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

Bonkhoff, AK; Schirmer, MD; Bretzner, M; Hong, S; Regenhardt, RW; Brudfors, M; Donahue, KL; Nardin, MJ; Dalca, AV; Giese, A-K; Etherton, MR; Hancock, BL; Mocking, SJT; McIntosh, EC; Attia, J; Benavente, OR; Bevan, S; Cole, JW; Donatti, A; Griessenauer, CJ; Heitsch, L; Holmegaard, L; Jood, K; Jimenez-Conde, J; Kittner, SJ; Lemmens, R; Levi, CR; McDonough, CW; Meschia, JF; Phuah, C-L; Rolfs, A; Ropele, S; Rosand, J; Roquer, J; Rundek, T; Sacco, RL; Schmidt, R; Sharma, P; Slowik, A; Söderholm, M; Sousa, A; Stanne, TM; Strbian, D; Tatlisumak, T; Thijs, V; Vagal, A; Wasselius, J; Woo, D; Zand, R; McArdle, PF; Worrall, BB; Jern, C; Lindgren, AG; Maguire, J; Bzdok, D; Wu, O; Rost, NS

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

Bonkhoff, AK Schirmer, MD Bretzner, M Hong, S Regenhardt, RW Brudfors, M Donahue, KL Nardin, MJ Dalca, AV Giese, A-K Etherton, MR Hancock, BL Mocking, SJT McIntosh, EC Attia, J Benavente, OR Bevan, S Cole, JW Donatti, A Griessenauer, CJ Heitsch, L Holmegaard, L Jood, K Jimenez-Conde, J Kittner, SJ Lemmens, R Levi, CR McDonough, CW Meschia, JF Phuah, C-L Rolfs, A Ropele, S Rosand, J Roquer, J Rundek, T Sacco, RL Schmidt, R Sharma, P Slowik, A Söderholm, M Sousa, A Stanne, TM Strbian, D Tatlisumak, T Thijs, V Vagal, A Wasselius, J Woo, D Zand, R McArdle, PF Worrall, BB Jern, C Lindgren, AG Maguire, J

Bzdok, D Wu, O Rost, NS

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Publisher:: Nature Research
Publication Type:: Journal Article
Citation:: Nature Communications, 2021, 12, (1), pp. 1-14
Issue Date:: 2021-06-02

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Field	Value	Language
dc.contributor.author	Bonkhoff, AK
dc.contributor.author	Schirmer, MD
dc.contributor.author	Bretzner, M
dc.contributor.author	Hong, S
dc.contributor.author	Regenhardt, RW
dc.contributor.author	Brudfors, M
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	Hancock, BL
dc.contributor.author	Mocking, SJT
dc.contributor.author	McIntosh, EC
dc.contributor.author	Attia, J
dc.contributor.author	Benavente, OR
dc.contributor.author	Bevan, S
dc.contributor.author	Cole, JW
dc.contributor.author	Donatti, A
dc.contributor.author	Griessenauer, CJ
dc.contributor.author	Heitsch, L
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	Levi, CR
dc.contributor.author	McDonough, CW
dc.contributor.author	Meschia, JF
dc.contributor.author	Phuah, C-L
dc.contributor.author	Rolfs, A
dc.contributor.author	Ropele, S
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	Söderholm, M
dc.contributor.author	Sousa, A
dc.contributor.author	Stanne, TM
dc.contributor.author	Strbian, D
dc.contributor.author	Tatlisumak, T
dc.contributor.author	Thijs, V
dc.contributor.author	Vagal, A
dc.contributor.author	Wasselius, J
dc.contributor.author	Woo, D
dc.contributor.author	Zand, R
dc.contributor.author	McArdle, PF
dc.contributor.author	Worrall, BB
dc.contributor.author	Jern, C
dc.contributor.author	Lindgren, AG
dc.contributor.author	Maguire, J https://orcid.org/0000-0001-5722-8311
dc.contributor.author	Bzdok, D
dc.contributor.author	Wu, O
dc.contributor.author	Rost, NS
dc.date.accessioned	2022-01-06T22:26:04Z
dc.date.available	2021-04-30
dc.date.available	2022-01-06T22:26:04Z
dc.date.issued	2021-06-02
dc.identifier.citation	Nature Communications, 2021, 12, (1), pp. 1-14
dc.identifier.issn	2041-1723
dc.identifier.issn	2041-1723
dc.identifier.uri	http://hdl.handle.net/10453/152780
dc.description.abstract	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.
dc.format	Electronic
dc.language	eng
dc.publisher	Nature Research
dc.relation.ispartof	Nature Communications
dc.relation.isbasedon	10.1038/s41467-021-23492-3
dc.rights	info:eu-repo/semantics/openAccess
dc.subject.mesh	Aged
dc.subject.mesh	Aged, 80 and over
dc.subject.mesh	Bayes Theorem
dc.subject.mesh	Brain Mapping
dc.subject.mesh	Brain Stem
dc.subject.mesh	Cerebral Revascularization
dc.subject.mesh	Cohort Studies
dc.subject.mesh	Female
dc.subject.mesh	Humans
dc.subject.mesh	Image Processing, Computer-Assisted
dc.subject.mesh	Ischemic Stroke
dc.subject.mesh	Magnetic Resonance Imaging
dc.subject.mesh	Male
dc.subject.mesh	Middle Aged
dc.subject.mesh	Risk Factors
dc.subject.mesh	Sensorimotor Cortex
dc.subject.mesh	Severity of Illness Index
dc.subject.mesh	Sex Factors
dc.subject.mesh	Thalamus
dc.subject.mesh	Treatment Outcome
dc.subject.mesh	Brain Stem
dc.subject.mesh	Thalamus
dc.subject.mesh	Humans
dc.subject.mesh	Magnetic Resonance Imaging
dc.subject.mesh	Treatment Outcome
dc.subject.mesh	Cerebral Revascularization
dc.subject.mesh	Brain Mapping
dc.subject.mesh	Severity of Illness Index
dc.subject.mesh	Bayes Theorem
dc.subject.mesh	Risk Factors
dc.subject.mesh	Cohort Studies
dc.subject.mesh	Sex Factors
dc.subject.mesh	Image Processing, Computer-Assisted
dc.subject.mesh	Aged
dc.subject.mesh	Aged, 80 and over
dc.subject.mesh	Middle Aged
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Sensorimotor Cortex
dc.subject.mesh	Ischemic Stroke
dc.title	Outcome after acute ischemic stroke is linked to sex-specific lesion patterns
dc.type	Journal Article
utslib.citation.volume	12
utslib.location.activity	England
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
utslib.copyright.status	open_access	*
pubs.consider-herdc	false
dc.date.updated	2022-01-06T22:25:59Z
pubs.issue	1
pubs.publication-status	Published
pubs.volume	12
utslib.citation.issue	1

Abstract:

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.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/152780