Sex-specific lesion pattern of functional outcomes after stroke
(2022) In Brain Communications 4(2).- Abstract
- 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... (More)
- 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. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/03c92117-7408-45fc-b465-5105e0d26e2c
- author
- Bonkhoff, A.K. ; Söderholm, Martin LU ; Wasselius, Johan LU ; Lindgren, Arne G. LU ; Wu, O. and Rost, N.S.
- author collaboration
- organization
- publishing date
- 2022
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Brain Communications
- volume
- 4
- issue
- 2
- article number
- fcac020
- publisher
- Oxford University Press
- external identifiers
-
- scopus:85134964291
- pmid:35282166
- ISSN
- 2632-1297
- DOI
- 10.1093/braincomms/fcac020
- language
- English
- LU publication?
- yes
- id
- 03c92117-7408-45fc-b465-5105e0d26e2c
- date added to LUP
- 2023-01-12 12:45:56
- date last changed
- 2023-01-13 03:00:08
@article{03c92117-7408-45fc-b465-5105e0d26e2c,
abstract = {{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.}},
author = {{Bonkhoff, A.K. and Söderholm, Martin and Wasselius, Johan and Lindgren, Arne G. and Wu, O. and Rost, N.S.}},
issn = {{2632-1297}},
language = {{eng}},
number = {{2}},
publisher = {{Oxford University Press}},
series = {{Brain Communications}},
title = {{Sex-specific lesion pattern of functional outcomes after stroke}},
url = {{http://dx.doi.org/10.1093/braincomms/fcac020}},
doi = {{10.1093/braincomms/fcac020}},
volume = {{4}},
year = {{2022}},
}