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Excessive White Matter Hyperintensity Increases Susceptibility to Poor Functional Outcomes After Acute Ischemic Stroke.
Hong, Sungmin; Giese, Anne-Katrin; Schirmer, Markus D; Bonkhoff, Anna K; Bretzner, Martin; Rist, Pamela; Dalca, Adrian V; Regenhardt, Robert W; Etherton, Mark R; Donahue, Kathleen L; Nardin, Marco; Mocking, Steven J T; McIntosh, Elissa C; Attia, John; Benavente, Oscar R; Cole, John W; Donatti, Amanda; Griessenauer, Christoph J; Heitsch, Laura; Holmegaard, Lukas; Jood, Katarina; Jimenez-Conde, Jordi; Roquer, Jaume; Kittner, Steven J; Lemmens, Robin; Levi, Christopher R; McDonough, Caitrin W; Meschia, James F; Phuah, Chia-Ling; Rolfs, Arndt; Ropele, Stefan; Rosand, Jonathan; Rundek, Tatjana; Sacco, Ralph L; Schmidt, Reinhold; Enzinger, Christian; Sharma, Pankaj; Slowik, Agnieszka; 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; Wu, Ona.
Afiliação
  • Hong S; J. Philip Kistler Stroke Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.
  • Giese AK; Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Schirmer MD; J. Philip Kistler Stroke Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.
  • Bonkhoff AK; Clinic for Neuroradiology, University Hospital Bonn, Bonn, Germany.
  • Bretzner M; J. Philip Kistler Stroke Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.
  • Rist P; J. Philip Kistler Stroke Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.
  • Dalca AV; Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog (JPARC) - Lille Neurosciences & Cognition, Lille, France.
  • Regenhardt RW; Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States.
  • Etherton MR; Computer Science and Artificial Intelligence Lab, Massachusetts Institute of Technology, Boston, MA, United States.
  • Donahue KL; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, United States.
  • Nardin M; J. Philip Kistler Stroke Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.
  • Mocking SJT; J. Philip Kistler Stroke Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.
  • McIntosh EC; J. Philip Kistler Stroke Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.
  • Attia J; J. Philip Kistler Stroke Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.
  • Benavente OR; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, United States.
  • Cole JW; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, United States.
  • Donatti A; Hunter Medical Research Institute, Newcastle, NSW, Australia.
  • Griessenauer CJ; School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia.
  • Heitsch L; Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
  • Holmegaard L; Department of Neurology, University of Maryland School of Medicine and Veterans Affairs Maryland Health Care System, Baltimore, MD, United States.
  • Jood K; School of Medical Sciences, University of Campinas (UNICAMP) and the Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, Brazil.
  • Jimenez-Conde J; Department of Neurosurgery, Geisinger, Danville, PA, United States.
  • Roquer J; Research Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria.
  • Kittner SJ; Division of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, United States.
  • Lemmens R; Department of Neurology, Washington University School of Medicine & Barnes-Jewish Hospital, St. Louis, MO, United States.
  • Levi CR; Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg and Department of Neurology, The Sahlgrenska University Hospital, Gothenburg, Sweden.
  • McDonough CW; Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg and Department of Neurology, The Sahlgrenska University Hospital, Gothenburg, Sweden.
  • Meschia JF; Department of Neurology, Neurovascular Research Group (NEUVAS), IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions M'ediques), Universitat Autonoma de Barcelona, Barcelona, Spain.
  • Phuah CL; Department of Neurology, Neurovascular Research Group (NEUVAS), IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions M'ediques), Universitat Autonoma de Barcelona, Barcelona, Spain.
  • Rolfs A; Department of Neurology, University of Maryland School of Medicine and Veterans Affairs Maryland Health Care System, Baltimore, MD, United States.
  • Ropele S; KU Leuven - University of Leuven, Department of Neurosciences, Experimental Neurology and Leuven Research Institute for Neuroscience and Disease (LIND), Leuven, Belgium.
