Academic Center for Sensory Disorders

Last updated: 365 days ago.

To join forces in doing excellent fundamental, translational, clinical, and epidemiological research on sensory systems and sensory disorders

Academic Center of Excellence

Research Activities

The main goal of the ACE is to identify the essential mechanisms contributing to sensory-related dysfunction, analyzing both the sensory disorder itself as well as its consequences for processing of sensory information in the brain. The strength of the ACE Sensory Disorders lies in combining research activities at each of the four levels: fundamental, translational, clinical and epidemiological.

The epidemiological research activities are strongly embedded in an international framework, focusing on genetic susceptibility to eye and ear diseases and sensory-related structural changes in the brain (MRI). Clinical and translational research activities are in collaboration with external parties, including companies of medical devices, as well as other departments at Erasmus MC involving neuroscientists, physicists, neonatologists, ENT doctors and ophthalmologists.

Main research topics are the consequences of premature birth for sensory development, dysfunctional sensory development in youth (such as development of severe refractive errors), and reduced sensory function in older adults. Clinical research is currently performed in the outpatient clinics using biobanks containing various patient materials; epidemiologic research is carried out in the large Erasmus MC cohorts Generation R and the Rotterdam Study, and fundamental research in cell lines, animal models, and human subjects. Clinical and epidemiologic research is focused on the pathogenesis of sensory disorders and on finding starting points for therapy and prevention.

Fundamental and translational research topics are synaptic development in the auditory and visual system, mechanisms underlying sound localization and tinnitus, and the way the auditory and visual system change their sensitivity to deal with the large range of intensities in external stimuli.

The ACE will form 3 working groups that will lead research focused on 3 main topics:

  1. Development of senses in youth
  2. Dysfunctional senses at advanced age
  3. Comorbidity between eye and ear: causes, diagnostics and functional consequences.

The groups will consist of PIs, postdocs and PhD students from the various departments involved, and members within the groups will share knowledge gained from earlier research and reinforce more into depth collaborations within the ACE.

Type of

Collaborations

Educational

Contributions

Our ACE provides education on sensory systems and sensory disorders for medical students (>400 students, 3B, masters students and students performing their clinical rotations), Masters of Neuroscience students (~20 students, separate module on sensory systems), PhD students within the graduate schools ONWAR (~20 students, as part of electrophysiology and imaging courses), MolMed, NIHES, and various other training programs. We accommodate 2-4 Master and PhD students from abroad at a regular basis, and currently have students from Europe (Denmark) and the Middle East (Iran).

We also provide education in the medical curriculum (minor 'hoofd-hals' ). As academic departments, we contribute substantially to the training programmes of medical specialists ENT/ophthalmology and medical physicists in OOR-ZW.

Patient

Care Activities

Multidisciplinary and specialized academic care: Our primary aim is to learn from each other's current clinical practice and develop a uniform approach for care of patients with one or more sensory deficits. Current patient care is directed at only one sense, and each department has developed its own patient management.

The departments mainly receive referrals from peripheral hospitals and from within the Erasmus MC. ENT has developed clinical pathways for tinnitus, neonatal care for hearing loss and Cochlear Implants; Ophthalmology for age-related macular degeneration, vascular occlusions, and diabetic retinopathy, and is a center of expertise for rare hereditary retinal dystrophies and inflammatory retinal disorders. As for child care, we are specialized in the treatment of myopia and have set up a national Myopia Control Center for Ophthalmology, and are experts in communication disorders which are treated in our Speech and Hearing center for ENT.

Value based health care: The Ophthalmology Department has actively participated in defining the value-based health outcome measures (ICHOM) for age-related macular degeneration, and is currently involved in setting up a national patient database to compare treatment results among vision clinics.

This has been set up together with the international organization Fighting Retinal Blindness. The ENT Department was involved in the development of value-based health outcomes for cleft lip and palate, together with ICHOM-partners. Additionally, ENT has implemented a "zorgmonitor" in the complete clinical process of the department ENT, with the aim to improve patient care using standardized outcome measures. Visitations are performed on a very regular base from different perspectives (educational level, patient groups, department).

Research projects with Cochlear Implant companies and a recent ZON-MW intervention study on stuttering have contributed to improvement of patient care. With this ACE, we will integrate the clinical experience on all senses, and set up clinical pathways for overlapping disorders (e.g. hereditary dystrophies) and similar care paths (e.g. functional rehabilitation). We will combine clinical expertise and organizational issues with recent scientific insights to achieve a high level of multidisciplinary care for patients with sensory deficits. Research and clinical care are closely tied together. Research is performed in the areas of clinical expertise, and results from research are quickly translated into patient care (see for example www.myopie.nl).

Societal Relevance to Research, Education and Patient Care

An important aim of our ACE is to translate findings from basic research to clinical practice which will lead to better care for patients. Sensory disorders are highly prevalent and have a relatively large impact on health and well-being compared to other diseases. We aim to improve diagnostics of eye and ear disorders by studying the sensitivity and specificity of multimodal imaging and psychophysical testing.

