Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/23142
Title: Brain Volume: An Important Determinant of Functional Outcome After Acute Ischemic Stroke.
Authors: Schirmer, Markus D;Donahue, Kathleen L;Nardin, Marco J;Dalca, Adrian V;Giese, Anne-Katrin;Etherton, Mark R;Mocking, Steven J T;McIntosh, Elissa C;Cole, John W;Holmegaard, Lukas;Jood, Katarina;Jimenez-Conde, Jordi;Kittner, Steven J;Lemmens, Robin;Meschia, James F;Rosand, Jonathan;Roquer, Jaume;Rundek, Tatjana;Sacco, Ralph L;Schmidt, Reinhold;Sharma, Pankaj;Slowik, Agnieszka;Stanne, Tara M;Vagal, Achala;Wasselius, Johan;Woo, Daniel;Bevan, Stephen;Heitsch, Laura;Phuah, Chia-Ling;Strbian, Daniel;Tatlisumak, Turgut;Levi, Christopher R;Attia, John;McArdle, Patrick F;Worrall, Bradford B;Wu, Ona;Jern, Christina;Lindgren, Arne;Maguire, Jane;Thijs, Vincent N;Rost, Natalia S
Affiliation: Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts General Hospital, Boston
Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Boston
Department of Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia
Department of Neurology, Austin Health, Heidelberg, Victoria, Australia
Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown
Department of Neurology, University of Maryland School of Medicine, Baltimore, MD
Veterans Affairs Maryland Health Care System, Baltimore, MD
Center for Genomic Medicine, Massachusetts General Hospital, Boston
Institute of Cardiovascular Research, Royal Holloway University of London (ICR2UL), Egham, UK
St Peter's and Ashford Hospitals Foundation Trust, Chertsey, UK
Department of Clinical Sciences, Radiology, Lund University, Lund, Sweden
Department of Radiology, Division of Neuroradiology, Skåne University Hospital, Malmö, Sweden
Department of Neurology, Washington University School of Medicine, St Louis, MO
Barnes-Jewish Hospital, St Louis, MO
Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
Department of Neurology, Lund University, Lund, Sweden
Department of Neurology, John Hunter Hospital, Newcastle, New South Wales, Australia
Hunter Medical Research Institute, Newcastle, New South Wales, Australia
School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
University of Technology Sydney, Sydney, Australia
Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts General Hospital, Boston
Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown
Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
Department of Neurology, Neurovascular Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Universitat Autonoma de Barcelona, Barcelona, Spain
Department of Neurology, University of Maryland School of Medicine, Baltimore, MD; Veterans Affairs Maryland Health Care System, Baltimore, MD
Department of Neurosciences, Experimental Neurology and Leuven Research Institute for Neuroscience and Disease, KU Leuven-University of Leuven, Flemish Institute for Biotechnology, Vesalius Research Center, Laboratory of Neurobiology, and Department of Neurology, University Hospitals Leuven, Leuven, Belgium
Department of Neurology, Mayo Clinic, Jacksonville, FL
Department of Neurology, Neurovascular Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Universitat Autonoma de Barcelona, Barcelona, Spain
Department of Neurology and Evelyn F. McKnight Brain Institute, Miller School of Medicine, University of Miami, Miami, FL
Department of Neurology, Clinical Division of Neurogeriatrics, Medical University Graz, Graz, Austria
Department of Neurology, Jagiellonian University Medical College, Krakow, Poland
Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH
Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH
School of Life Sciences, University of Lincoln, Lincoln, UK
Division of Emergency Medicine, Washington University School of Medicine, St Louis, MO
Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland
Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD
Department of Neurology and Department of Public Health Sciences, University of Virginia, Charlottesville, VA
Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown
Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts General Hospital, Boston
Issue Date: May-2020
Citation: Mayo Clinic proceedings 2020; 95(5): 955-965
Abstract: To determine whether brain volume is associated with functional outcome after acute ischemic stroke (AIS). This study was conducted between July 1, 2014, and March 16, 2019. We analyzed cross-sectional data of the multisite, international hospital-based MRI-Genetics Interface Exploration study with clinical brain magnetic resonance imaging obtained on admission for index stroke and functional outcome assessment. Poststroke outcome was determined using the modified Rankin Scale score (0-6; 0 = asymptomatic; 6 = death) recorded between 60 and 190 days after stroke. Demographic characteristics and other clinical variables including acute stroke severity (measured as National Institutes of Health Stroke Scale score), vascular risk factors, and etiologic stroke subtypes (Causative Classification of Stroke system) were recorded during index admission. Utilizing the data from 912 patients with AIS (mean ± SD age, 65.3±14.5 years; male, 532 [58.3%]; history of smoking, 519 [56.9%]; hypertension, 595 [65.2%]) in a generalized linear model, brain volume (per 155.1 cm3) was associated with age (β -0.3 [per 14.4 years]), male sex (β 1.0), and prior stroke (β -0.2). In the multivariable outcome model, brain volume was an independent predictor of modified Rankin Scale score (β -0.233), with reduced odds of worse long-term functional outcomes (odds ratio, 0.8; 95% CI, 0.7-0.9) in those with larger brain volumes. Larger brain volume quantified on clinical magnetic resonance imaging of patients with AIS at the time of stroke purports a protective mechanism. The role of brain volume as a prognostic, protective biomarker has the potential to forge new areas of research and advance current knowledge of the mechanisms of poststroke recovery.
URI: http://ahro.austin.org.au/austinjspui/handle/1/23142
DOI: 10.1016/j.mayocp.2020.01.027
ORCID: 0000-0002-6614-8417
PubMed URL: 32370856
Type: Journal Article
Appears in Collections:Journal articles

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