Antoine Bernas

PhD candidate

Lisanne Breuer

PhD candidate

Sveta Zinger

daily supervisor

Anton de Louw

daily supervisor

Bert Aldenkamp



MACA-E stands for ‘MRI study of Accelerated Cognitive Aging in Epilepsy’. The notion of accelerated cognitive aging (ACA) as a specific form of cognitive impairment in epilepsy is at the basis of the Neu3CA program, but is based on clinical experience rather than systematic investigation. The MACA-E study aims to investigate how prevalent ACA in epilepsy is, and what (specific) brain (network) abnormalities are associated with it.

Study rationale

The goal of the MACA-E study is to better characterize ACA in the context of the brain (MRI) and cognitive profile (neuropsychology).

Primary Objectives:

  • Can we identify neuronal markers of ACA in adult patients with epilepsy on the level of functional connectivity (resting state fMRI), structural connectivity (DTI), structural level (cortical mapping) or blood-brain perfusion?
  • Do these neuronal characteristics/differences in fMRI connectivity correlate with cognitive performance?
  • Can ACA be characterized by a greater loss of cognitive reserve capacity (defined as the change in the first versus the second resting state fMRI, mediated by cognitive activation with a cognitive activation task) , compared to the two control groups?

Secondary Objectives:

  • What influence do clinical characteristics (patient characteristics, epilepsy-related factors) have on neuropsychological and MRI outcome?

Study design:

prospective observational study. Multimodal MRI and neuropsychological assessment will be performed at Epilepsy Centre Kempenhaeghe.

Study population:

Three cohorts: 20 adult patients with epilepsy and the clinical diagnosis of ACA, 20 age- , education- and type of epilepsy (etiology)-matched adult patients with epilepsy without ACA, 20 age- and education-matched healthy controls, all aged 18 to 80 years, with (premorbid) FSIQ > 70.

Main study parameters/endpoints:

  1. Cognitive parameters, i.e. the neuropsychological parameters for global cognitive decline (intelligence discrepancy scores, i.e. the discrepancy between the actual IQ and the estimated IQ according to the formula proposed by Schoenberg et al. [3]), information processing speed, attention and memory.
  2. MRI parameters: macrostructural, microstructural and functional, and blood brain perfusion.