Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/29057
Title: Sex-specific lesion pattern of functional outcomes after stroke.
Austin Authors: Bonkhoff, Anna K;Bretzner, Martin;Hong, Sungmin;Schirmer, Markus D;Cohen, Alexander;Regenhardt, Robert W;Donahue, Kathleen L;Nardin, Marco J;Dalca, Adrian V;Giese, Anne-Katrin;Etherton, Mark R;Hancock, Brandon L;Mocking, Steven J T;McIntosh, Elissa C;Attia, John;Benavente, Oscar R;Bevan, Stephen;Cole, John W;Donatti, Amanda;Griessenauer, Christoph J;Heitsch, Laura;Holmegaard, Lukas;Jood, Katarina;Jimenez-Conde, Jordi;Kittner, Steven J;Lemmens, Robin;Levi, Christopher R;McDonough, Caitrin W;Meschia, James F;Phuah, Chia-Ling;Rolfs, Arndt;Ropele, Stefan;Rosand, Jonathan;Roquer, Jaume;Rundek, Tatjana;Sacco, Ralph L;Schmidt, Reinhold;Sharma, Pankaj;Slowik, Agnieszka;Söderholm, Martin;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;Jern, Christina;Lindgren, Arne G;Maguire, Jane;Fox, Michael D;Bzdok, Danilo;Wu, Ona;Rost, Natalia S
Affiliation: Department of Neurology, Geisinger, Danville, PA, USA..
School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia..
Department of Neurology, John Hunter Hospital, Newcastle, NSW, Australia..
J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA..
Univ. Lille, Inserm, CHU Lille, U1171-LilNCog (JPARC)-Lille Neurosciences & Cognition, Lille F-59000, France..
Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA..
Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA..
The Florey Institute of Neuroscience and Mental Health
Neurology
University of Technology Sydney, Sydney, Australia..
Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics, University of Florida, Gainesville, FL, USA..
Department of Neurology, Mayo Clinic, Jacksonville, FL, USA..
Department of Neurology, Washington University School of Medicine & Barnes-Jewish Hospital, St Louis, MO, USA..
Department of Neurology and Evelyn F. McKnight Brain Institute, Miller School of Medicine, University of Miami, Miami, FL, USA..
Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA..
Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA..
Hunter Medical Research Institute, Newcastle, NSW, Australia..
Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA..
Department of Neurology, University of Virginia, Charlottesville, VA, USA..
Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA..
Center for Brain Circuit Therapeutics, Department of Neurology, Psychiatry, and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA..
Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA..
Clinic for Neuroradiology, University Hospital Bonn, Bonn, Germany..
Computer Science and Artificial Intelligence Lab, Massachusetts Institute of Technology, Boston, MA, USA..
Department of Neurology, University of Maryland School of Medicine and Veterans Affairs Maryland Health Care System, Baltimore, MD, USA..
Research Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria..
Department of Emergency Medicine, Washington University School of Medicine, St Louis, MO, USA..
Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany..
Department of Medicine, Division of Neurology, University of British Columbia, Vancouver, BC, Canada..
School of Life Sciences, University of Lincoln, Lincoln, UK..
School of Medical Sciences, University of Campinas (UNICAMP) and the Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil..
Department of Neurology, Neurovascular Research Group (NEUVAS), IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions Mèdiques), Universitat Autonoma de Barcelona, Barcelona, Spain..
Department of Neurosciences, Experimental Neurology and Leuven Research Institute for Neuroscience and Disease (LIND), KU Leuven-University of Leuven, Leuven, Belgium..
Centogene AG, Rostock, Germany..
Department of Neurology, Clinical Division of Neurogeriatrics, Medical University Graz, Graz, Austria..
Institute of Cardiovascular Research Royal Holloway, University of London (ICR2UL), London, UK..
Department of Neurology, Jagiellonian University Medical College, Krakow, Poland..
Department of Clinical Sciences Malmö, Lund University, Lund, Sweden..
School of Medical Sciences, University of Campinas (UNICAMP) and the Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil..
Department of Laboratory Medicine, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden..
Department of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland..
Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden..
Department of Clinical Sciences Lund, Radiology, Lund University, Lund, Sweden..
Department of Laboratory Medicine, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden..
Department of Neurology, Skåne University Hospital, Lund, Sweden..
Department of Biomedical Engineering, McConnell Brain Imaging Centre, Montreal Neurological Institute, Faculty of Medicine, School of Computer Science, McGill University, Montreal, Canada..
Department of Neurology, VIB, Vesalius Research Center, Laboratory of Neurobiology, University Hospitals Leuven, Leuven, Belgium..
St Peter's and Ashford Hospital, Egham, UK..
Department of Neurology, Skåne University Hospital, Lund and Malmö, Malmo, Sweden..
Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden..
Department of Radiology, Neuroradiology, Skåne University Hospital, Lund, Sweden..
Department of Clinical Genetics and Genomics, Sahlgrenska University Hospital, Gothenburg, Sweden..
Department of Clinical Sciences Lund, Neurology, Lund University, Lund, Sweden..
Mila-Quebec Artificial Intelligence Institute, Montreal, Canada..
Issue Date: 2-Feb-2022
Date: 2022
Publication information: Brain communications 2022; 4(2): fcac020
Abstract: Stroke represents a considerable burden of disease for both men and women. However, a growing body of literature suggests clinically relevant sex differences in the underlying causes, presentations and outcomes of acute ischaemic stroke. In a recent study, we reported sex divergences in lesion topographies: specific to women, acute stroke severity was linked to lesions in the left-hemispheric posterior circulation. We here determined whether these sex-specific brain manifestations also affect long-term outcomes. We relied on 822 acute ischaemic patients [age: 64.7 (15.0) years, 39% women] originating from the multi-centre MRI-GENIE study to model unfavourable outcomes (modified Rankin Scale >2) based on acute neuroimaging data in a Bayesian hierarchical framework. Lesions encompassing bilateral subcortical nuclei and left-lateralized regions in proximity to the insula explained outcomes across men and women (area under the curve = 0.81). A pattern of left-hemispheric posterior circulation brain regions, combining left hippocampus, precuneus, fusiform and lingual gyrus, occipital pole and latero-occipital cortex, showed a substantially higher relevance in explaining functional outcomes in women compared to men [mean difference of Bayesian posterior distributions (men - women) = -0.295 (90% highest posterior density interval = -0.556 to -0.068)]. Once validated in prospective studies, our findings may motivate a sex-specific approach to clinical stroke management and hold the promise of enhancing outcomes on a population level.
URI: https://ahro.austin.org.au/austinjspui/handle/1/29057
DOI: 10.1093/braincomms/fcac020
ORCID: https://orcid.org/0000-0002-7594-4159
https://orcid.org/0000-0001-6557-5866
https://orcid.org/0000-0002-4739-2449
https://orcid.org/0000-0001-8746-1771
https://orcid.org/0000-0002-4948-5956
https://orcid.org/0000-0001-9095-2344
0000-0002-6614-8417
Journal: Brain communications
PubMed URL: 35282166
PubMed URL: https://pubmed.ncbi.nlm.nih.gov/35282166/
Type: Journal Article
Subjects: Bayesian hierarchical modelling
acute ischaemic stroke
functional outcomes
lesion patterns
sex differences
Appears in Collections:Journal articles

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