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Sex-specific lesion pattern of functional outcomes after stroke

Stroke represents a considerable burden of disease for both men and women. However, a growing body of literature suggests clinically relevant sex differences in the underlying causes, presentations and outcomes of acute ischaemic stroke. In a recent study, we reported sex divergences in lesion topog...

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Autores principales: Bonkhoff, Anna K., Bretzner, Martin, Hong, Sungmin, Schirmer, Markus D., Cohen, Alexander, 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, Benavente, Oscar R., Bevan, Stephen, 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, Rolfs, Arndt, Ropele, Stefan, Rosand, Jonathan, Roquer, Jaume, Rundek, Tatjana, Sacco, Ralph L., Schmidt, Reinhold, Sharma, Pankaj, Slowik, Agnieszka, Söderholm, Martin, Sousa, Alessandro, Stanne, Tara M., Strbian, Daniel, Tatlisumak, Turgut, Thijs, Vincent, Vagal, Achala, Wasselius, Johan, Woo, Daniel, Zand, Ramin, McArdle, Patrick F., Worrall, Bradford B., Jern, Christina, Lindgren, Arne G., Maguire, Jane, Fox, Michael D., Bzdok, Danilo, Wu, Ona, Rost, Natalia S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8914504/
https://www.ncbi.nlm.nih.gov/pubmed/35282166
http://dx.doi.org/10.1093/braincomms/fcac020
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author Bonkhoff, Anna K.
Bretzner, Martin
Hong, Sungmin
Schirmer, Markus D.
Cohen, Alexander
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
Benavente, Oscar R.
Bevan, Stephen
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
Rolfs, Arndt
Ropele, Stefan
Rosand, Jonathan
Roquer, Jaume
Rundek, Tatjana
Sacco, Ralph L.
Schmidt, Reinhold
Sharma, Pankaj
Slowik, Agnieszka
Söderholm, Martin
Sousa, Alessandro
Stanne, Tara M.
Strbian, Daniel
Tatlisumak, Turgut
Thijs, Vincent
Vagal, Achala
Wasselius, Johan
Woo, Daniel
Zand, Ramin
McArdle, Patrick F.
Worrall, Bradford B.
Jern, Christina
Lindgren, Arne G.
Maguire, Jane
Fox, Michael D.
Bzdok, Danilo
Wu, Ona
Rost, Natalia S.
author_facet Bonkhoff, Anna K.
Bretzner, Martin
Hong, Sungmin
Schirmer, Markus D.
Cohen, Alexander
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
Benavente, Oscar R.
Bevan, Stephen
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
Rolfs, Arndt
Ropele, Stefan
Rosand, Jonathan
Roquer, Jaume
Rundek, Tatjana
Sacco, Ralph L.
Schmidt, Reinhold
Sharma, Pankaj
Slowik, Agnieszka
Söderholm, Martin
Sousa, Alessandro
Stanne, Tara M.
Strbian, Daniel
Tatlisumak, Turgut
Thijs, Vincent
Vagal, Achala
Wasselius, Johan
Woo, Daniel
Zand, Ramin
McArdle, Patrick F.
Worrall, Bradford B.
Jern, Christina
Lindgren, Arne G.
Maguire, Jane
Fox, Michael D.
Bzdok, Danilo
Wu, Ona
Rost, Natalia S.
author_sort Bonkhoff, Anna K.
collection PubMed
description Stroke represents a considerable burden of disease for both men and women. However, a growing body of literature suggests clinically relevant sex differences in the underlying causes, presentations and outcomes of acute ischaemic stroke. In a recent study, we reported sex divergences in lesion topographies: specific to women, acute stroke severity was linked to lesions in the left-hemispheric posterior circulation. We here determined whether these sex-specific brain manifestations also affect long-term outcomes. We relied on 822 acute ischaemic patients [age: 64.7 (15.0) years, 39% women] originating from the multi-centre MRI-GENIE study to model unfavourable outcomes (modified Rankin Scale >2) based on acute neuroimaging data in a Bayesian hierarchical framework. Lesions encompassing bilateral subcortical nuclei and left-lateralized regions in proximity to the insula explained outcomes across men and women (area under the curve = 0.81). A pattern of left-hemispheric posterior circulation brain regions, combining left hippocampus, precuneus, fusiform and lingual gyrus, occipital pole and latero-occipital cortex, showed a substantially higher relevance in explaining functional outcomes in women compared to men [mean difference of Bayesian posterior distributions (men – women) = −0.295 (90% highest posterior density interval = −0.556 to −0.068)]. Once validated in prospective studies, our findings may motivate a sex-specific approach to clinical stroke management and hold the promise of enhancing outcomes on a population level.
