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Title: Early Brain Volume Changes After Stroke: Subgroup Analysis From the AXIS-2 Trial.
Austin Authors: Bu, Ning;Churilov, Leonid ;Khlif, Mohamed Salah;Lemmens, Robin;Wouters, Anke;Fiebach, Jochen B;Chamorro, Angel;Ringelstein, E Bernd;Norrving, Bo;Laage, Rico;Grond, Martin;Wilms, Guido;Brodtmann, Amy ;Thijs, Vincent N 
Affiliation: The Florey Institute of Neuroscience and Mental Health..
Department of Medicine and Neurology, Melbourne Brain Centre, University of Melbourne, Melbourne, VIC, Australia..
Department of Medicine, University of Melbourne, Melbourne, VIC, Australia..
Department of Neurology, University of Barcelona, Barcelona, Spain..
Department of Neurosciences, Experimental Neurology, KU Leuven - University of Leuven, Leuven, Belgium..
Laboratory of Neurobiology, VIB, Center for Brain & Disease Research, Leuven, Belgium..
Department of Neurology, University Hospitals Leuven, Leuven, Belgium..
Center for Stroke Research, Charité University Medicine Berlin, Berlin, Germany..
Department of Neurology, Wilhelms University of Muenster, Münster, Germany..
Section of Neurology, Department of Clinical Sciences, Lund University, Lund, Sweden..
Department of Clinical Research, Guided Development GmbH, Heidelberg, Germany..
Department of Neurology, Kreisklinikum Siegen, University of Marburg Germany, Marburg, Germany..
Department of Radiology, University Hospitals of Leuven, Leuven, Belgium..
Department of Neurology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China..
Issue Date: 28-Jan-2022 2021
Publication information: Frontiers in neurology 2021; 12: 747343
Abstract: The evolution of total brain volume early after stroke is not well understood. We investigated the associations between age and imaging features and brain volume change in the first month after stroke. We retrospectively studied patients with acute ischemic stroke enrolled in the AXIS-2 trial. Total brain volume change from hyperacute MRI data to the first month after stroke was assessed using unified segmentation in SPM12. We hypothesized that age, ischemic brain lesion size, and white matter (WM) changes were associated with larger brain volume change. Enlarged perivascular spaces (EPVSs) and white matter hyperintensities (WMHs) were rated visually and the presence of lacunes was assessed. We enrolled 173 patients with a mean age of 67 ± 11 years, 44% were women. There was a median 6 ml decrease in volume (25th percentile -1 ml to 75th percentile 21 ml) over time, equivalent to a median 0.5% (interquartile range [IQR], -0.07%-1.4%), decrease in brain volume. Age was associated with larger brain volume loss (per 10 years of age, 5 ml 95% CI 2-8 ml). Baseline diffusion weighted imaging (DWI) lesion volume was not associated with greater volume loss per 10 ml of lesion volume, change by 0 ml (95% CI -0.1 to 0.1 ml). Increasing Fazekas scores of deep WMH were associated with greater tissue loss (5 ml, 95% CI 1-10 ml). Total brain volume changes in a heterogenous fashion after stroke. Volume loss occurs over 1 month after stroke and is associated with age and deep WM disease. We did not find evidence that more severe strokes lead to increased early tissue loss.
DOI: 10.3389/fneur.2021.747343
ORCID: 0000-0001-7329-2786
Journal: Frontiers in neurology
PubMed URL: 35153972
PubMed URL:
ISSN: 1664-2295
Type: Journal Article
Subjects: atrophy
brain volume changes
clinical trial
hemorrhagic transformation
ischemic stroke
Appears in Collections:Journal articles

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