We aim to develop prediction tools and risk profiles of patients by modelling all known risk factors and developing a risk score. We will develop a web-based tool for evaluation of risks of blindness and deafness which can be used by clinicians and patients. Other points of focus are development of pharmacotherapy, evaluation of artificial sensory implants, neuroprotection, using eye tracking as a diagnostic tool, and (visual) neurorehabilitation.

The questions addressed in the ACE directly relate to essential societal/economic issues, such as the long-term effect of exposure to loud music on hearing and effects of deprived sensory input on health and well-being. The ACE actively contributes to the national and international discussion on prevention. The different research lines within the ACE collaborate with high standard- well recognized research groups over the world and in various consortia (CREAM, IGGC, AMD gene consortia, CHARGE). This will open a network of research opportunities for all ACE members and will contribute to the innovational character of the research in the ACE.

Viability of Research, Education and Patient Care

The ACE actively promotes interaction with international research groups. Talented PhD students are stimulated to visit collaborating groups for their research project (V. Verhoeven, PhD, visit Singapore during PhD training for 6 Months 2014; H. Springelkamp, PhD, visit Australia during PhD training for 5 Months, 2015, G van Ingen PhD visit Philadelphia for 4 months 2015, C.M.P le Clercq visit Melbourne for 4 months 2016. and we promote visits from students to Erasmus MC (C. Williams, UK); Z. Kilic (Denmark), F. Fujuhara (Brasil)

The eye-epidemiology part of the ACE participates in and leads active consortia (3CC, CREAM, IGGC, AMD gene, E3, EYE-RISK). The ear-epidemiology part of the ACE leads an international working group on hearing (CHARGE consortium) and is starting up new collaborations (Johns Hopkins University, Royal Children's Hospital Melbourne). This opens up a large research network for all ACE members.

Key and relevant publications of the last five years

  • Borst JGG, Soria van Hoeve J (2012) The calyx of Held synapse: from model synapse to auditory relay. Annu Rev Physiol 74:199-224.
  • Buitendijk GH et al. (2013) Prediction of age-related macular degeneration in the general population: the Three Continent AMD Consortium. Ophthalmology 120:2644-2655.
  • Coenraad S, Toll MS, Hoeve HL, Goedegebure A (2011) Auditory brainstem response morphology and analysis in very preterm neonatal intensive care unit infants. Laryngoscope 121:2245-2249.
  • Dingemanse JG, Goedegebure A (2015) Application of noise reduction algorithm ClearVoice in cochlear implant processing: effects on noise tolerance and speech intelligibility in noise in relation to spectral resolution. Ear Hear 36:357-367.
  • Hofman A, Brusselle GG, Darwish Murad S, van Duijn CM, Franco OH, Goedegebure A, Ikram MA, Klaver CC, Nijsten TE, Peeters RP, Stricker BH, Tiemeier HW, Uitterlinden AG, Vernooij MW (2015) The Rotterdam Study: 2016 objectives and design update. Eur J Epidemiol 30:661-708.
  • Pierrache LH, Hartel BP, van Wijk E, Meester-Smoor MA, Cremers FP, de Baere E, de Zaeytijd J, van Schooneveld MJ, Cremers CW, Dagnelie G, Hoyng CB, Bergen AA, Leroy BP, Pennings RJ, van den Born LI, Klaver CC (2016) Visual prognosis in USH2A-associated retinitis pigmentosa is worse for patients with Usher syndrome type IIa than for those with nonsyndromic retinitis pigmentosa. Ophthalmology 123:1151-1160.
  • Springelkamp H et al. (2014) Meta-analysis of genome-wide association studies identifies novel loci that influence cupping and the glaucomatous process. Nat Commun 5:4883.
  • van der Heijden M, Lorteije JAM, Plauška A, Roberts MT, Golding NL, Borst JGG (2013) Directional hearing by linear summation of binaural inputs at the medial superior olive. Neuron 78:936-948.
  • van der Steen J, Dits J (2012) Binocular eye movement control and motion perception: what is being tracked? Invest Ophthalmol Vis Sci 53:7268-7275.
  • Verhoeven VJ et al. (2013) Genome-wide meta-analyses of multiancestry cohorts identify multiple new susceptibility loci for refractive error and myopia. Nat Genet 45:314-318.

PhD theses of the last five years

  • T. T. H. Crins (2016) Developmental changes in synaptic function in a giant auditory synapse (KNO + Neuro).
  • S. Coenraad (2011) Auditory maturation and congenital hearing loss in NICU infants (K).
  • J. Dits (2014). Ocular stability in 3-D space (N).
  • A.P. Nagtegaal (2013). On the auditory system: genes, DNA repair and ion channels (N).
  • S. Roosing (2014). Cone dystrophies: enlightening the genetic spectrum (Oog).
  • C. de Sonneville (2016) The impact and treatment of developmental stuttering (K).
  • H. Springelkamp (2016). Open Angle Glaucoma: from epidemiology to molecular aspects and anatomical features (O).
  • V.J.M. Verhoeven (2015). What causes myopia? Complex genetics and epidemiology of a common condition. (O; cum laude)
  • C.P.C. Versteegh (2013). Nonlinear processing of sound by the cochlea. (K; cum laude)
  • T. Wang (2015). In vivo synaptic transmission in mouse models for neurological disorders (N).

Non-scientific publications related to the ACE

Principal coordinator(s)