Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/30909
Title: Deep profiling of multiple ischemic lesions in a large, multi-center cohort: Frequency, spatial distribution, and associations to clinical characteristics.
Austin Authors: Bonkhoff, Anna K;Ullberg, Teresa;Bretzner, Martin;Hong, Sungmin;Schirmer, Markus D;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;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;Ropele, Stefan;Rosand, Jonathan;Roquer, Jaume;Rundek, Tatjana;Sacco, Ralph L;Schmidt, Reinhold;Sharma, Pankaj;Slowik, Agnieszka;Sousa, Alessandro;Stanne, Tara M;Strbian, Daniel;Tatlisumak, Turgut;Thijs, Vincent ;Vagal, Achala;Woo, Daniel;Zand, Ramin;McArdle, Patrick F;Worrall, Bradford B;Jern, Christina;Lindgren, Arne G;Maguire, Jane;Wu, Ona;Frid, Petrea;Rost, Natalia S;Wasselius, Johan
Affiliation: Neurology
J. Philip Kistler Stroke Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States..
School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
University of Technology, Faculty of Health, Sydney, NSW, Australia
Hunter Medical Research Institute, Newcastle, NSW, Australia
Department of Neurology, John Hunter Hospital, Newcastle, NSW, Australia
Department of Pharmacotherapy, Translational Research, Center for Pharmacogenomics, University of Florida, Gainesville, FL, United States..
Division of Stroke, Florey Institute of Neuroscience and Mental Health, Heidelberg, VIC, Australia
Department of Clinical Sciences Lund, Radiology, Lund University, Lund, Sweden.. Department of Radiology and Neuroradiology, Skåne University Hospital, Lund, Sweden..
J. Philip Kistler Stroke Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.. U1171 - LilNCog (JPARC) - Lille Neurosciences Cognition and University of Lille, Inserm, CHU Lille, Lille, France..
Computer Science and Artificial Intelligence Lab, Massachusetts Institute of Technology, Boston, MA, United States.. Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States..
Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany..
J. Philip Kistler Stroke Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States..
Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States..
Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD, United States..
Department of Neurology, University of Maryland, School of Medicine and Veterans Affairs Maryland Health Care System, Baltimore, MD, United States..
School of Medical Sciences, The Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas (UNICAMP), Campinas, Brazil..
Department of Neurosurgery, Geisinger, Danville, PA, United States.. Department of Neurosurgery, Christian Doppler Clinic, Paracelsus Medical University, Salzburg, Austria..
Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, United States.. Department of Neurology, Barnes-Jewish Hospital, Washington University School of Medicine, St. Louis, MO, United States..
Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.. Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden..
Department of Neurology, Neurovascular Research Group (NEUVAS), IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions Mèdiques), Universitat Pompeu Fabra, Barcelona, Spain.. Department of Medicine and Life Sciences (MELIS), Universitat Pompeu Fabra, Barcelona, Spain..
Department of Neurology, University of Maryland, School of Medicine and Veterans Affairs Maryland Health Care System, Baltimore, MD, United States..
Department of Neurosciences, Experimental Neurology and Leuven Research Institute for Neuroscience, Disease (LIND), KU Leuven - University of Leuven, Leuven, Belgium.. Laboratory of Neurobiology, Department of Neurology, Vesalius Research Center (VIB), University Hospitals Leuven, Leuven, Belgium..
Department of Neurology, Mayo Clinic, Jacksonville, FL, United States..
Department of Neurology, Clinical Division of Neurogeriatrics, Medical University Graz, Graz, Austria..
Department of Neurology, Barnes-Jewish Hospital, Washington University School of Medicine, St. Louis, MO, United States..
Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States..
J. Philip Kistler Stroke Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.. Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States.. Department of Neurology, Evelyn F. McKnight Brain Institute, Miller School of Medicine, University of Miami, Miami, FL, United States..
Department of Neurology, Neurovascular Research Group (NEUVAS), IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions Mèdiques), Universitat Pompeu Fabra, Barcelona, Spain.. Department of Medicine and Life Sciences (MELIS), Universitat Pompeu Fabra, Barcelona, Spain..
Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States..
Institute of Cardiovascular Research, St Peter's, Ashford Hospitals, Royal Holloway University of London (ICR2UL), Egham, United Kingdom..
Department of Neurology, Jagiellonian University Medical College, Kraków, Poland..
School of Medical Sciences, The Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas (UNICAMP), Campinas, 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 Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.. Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden..
Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, United States..
Department of Neurology, Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, United States..
Department of Neurology, Pennsylvania State University, Hershey, PA, United States..
Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, United States..
Department of Neurology, University of Virginia, Charlottesville, VA, United States.. Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States..
Department of Laboratory Medicine, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.. Department of Clinical Genetics and Genomics, Sahlgrenska University Hospital, Gothenburg, Sweden..
Department of Neurology, Skåne University Hospital, Lund, Sweden.. Department of Clinical Sciences Lund, Neurology, Lund University, Lund, Sweden..
Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States..
Department of Clinical Sciences Lund, Neurology, Lund University, Lund, Sweden..
J. Philip Kistler Stroke Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States..
Department of Clinical Sciences Lund, Radiology, Lund University, Lund, Sweden.. Department of Radiology and Neuroradiology, Skåne University Hospital, Lund, Sweden..
Issue Date: 2022
Date: 2022
Publication information: Frontiers in Neuroscience 2022; 16: 994458
Abstract: A substantial number of patients with acute ischemic stroke (AIS) experience multiple acute lesions (MAL). We here aimed to scrutinize MAL in a large radiologically deep-phenotyped cohort. Analyses relied upon imaging and clinical data from the international MRI-GENIE study. Imaging data comprised both Fluid-attenuated inversion recovery (FLAIR) for white matter hyperintensity (WMH) burden estimation and diffusion-weighted imaging (DWI) sequences for the assessment of acute stroke lesions. The initial step featured the systematic evaluation of occurrences of MAL within one and several vascular supply territories. Associations between MAL and important imaging and clinical characteristics were subsequently determined. The interaction effect between single and multiple lesion status and lesion volume was estimated by means of Bayesian hierarchical regression modeling for both stroke severity and functional outcome. We analyzed 2,466 patients (age = 63.4 ± 14.8, 39% women), 49.7% of which presented with a single lesion. Another 37.4% experienced MAL in a single vascular territory, while 12.9% featured lesions in multiple vascular territories. Within most territories, MAL occurred as frequently as single lesions (ratio ∼1:1). Only the brainstem region comprised fewer patients with MAL (ratio 1:4). Patients with MAL presented with a significantly higher lesion volume and acute NIHSS (7.7 vs. 1.7 ml and 4 vs. 3, p FDR < 0.001). In contrast, patients with a single lesion were characterized by a significantly higher WMH burden (6.1 vs. 5.3 ml, p FDR = 0.048). Functional outcome did not differ significantly between patients with single versus multiple lesions. Bayesian analyses suggested that the association between lesion volume and stroke severity between single and multiple lesions was the same in case of anterior circulation stroke. In case of posterior circulation stroke, lesion volume was linked to a higher NIHSS only among those with MAL. Multiple lesions, especially those within one vascular territory, occurred more frequently than previously reported. Overall, multiple lesions were distinctly linked to a higher acute stroke severity, a higher total DWI lesion volume and a lower WMH lesion volume. In posterior circulation stroke, lesion volume was linked to a higher stroke severity in multiple lesions only.
URI: https://ahro.austin.org.au/austinjspui/handle/1/30909
DOI: 10.3389/fnins.2022.994458
Journal: Frontiers in Neuroscience
PubMed URL: 36090258
ISSN: 1662-4548
Type: Journal Article
Subjects: Bayesian hierarchical regression
acute ischemic stroke
lesion volume
magnetic resonance imaging
multiple acute ischemic lesions
quantitative imaging
Appears in Collections:Journal articles

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