Stroke-Related Visceral Alterations: A Voxel-Based Neuroanatomic Localization Study.

Autor: Arsava EM; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA., Chang K; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA.; Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Tawakol A; Cardiology Division and Cardiovascular Imaging Research Center, Massachusetts General Hospital, Boston, MA, USA., Loggia ML; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA., Goldstein JN; Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA., Brown J; School of Computer Science, University of Lincoln, Lincoln, UK., Park KY; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA.; Department of Neurology, Chung-Ang University Hospital, Seoul, Republic of Korea., Singhal AB; Department of Neurology, Massachusetts General Hospital, Boston, MA, USA., Kalpathy-Cramer J; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA., Sorensen AG; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA., Rosen BR; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA., Samuels MA; Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA., Ay H; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA.
Jazyk: angličtina
Zdroj: Annals of neurology [Ann Neurol] 2023 Dec; Vol. 94 (6), pp. 1155-1163. Date of Electronic Publication: 2023 Sep 22.
DOI: 10.1002/ana.26785
Abstrakt: Objective: Functional and morphologic changes in extracranial organs can occur after acute brain injury. The neuroanatomic correlates of such changes are not fully known. Herein, we tested the hypothesis that brain infarcts are associated with cardiac and systemic abnormalities (CSAs) in a regionally specific manner.
Methods: We generated voxelwise p value maps of brain infarcts for poststroke plasma cardiac troponin T (cTnT) elevation, QTc prolongation, in-hospital infection, and acute stress hyperglycemia (ASH) in 1,208 acute ischemic stroke patients prospectively recruited into the Heart-Brain Interactions Study. We examined the relationship between infarct location and CSAs using a permutation-based approach and identified clusters of contiguous voxels associated with p < 0.05.
Results: cTnT elevation not attributable to a known cardiac reason was detected in 5.5%, QTc prolongation in the absence of a known provoker in 21.2%, ASH in 33.9%, and poststroke infection in 13.6%. We identified significant, spatially segregated voxel clusters for each CSA. The clusters for troponin elevation and QTc prolongation mapped to the right hemisphere. There were 3 clusters for ASH, the largest of which was in the left hemisphere. We found 2 clusters for poststroke infection, one associated with pneumonia in the left and one with urinary tract infection in the right hemisphere. The relationship between infarct location and CSAs persisted after adjusting for infarct volume.
Interpretation: Our results show that there are discrete regions of brain infarcts associated with CSAs. This information could be used to bootstrap toward new markers for better differentiation between neurogenic and non-neurogenic mechanisms of poststroke CSAs. ANN NEUROL 2023;94:1155-1163.
(© 2023 American Neurological Association.)
Databáze: MEDLINE
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