Juan Pablo Castello1, Marco Pasi1, Jessica R Abramson1, Axana Rodriguez-Torres1, Sandro Marini1, Stacie Demel1, Lee Gilkerson1, Patryk Kubiszewski1, Andreas Charidimou1, Christina Kourkoulis1, Zora DiPucchio1, Kristin Schwab1, M Edip Gurol1, Anand Viswanathan1, Christopher D Anderson1, Carl D Langefeld1, Matthew L Flaherty1, Amytis Towfighi1, Steven M Greenberg1, Daniel Woo1, Jonathan Rosand1, Alessandro Biffi2. 1. From the Department of Neurology (J.P.C., J.R.A., A.R.-T., S.M., P.K., A.C., C.K., Z.D., K.S., M.E.G., A.V., C.D.A., S.M.G., J.R., A.B.), Hemorrhagic Stroke Research Program (J.P.C., J.R.A., A.R.-T., S.M., P.K., A.C., C.K, Z.D., K.S., M.E.G., A.V., C.D.A., S.M.G., J.R., A.B.), Henry and Allison McCance Center for Brain Health (J.P.C., J.R.A., P.K., C.K., C.D.A., J.R., A.B.), and Center for Genomic Medicine (J.R.A., S.M., P.K., C.K., C.D.A., J.R., A.B.), Massachusetts General Hospital, Boston; University of Lille (M.P.), Inserm, CHU Lille, U1172-LilNCog-Lille Neuroscience & Cognition, France; School of Medicine (A.R.-T.), University of California, Irvine; Department of Neurology and Rehabilitation Medicine (S.D., L.G., M.L.F., D.W.), University of Cincinnati, OH; Department of Biostatistics and Data Sciences (C.D.L.), Wake Forest University, Winston-Salem, NC; Department of Neurology (A.T.), Keck School of Medicine, University of Southern California; and Los Angeles County Department of Health Services (A.T.), CA. 2. From the Department of Neurology (J.P.C., J.R.A., A.R.-T., S.M., P.K., A.C., C.K., Z.D., K.S., M.E.G., A.V., C.D.A., S.M.G., J.R., A.B.), Hemorrhagic Stroke Research Program (J.P.C., J.R.A., A.R.-T., S.M., P.K., A.C., C.K, Z.D., K.S., M.E.G., A.V., C.D.A., S.M.G., J.R., A.B.), Henry and Allison McCance Center for Brain Health (J.P.C., J.R.A., P.K., C.K., C.D.A., J.R., A.B.), and Center for Genomic Medicine (J.R.A., S.M., P.K., C.K., C.D.A., J.R., A.B.), Massachusetts General Hospital, Boston; University of Lille (M.P.), Inserm, CHU Lille, U1172-LilNCog-Lille Neuroscience & Cognition, France; School of Medicine (A.R.-T.), University of California, Irvine; Department of Neurology and Rehabilitation Medicine (S.D., L.G., M.L.F., D.W.), University of Cincinnati, OH; Department of Biostatistics and Data Sciences (C.D.L.), Wake Forest University, Winston-Salem, NC; Department of Neurology (A.T.), Keck School of Medicine, University of Southern California; and Los Angeles County Department of Health Services (A.T.), CA. abiffi@mgh.harvard.edu.
Abstract
OBJECTIVE: Black and Hispanic survivors of intracerebral hemorrhage (ICH) are at higher risk of recurrent intracranial bleeding. MRI-based markers of chronic cerebral small vessel disease (CSVD) are consistently associated with recurrent ICH. We therefore sought to investigate whether racial/ethnic differences in MRI-defined CSVD subtype and severity contribute to disparities in ICH recurrence risk. METHODS: We analyzed data from the Massachusetts General Hospital ICH study (n = 593) and the Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) study (n = 329). Using CSVD markers derived from MRIs obtained within 90 days of index ICH, we classified ICH cases as cerebral amyloid angiopathy (CAA)-related, hypertensive arteriopathy (HTNA)-related, and mixed etiology. We quantified CSVD burden using validated global, CAA-specific, and HTNA-specific scores. We compared CSVD subtype and severity among White, Black, and Hispanic ICH survivors and investigated its association with ICH recurrence risk. RESULTS: We analyzed data for 922 ICH survivors (655 White, 130 Black, 137 Hispanic). Minority ICH survivors had greater global CSVD (p = 0.011) and HTNA burden (p = 0.021) on MRI. Furthermore, minority survivors of HTNA-related and mixed-etiology ICH demonstrated higher HTNA burden, resulting in increased ICH recurrence risk (all p < 0.05). CONCLUSIONS: We uncovered significant differences in CSVD subtypes and severity among White and minority survivors of primary ICH, with direct implication for known disparities in ICH recurrence risk. Future studies of racial/ethnic disparities in ICH outcomes will benefit from including detailed MRI-based assessment of CSVD subtypes and severity and investigating social determinants of health.
