Imaging Markers of Brain Frailty and Outcome in Patients With Acute Ischemic Stroke
| Autor: | Robin Lemmens, Martin Grond, E. Bernd Ringelstein, Anke Wouters, Guido Wilms, Jochen B. Fiebach, Rico Laage, Ning Bu, Ángel Chamorro, Vincent Thijs, Mohamed Salah Khlif, Bo Norrving, Amy Brodtmann |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Neurology Adolescent White matter Young Adult Neuroimaging Modified Rankin Scale Internal medicine Granulocyte Colony-Stimulating Factor medicine Humans Stroke Aged Ischemic Stroke Retrospective Studies Aged 80 and over Advanced and Specialized Nursing Brain Diseases medicine.diagnostic_test business.industry Magnetic resonance imaging Odds ratio Middle Aged medicine.disease Hyperintensity Treatment Outcome medicine.anatomical_structure Cardiology Female Neurology (clinical) Cardiology and Cardiovascular Medicine business Algorithms Magnetic Resonance Angiography |
| Zdroj: | Stroke. 52:1004-1011 |
| ISSN: | 1524-4628 0039-2499 |
| Popis: | Background and Purpose: Functional outcome after stroke may be related to preexisting brain health. Several imaging markers of brain frailty have been described including brain atrophy and markers of small vessel disease. We investigated the association of these imaging markers with functional outcome after acute ischemic stroke. Methods: We retrospectively studied patients with acute ischemic stroke enrolled in the AXIS-2 trial (AX200 in Ischemic Stroke Trial), a randomized controlled clinical trial of granulocyte colony-stimulating factor versus placebo. We assessed the ratio of brain parenchymal volume to total intracerebral volumes (ie, the brain parenchymal fraction) and total brain volumes from routine baseline magnetic resonance imaging data obtained within 9 hours of symptom onset using the unified segmentation algorithm in SPM12. Enlarged perivascular spaces, white matter hyperintensities, lacunes, as well as a small vessel disease burden, were rated visually. Functional outcomes (modified Rankin Scale score) at day 90 were determined. Logistic regression was used to test associations between brain imaging features and functional outcomes. Results: We enrolled 259 patients with a mean age of 69±12 years and 46 % were female. Increased brain parenchymal fraction was associated with higher odds of excellent outcome (odds ratio per percent increase, 1.078 [95% CI, 1.008–1.153]). Total brain volumes and small vessel disease burden were not associated with functional outcome. An interaction between brain parenchymal fraction and large vessel occlusion on excellent outcome was not observed. Conclusions: Global brain health, as assessed by brain parenchymal fraction on magnetic resonance imaging, is associated with excellent functional outcome after ischemic stroke. Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT00927836. |
| Databáze: | OpenAIRE |
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