TY - JOUR
T1 - Brain Volume
T2 - An Important Determinant of Functional Outcome After Acute Ischemic Stroke
AU - MRI-GENIE and GISCOME Investigators and the International Stroke Genetics Consortium
AU - Schirmer, Markus D.
AU - Donahue, Kathleen L.
AU - Nardin, Marco J.
AU - Dalca, Adrian V.
AU - Giese, Anne Katrin
AU - Etherton, Mark R.
AU - Mocking, Steven J.T.
AU - McIntosh, Elissa C.
AU - Cole, John W.
AU - Holmegaard, Lukas
AU - Jood, Katarina
AU - Jimenez-Conde, Jordi
AU - Kittner, Steven J.
AU - Lemmens, Robin
AU - Meschia, James F.
AU - Rosand, Jonathan
AU - Roquer, Jaume
AU - Rundek, Tatjana
AU - Sacco, Ralph L.
AU - Schmidt, Reinhold
AU - Sharma, Pankaj
AU - Slowik, Agnieszka
AU - Stanne, Tara M.
AU - Vagal, Achala
AU - Wasselius, Johan
AU - Woo, Daniel
AU - Bevan, Stephen
AU - Heitsch, Laura
AU - Phuah, Chia Ling
AU - Strbian, Daniel
AU - Tatlisumak, Turgut
AU - Levi, Christopher R.
AU - Attia, John
AU - McArdle, Patrick F.
AU - Worrall, Bradford B.
AU - Wu, Ona
AU - Jern, Christina
AU - Lindgren, Arne
AU - Maguire, Jane
AU - Thijs, Vincent
AU - Rost, Natalia S.
N1 - Publisher Copyright:
© 2020
PY - 2020/5
Y1 - 2020/5
N2 - 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.
AB - 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.
UR - https://www.scopus.com/pages/publications/85084040712
U2 - 10.1016/j.mayocp.2020.01.027
DO - 10.1016/j.mayocp.2020.01.027
M3 - Article
C2 - 32370856
AN - SCOPUS:85084040712
SN - 0025-6196
VL - 95
SP - 955
EP - 965
JO - Mayo Clinic Proceedings
JF - Mayo Clinic Proceedings
IS - 5
ER -