OBJECTIVE: Black and Hispanic survivors of intracerebral hemorrhage (ICH) are at higher risk of recurrent intracranial bleeding. MRI-based markers of chronic cerebral small vessel disease (CSVD) are consistently associated with recurrent ICH. We therefore sought to investigate whether racial/ethnic differences in MRI-defined CSVD subtype and severity contribute to disparities in ICH recurrence risk. METHODS: We analyzed data from the Massachusetts General Hospital ICH study (n = 593) and the Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) study (n = 329). Using CSVD markers derived from MRIs obtained within 90 days of index ICH, we classified ICH cases as cerebral amyloid angiopathy (CAA)-related, hypertensive arteriopathy (HTNA)-related, and mixed etiology. We quantified CSVD burden using validated global, CAA-specific, and HTNA-specific scores. We compared CSVD subtype and severity among White, Black, and Hispanic ICH survivors and investigated its association with ICH recurrence risk. RESULTS: We analyzed data for 922 ICH survivors (655 White, 130 Black, 137 Hispanic). Minority ICH survivors had greater global CSVD (p = 0.011) and HTNA burden (p = 0.021) on MRI. Furthermore, minority survivors of HTNA-related and mixed-etiology ICH demonstrated higher HTNA burden, resulting in increased ICH recurrence risk (all p < 0.05). CONCLUSIONS: We uncovered significant differences in CSVD subtypes and severity among White and minority survivors of primary ICH, with direct implication for known disparities in ICH recurrence risk. Future studies of racial/ethnic disparities in ICH outcomes will benefit from including detailed MRI-based assessment of CSVD subtypes and severity and investigating social determinants of health.
Authors: Kyle B Walsh; Daniel Woo; Padmini Sekar; Jennifer Osborne; Charles J Moomaw; Carl D Langefeld; Opeolu Adeoye Journal: Circulation Date: 2016-10-13 Impact factor: 29.690
Authors: Rocco J Cannistraro; Mohammed Badi; Benjamin H Eidelman; Dennis W Dickson; Erik H Middlebrooks; James F Meschia Journal: Neurology Date: 2019-05-29 Impact factor: 9.910
Authors: Gregoire Boulouis; Andreas Charidimou; Marco Pasi; Duangnapa Roongpiboonsopit; Li Xiong; Eitan Auriel; Ellis S van Etten; Sergi Martinez-Ramirez; Alison Ayres; Anastasia Vashkevich; Kristin M Schwab; Jonathan Rosand; Joshua N Goldstein; M Edip Gurol; Steven M Greenberg; Anand Viswanathan Journal: J Neurol Sci Date: 2017-07-09 Impact factor: 3.181
Authors: J Claude Hemphill; Steven M Greenberg; Craig S Anderson; Kyra Becker; Bernard R Bendok; Mary Cushman; Gordon L Fung; Joshua N Goldstein; R Loch Macdonald; Pamela H Mitchell; Phillip A Scott; Magdy H Selim; Daniel Woo Journal: Stroke Date: 2015-05-28 Impact factor: 7.914
Authors: Axana Rodriguez-Torres; Meredith Murphy; Christina Kourkoulis; Kristin Schwab; Alison M Ayres; Charles J Moomaw; Soo Young Kwon; Jimmy V Berthaud; M Edip Gurol; Steven M Greenberg; Anand Viswanathan; Christopher D Anderson; Matthew Flaherty; Michael L James; Lee Birnbaum; Gene Yong Sung; Gunjan Parikh; Amelia K Boehme; Douglas Mayson; Kevin N Sheth; Chelsea Kidwell; Sebastian Koch; Michael Frankel; Carl D Langefeld; Fernando D Testai; Daniel Woo; Jonathan Rosand; Alessandro Biffi Journal: Neurology Date: 2018-06-06 Impact factor: 9.910
Authors: Andreas Charidimou; Gregoire Boulouis; Duangnapa Roongpiboonsopit; Eitan Auriel; Marco Pasi; Kellen Haley; Ellis S van Etten; Sergi Martinez-Ramirez; Alison Ayres; Anastasia Vashkevich; Kristin M Schwab; Joshua N Goldstein; Jonathan Rosand; Anand Viswanathan; Steven M Greenberg; M Edip Gurol Journal: Neurology Date: 2017-10-25 Impact factor: 11.800
Authors: Marco Pasi; Andreas Charidimou; Gregoire Boulouis; Eitan Auriel; Alison Ayres; Kristin M Schwab; Joshua N Goldstein; Jonathan Rosand; Anand Viswanathan; Leonardo Pantoni; Steven M Greenberg; M Edip Gurol Journal: Neurology Date: 2017-12-15 Impact factor: 11.800
Authors: Naaem Simaan; Andrei Filioglo; José E Cohen; Yonatan Lorberboum; Ronen R Leker; Asaf Honig Journal: J Clin Med Date: 2022-04-11 Impact factor: 4.964
Authors: Amy Christina Ferguson; Sophie Thrippleton; David Henshall; Ed Whittaker; Bryan Conway; Malcolm MacLeod; Rainer Malik; Konrad Rawlik; Albert Tenesa; Cathie Sudlow; Kristiina Rannikmae Journal: Neurol Genet Date: 2022-08-24