Sex-specific lesion pattern of functional outcomes after stroke.
Bonkhoff, AK
Bretzner, M
Hong, S
Schirmer, MD
Cohen, A
Regenhardt, RW
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
Fox, MD
Bzdok, D
Wu, O
Rost, NS
MRI-GENIE and GISCOME Investigators and the International Stroke Genetics Consortium,
- Publisher:
- Oxford University Press
- Publication Type:
- Journal Article
- Citation:
- Brain Communications, 2022, 4, (2), pp. 1-12
- Issue Date:
- 2022
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Full metadata record
| Field | Value | Language |
|---|---|---|
| dc.contributor.author | Bonkhoff, AK | |
| dc.contributor.author | Bretzner, M | |
| dc.contributor.author | Hong, S | |
| dc.contributor.author | Schirmer, MD | |
| dc.contributor.author | Cohen, A | |
| dc.contributor.author | Regenhardt, RW | |
| 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 | |
| dc.contributor.author | Fox, MD | |
| dc.contributor.author | Bzdok, D | |
| dc.contributor.author | Wu, O | |
| dc.contributor.author | Rost, NS | |
| dc.contributor.author | MRI-GENIE and GISCOME Investigators and the International Stroke Genetics Consortium, | |
| dc.date.accessioned | 2022-10-12T04:48:28Z | |
| dc.date.available | 2022-01-31 | |
| dc.date.available | 2022-10-12T04:48:28Z | |
| dc.date.issued | 2022 | |
| dc.identifier.citation | Brain Communications, 2022, 4, (2), pp. 1-12 | |
| dc.identifier.issn | 2632-1297 | |
| dc.identifier.issn | 2632-1297 | |
| dc.identifier.uri | http://hdl.handle.net/10453/162523 | |
| dc.description.abstract | Stroke represents a considerable burden of disease for both men and women. However, a growing body of literature suggests clinically relevant sex differences in the underlying causes, presentations and outcomes of acute ischaemic stroke. In a recent study, we reported sex divergences in lesion topographies: specific to women, acute stroke severity was linked to lesions in the left-hemispheric posterior circulation. We here determined whether these sex-specific brain manifestations also affect long-term outcomes. We relied on 822 acute ischaemic patients [age: 64.7 (15.0) years, 39% women] originating from the multi-centre MRI-GENIE study to model unfavourable outcomes (modified Rankin Scale >2) based on acute neuroimaging data in a Bayesian hierarchical framework. Lesions encompassing bilateral subcortical nuclei and left-lateralized regions in proximity to the insula explained outcomes across men and women (area under the curve = 0.81). A pattern of left-hemispheric posterior circulation brain regions, combining left hippocampus, precuneus, fusiform and lingual gyrus, occipital pole and latero-occipital cortex, showed a substantially higher relevance in explaining functional outcomes in women compared to men [mean difference of Bayesian posterior distributions (men - women) = -0.295 (90% highest posterior density interval = -0.556 to -0.068)]. Once validated in prospective studies, our findings may motivate a sex-specific approach to clinical stroke management and hold the promise of enhancing outcomes on a population level. | |
| dc.format | Electronic-eCollection | |
| dc.language | eng | |
| dc.publisher | Oxford University Press | |
| dc.relation.ispartof | Brain Communications | |
| dc.relation.isbasedon | 10.1093/braincomms/fcac020 | |
| dc.rights | info:eu-repo/semantics/openAccess | |
| dc.title | Sex-specific lesion pattern of functional outcomes after stroke. | |
| dc.type | Journal Article | |
| utslib.citation.volume | 4 | |
| 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 | 2022-10-12T04:47:20Z | |
| pubs.issue | 2 | |
| pubs.publication-status | Published | |
| pubs.volume | 4 | |
| utslib.citation.issue | 2 |
Abstract:
Stroke represents a considerable burden of disease for both men and women. However, a growing body of literature suggests clinically relevant sex differences in the underlying causes, presentations and outcomes of acute ischaemic stroke. In a recent study, we reported sex divergences in lesion topographies: specific to women, acute stroke severity was linked to lesions in the left-hemispheric posterior circulation. We here determined whether these sex-specific brain manifestations also affect long-term outcomes. We relied on 822 acute ischaemic patients [age: 64.7 (15.0) years, 39% women] originating from the multi-centre MRI-GENIE study to model unfavourable outcomes (modified Rankin Scale >2) based on acute neuroimaging data in a Bayesian hierarchical framework. Lesions encompassing bilateral subcortical nuclei and left-lateralized regions in proximity to the insula explained outcomes across men and women (area under the curve = 0.81). A pattern of left-hemispheric posterior circulation brain regions, combining left hippocampus, precuneus, fusiform and lingual gyrus, occipital pole and latero-occipital cortex, showed a substantially higher relevance in explaining functional outcomes in women compared to men [mean difference of Bayesian posterior distributions (men - women) = -0.295 (90% highest posterior density interval = -0.556 to -0.068)]. Once validated in prospective studies, our findings may motivate a sex-specific approach to clinical stroke management and hold the promise of enhancing outcomes on a population level.
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