatively. In the near future, a NBIA treatment trial will start in close collaboration with BSCS.

  • Innovative treatments, with a main focus on advanced treatments in PD, disease modification and the role of pharmacogenetics. Our TULIP cohort consists of 160 GBA1 patients, part of a national GBA1 cohort of over 500 patients, in which the clinical course of the different mutations is established. The TULIP cohort is also the basis for new therapeutics, focussing on lysosomal hypo/dysfunction, in order to modify the course of PD.

    At this moment, the use of medication in PD is based on trial and error, which has to become more personalized, using a medication passport for PD patients. This passport is now being created and tested, including all genetic variants of receptors and enzymes, involved in the dopaminergic and cholinergic treatment of PD patients.

  • Value-based healthcare in PD, with a focus on analyzing the outcomes of a new organisational model on regional PD-care. Since 2017, PD care in Groningen is organised in ‘Punt voor Parkinson’ (PVP), which is a regional PD expertise center. ​This center offers all advanced therapies, and coordinates professional education and clinical research for the northern regions of the Netherlands. The concept of PVP is now extended to other regions as well. Analysis of the costs and benefits of this model, focussing on value instead of volume is now ongoing, and will serve to definitely establish this new way of organising PD care.