Patient diagnosis, treatment & follow-up

The CHU de Liège has pulled together a team of clinicians and scientists to focus their research activities on cognition and memory impairment in patients suffering from Alzheimer’s disease. This group is specialized in:

  • Diagnostic consultations of patients with cognitive impairment: Alzheimer’s disease, neurodegenerative and vascular dementia, Mild Cognitive Impairment, Subjective Cognitive Impairment
  • Neuropsychological characterization of cognitive difficulties
  • Combining PET images, Magnetic Resonance Imaging images and neuropsychological test data for an automatic diagnosis of Alzheimer’s disease
  • Evaluating treatments for cognitive difficulties
  • Evaluating rehabilitation methods for patients with neurocognitive disorders
  • Implementing cognitive rehabilitation methods

Looking for clinical advice or support, or preparing for a clinical study? We will help you set up a cost-effective and time-efficient study! Get in touch with our experts [info@b2h.be].

Radiotracers

Our team at CRC constantly develops faster, cheaper and safer techniques to prepare PET tracers. They are able to produce multiple high-quality 18F based tracers suitable for clinical studies (GMP facilities).

For more information about our services and capabilities in radiopharmaceutical development and production, click here.

More specifically, within Alzheimer’s disease, following tracers are being developed:

The 5-HT1A serotonin receptors are involved in several physiological functions including sleep, mood, neurogenesis and learning. Consequently, huge efforts have been done to find ligands for this receptor. [11C]WAY-100635 is a high affinity radioligand used for quantifying serotonin 5-HT1A receptors with positron emission tomography. A 18F-labeled radioligand is advantageous because of high specific activity and physical/nuclear properties (t1/2= 109 min, 97% of positron decay and positron energy of 635 keV maximum). [18F]MPPF, a selective 5-HT1A antagonist derived from WAY-100635, is currently one of the most successful PET ligand used for 5-HT1A receptor imaging. However, the affinity is lower than WAY-100635 and the amount of [18F]MPPF reaching the brain is relatively low since MPPF is a substrate for p-glycoprotein.

In order to improve the brain uptake of the radiotracer, a desmethylated analog has been developed by our CRC researchers.

Looking for clinical advice or support, or preparing for a clinical study? We will help you set up a cost-effective and time-efficient study! Get in touch with our experts [info@b2h.be].

In order to better understand the in vivo mapping of AMPA receptors and its evolution in neurological diseases, research at CRC aims at developing the design and the synthesis of 1,2,4-benzothiadiazine 1,1-dioxides (BTDs) positive allosteric modulators radiolabeled with a fluorine-18 atom.

They also developed pharmacological tests to evaluate the best candidate for the radiochemical synthesis for its in vivo applications.

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The synaptic vesicle protein 2A (SV2A) is widely distributed in the brain and has been demonstrated to be involved in vesicle trafficking. The critical role of SV2A in proper nervous system function is shown, e.g., by the fact that it is a binding site and the primary mechanism of the antiepileptic drug levetiracetam. This drug has recently been suggested to reduce synaptic deficits in a mouse model for Alzheimer’s disease.

Researchers at CRC have developed a new [18F]-radioligand which has a high affinity for the SV2A protein.

The PET images showed a high and rapid uptake of [18F]-synaptic vesicle SV2A radiotracer in the grey matter structures, matching the known ubiquitous distribution of the SV2A in human brain. The kinetics of the tracer in the brain was characterized by an initial high uptake phase followed by rapid washout.

The obtained results suggest that [18F]-radioligand is a good candidate as radiotracer for brain SV2A proteins and could be used to assess SV2A modifications in neurological pathologies such as Alzheimer’s disease and epilepsy.

Looking for clinical advice or support, or preparing for a clinical study? We will help you set up a cost-effective and time-efficient study! Get in touch with our experts [info@b2h.be].

Electroneuromyography

The electroneuromyography (EMG) is a set of techniques for functional study of peripheral nerve conduction, neuromuscular transmission and muscular activity.

The research activity at the CHU de Liège in the EMG sector is primarily clinical. It aims at developing new tools to both improve diagnostic efficiency and to increase functional exploration field. The following techniques are being developed:

  • Evoked potentials (EP) laser stimulation to improve the functional exploration of small fiber neuropathies (diabetes, amyloidosis, etc) and neuropathic pain
  • Triple nerve stimulation (cortical magnetic stimulation and two peripheral electrical stimulation) to expose the proximal conduction blocks within some dysimmune neuropathies and to quantify the central motor impairment in patients with multiple sclerosis
  • Nerve ultrasound (coupled with EMG) applied to entrapment neuropathy (carpal tunnel syndrome and others), as well as dysimmune neuropathies

Looking for clinical advice or support, or preparing for a clinical study? We will help you set up a cost-effective and time-efficient study! Get in touch with our experts [info@b2h.be].

