Understanding what happens in the brain
At the heart of professor Jaap Jansen’s work is the use of MRI to explore the brain. As professor of Clinical Neuroimaging, with a special focus on MRI, at both Maastricht University and Eindhoven University of Technology (TU/e), he combines the strengths of both institutions: Eindhoven’s expertise in complex signal analysis and strong industry partnerships, and Maastricht’s role as a bridge between clinical practice and technological innovation. This synergy enables rapid translation of neuroimaging innovations into patient care, amplifying their impact.
The title of Jaap Jansen’s inaugural lecture is: My favorite things: MRI innovations for healthy and diseased brains. MRI1 is undeniably the unifying thread in Jansen’s research. He explains: “From my first experiences with MRI, it was clear to me that I wanted to specialise in this field, particularly in researching neurological and psychiatric disorders. MRI is incredibly versatile, allowing us to visualise far more than standard hospital scans. By using different techniques to map various aspects of the brain, we aim to understand what is actually happening in the brains of both healthy and unwell individuals”.
MRI techniques
Jansen elaborates: “With MRI, for example, we can visualise myelin, a fatty substance in the brain essential for transmitting signals. Many progressive brain diseases are associated with reduced myelin. Using spectroscopy, we can examine the function of neurotransmitters crucial for healthy brain activity. Functional MRI allows us to study brain networks and their functional connectivity, while diffusion MRI visualises these connections. Understanding the presence and state of these connections can tell us a lot about the stage of a disease. By continuously improving our ability to map brain activity and refining these techniques, we hope to make a real difference in patient care. However, the current impact on patients is limited. While imaging is a powerful tool, even with perfect scans, we often have little to offer patients simply because effective treatments for many brain diseases do not yet exist. Our goal is to use advanced MRI techniques to find leads that could, in the future, improve patients’ lives.”
IVIM and the glymphatic system
Jansen continues: “MRI allows us to explore many different facets of the brain. One such aspect, which I haven’t mentioned yet, is the glymphatic system; a waste clearance system in the brain. We’ve known about its existence for just over a decade, and we’re increasingly finding that it is impaired in various conditions, such as Alzheimer’s disease, which is characterised by protein buildup. We suspect this may be due to faulty waste clearance in the brain. MRI enables us to study this. One technique I introduced in Maastricht, and which I’m particularly proud of, is IVIM2, a derivative of diffusion MRI. What started as a small project has now become a standard part of almost all our studies. The beauty of IVIM is that it not only provides information about tissue damage and vascular impairment but also about waste clearance in the brain. We’ve observed that patients with cognitive complaints often have issues with this clearance process. While most MRI techniques were developed by others, we’ve truly refined and optimised IVIM here in Maastricht. In applying this technique to brain research, we’re at the international forefront”.
“We aim to uncover the hidden information that tells us exactly what’s really going wrong."
Highlighted projects
Jansen initially focused on epilepsy research, which remains one of his active areas. However, his work now spans a broader range of conditions, including Alzheimer’s, MS, cerebral microangiopathy2, Parkinson’s, diabetes, and depression. Jansen explains: “We collaborate with the Alzheimer Centre Limburg, the Kempenhaeghe Epilepsy Centre, and Zuyderland Hospital on MS research. We also work closely with The Maastricht Study on diabetes research. Our expertise allows us to contribute across many fronts. Collaboration with clinicians is invaluable: they are essential sparring partners, and these partnerships ensure our research is directly relevant to patient care. I’ll highlight a few ongoing studies”.
MS and myelin
“The MS project I’m conducting with Zuyderland is a close collaboration between TU/e, MUMC+, and Philips. The goal is to improve scanning techniques, specifically targeting myelin. For this study, we’ve selected MS patients as a test case, scanning and following around 100 patients for two years using advanced MRI techniques. We’re also conducting blood tests and cognitive assessments”.
Complex epilepsy
Jansen notes: “In a study on imaging in patients with complex epilepsy, we’re looking at individuals who don’t respond well to anti-seizure medications. These patients are referred by their GP to centres like Kempenhaeghe, where specialist neurologists have access to multiple treatment options. We scan patients at two points to examine neurotransmitters (using spectroscopy) and brain networks (using functional MRI). By better mapping what’s happening in the brain, we hope to predict which patients will benefit from specific medications. In another collaboration with Kempenhaeghe, with neurologist Ilse van Straten, we’re studying patients eligible for epilepsy surgery. It’s often assumed that surgery will cure epilepsy, but unfortunately, 30-40% of patients still experience seizures two years post-surgery. Using MRI, we’re investigating whether we can predict which patients will benefit most from surgery.”
Understanding is key
Jansen emphasises: “With the data available to doctors, such as a patient’s medical history and blood markers, it’s still difficult to predict disease progression. Many things remain invisible. With MRI, we aim to uncover this hidden information to understand what’s really going wrong. In my research, we’re interested in two main things: understanding why patients have symptoms or respond poorly to treatment, and predicting whether patients will improve or worsen - either with a specific treatment or over time. The reality is that there are no medications that can, for example, regrow myelin. So, while knowing who will do well or poorly doesn’t yet translate into new treatments - beyond lifestyle interventions, which are beneficial for every condition - the main focus is on better understanding. First, improving understanding; then, improving prediction; and ultimately, improving treatment!”
1Magnetic Resonance Imaging (MRI) is a medical imaging technique used to visualise the body and certain physiological processes. MRI scanners employ a powerful magnetic field and radio waves to generate detailed images of organs and tissues within the body. MRI encompasses several specialised (and derived) techniques, including functional MRI, diffusion MRI, physiological MRI, spectroscopy, nuclear magnetic resonance (NMR), and intra-voxel incoherent motion (IVIM).
2Intra Voxel Incoherent Motion
3Cerebral microangiopathy is a condition in which the small blood vessels in the brain become damaged, potentially leading to reduced blood flow and minor brain injuries.
Text: Eline Dekker
Photo: Joey Roberts
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