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Brain Volume : An Important Determinant of Functional Outcome After Acute Ischemic Stroke

Schirmer, Markus D. ; Donahue, Kathleen L. ; Nardin, Marco J. ; Dalca, Adrian V. ; Giese, Anne Katrin ; Etherton, Mark R. ; Mocking, Steven J.T. ; McIntosh, Elissa C. ; Cole, John W. and Holmegaard, Lukas , et al. (2020) In Mayo Clinic Proceedings 95(5). p.955-965
Abstract

Objective: To determine whether brain volume is associated with functional outcome after acute ischemic stroke (AIS). Patients and Methods: This study was conducted between July 1, 2014, and March 16, 2019. We analyzed cross-sectional data of the multisite, international hospital-based MRI-Genetics Interface Exploration study with clinical brain magnetic resonance imaging obtained on admission for index stroke and functional outcome assessment. Poststroke outcome was determined using the modified Rankin Scale score (0-6; 0 = asymptomatic; 6 = death) recorded between 60 and 190 days after stroke. Demographic characteristics and other clinical variables including acute stroke severity (measured as National Institutes of Health Stroke... (More)

Objective: To determine whether brain volume is associated with functional outcome after acute ischemic stroke (AIS). Patients and Methods: This study was conducted between July 1, 2014, and March 16, 2019. We analyzed cross-sectional data of the multisite, international hospital-based MRI-Genetics Interface Exploration study with clinical brain magnetic resonance imaging obtained on admission for index stroke and functional outcome assessment. Poststroke outcome was determined using the modified Rankin Scale score (0-6; 0 = asymptomatic; 6 = death) recorded between 60 and 190 days after stroke. Demographic characteristics and other clinical variables including acute stroke severity (measured as National Institutes of Health Stroke Scale score), vascular risk factors, and etiologic stroke subtypes (Causative Classification of Stroke system) were recorded during index admission. Results: Utilizing the data from 912 patients with AIS (mean ± SD age, 65.3±14.5 years; male, 532 [58.3%]; history of smoking, 519 [56.9%]; hypertension, 595 [65.2%]) in a generalized linear model, brain volume (per 155.1 cm3) was associated with age (β −0.3 [per 14.4 years]), male sex (β 1.0), and prior stroke (β −0.2). In the multivariable outcome model, brain volume was an independent predictor of modified Rankin Scale score (β −0.233), with reduced odds of worse long-term functional outcomes (odds ratio, 0.8; 95% CI, 0.7-0.9) in those with larger brain volumes. Conclusion: Larger brain volume quantified on clinical magnetic resonance imaging of patients with AIS at the time of stroke purports a protective mechanism. The role of brain volume as a prognostic, protective biomarker has the potential to forge new areas of research and advance current knowledge of the mechanisms of poststroke recovery.

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published
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Mayo Clinic Proceedings
volume
95
issue
5
pages
11 pages
publisher
Mayo Clinic Proceedings
external identifiers
  • scopus:85084040712
  • pmid:32370856
ISSN
0025-6196
DOI
10.1016/j.mayocp.2020.01.027
language
English
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yes
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467088ab-660c-4362-994a-0936f0b8c469
date added to LUP
2020-05-19 09:38:56
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2021-01-06 06:08:44
@article{467088ab-660c-4362-994a-0936f0b8c469,
  abstract     = {<p>Objective: To determine whether brain volume is associated with functional outcome after acute ischemic stroke (AIS). Patients and Methods: This study was conducted between July 1, 2014, and March 16, 2019. We analyzed cross-sectional data of the multisite, international hospital-based MRI-Genetics Interface Exploration study with clinical brain magnetic resonance imaging obtained on admission for index stroke and functional outcome assessment. Poststroke outcome was determined using the modified Rankin Scale score (0-6; 0 = asymptomatic; 6 = death) recorded between 60 and 190 days after stroke. Demographic characteristics and other clinical variables including acute stroke severity (measured as National Institutes of Health Stroke Scale score), vascular risk factors, and etiologic stroke subtypes (Causative Classification of Stroke system) were recorded during index admission. Results: Utilizing the data from 912 patients with AIS (mean ± SD age, 65.3±14.5 years; male, 532 [58.3%]; history of smoking, 519 [56.9%]; hypertension, 595 [65.2%]) in a generalized linear model, brain volume (per 155.1 cm<sup>3</sup>) was associated with age (β −0.3 [per 14.4 years]), male sex (β 1.0), and prior stroke (β −0.2). In the multivariable outcome model, brain volume was an independent predictor of modified Rankin Scale score (β −0.233), with reduced odds of worse long-term functional outcomes (odds ratio, 0.8; 95% CI, 0.7-0.9) in those with larger brain volumes. Conclusion: Larger brain volume quantified on clinical magnetic resonance imaging of patients with AIS at the time of stroke purports a protective mechanism. The role of brain volume as a prognostic, protective biomarker has the potential to forge new areas of research and advance current knowledge of the mechanisms of poststroke recovery.</p>},
  author       = {Schirmer, Markus D. and Donahue, Kathleen L. and Nardin, Marco J. and Dalca, Adrian V. and Giese, Anne Katrin and Etherton, Mark R. and Mocking, Steven J.T. and McIntosh, Elissa C. and Cole, John W. and Holmegaard, Lukas and Jood, Katarina and Jimenez-Conde, Jordi and Kittner, Steven J. and Lemmens, Robin and Meschia, James F. and Rosand, Jonathan and Roquer, Jaume and Rundek, Tatjana and Sacco, Ralph L. and Schmidt, Reinhold and Sharma, Pankaj and Slowik, Agnieszka and Stanne, Tara M. and Vagal, Achala and Wasselius, Johan and Woo, Daniel and Bevan, Stephen and Heitsch, Laura and Phuah, Chia Ling and Strbian, Daniel and Tatlisumak, Turgut and Levi, Christopher R. and Attia, John and McArdle, Patrick F. and Worrall, Bradford B. and Wu, Ona and Jern, Christina and Lindgren, Arne and Maguire, Jane and Thijs, Vincent and Rost, Natalia S.},
  issn         = {0025-6196},
  language     = {eng},
  number       = {5},
  pages        = {955--965},
  publisher    = {Mayo Clinic Proceedings},
  series       = {Mayo Clinic Proceedings},
  title        = {Brain Volume : An Important Determinant of Functional Outcome After Acute Ischemic Stroke},
  url          = {http://dx.doi.org/10.1016/j.mayocp.2020.01.027},
  doi          = {10.1016/j.mayocp.2020.01.027},
  volume       = {95},
  year         = {2020},
}