ABSTRACT
Acute ischemic stroke affects men and women differently. In particular, women are often reported to experience higher acute stroke severity than men. We derived a low-dimensional representation of anatomical stroke lesions and designed a Bayesian hierarchical modeling framework tailored to estimate possible sex differences in lesion patterns linked to acute stroke severity (National Institute of Health Stroke Scale). This framework was developed in 555 patients (38% female). Findings were validated in an independent cohort (n = 503, 41% female). Here, we show brain lesions in regions subserving motor and language functions help explain stroke severity in both men and women, however more widespread lesion patterns are relevant in female patients. Higher stroke severity in women, but not men, is associated with left hemisphere lesions in the vicinity of the posterior circulation. Our results suggest there are sex-specific functional cerebral asymmetries that may be important for future investigations of sex-stratified approaches to management of acute ischemic stroke.
Subject(s)
Brain Stem/pathology , Ischemic Stroke/pathology , Sensorimotor Cortex/pathology , Thalamus/pathology , Aged , Aged, 80 and over , Bayes Theorem , Brain Mapping , Brain Stem/blood supply , Brain Stem/diagnostic imaging , Cerebral Revascularization/methods , Cohort Studies , Female , Humans , Image Processing, Computer-Assisted , Ischemic Stroke/diagnostic imaging , Ischemic Stroke/therapy , Magnetic Resonance Imaging , Male , Middle Aged , Risk Factors , Sensorimotor Cortex/blood supply , Sensorimotor Cortex/diagnostic imaging , Severity of Illness Index , Sex Factors , Thalamus/blood supply , Thalamus/diagnostic imaging , Treatment OutcomeABSTRACT
Dynamic exercise elicits fluctuations in blood pressure (BP) and cerebral blood flow (CBF). This study investigated responses in BP and CBF during cycling exercise and post-exercise hypotension (PEH) using positron emission tomography (PET). CBF was measured using oxygen-15-labeled water (H215O) and PET in 11 human subjects at rest (Rest), at the onset of exercise (Ex1), later in the exercise (Ex2), and during PEH. Global CBF significantly increased by 13% at Ex1 compared with Rest, but was unchanged at Ex2 and during PEH. Compared with at Rest, regional CBF (rCBF) increased at Ex1 (20~42%) in the cerebellar vermis, sensorimotor cortex for the bilateral legs (M1Leg and S1Leg), insular cortex and brain stem, but increased at Ex2 (28~31%) only in the vermis and M1Leg and S1Leg. During PEH, rCBF decreased compared with Rest (8~13%) in the cerebellum, temporal gyrus, piriform lobe, thalamus and pons. The areas showing correlations between rCBF and mean BP during exercise and PEH were consistent with the central autonomic network, including the brain stem, cerebellum, and hypothalamus (R2=0.25-0.64). The present study suggests that higher brain regions are coordinated through reflex centers in the brain stem in order to regulate the cardiovascular response to exercise.
Subject(s)
Blood Pressure/physiology , Brain/diagnostic imaging , Cerebrovascular Circulation/physiology , Exercise/physiology , Positron-Emission Tomography/methods , Brain/blood supply , Brain Mapping , Brain Stem/blood supply , Brain Stem/diagnostic imaging , Cerebellar Vermis/blood supply , Cerebellar Vermis/diagnostic imaging , Cerebral Cortex/blood supply , Cerebral Cortex/diagnostic imaging , Humans , Image Processing, Computer-Assisted , Male , Oxygen Radioisotopes , Pons/blood supply , Pons/diagnostic imaging , Sensorimotor Cortex/blood supply , Sensorimotor Cortex/diagnostic imaging , Temporal Lobe/blood supply , Temporal Lobe/diagnostic imaging , Thalamus/blood supply , Thalamus/diagnostic imaging , Young AdultABSTRACT
Using a TV unit for microcirculation studies, we studied the density of the entire microvascular network and its arterial compartment in the pia mater of the sensorimotor cortex in intact young and aged rats (2-3 and 22-24 months) and aged rats after a course of vascular peptide bioregulator Slavinorm. The experiments showed that the density of microvascular network in intact animals decreased by 1.6 times with aging. Treatment with the peptide bioregulator 2.5-fold increased the density of the microvascular network in aged rats in comparison with intact animals of the same age, the density of the arterial compartment of the microvascular network in the pia mater increased by 2.8 times.