Triple stimulation technique

Triple Stimulation Technique (TST) studies motor responses using a neurophysiological recorder, coupled to a dual electrical stimulator and a magnetic stimulator. This technique links central to peripheral conduction and suppresses desynchronization of motor evoked potential. It helps to better quantify the proportion of motor units activated by transcranial magnetic stimulation. The abnormal amplitude registered by TST is proportional to the intensity of conduction disorders.

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Motion Analysis

We can offer you a fully integrated analysis of the subject including spatio-temporal parameters (step frequency, step length, velocity, single and double support time …) and kinematics parameters (angular range of motion, velocity, ground reaction forces, muscles activity). Tests are performed in a 27 meters-long room (ensuring that subjects reach stabilized gait) in which the equipment can be used simultaneously and be synchronized on demand.

Picture14Force plates measure the ground reaction forces generated by a body standing on or moving across them, allowing investigators to quantify balance, gait and other biomechanical parameters.

Looking for clinical advice or support, or preparing for a clinical study? We will help you set up a cost-effective and time-efficient study! Get in touch with our experts [info@b2h.be].

Picture17Electromyography (EMG) allows to evaluate the activity of the muscles and is composed of several sensors (one for each studied muscle) placed at the surface of the skin. EMG is mainly used as a diagnostic tool to identify neuromuscular diseases and can be applied to the study of the effect of a given treatment (drug, rehabilitation program), ergonomics…

Looking for clinical advice or support, or preparing for a clinical study? We will help you set up a cost-effective and time-efficient study! Get in touch with our experts [info@b2h.be].

Picture15The Locometrix® accelerometer device provides a quick and informative walking test in the context of defining a diagnosis. The software automatically calculates 6 common dynamic characteristics of walking: symmetry, regularity, force, frequency, pathogenic shock waves and frontal instability. The system provides reference databases, allowing the user to interpret the test results in a matter of minutes. In practice, an accelerometer, fixed by a belt on the lumbar region, registers all movements of the center of gravity during walking, running or other athletic movements.

Its applications include:

  • Evaluation and monitoring of diseases such as Alzheimer’s disease, Parkinson’s disease and fibromyalgia. It can be used for measuring the severity and the activity of the disease and provides information on subgroups of patients through the identification of gait abnormalities. This ensures an earlier and more appropriate patient care
  • Geriatrics: individual characterization of the degradation of walking (loss of speed, smoothness, cadence…)

Looking for clinical advice or support, or preparing for a clinical study? We will help you set up a cost-effective and time-efficient study! Get in touch with our experts [info@b2h.be].

Picture16Codamotion® is a 3D motion capture system, which tracks and analyzes 3D movement. This system is very versatile and can provide a large variety of information including the common gait parameters (stride frequency, gait velocity…) as well as kinematic information (ankle, knee, hip angles).

A Codamotion® system is ideal for analyzing all scales of human body. Small scales details of hand, face, feet and spine can be captured together with large-scale whole-body movements. Critically, the active maker technology used in Codamotion® system produces real time data. Less than 1ms elapses between a measurement and its availability for processing and display.

Looking for clinical advice or support, or preparing for a clinical study? We will help you set up a cost-effective and time-efficient study! Get in touch with our experts [info@b2h.be].

With a set of range laser scanners, engineers at ULg have developed a new non-intrusive feet tracker system called GAIMS (for “Gait Analysis Imaging System”, “Gait Measuring System »). The observed person does not need to carry any sensor or marker, has not to wear special clothes and is not restricted to walk on a small area such as a treadmill.

This system can detect the real time position of each foot during different types of simple walking tasks. It enables the calculation of different gait parameters (global or single foot walking speed, single and double limb support times, base of support width, number of missteps…).

These characteristics can be used for the diagnostic of various diseases and for the longitudinal follow-up of patients with walking impairments.

Looking for clinical advice or support, or preparing for a clinical study? We will help you set up a cost-effective and time-efficient study! Get in touch with our experts [info@b2h.be].

Clinical imaging capabilities

Together, the CHU and the GIGA have a vast expertise in clinical imaging techniques, individually or combined in a multimodal functional imaging approach.

 

gemini tf16Positron Emission Tomography (PET) has the sensitivity to visualize at picomolar level molecular processes in 3D and in a volume and target-depth independent manner. As a stand-alone device or combined with a CT scanner (PET-CT), it allows a wide range of clinical and experimental applications:

  • Dynamic brain imaging (arterial blood sampling):
    • Concentration analysis of targeted analytes
    • Dynamic PET with tracer kinetic modeling techniques
  • Static brain imaging with 18F radiopharmaceuticals
  • Whole-body imaging for dosimetry:
    • Collection of quantitative and dynamic biodistribution data
    • Detailed drug occupancy studies
  • Whole-body imaging for metabolic evaluation, receptor or gene expression, with or without full diagnostic contrast-enhanced CT imaging

Equipment: PET scanner Siemens HR+, PET/CT Philips Gemini TF16 & Philips Gemini TF Big Bore (fully fitted for RT Planning)

In addition, we have:

  • Expertise in the development of new radioligand (for more info, click here)
  • Marketing Authorization Application to produce 18F-FDG (#BE241132)
  • Marketing Authorization Application to produce 68GA labelled compound
  • Certification to synthesize radiolabeled registered and experimental drugs
  • Authorization to conduct research programs with clinically validated 18F-FDG or original radiotracers
  • Expertise in experimental design, data collection, correction and modeling for kinetic analysis

Looking for clinical advice or support, or preparing for a clinical study? We will help you set up a cost-effective and time-efficient study! Get in touch with our experts [info@b2h.be].

