After completing my studies in Movement Sciences at the VU in Amsterdam, I began a PhD research project in 2012 at Radboud UMC in Nijmegen. During my PhD, I used MRI and MR spectroscopy to study metabolism in muscles. Following this, I continued using these same techniques in Nijmegen to investigate the muscles of patients with facioscapulohumeral dystrophy (FSHD). In this research, we developed a new method to measure muscle fat infiltration and discovered that muscle metabolism only differs when fat infiltration is already visible in the muscles.

In 2008, I joined LUMC, where I was able to establish my own research line focused on MRI of muscles. In close collaboration with the Neurology department, we initiated natural history studies in Duchenne and Becker muscular dystrophy, aiming both to describe the disease process and to investigate its pathophysiology. My research is funded through grants from the Duchenne Parent Project, the European Union, and the Association Française de Myologie. In 2015, I received a Vidi grant from the Dutch Research Council (NWO) to investigate why certain muscles remain spared for a long time in muscular dystrophies. A new research line in my group focuses on imaging the eye muscles in Myasthenia Gravis.

Research lines Hermien Kan

I am associate professor of imaging in neuromuscular diseases at the Department of Radiology of Leiden University Medical Center. At a national level, I am board member of the Duchenne Center Netherlands (Duchenne Centrum Nederland) and at an international level I am member of the Program Committee of the International Society for Magnetic Resonance in Imaging. My research group focuses on the development and application of magnetic resonance (MR) techniques in neuromuscular disease.

After completing my studies in Movement Sciences at the VU in Amsterdam, I obtained my PhD in 2007 at the Radboud UMC in Nijmegen. During my PhD, I used MRI and MR spectroscopy to study metabolism in muscles. I continued using these same techniques in Nijmegen to investigate the muscles of patients with facioscapulohumeral dystrophy (FSHD). In this research, we developed a new method to measure muscle fat replacement and discovered that muscle metabolism only differs when fat replacement is already visible in the muscles.

In 2008, I joined LUMC, where I established my own research line focused on imaging in neuromuscular disease. My research focuses on developing new MRI methods and applying them in various muscle diseases, including Duchenne and Becker muscular dystrophy, Myasthenia Gravis and Pompe disease. In close collaboration with the Neurology department, we have set up natural history studies where we focus on finding biomarkers for describing the disease process as well as investigating the pathophysiology. Recent projects focus on the implementation of quantitative MRI in the care of children with a muscular disease, the development of MRI techniques during movement in the MRI scanner and the development of a therapy for patients with Duchenne Muscular Dystrophy. My research is funded through grants from the Duchenne Parent Project, the Dutch Research Council (NWW) the European Union, and reNEW.

Research Line 1: Skeletal muscle

Summary: Histologically, atrophy, inflammation, fibrosis and/or fat replacement of muscle tissue and fiber size changes are prominent features of muscle diseases. While these aspects can be assessed using a muscle biopsy, this is invasive and only covers a specific small area in a single muscle. In the neuromuscular imaging group, we have implemented quantitative MRI tools to study fat replacement, inflammation, muscle metabolism and muscle architecture in a large range of muscles and in several of the diseases where the LUMC is are NFU expert center. These include Duchenne muscular dystrophy, Becker muscular dystrophy (BMD), Limb Girdle Muscular Dystrophy (LGMD) and Myasthenia Gravis (MG). In addition, we focus on the development of new tools to assess muscle function during movement.

Research Center: Leiden UMC, Radiology

Diseases: Duchenne muscular dystrophy, Becker muscular dystrophy (BMD). Limb Girdle Muscular Dystrophy (LGMD) and Myasthenia Gravis (MG).

Experts involved: Ozge Findik Sener (PhD-candidate); Evelien Fleerakkers (PhD-candidate); Melissa Hooijmans (PhD, Vrije Universiteit Amsterdam); Michel Michaels (PhD-candidate), Makeda Moore (PhD-candidate); Erik Niks (MD-PhD); Esther Schrama (PhD-candidate); Maaike Smit (PhD-candidate), Gustav Strijkers (PhD, Amsterdam UMC) Susi Rauh (post-doc).

Research line 2: Brain

Summary Since 2010, we are performing both cross-sectional and longitudinal MR studies in DMD. The first cross-sectional studies showed decreases in grey matter volume, changes in white matter structure and decreases in cerebral perfusion. All of these changes were larger in patients lacking more isoforms of dystrophin. No clear differences in brain metabolites were observed. While there was no direct correlation to cognitive and behavioral tests, these showed the same trends in relation to the isoforms. We are now extending these studies in multi-center studies with the University of Leuven and Newcastle, and participated in the EU H2020 funded project BIND.

In addition, we are collaborating with the Erasmus Medical Center in Rotterdam on brain involvement in patients with Pompe disease. We perform ¹H MRS at our 7T system to study glycogen accumulation in the brain.

Research Center: Leiden UMC, Radiology

Diseases: Duchenne muscular dystrophy, Becker muscular dystrophy, Pompe disease

Experts involved: Rosanne Govaarts (senior-researcher); Erik Niks (MD-PhD), Hannerieke van den Hout (MD-PhD, Erasmus MC). Nadine van der Beek (MD-PhD, Erasmus MC)

Techniques/keywords: Magnetic Resonance Imaging, brain, skeletal muscle, metabolism, MR spectroscopy