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  • Bonkhoff, A. K.Harvard Medical School,Massachusetts General Hospital (author)

Deep profiling of multiple ischemic lesions in a large, multi-center cohort: Frequency, spatial distribution, and associations to clinical characteristics

  • Article/chapterEnglish2022

Publisher, publication year, extent ...

  • 2022-08-25
  • Frontiers Media SA,2022

Numbers

  • LIBRIS-ID:oai:gup.ub.gu.se/320306
  • https://gup.ub.gu.se/publication/320306URI
  • https://doi.org/10.3389/fnins.2022.994458DOI
  • https://lup.lub.lu.se/record/960d432a-1584-4ba0-8072-4691e49de93fURI

Supplementary language notes

  • Language:English

Part of subdatabase

Classification

  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Background purposeA substantial number of patients with acute ischemic stroke (AIS) experience multiple acute lesions (MAL). We here aimed to scrutinize MAL in a large radiologically deep-phenotyped cohort. Materials and methodsAnalyses relied upon imaging and clinical data from the international MRI-GENIE study. Imaging data comprised both Fluid-attenuated inversion recovery (FLAIR) for white matter hyperintensity (WMH) burden estimation and diffusion-weighted imaging (DWI) sequences for the assessment of acute stroke lesions. The initial step featured the systematic evaluation of occurrences of MAL within one and several vascular supply territories. Associations between MAL and important imaging and clinical characteristics were subsequently determined. The interaction effect between single and multiple lesion status and lesion volume was estimated by means of Bayesian hierarchical regression modeling for both stroke severity and functional outcome. ResultsWe analyzed 2,466 patients (age = 63.4 +/- 14.8, 39% women), 49.7% of which presented with a single lesion. Another 37.4% experienced MAL in a single vascular territory, while 12.9% featured lesions in multiple vascular territories. Within most territories, MAL occurred as frequently as single lesions (ratio similar to 1:1). Only the brainstem region comprised fewer patients with MAL (ratio 1:4). Patients with MAL presented with a significantly higher lesion volume and acute NIHSS (7.7 vs. 1.7 ml and 4 vs. 3, p(FDR) < 0.001). In contrast, patients with a single lesion were characterized by a significantly higher WMH burden (6.1 vs. 5.3 ml, p(FDR) = 0.048). Functional outcome did not differ significantly between patients with single versus multiple lesions. Bayesian analyses suggested that the association between lesion volume and stroke severity between single and multiple lesions was the same in case of anterior circulation stroke. In case of posterior circulation stroke, lesion volume was linked to a higher NIHSS only among those with MAL. ConclusionMultiple lesions, especially those within one vascular territory, occurred more frequently than previously reported. Overall, multiple lesions were distinctly linked to a higher acute stroke severity, a higher total DWI lesion volume and a lower WMH lesion volume. In posterior circulation stroke, lesion volume was linked to a higher stroke severity in multiple lesions only.

Subject headings and genre

Added entries (persons, corporate bodies, meetings, titles ...)

  • Ullberg, T.Lund University,Lunds universitet,Stroke policy och kvalitetsregisterforskning,Forskargrupper vid Lunds universitet,Stroke Imaging Research group,Stroke policy and quality register research,Lund University Research Groups,Skåne University Hospital(Swepub:lu)med-tsu (author)
  • Bretzner, M. (author)
  • Hong, S. M. (author)
  • Schirmer, M. D. (author)
  • Regenhardt, R. W. (author)
  • Donahue, K. L. (author)
  • Nardin, M. J. (author)
  • Dalca, A. V. (author)
  • Giese, A. K. (author)
  • Etherton, M. R. (author)
  • Hancock, B. L. (author)
  • Stanne, Tara M,1979Gothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för laboratoriemedicin,Department of Laboratory Medicine(Swepub:gu)xmcdta (author)
  • McIntosh, E. C. (author)
  • Attia, J. (author)
  • Wasselius, J.Lund University,Lunds universitet,Neuroradiologi,Forskargrupper vid Lunds universitet,Stroke Imaging Research group,Neuroradiology,Lund University Research Groups,Skåne University Hospital(Swepub:lu)oft-jws (author)
  • Donatti, A. (author)
  • Jern, Christina,1962Gothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för laboratoriemedicin,Department of Laboratory Medicine(Swepub:gu)xjerch (author)
  • Heitsch, L. (author)
  • Holmegaard, LukasGothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience(Swepub:gu)xhollu (author)
  • Jood, Katarina,1966Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience(Swepub:gu)xjooka (author)
  • Jimenez-Conde, J. (author)
  • Kittner, S. J. (author)
  • Lemmens, R. (author)
  • Levi, C. R. (author)
  • McDonough, C. W. (author)
  • Meschia, J. F. (author)
  • Phuah, C. L. (author)
  • Ropele, S. (author)
  • Rosand, J. (author)
  • Roquer, J. (author)
  • Rundek, T. (author)
  • Sacco, R. L. (author)
  • Schmidt, R. (author)
  • Sharma, P. (author)
  • Slowik, A. (author)
  • Sousa, A. (author)
  • Stanne, Tara M,1979Gothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för laboratoriemedicin,Department of Laboratory Medicine(Swepub:gu)xmcdta (author)
  • Strbian, D. (author)
  • Tatlisumak, T. (author)
  • Thijs, V. (author)
  • Vagal, A. (author)
  • Woo, D. (author)
  • Zand, R. (author)
  • Frid, P.Lund University,Lunds universitet,Neurologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Stroke Imaging Research group,Forskargrupper vid Lunds universitet,Neurology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund University Research Groups(Swepub:lu)med-ptf (author)
  • Worrall, B. B. (author)
  • Jern, Christina,1962Gothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för laboratoriemedicin,Department of Laboratory Medicine(Swepub:gu)xjerch (author)
  • Lindgren, A.G.Lund University,Lunds universitet,Neurologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Klinisk strokeforskning,Forskargrupper vid Lunds universitet,Neurology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Clinical Stroke Research Group,Lund University Research Groups,Skåne University Hospital(Swepub:lu)neur-ali (author)
  • Maguire, J. (author)
  • Wu, O. (author)
  • Frid, P. (author)
  • Rost, N. S. (author)
  • Wasselius, J. (author)
  • Harvard Medical SchoolMassachusetts General Hospital (creator_code:org_t)
  • International Stroke Genetics Consortium

Related titles

  • In:Frontiers in Neuroscience: Frontiers Media SA161662-453X1662-4548

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