Prof Jeroen Geurts
VU University Medical Center Amsterdam, Netherlands
For decades, multiple sclerosis was regarded as a ‘typical white matter disease’. Geurts’, however, has shown that the grey matter is severely affected as well, and the clinical impact of grey matter damage in MS is often greater than that of white matter damage. Especially cognitive decline, socially and psychologically highly incapacitating to patients, cannot be explained by white matter damage alone. Hisinitial work, elucidating the histopathological characteristics of grey matter damage, the development of new neuroimaging tools to visualize grey matter lesions and the investigation of their clinical relevance, has been importantly expanded by his team in recent years. They investigated specific brain structures important to cognition, such as the thalamus and the hippocampus, and found that these structures are abnormally active and differentially connected within the entire brain network, already in early disease phases. They subsequently set up a unique cohort of stringently selected cognitively impaired MS patients, performed extensive neuropsychological testing, acquired multimodal neuroimaging, and developed our network analysis skills. They found that MS cognitive impairment can be partly compensated for by a temporary reorganization of brain function, a finding that sparked our interest in cognitive rehabilitation. If the peak of functional reorganization can be therapeutically shifted in time, MS patients could perhaps be safeguarded from cognitive decline, potentially for many years. With their comprehensive approach, spanning molecule to mind, they are currently one of the leading teams in the field worldwide. They are currently setting up a Center for Cognitive Rehabilitation that will provide specialist care targeted to the individual patient and accompanied by forefront translational research. Geurts is also working to translate their findings concerning brain network degeneration between neurological diseases (Alzheimer’s, Parkinson’s, neuro-oncology).