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Early Brain Volume Changes After Stroke : Subgroup Analysis From the AXIS-2 Trial

Bu, Ning ; Churilov, Leonid ; Khlif, Mohamed Salah ; Lemmens, Robin ; Wouters, Anke ; Fiebach, Jochen B. ; Chamorro, Angel ; Ringelstein, E. Bernd ; Norrving, Bo LU and Laage, Rico , et al. (2022) In Frontiers in Neurology 12.
Abstract

Background and Purpose: The evolution of total brain volume early after stroke is not well understood. We investigated the associations between age and imaging features and brain volume change in the first month after stroke. Methods: We retrospectively studied patients with acute ischemic stroke enrolled in the AXIS-2 trial. Total brain volume change from hyperacute MRI data to the first month after stroke was assessed using unified segmentation in SPM12. We hypothesized that age, ischemic brain lesion size, and white matter (WM) changes were associated with larger brain volume change. Enlarged perivascular spaces (EPVSs) and white matter hyperintensities (WMHs) were rated visually and the presence of lacunes was assessed. Results: We... (More)

Background and Purpose: The evolution of total brain volume early after stroke is not well understood. We investigated the associations between age and imaging features and brain volume change in the first month after stroke. Methods: We retrospectively studied patients with acute ischemic stroke enrolled in the AXIS-2 trial. Total brain volume change from hyperacute MRI data to the first month after stroke was assessed using unified segmentation in SPM12. We hypothesized that age, ischemic brain lesion size, and white matter (WM) changes were associated with larger brain volume change. Enlarged perivascular spaces (EPVSs) and white matter hyperintensities (WMHs) were rated visually and the presence of lacunes was assessed. Results: We enrolled 173 patients with a mean age of 67 ± 11 years, 44% were women. There was a median 6 ml decrease in volume (25th percentile −1 ml to 75th percentile 21 ml) over time, equivalent to a median 0.5% (interquartile range [IQR], −0.07%−1.4%), decrease in brain volume. Age was associated with larger brain volume loss (per 10 years of age, 5 ml 95% CI 2–8 ml). Baseline diffusion weighted imaging (DWI) lesion volume was not associated with greater volume loss per 10 ml of lesion volume, change by 0 ml (95% CI −0.1 to 0.1 ml). Increasing Fazekas scores of deep WMH were associated with greater tissue loss (5 ml, 95% CI 1–10 ml). Conclusions: Total brain volume changes in a heterogenous fashion after stroke. Volume loss occurs over 1 month after stroke and is associated with age and deep WM disease. We did not find evidence that more severe strokes lead to increased early tissue loss.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
atrophy, brain volume changes, clinical trial, edema, hemorrhagic transformation, ischemic stroke
in
Frontiers in Neurology
volume
12
article number
747343
publisher
Frontiers Media S. A.
external identifiers
  • scopus:85124588431
  • pmid:35153972
ISSN
1664-2295
DOI
10.3389/fneur.2021.747343
language
English
LU publication?
yes
id
3361d6e4-9612-45bc-8604-c96f5e2feb42
date added to LUP
2022-04-13 09:12:44
date last changed
2024-06-18 15:47:25
@article{3361d6e4-9612-45bc-8604-c96f5e2feb42,
  abstract     = {{<p>Background and Purpose: The evolution of total brain volume early after stroke is not well understood. We investigated the associations between age and imaging features and brain volume change in the first month after stroke. Methods: We retrospectively studied patients with acute ischemic stroke enrolled in the AXIS-2 trial. Total brain volume change from hyperacute MRI data to the first month after stroke was assessed using unified segmentation in SPM12. We hypothesized that age, ischemic brain lesion size, and white matter (WM) changes were associated with larger brain volume change. Enlarged perivascular spaces (EPVSs) and white matter hyperintensities (WMHs) were rated visually and the presence of lacunes was assessed. Results: We enrolled 173 patients with a mean age of 67 ± 11 years, 44% were women. There was a median 6 ml decrease in volume (25th percentile −1 ml to 75th percentile 21 ml) over time, equivalent to a median 0.5% (interquartile range [IQR], −0.07%−1.4%), decrease in brain volume. Age was associated with larger brain volume loss (per 10 years of age, 5 ml 95% CI 2–8 ml). Baseline diffusion weighted imaging (DWI) lesion volume was not associated with greater volume loss per 10 ml of lesion volume, change by 0 ml (95% CI −0.1 to 0.1 ml). Increasing Fazekas scores of deep WMH were associated with greater tissue loss (5 ml, 95% CI 1–10 ml). Conclusions: Total brain volume changes in a heterogenous fashion after stroke. Volume loss occurs over 1 month after stroke and is associated with age and deep WM disease. We did not find evidence that more severe strokes lead to increased early tissue loss.</p>}},
  author       = {{Bu, Ning and Churilov, Leonid and Khlif, Mohamed Salah and Lemmens, Robin and Wouters, Anke and Fiebach, Jochen B. and Chamorro, Angel and Ringelstein, E. Bernd and Norrving, Bo and Laage, Rico and Grond, Martin and Wilms, Guido and Brodtmann, Amy and Thijs, Vincent}},
  issn         = {{1664-2295}},
  keywords     = {{atrophy; brain volume changes; clinical trial; edema; hemorrhagic transformation; ischemic stroke}},
  language     = {{eng}},
  publisher    = {{Frontiers Media S. A.}},
  series       = {{Frontiers in Neurology}},
  title        = {{Early Brain Volume Changes After Stroke : Subgroup Analysis From the AXIS-2 Trial}},
  url          = {{http://dx.doi.org/10.3389/fneur.2021.747343}},
  doi          = {{10.3389/fneur.2021.747343}},
  volume       = {{12}},
  year         = {{2022}},
}