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https://ahro.austin.org.au/austinjspui/handle/1/27643| Title: | Excessive White Matter Hyperintensity Increases Susceptibility to Poor Functional Outcomes After Acute Ischemic Stroke. | Austin Authors: | Hong, Sungmin;Giese, Anne-Katrin;Schirmer, Markus D;Bonkhoff, Anna K;Bretzner, Martin;Rist, Pamela;Dalca, Adrian V;Regenhardt, Robert W;Etherton, Mark R;Donahue, Kathleen L;Nardin, Marco;Mocking, Steven J T;McIntosh, Elissa C;Attia, John;Benavente, Oscar R;Cole, John W;Donatti, Amanda;Griessenauer, Christoph J;Heitsch, Laura;Holmegaard, Lukas;Jood, Katarina;Jimenez-Conde, Jordi;Roquer, Jaume;Kittner, Steven J;Lemmens, Robin;Levi, Christopher R;McDonough, Caitrin W;Meschia, James F;Phuah, Chia-Ling;Rolfs, Arndt;Ropele, Stefan;Rosand, Jonathan;Rundek, Tatjana;Sacco, Ralph L;Schmidt, Reinhold;Enzinger, Christian;Sharma, Pankaj;Slowik, Agnieszka;Sousa, Alessandro;Stanne, Tara M;Strbian, Daniel;Tatlisumak, Turgut;Thijs, Vincent N ;Vagal, Achala;Wasselius, Johan;Woo, Daniel;Zand, Ramin;McArdle, Patrick F;Worrall, Bradford B;Wu, Ona;Jern, Christina;Lindgren, Arne G;Maguire, Jane;Tomppo, Liisa;Golland, Polina;Rost, Natalia S | Affiliation: | Clinic for Neuroradiology, University Hospital Bonn, Bonn, Germany Neurology Hunter Medical Research Institute, Newcastle, NSW, Australia School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia J. Philip Kistler Stroke Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, United States Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States Computer Science and Artificial Intelligence Lab, Massachusetts Institute of Technology, Boston, MA, United States Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, United States Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog (JPARC) - Lille Neurosciences & Cognition, Lille, France Department of Neurology, Neurovascular Research Group (NEUVAS), IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions M'ediques), Universitat Autonoma de Barcelona, Barcelona, Spain School of Medical Sciences, University of Campinas (UNICAMP) and the Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, Brazil Department of Clinical Sciences Lund, Radiology, Lund University, Lund, Sweden Department of Radiology, Neuroradiology, Skåne University Hospital, Malmo, Sweden School of Nursing and Midwifery, University of Technology Sydney, Sydney, NSW, Australia Department of Laboratory Medicine, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden Department of Clinical Sciences Lund, Neurology, Lund University, Lund, Sweden Institute of Cardiovascular Research, Royal Holloway University of London (ICR2UL), Egham, United Kingdom Department of Neurology, Clinical Division of Neurogeriatrics, Medical University Graz, Graz, Austria Centogene AG, Rostock, Germany Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg and Department of Neurology, The Sahlgrenska University Hospital, Gothenburg, Sweden 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, John Hunter Hospital, Newcastle, NSW, Australia Division of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, United States Department of Neurology, Washington University School of Medicine & Barnes-Jewish Hospital, St. Louis, MO, United States KU Leuven - University of Leuven, Department of Neurosciences, Experimental Neurology and Leuven Research Institute for Neuroscience and Disease (LIND), Leuven, Belgium Department of Neurosurgery, Geisinger, Danville, PA, United States Research Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany The Florey Institute of Neuroscience and Mental Health Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada Department of Neurology, Jagiellonian University Medical College, Krakow, Poland Department of Neurology, Helsinki University Hospital and Clinical Neurosciences, University of Helsinki, Helsinki, Finland VIB, Vesalius Research Center, Laboratory of Neurobiology, University Hospitals Leuven, Department of Neurology, Leuven, Belgium St. Peter's and Ashford Hospitals, Egham, United Kingdom J. Philip Kistler Stroke Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States J. Philip Kistler Stroke Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, United States Department of Neurology, University of Maryland School of Medicine and Veterans Affairs Maryland Health Care System, Baltimore, MD, United States Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics, University of Florida, Gainesville, FL, United States Department of Neurology, Mayo Clinic, Jacksonville, FL, United States Department of Neurology, Washington University School of Medicine & Barnes-Jewish Hospital, St. Louis, MO, United States Department of Neurology and Evelyn F. McKnight Brain Institute, Miller School of Medicine, University of Miami, Miami, FL, United States Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, United States Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, United States Department of Neurology, Geisinger, Danville, PA, United States Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, United States Departments of Neurology and Public Health Sciences, University of Virginia, Charlottesville, VA, United States Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, United States Computer Science and Artificial Intelligence Lab, Massachusetts Institute of Technology, Boston, MA, United States J. Philip Kistler Stroke Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States |
Issue Date: | 10-Sep-2021 | Date: | 2021 | Publication information: | Frontiers in Neurology 2021; 12: 700616 | Abstract: | Objective: To personalize the prognostication of post-stroke outcome using MRI-detected cerebrovascular pathology, we sought to investigate the association between the excessive white matter hyperintensity (WMH) burden unaccounted for by the traditional stroke risk profile of individual patients and their long-term functional outcomes after a stroke. Methods: We included 890 patients who survived after an acute ischemic stroke from the MRI-Genetics Interface Exploration (MRI-GENIE) study, for whom data on vascular risk factors (VRFs), including age, sex, atrial fibrillation, diabetes mellitus, hypertension, coronary artery disease, smoking, prior stroke history, as well as acute stroke severity, 3- to-6-month modified Rankin Scale score (mRS), WMH, and brain volumes, were available. We defined the unaccounted WMH (uWMH) burden via modeling of expected WMH burden based on the VRF profile of each individual patient. The association of uWMH and mRS score was analyzed by linear regression analysis. The odds ratios of patients who achieved full functional independence (mRS < 2) in between trichotomized uWMH burden groups were calculated by pair-wise comparisons. Results: The expected WMH volume was estimated with respect to known VRFs. The uWMH burden was associated with a long-term functional outcome (β = 0.104, p < 0.01). Excessive uWMH burden significantly reduced the odds of achieving full functional independence after a stroke compared to the low and average uWMH burden [OR = 0.4, 95% CI: (0.25, 0.63), p < 0.01 and OR = 0.61, 95% CI: (0.42, 0.87), p < 0.01, respectively]. Conclusion: The excessive amount of uWMH burden unaccounted for by the traditional VRF profile was associated with worse post-stroke functional outcomes. Further studies are needed to evaluate a lifetime brain injury reflected in WMH unrelated to the VRF profile of a patient as an important factor for stroke recovery and a plausible indicator of brain health. | URI: | https://ahro.austin.org.au/austinjspui/handle/1/27643 | DOI: | 10.3389/fneur.2021.700616 | ORCID: | Journal: | Frontiers in Neurology | PubMed URL: | 34566844 | ISSN: | 1664-2295 | Type: | Journal Article | Subjects: | acute ischemic stroke brain health brain vulnerability functional independence functional outcome after acute stroke post-stroke outcomes stroke white matter hyper intensity |
| Appears in Collections: | Journal articles |
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