Outcome after acute ischemic stroke is linked to sex-specific lesion patterns.
Anna K BonkhoffMarkus D SchirmerMartin BretznerSungmin HongRobert William RegenhardtMikael BrudforsKathleen L DonahueMarco J NardinAdrian V DalcaAnne-Katrin GieseMark R EthertonBrandon L HancockSteven J T MockingElissa C McIntoshJohn Richard AttiaOscar R BenaventeStephen BevanJohn W ColeAmanda DonattiChristoph J GriessenauerLaura HeitschLukas HolmegaardKatarina JoodJordi Jimenez-CondeSteven J KittnerRobin LemmensChristopher R LeviCaitrin W McDonoughJames F MeschiaChia-Ling PhuahArndt RolfsStefan RopeleJonathan RosandJaume RoquerTatjana RundekRalph L SaccoReinhold SchmidtPankaj SharmaAgnieszka SlowikMartin SöderholmAlessandro SousaTara M StanneStrbian DanielTurgut TatlisumakVincent ThijsAchala VagalJohan WasseliusDaniel WooRamin ZandPatrick F McArdleBradford B WorrallChristina JernArne G LindgrenJane MaguireDanilo BzdokOna Wunull nullNatalia S RostPublished in: Nature communications (2021)
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.
Keyphrases
- acute ischemic stroke
- end stage renal disease
- atrial fibrillation
- newly diagnosed
- ejection fraction
- chronic kidney disease
- healthcare
- polycystic ovary syndrome
- peritoneal dialysis
- cerebral ischemia
- mental health
- prognostic factors
- autism spectrum disorder
- adipose tissue
- subarachnoid hemorrhage
- white matter
- brain injury
- pregnancy outcomes
- patient reported outcomes
- blood brain barrier
- social media
- risk assessment
- functional connectivity
- health information
- human health