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spelling pubmed-89145042022-03-11 Sex-specific lesion pattern of functional outcomes after stroke Bonkhoff, Anna K. Bretzner, Martin Hong, Sungmin Schirmer, Markus D. Cohen, Alexander 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 Benavente, Oscar R. Bevan, Stephen 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 Rolfs, Arndt Ropele, Stefan Rosand, Jonathan Roquer, Jaume Rundek, Tatjana Sacco, Ralph L. Schmidt, Reinhold Sharma, Pankaj Slowik, Agnieszka Söderholm, Martin Sousa, Alessandro Stanne, Tara M. Strbian, Daniel Tatlisumak, Turgut Thijs, Vincent Vagal, Achala Wasselius, Johan Woo, Daniel Zand, Ramin McArdle, Patrick F. Worrall, Bradford B. Jern, Christina Lindgren, Arne G. Maguire, Jane Fox, Michael D. Bzdok, Danilo Wu, Ona Rost, Natalia S. Brain Commun Original Article Stroke represents a considerable burden of disease for both men and women. However, a growing body of literature suggests clinically relevant sex differences in the underlying causes, presentations and outcomes of acute ischaemic stroke. In a recent study, we reported sex divergences in lesion topographies: specific to women, acute stroke severity was linked to lesions in the left-hemispheric posterior circulation. We here determined whether these sex-specific brain manifestations also affect long-term outcomes. We relied on 822 acute ischaemic patients [age: 64.7 (15.0) years, 39% women] originating from the multi-centre MRI-GENIE study to model unfavourable outcomes (modified Rankin Scale >2) based on acute neuroimaging data in a Bayesian hierarchical framework. Lesions encompassing bilateral subcortical nuclei and left-lateralized regions in proximity to the insula explained outcomes across men and women (area under the curve = 0.81). A pattern of left-hemispheric posterior circulation brain regions, combining left hippocampus, precuneus, fusiform and lingual gyrus, occipital pole and latero-occipital cortex, showed a substantially higher relevance in explaining functional outcomes in women compared to men [mean difference of Bayesian posterior distributions (men – women) = −0.295 (90% highest posterior density interval = −0.556 to −0.068)]. Once validated in prospective studies, our findings may motivate a sex-specific approach to clinical stroke management and hold the promise of enhancing outcomes on a population level. Oxford University Press 2022-02-02 /pmc/articles/PMC8914504/ /pubmed/35282166 http://dx.doi.org/10.1093/braincomms/fcac020 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the Guarantors of Brain. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Bonkhoff, Anna K.
Bretzner, Martin
Hong, Sungmin
Schirmer, Markus D.
Cohen, Alexander
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
Benavente, Oscar R.
Bevan, Stephen
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
Rolfs, Arndt
Ropele, Stefan
Rosand, Jonathan
Roquer, Jaume
Rundek, Tatjana
Sacco, Ralph L.
Schmidt, Reinhold
Sharma, Pankaj
Slowik, Agnieszka
Söderholm, Martin
Sousa, Alessandro
Stanne, Tara M.
Strbian, Daniel
Tatlisumak, Turgut
Thijs, Vincent
Vagal, Achala
Wasselius, Johan
Woo, Daniel
Zand, Ramin
McArdle, Patrick F.
Worrall, Bradford B.
Jern, Christina
Lindgren, Arne G.
Maguire, Jane
Fox, Michael D.
Bzdok, Danilo
Wu, Ona
Rost, Natalia S.
Sex-specific lesion pattern of functional outcomes after stroke
title Sex-specific lesion pattern of functional outcomes after stroke
title_full Sex-specific lesion pattern of functional outcomes after stroke
title_fullStr Sex-specific lesion pattern of functional outcomes after stroke
title_full_unstemmed Sex-specific lesion pattern of functional outcomes after stroke
title_short Sex-specific lesion pattern of functional outcomes after stroke
title_sort sex-specific lesion pattern of functional outcomes after stroke
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8914504/
https://www.ncbi.nlm.nih.gov/pubmed/35282166
http://dx.doi.org/10.1093/braincomms/fcac020
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