Markus D Schirmer1, Kathleen L Donahue2, Marco J Nardin2, Adrian V Dalca3, Anne-Katrin Giese2, Mark R Etherton2, Steven J T Mocking4, Elissa C McIntosh4, John W Cole5, Lukas Holmegaard6, Katarina Jood6, Jordi Jimenez-Conde7, Steven J Kittner5, Robin Lemmens8, James F Meschia9, Jonathan Rosand10, Jaume Roquer7, Tatjana Rundek11, Ralph L Sacco11, Reinhold Schmidt12, Pankaj Sharma13, Agnieszka Slowik14, Tara M Stanne6, Achala Vagal15, Johan Wasselius16, Daniel Woo17, Stephen Bevan18, Laura Heitsch19, Chia-Ling Phuah20, Daniel Strbian21, Turgut Tatlisumak22, Christopher R Levi23, John Attia24, Patrick F McArdle25, Bradford B Worrall26, Ona Wu4, Christina Jern6, Arne Lindgren27, Jane Maguire28, Vincent Thijs29, Natalia S Rost2. 1. 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. Electronic address: mschirmer1@mgh.harvard.edu. 2. Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts General Hospital, Boston. 3. Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Boston; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown. 4. Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown. 5. Department of Neurology, University of Maryland School of Medicine, Baltimore, MD; Veterans Affairs Maryland Health Care System, Baltimore, MD. 6. Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden. 7. Department of Neurology, Neurovascular Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Universitat Autonoma de Barcelona, Barcelona, Spain. 8. 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. 9. Department of Neurology, Mayo Clinic, Jacksonville, FL. 10. Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts General Hospital, Boston; Center for Genomic Medicine, Massachusetts General Hospital, Boston; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown. 11. Department of Neurology and Evelyn F. McKnight Brain Institute, Miller School of Medicine, University of Miami, Miami, FL. 12. Department of Neurology, Clinical Division of Neurogeriatrics, Medical University Graz, Graz, Austria. 13. Institute of Cardiovascular Research, Royal Holloway University of London (ICR2UL), Egham, UK, and St Peter's and Ashford Hospitals Foundation Trust, Chertsey, UK. 14. Department of Neurology, Jagiellonian University Medical College, Krakow, Poland. 15. Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH. 16. Department of Clinical Sciences, Radiology, Lund University, Lund, Sweden; Department of Radiology, Division of Neuroradiology, Skåne University Hospital, Malmö, Sweden. 17. Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH. 18. School of Life Sciences, University of Lincoln, Lincoln, UK. 19. Division of Emergency Medicine, Washington University School of Medicine, St Louis, MO. 20. Department of Neurology, Washington University School of Medicine, St Louis, MO; Barnes-Jewish Hospital, St Louis, MO. 21. Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland. 22. 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. 23. School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia; Department of Neurology, John Hunter Hospital, Newcastle, New South Wales, Australia. 24. School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia; Hunter Medical Research Institute, Newcastle, New South Wales, Australia. 25. Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD. 26. Department of Neurology and Department of Public Health Sciences, University of Virginia, Charlottesville, VA. 27. Department of Neurology, Lund University, Lund, Sweden; Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden. 28. University of Technology Sydney, Sydney, Australia. 29. Stroke Division, Florey Institute of Neuroscience and Mental Health and Department of Neurology, Austin Health, Heidelberg, Australia.
Abstract
OBJECTIVE: To determine whether brain volume is associated with functional outcome after acute ischemic stroke (AIS). PATIENTS AND METHODS: 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. RESULTS: 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. CONCLUSION: 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.
OBJECTIVE: To determine whether brain volume is associated with functional outcome after acute ischemic stroke (AIS). PATIENTS AND METHODS: 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. RESULTS: 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. CONCLUSION: 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.
Authors: Sungmin Hong; Anne-Katrin Giese; Markus D Schirmer; Anna K Bonkhoff; Martin Bretzner; Pamela Rist; Adrian V Dalca; Robert W Regenhardt; Mark R Etherton; Kathleen L Donahue; Marco Nardin; Steven J T Mocking; Elissa C McIntosh; John Attia; Oscar R Benavente; John W Cole; Amanda Donatti; Christoph J Griessenauer; Laura Heitsch; Lukas Holmegaard; Katarina Jood; Jordi Jimenez-Conde; Jaume Roquer; Steven J Kittner; Robin Lemmens; Christopher R Levi; Caitrin W McDonough; James F Meschia; Chia-Ling Phuah; Arndt Rolfs; Stefan Ropele; Jonathan Rosand; Tatjana Rundek; Ralph L Sacco; Reinhold Schmidt; Christian Enzinger; Pankaj Sharma; Agnieszka Slowik; Alessandro Sousa; Tara M Stanne; Daniel Strbian; Turgut Tatlisumak; Vincent Thijs; Achala Vagal; Johan Wasselius; Daniel Woo; Ramin Zand; Patrick F McArdle; Bradford B Worrall; Ona Wu; Christina Jern; Arne G Lindgren; Jane Maguire; Liisa Tomppo; Polina Golland; Natalia S Rost Journal: Front Neurol Date: 2021-09-10 Impact factor: 4.086
Authors: Thomas Meinel; Christine Lerch; Urs Fischer; Morin Beyeler; Adnan Mujanovic; Christoph Kurmann; Bernhard Siepen; Adrian Scutelnic; Madlaine Müller; Martina Goeldlin; Nebiyat Filate Belachew; Tomas Dobrocky; Jan Gralla; David Seiffge; Simon Jung; Marcel Arnold; Roland Wiest; Raphael Meier; Johannes Kaesmacher Journal: Neurology Date: 2022-07-08 Impact factor: 11.800