  • Rosand J; VIB, Vesalius Research Center, Laboratory of Neurobiology, University Hospitals Leuven, Department of Neurology, Leuven, Belgium.
  • Rundek T; Hunter Medical Research Institute, Newcastle, NSW, Australia.
  • Sacco RL; Department of Neurology, John Hunter Hospital, Newcastle, NSW, Australia.
  • Schmidt R; Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics, University of Florida, Gainesville, FL, United States.
  • Enzinger C; Department of Neurology, Mayo Clinic, Jacksonville, FL, United States.
  • Sharma P; Department of Neurology, Washington University School of Medicine & Barnes-Jewish Hospital, St. Louis, MO, United States.
  • Slowik A; Centogene AG, Rostock, Germany.
  • Sousa A; Department of Neurology, Clinical Division of Neurogeriatrics, Medical University Graz, Graz, Austria.
  • Stanne TM; J. Philip Kistler Stroke Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.
  • Strbian D; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, United States.
  • Tatlisumak T; Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States.
  • Thijs V; Department of Neurology and Evelyn F. McKnight Brain Institute, Miller School of Medicine, University of Miami, Miami, FL, United States.
  • Vagal A; Department of Neurology and Evelyn F. McKnight Brain Institute, Miller School of Medicine, University of Miami, Miami, FL, United States.
  • Wasselius J; Department of Neurology, Clinical Division of Neurogeriatrics, Medical University Graz, Graz, Austria.
  • Woo D; Department of Neurology, Clinical Division of Neurogeriatrics, Medical University Graz, Graz, Austria.
  • Zand R; Institute of Cardiovascular Research, Royal Holloway University of London (ICR2UL), Egham, United Kingdom.
  • McArdle PF; St. Peter's and Ashford Hospitals, Egham, United Kingdom.
  • Worrall BB; Department of Neurology, Jagiellonian University Medical College, Krakow, Poland.
  • Wu O; School of Medical Sciences, University of Campinas (UNICAMP) and the Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, Brazil.
Front Neurol ; 12: 700616, 2021.
Article em En | MEDLINE | ID: mdl-34566844
Objective: To personalize the prognostication of post-stroke outcome using MRI-detected cerebrovascular pathology, we sought to investigate the association between the excessive white matter hyperintensity (WMH) burden unaccounted for by the traditional stroke risk profile of individual patients and their long-term functional outcomes after a stroke. Methods: We included 890 patients who survived after an acute ischemic stroke from the MRI-Genetics Interface Exploration (MRI-GENIE) study, for whom data on vascular risk factors (VRFs), including age, sex, atrial fibrillation, diabetes mellitus, hypertension, coronary artery disease, smoking, prior stroke history, as well as acute stroke severity, 3- to-6-month modified Rankin Scale score (mRS), WMH, and brain volumes, were available. We defined the unaccounted WMH (uWMH) burden via modeling of expected WMH burden based on the VRF profile of each individual patient. The association of uWMH and mRS score was analyzed by linear regression analysis. The odds ratios of patients who achieved full functional independence (mRS < 2) in between trichotomized uWMH burden groups were calculated by pair-wise comparisons. Results: The expected WMH volume was estimated with respect to known VRFs. The uWMH burden was associated with a long-term functional outcome (ß = 0.104, p < 0.01). Excessive uWMH burden significantly reduced the odds of achieving full functional independence after a stroke compared to the low and average uWMH burden [OR = 0.4, 95% CI: (0.25, 0.63), p < 0.01 and OR = 0.61, 95% CI: (0.42, 0.87), p < 0.01, respectively]. Conclusion: The excessive amount of uWMH burden unaccounted for by the traditional VRF profile was associated with worse post-stroke functional outcomes. Further studies are needed to evaluate a lifetime brain injury reflected in WMH unrelated to the VRF profile of a patient as an important factor for stroke recovery and a plausible indicator of brain health.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Prognostic_studies / Risk_factors_studies Idioma: En Revista: Front Neurol Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Prognostic_studies / Risk_factors_studies Idioma: En Revista: Front Neurol Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Estados Unidos