Outcome after acute ischemic stroke is linked to sex-specific lesion patterns

• 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.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Medicinska och farmaceutiska grundvetenskaper -- Neurovetenskaper (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Basic Medicine -- Neurosciences (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Neurologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Neurology (hsv//eng)

Nyckelord

aged

Bayes theorem

brain ischemia

brain mapping

brain stem

cerebral revascularization

cohort analysis

diagnostic imaging

female

human

image processing

male

middle aged

nuclear magnetic resonance imaging

pathology

procedures

risk factor

sensorimotor cortex

severity of illness index

sex factor

thalamus

treatment outcome

vascularization

very elderly

Aged

80 and over

Cohort Studies

Humans

Image Processing

Computer-Assisted

Ischemic Stroke

Magnetic Resonance Imaging

Risk Factors

Sex Factors

Aged, 80 and over

Bayes Theorem

Brain Mapping

Brain Stem

Cerebral Revascularization

Female

Image Processing, Computer-Assisted

Male

Middle Aged

Sensorimotor Cortex

Severity of Illness Index

Thalamus

Treatment Outcome

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)