Brain Volume: An Important Determinant of Functional Outcome After Acute Ischemic Stroke.

Schirmer, MD; Donahue, KL; Nardin, MJ; Dalca, AV; Giese, A-K; Etherton, MR; Mocking, SJT; McIntosh, EC; Cole, JW; Holmegaard, L; Jood, K; Jimenez-Conde, J; Kittner, SJ; Lemmens, R; Meschia, JF; Rosand, J; Roquer, J; Rundek, T; Sacco, RL; Schmidt, R; Sharma, P; Slowik, A; Stanne, TM; Vagal, A; Wasselius, J; Woo, D; Bevan, S; Heitsch, L; Phuah, C-L; Strbian, D; Tatlisumak, T; Levi, CR; Attia, J; McArdle, PF; Worrall, BB; Wu, O; Jern, C; Lindgren, A; Maguire, J; Thijs, V; Rost, NS; MRI-GENIE and GISCOME Investigators and the International Stroke Genetics Consortium

Brain Volume: An Important Determinant of Functional Outcome After Acute Ischemic Stroke.

Schirmer, MD Donahue, KL Nardin, MJ Dalca, AV Giese, A-K Etherton, MR Mocking, SJT McIntosh, EC Cole, JW Holmegaard, L Jood, K Jimenez-Conde, J Kittner, SJ Lemmens, R Meschia, JF Rosand, J Roquer, J Rundek, T Sacco, RL Schmidt, R Sharma, P Slowik, A Stanne, TM Vagal, A Wasselius, J Woo, D Bevan, S Heitsch, L Phuah, C-L Strbian, D Tatlisumak, T Levi, CR Attia, J McArdle, PF Worrall, BB Wu, O Jern, C Lindgren, A Maguire, J

Thijs, V Rost, NS MRI-GENIE and GISCOME Investigators and the International Stroke Genetics Consortium

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Publisher:: ELSEVIER SCIENCE INC
Publication Type:: Journal Article
Citation:: Mayo Clinic Proceedings, 2020, 95, (5), pp. 955-965
Issue Date:: 2020-05

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Field	Value	Language
dc.contributor.author	Schirmer, MD
dc.contributor.author	Donahue, KL
dc.contributor.author	Nardin, MJ
dc.contributor.author	Dalca, AV
dc.contributor.author	Giese, A-K
dc.contributor.author	Etherton, MR
dc.contributor.author	Mocking, SJT
dc.contributor.author	McIntosh, EC
dc.contributor.author	Cole, JW
dc.contributor.author	Holmegaard, L
dc.contributor.author	Jood, K
dc.contributor.author	Jimenez-Conde, J
dc.contributor.author	Kittner, SJ
dc.contributor.author	Lemmens, R
dc.contributor.author	Meschia, JF
dc.contributor.author	Rosand, J
dc.contributor.author	Roquer, J
dc.contributor.author	Rundek, T
dc.contributor.author	Sacco, RL
dc.contributor.author	Schmidt, R
dc.contributor.author	Sharma, P
dc.contributor.author	Slowik, A
dc.contributor.author	Stanne, TM
dc.contributor.author	Vagal, A
dc.contributor.author	Wasselius, J
dc.contributor.author	Woo, D
dc.contributor.author	Bevan, S
dc.contributor.author	Heitsch, L
dc.contributor.author	Phuah, C-L
dc.contributor.author	Strbian, D
dc.contributor.author	Tatlisumak, T
dc.contributor.author	Levi, CR
dc.contributor.author	Attia, J
dc.contributor.author	McArdle, PF
dc.contributor.author	Worrall, BB
dc.contributor.author	Wu, O
dc.contributor.author	Jern, C
dc.contributor.author	Lindgren, A
dc.contributor.author	Maguire, J https://orcid.org/0000-0001-5722-8311
dc.contributor.author	Thijs, V
dc.contributor.author	Rost, NS
dc.contributor.author	MRI-GENIE and GISCOME Investigators and the International Stroke Genetics Consortium
dc.date.accessioned	2020-07-31T04:22:13Z
dc.date.available	2020-01-08
dc.date.available	2020-07-31T04:22:13Z
dc.date.issued	2020-05
dc.identifier.citation	Mayo Clinic Proceedings, 2020, 95, (5), pp. 955-965
dc.identifier.issn	0025-6196
dc.identifier.issn	1942-5546
dc.identifier.uri	http://hdl.handle.net/10453/141944
dc.description.abstract	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.
dc.format	Print
dc.language	eng
dc.publisher	ELSEVIER SCIENCE INC
dc.relation.ispartof	Mayo Clinic Proceedings
dc.relation.isbasedon	10.1016/j.mayocp.2020.01.027
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	11 Medical and Health Sciences
dc.title	Brain Volume: An Important Determinant of Functional Outcome After Acute Ischemic Stroke.
dc.type	Journal Article
utslib.citation.volume	95
utslib.location.activity	England
utslib.for	11 Medical and Health Sciences
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney
utslib.copyright.status	closed_access	*
pubs.consider-herdc	false
dc.date.updated	2020-07-31T04:22:07Z
pubs.issue	5
pubs.publication-status	Published
pubs.volume	95
utslib.citation.issue	5

Abstract:

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.

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http://hdl.handle.net/10453/141944