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| Pàgina inicial > Articles > Articles publicats > Excessive White Matter Hyperintensity Increases Susceptibility to Poor Functional Outcomes After Acute Ischemic Stroke |
(Massachusetts General Hospital) (Université du Lille) (Massachusetts General Hospital) (Massachusetts General Hospital) (University of Newcastle) (University of Maryland. School of Medicine) (University of Gothenburg) (Institut Hospital del Mar d'Investigacions Mèdiques) (University Hospitals Leuven (Bèlgica)) (Mayo Clinic (Estats Units d'Amèrica)) (Department of Neurology, Medical University Graz) (Department of Neurology, University of Miami) (University of Helsinki) (Austin Health (Austràlia)) (University of Virginia) (Lund University. Department of Clinical Sciences) (University of Helsinki)| Data: | 2021 |
| Resum: | 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 (β = 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. |
| Ajuts: | European Commission. Horizon 2020 753896 Ministerio de Economía y Competitividad PI15/00451 Fundació la Marató de TV3 76/C/2011-JJ-C "la Caixa" Foundation JJ086116 JJ-C |
| Drets: | Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.  |
| Llengua: | Anglès |
| Document: | Article ; recerca ; Versió publicada |
| Matèria: | White matter hyper intensity ; Stroke ; Brain health ; Brain vulnerability ; Post-stroke outcomes ; Functional independence ; Functional outcome after acute stroke ; Acute ischemic stroke |
| Publicat a: | Frontiers in neurology, Vol. 12 (september 2021) , ISSN 1664-2295 |
