scholarly journals Imaging Markers of Brain Frailty and Outcome in Patients With Acute Ischemic Stroke

Stroke ◽  
2021 ◽  
Author(s):  
Ning Bu ◽  
Mohamed Salah Khlif ◽  
Robin Lemmens ◽  
Anke Wouters ◽  
Jochen B. Fiebach ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Functional Outcome ◽  
Small Vessel Disease ◽  
Small Vessel ◽  
Excellent Outcome ◽  
Vessel Disease ◽  
Brain Parenchymal Fraction ◽  
Imaging Markers ◽  
Brain Parenchymal

Background and Purpose: Functional outcome after stroke may be related to preexisting brain health. Several imaging markers of brain frailty have been described including brain atrophy and markers of small vessel disease. We investigated the association of these imaging markers with functional outcome after acute ischemic stroke. Methods: We retrospectively studied patients with acute ischemic stroke enrolled in the AXIS-2 trial (AX200 in Ischemic Stroke Trial), a randomized controlled clinical trial of granulocyte colony-stimulating factor versus placebo. We assessed the ratio of brain parenchymal volume to total intracerebral volumes (ie, the brain parenchymal fraction) and total brain volumes from routine baseline magnetic resonance imaging data obtained within 9 hours of symptom onset using the unified segmentation algorithm in SPM12. Enlarged perivascular spaces, white matter hyperintensities, lacunes, as well as a small vessel disease burden, were rated visually. Functional outcomes (modified Rankin Scale score) at day 90 were determined. Logistic regression was used to test associations between brain imaging features and functional outcomes. Results: We enrolled 259 patients with a mean age of 69±12 years and 46 % were female. Increased brain parenchymal fraction was associated with higher odds of excellent outcome (odds ratio per percent increase, 1.078 [95% CI, 1.008–1.153]). Total brain volumes and small vessel disease burden were not associated with functional outcome. An interaction between brain parenchymal fraction and large vessel occlusion on excellent outcome was not observed. Conclusions: Global brain health, as assessed by brain parenchymal fraction on magnetic resonance imaging, is associated with excellent functional outcome after ischemic stroke. REGISTRATION: URL: https://www.clinicaltrials.gov . Unique identifier: NCT00927836.

Abstract P73: Imaging Markers of Brain Frailty and Outcome in Patients With Acute Ischemic Stroke

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Ning Bu ◽  
Mohamed S Khlif ◽  
Robin Lemmens ◽  
Anke Wouters ◽  
Jochen B Fiebach ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Functional Outcome ◽  
Small Vessel Disease ◽  
Brain Volumes ◽  
Excellent Outcome ◽  
Total Brain ◽  
Brain Parenchymal Fraction ◽  
Imaging Markers ◽  
Brain Parenchymal

Background and purpose: Functional outcome after stroke may be related to preexisting brain health. Several imaging markers of brain frailty have been described including brain atrophy and markers of small vessel disease. We investigated the association of these imaging markers with functional outcome after acute ischemic stroke. Methods: We retrospectively studied patients with acute ischemic stroke enrolled in the AXIS-2 trial, an international, multicenter, randomized controlled clinical trial of Granulocyte Colony Stimulating Factor versus placebo. We assessed the ratio of brain parenchymal volume to total intracerebral volumes (i.e., the brain parenchymal fraction [BPF]) and total brain volumes from routine baseline MRI data obtained within 9 hours of symptom onset using the unified segmentation algorithm in SPM12. Enlarged perivascular spaces (EPVS), white matter hyperintensities (WMH), lacunes as well as a small vessel disease (SVD) burden were rated visually. Functional outcomes (modified Rankin Scale [mRS] score) at day 90 were determined. Logistic regression was used to test associations between brain imaging features and functional outcomes. As there was no significant effect of G-CSF on any outcomes in AXIS-2, placebo and active groups were combined for these analyses. Results: We enrolled 259 patients with a mean age of 69±12 years and 46 % were female. Increased BPF was associated with higher odds of excellent outcome (OR per percent increase: 1.081, 95%CI: 1.012-1.155). Total brain volumes and SVD burden were not associated with functional outcome. An interaction between BPF and large vessel occlusion on excellent outcome was not observed. Conclusions: Global brain health, as assessed by brain parenchymal fraction on magnetic resonance imaging, is associated with excellent functional outcome after ischemic stroke. Clinical Trial Registration: URL: http://www.clinicaltrials.gov . Unique identifier: NCT00927836.

scholarly journals Total small vessel disease burden and functional outcome in patients with ischemic stroke

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242319
Author(s):  
Wi-Sun Ryu ◽  
Sang-Wuk Jeong ◽  
Dong-Eog Kim
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Ischemic Stroke ◽  
Functional Outcome ◽  
Logistic Regression Analysis ◽  
Small Vessel Disease ◽  
Ordinal Logistic Regression ◽  
Small Vessel ◽  
Vessel Disease ◽  
Ordinal Logistic Regression Analysis

Background Cerebral small vessel disease (SVD) is comprised of lacunes, cerebral microbleeds (CMBs), white matter hyperintensities (WMHs), and enlarged perivascular space (EPVS). We investigated the cumulative effect of SVD on 3-month functional outcome following ischemic stroke using the total SVD score. Methods The total SVD score of 477 acute ischemic stroke patients with adequate brain MRI was analyzed. We used multivariable ordinal logistic regression analysis to investigate the independent impact of total SVD score on ordinal modified Rankin Scale (mRS) score at 3-month after ischemic stroke. Results Mean age was 66±14 years, and 61% were men. The distribution of the total SVD score from 0 to 4 was 27%, 24%, 26%, 16%, and 7%, respectively. The proportion of mRS scores 2 or greater was 16% and 47% in total SVD score 0 and 4, respectively. Multivariable ordinal logistic regression analysis results showed that compared with the total SVD score of 0, total SVD scores of 2, 3, and 4 were independently associated with higher mRS scores with adjusted odds ratios (95% confidence intervals) of 1.68 (1.02–2.76), 2.24 (1.25–4.00), and 2.00 (1.02–4.29). Lacunes, CMBs, WMHs but not EPVS were associated with mRS scores at 3 months. However, the impact of each SVD marker on stroke outcome was smaller than that of the total SVD score. Conclusion We found an independent association between total SVD scores and functional outcome at 3 months following ischemic stroke. The total SVD score may be useful for stratification of patients who are at a high-risk of unfavorable outcomes.

Clinical and biochemical diagnosis of small-vessel disease in acute ischemic stroke

2009 ◽  
Vol 285 (1-2) ◽  
pp. 185-190 ◽  
Author(s):  
Raf Brouns ◽  
Jan Van Den Bossche ◽  
Didier De Surgeloose ◽  
Rishi Sheorajpanday ◽  
Peter P. De Deyn
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Small Vessel Disease ◽  
Small Vessel ◽  
Vessel Disease ◽  
Biochemical Diagnosis
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