mr. ing. M. (Geert Jan) Punter

mr. ing. M. (Geert Jan) Punter

Full Professor
mr. ing. M. (Geert Jan) Punter
  • Neurologen

Research Programs



Vascular causes of cognitive impairment and dementia is my main area of interest. At the UMC Brain Center of the University Medical Centre Utrecht, the Netherlands, I have established a multidisciplinary research program on vascular cognitive impairment (VCI) and small vessel diseases (SVDs). Our particular focus is on novel imaging markers of VCI and SVDs, that can improve diagnosis and support development of treatment. We implement the latest insights in our VCI clinic.


Using the unique properties of high field 7T-MRI we have been able – for the first time -to detect cerebral microinfarcts in vivo and we have subsequently translated the technique to 3T-MRI, and published standards on microinfarct detection in The Lancet Neurology. Currently we 1) explore small vessel disease in VCI at the level of the small vessels themselves, through novel measures of small vessel structure and function at 7T MRI, thus getting to the core disease processes and 2) improve understanding of the functional impact of vascular lesions through large multicenter lesion symptom mapping studies (through the META VCI MAP consortium; ; first results in The Lancet Neurology, 2021) and white matter network studies using diffusion MRI.


Another topic of interest is cognitive impairment in relation to diabetes. We have characterized trajectories and stages of cognitive dysfunction and established underlying structural brain changes with MRI. I served as PI of two large multicentre RCTs on prevention of cognitive decline in patients with in type 2 diabetes. I was also involved in clinical guidelines ( ). From 2016, I serve as a consultant on the brain MRI and cognition outcomes of the  Diabetes Control & Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications Study (EDIC) Cohort”, and several other NIH funded programs.


I work with international collaborators in Munich, Edinburgh, Seoul, Hong Kong, and Singapore and participate in the multinational EU-funded research programs SVDs@target and RECOGNISED. In 2016 I was appointed Fellow of the Royal College of Physicians Edinburgh and in 2015 I received the senior investigator award of the European Stroke Organisation (ESO) in recognition of my work.


Research line

Vascular Cognitive Impairment

Recent key publications

  1. van Veluw,SJ, Zwanenburg,JJ, Engelen-Lee,J, Spliet,WG, Hendrikse,J, Luijten,PR, Biessels,GJ: In vivo detection of cerebral cortical microinfarcts with high-resolution 7T MRI. J Cereb Blood Flow Metab 33:322-329, 2013
  2. Wardlaw,JM, Smith,EE, Biessels,GJ, …., Dichgans,M: Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration. Lancet Neurol 12:822-838, 2013
  3. Smith EE, Saposnik G, Biessels GJ…. Seshadri S; Prevention of Stroke in Patients With Silent Cerebrovascular Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke 2017 Feb;48(2):e44-e71.
  4. Detection, risk factors, and functional consequences of cerebral microinfarcts. van Veluw SJ, Shih AY, Smith EE, Chen C, Schneider JA, Wardlaw JM, Greenberg SM, Biessels GJ. Lancet Neurol. 2017 Sep;16(9):730-740.
  5. Biessels GJ, Despa F Cognitive decline and dementia in diabetes mellitus: mechanisms and clinical implications. Nat Rev Endocrinol 14: 591-604, 2018
  6. Geurts LJ, Zwanenburg JJM, Klijn CJM, Luijten PR, Biessels GJ. Higher Pulsatility in Cerebral Perforating Arteries in Patients With Small Vessel Disease Related Stroke, a 7T MRI Study. Stroke 2018: STROKEAHA118022516
  7. Biessels GJ, Verhagen C, Janssen J, van den Berg E, Zinman B, Rosenstock J, George JT, Passera A, Schnaidt S, Johansen OE, investigators C. Effect of Linagliptin on Cognitive Performance in Patients With Type 2 Diabetes and Cardiorenal Comorbidities: The CARMELINA Randomized Trial. Diabetes Care 2019.
  8. Weaver NA, Zhao L, Biesbroek JM, Kuijf HJ, Aben HP, Bae HJ, Caballero MAA, Chappell FM, Chen C, Dichgans M, Duering M, Georgakis MK, van der Giessen RS, Gyanwali B, Hamilton OKL, Hilal S, Vom Hofe EM, de Kort PLM, Koudstaal PJ, Lam BYK, Lim JS, Makin SDJ, Mok VCT, Shi L, Valdes Hernandez MC, Venketasubramanian N, Wardlaw JM, Wollenweber FA, Wong A, Xin X, Meta VCI Map consortium, Biessels GJ. The Meta VCI Map consortium for meta-analyses on strategic lesion locations for vascular cognitive impairment using lesion-symptom mapping: Design and multicenter pilot study. Alzheimers Dement (Amst) 2019; 11: 310-26.
  9. Biessels GJ, Nobili F, Teunissen CE, Simó R, Scheltens P. Understanding multifactorial brain changes in type 2 diabetes: a biomarker perspective. Lancet Neurol. 2020 Aug;19(8):699-710.
  1. Weaver NA, Kuijf, HJ, … Biessels GJ Strategic infarct locations for post-stroke cognitive impairment: a pooled analysis of individual patient data from 12 acute ischaemic stroke cohorts , Lancet Neurol 20: 448-459 2021