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Magnetic resonance imaging (MRI) scanners use strong magnetic fields and radio-waves to visualize detailed-internal structures. Images are obtained in vivo with very high spatial and temporal resolution and good contrast for brain and soft tissues. MRI can be used in a wide variety of applications including anatomical, functional (fMRI) and molecular imaging for medical diagnosis, staging of disease and for follow-up without exposure to ionizing radiation.

Equipment: two 3T Siemens Allegra with parallel imaging capabilities (8-channel receive coil), one 1.5T Siemens Symphony and two 1.5 Siemens Aera Scanners.

Looking for clinical advice or support, or preparing for a clinical study? We will help you set up a cost-effective and time-efficient study! Get in touch with our experts [info@b2h.be].

This non-invasive technique relies on the in vivo mapping of the water diffusion process. It supports inferences about the tissue microstructure and brain connectivity.

DTI (diffusion tensor imaging) is one of the most popular MRI techniques investigated in current brain-imaging research. This method characterizes microstructural changes or differences with neuropathology and treatment. It is an extension of diffusion-weighted imaging (DWI), which is based on the principle that water molecule movement is restricted by barriers to diffusion in the brain depending on tissue organization.

 DKI (diffusion kurtosis imaging) is an extension of DTI, exhibiting improved sensitivity and specificity in detecting developmental and pathological changes in neural tissue. This technique is based on the non-Gaussian diffusion of water in biologic system. It provides independent and complementary information to that acquired with traditional diffusion techniques.

The diffusion imaging provides several advantages such as showing abnormalities invisible on standard morphological MRI and providing a better assessment of neurological impairment degree. Our diffusion imaging techniques are equipped with structure T1/T2 weighted MRI (sMRI), diffusion weighted imaging (DWI) and quantitative MRI (qMRI).

Looking for clinical advice or support, or preparing for a clinical study? We will help you set up a cost-effective and time-efficient study! Get in touch with our experts [info@b2h.be].

 

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SPECT is a nuclear medicine tomographic imaging technique, which uses radiopharmaceutical emitting gamma rays. Similar to PET, it can be combined with a computed tomography (CT), a cross-sectional technique that yields structural and anatomical high-resolution 3D images.

Equipment: 2 SPECT-CT Siemens Symbia T6, 1 SPECT Siemens E-Cam.

Looking for clinical advice or support, or preparing for a clinical study? We will help you set up a cost-effective and time-efficient study! Get in touch with our experts [info@b2h.be].

BrightSpeedElite-281x300A computerized tomography (CT) scan combines a series of X-ray images taken from different angles and uses computer processing to create cross-sectional images, or slices, of bones, blood vessels and soft tissues inside the body.

Equipment: 2 GE Brightspeed Elite scanners, 2 Siemens Somaton Emotion scanners, 1 Siemens Somaton Definition scanner.

EEG coregistration during (f)MRI with analysis tools to correct magnetic artefacts on the EEG data.

We are equipped with:

  • 64 channel Brain Products MRI-compatible EEG (Gilching, Germany)
  • Two easily transportable, high-density 256 channels EGI EEG systems (Eugene, OR, USA)
  • Electrode tracking system Zebris (Isny, Germany) allowing the digitalized localization of electrode positions on the test subject’s skull

Looking for clinical advice or support, or preparing for a clinical study? We will help you set up a cost-effective and time-efficient study! Get in touch with our experts [info@b2h.be].

Our Magstim1 TMS system (Whitland, UK), coupled with a Brainsight neuronavigator (Rogue Research, UK) allows transcranial magnetic stimulation of specific brain regions based on the MRI data of the patient.

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Our Nexstim NBS/Eximia EEG/TMS system (Helsinki, Finland) allows simultaneous transcranial magnetic stimulation of precise brain areas and EEG determination.

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Our soundproofed rooms are equipped with:

  • EEG system
  • Infrared camera
  • Control systems for hygrometry, temperature and ambient light level

This infrastructure allows chronobiological studies in complete isolation.

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Fixed and portable, MRI-compatible, visual tracking and pupillometry systems (Arrington Research, Scottsdale, AZ, USA; Applied Science Laboratories, Bedford, MA, USA), allowing the measurement of pupil size and gaze position during (f)MRI.

Looking for clinical advice or support, or preparing for a clinical study? We will help you set up a cost-effective and time-efficient study! Get in touch with our experts [info@b2h.be].