Side Activities

GJ Biessels has consulted for and received research support from Boehringer Ingelheim.  He has also consulted for Eli Lilly and Nestle HealthScience. All financial compensation for these services is transferred to his employer, the UMC Utrecht.

Fellowship and Awards


1998: Dutch Association for Pharmacology, best thesis: Cerebral function in diabetes mellitus

1999: Neurodiab prize for preclinical science. Neurodiab is the official diabetic neuropathy study group of the European Association for the Study of Diabetes (EASD)

2015: Senior Investigator Award European Stroke Organisation

2015: Fellow of the Royal College of Physicians Edinburgh

Personal grants/awards

2004: Cognitive dysfunction in DM2: course of development and relation to vascular disease. (2004-2009), Career Development Grant from the Dutch Diabetes Foundation.

2005: Glucose, insulin and cerebrovascular disease: impact on cognition (2005-2009). Clinical Fellowship from Dutch Research Council (ZonMW).

2006: Vascular cognitive impairment: interactions between clinical features, brain imaging and memory (2006-2011). High Potential grant University of Utrecht, together with RPC Kessels

2010: ‘Diabetes and vascular damage: who is at risk for dementia?’, VIDI, from Dutch Research Council (ZonMW).

2010: Vascular cognitive impairment: the hidden burden of cerebrovascular disease, Clinical Established Investigator Grant, Nederlandse Hartstichting

2015: Senior Investigator Award of European Stroke Organisation (ESO) for VCI research program

2016: Microvascular function and brain networks: Keys to understanding the vascular burden in dementia. VICI, from Dutch Research Council (NWO).


Research Output (459)

Automatic quantification of perivascular spaces in T2-weighted images at 7 T MRI

Verbeek-Spijkerman Jolanda, Zwanenburg J. J.M., Bouvy W. H., Geerlings M. I., Biessels G. J., Hendrikse J., Luijten P. R., Kuijf H. J. 13 Apr 2022, In: Cerebral Circulation - Cognition and Behavior. 3 , p. 1-9

New insights into the genetic etiology of Alzheimer's disease and related dementias

Bellenguez Céline, Küçükali Fahri, Jansen Iris E, Kleineidam Luca, Moreno-Grau Sonia, Amin Najaf, Naj Adam C, Campos-Martin Rafael, Grenier-Boley Benjamin, Andrade Victor, Holmans Peter A, Boland Anne, Damotte Vincent, van der Lee Sven J, Costa Marcos R, Kuulasmaa Teemu, Yang Qiong, de Rojas Itziar, Bis Joshua C, Yaqub Amber, Prokic Ivana, Chapuis Julien, Ahmad Shahzad, Giedraitis Vilmantas, Aarsland Dag, Garcia-Gonzalez Pablo, Abdelnour Carla, Alarcón-Martín Emilio, Alcolea Daniel, Alegret Montserrat, Alvarez Ignacio, Álvarez Victoria, Armstrong Nicola J, Tsolaki Anthoula, Antúnez Carmen, Appollonio Ildebrando, Arcaro Marina, Archetti Silvana, Pastor Alfonso Arias, Arosio Beatrice, Athanasiu Lavinia, Bailly Henri, Banaj Nerisa, Baquero Miquel, Barral Sandra, Beiser Alexa, de Witte Lot D, Ferrari Raffaele, Biessels Geert Jan, Snijders Gijsje J L, Apr 2022, In: Nature Genetics. 54 , p. 412-436 25 p.

Dynamic brain ADC variations over the cardiac cycle and their relation to tissue strain assessed with DENSE at high-field MRI

Sloots Jacob-Jan, Froeling Martijn, Biessels Geert Jan, Zwanenburg Jaco J M 2022, In: Magnetic Resonance in Medicine. 88 , p. 266-279 14 p.

Does the Internal Carotid Artery Attenuate Blood-Flow Pulsatility in Small Vessel Disease?:A 7 T 4D-Flow MRI Study

van Tuijl Rick J, Ruigrok Ynte M, Geurts Lennart J, van der Schaaf Irene C, Biessels Geert Jan, Rinkel Gabriël J E, Velthuis Birgitta K, Zwanenburg Jaco J M 2022, In: Journal of Magnetic Resonance Imaging.

Association Between Cerebral Cortical Microinfarcts and Perilesional Cortical Atrophy on 3T MRI

Ferro Doeschka A, Kuijf Hugo J, Hilal Saima, van Veluw Susanne J, van Veldhuizen Daniëlle, Venketasubramanian Narayanaswamy, Tan Boon Yeow, Biessels Geert Jan, Chen Christopher 3 Dec 2021, In: Neurology. 98 , p. E612-E622

Females with type 2 diabetes are at higher risk for accelerated cognitive decline than males:CAROLINA-COGNITION study

Verhagen Chloë, Janssen Jolien, Biessels Geert Jan, Johansen Odd Erik, Exalto Lieza G 27 Oct 2021, In: NMCD : Nutrition metabolism and cardiovascular diseases. 32 , p. 355-364 10 p.

Sex and Cardiovascular Function in Relation to Vascular Brain Injury in Patients with Cognitive Complaints

Kuipers Sanne, Biessels Geert Jan, Greving Jacoba P, Amier Raquel P, de Bresser Jeroen, Bron Esther E, van der Flier Wiesje M, van der Geest Rob J, Hooghiemstra Astrid M, van Oostenbrugge Robert J, van Osch Matthias J P, Kappelle L Jaap, Exalto Lieza G, 26 Oct 2021, In: Journal of Alzheimer's Disease. 84 , p. 261-271 11 p.

Towards multicentre diffusion MRI studies in cerebral small vessel disease

de Luca Alberto, Biessels Geert Jan 18 Oct 2021, In: Journal of neurology, neurosurgery, and psychiatry. 93 , p. 5

Genome-wide association study of frontotemporal dementia identifies a C9ORF72 haplotype with a median of 12-G4C2 repeats that predisposes to pathological repeat expansions

Reus Lianne M, Jansen Iris E, Mol Merel O, van Ruissen Fred, van Rooij Jeroen, van Schoor Natasja M, Tesi Niccolò, Reinders Marcel J T, Huisman Martijn A, Holstege Henne, Visser Pieter Jelle, de Boer Sterre C M, Hulsman Marc, Ahmad Shahzad, Amin Najaf, Uitterlinden Andre G, Ikram Arfan, van Duijn Cornelia M, Seelaar Harro, Ramakers Inez H G B, Verhey Frans R J, van der Lugt Aad, Claassen Jurgen A H R, Jan Biessels Geert, De Deyn Peter Paul, Scheltens Philip, van der Flier Wiesje M, van Swieten John C, Pijnenburg Yolande A L, van der Lee Sven J 2 Sep 2021, In: Translational Psychiatry. 11

Anatomy of phonemic and semantic fluency:A lesion and disconnectome study in 1231 stroke patients

Biesbroek J Matthijs, Lim Jae-Sung, Weaver Nick A, Arikan Gozdem, Kang Yeonwook, Kim Beom Joon, Kuijf Hugo J, Postma Albert, Lee Byung-Chul, Lee Keon-Joo, Yu Kyung-Ho, Bae Hee-Joon, Biessels Geert Jan 5 Aug 2021, In: Cortex. 143 , p. 148-163 16 p.

All research output

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