Sex-specific lesion pattern of functional outcomes after stroke

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• dc.contributor.author Bonkhoff, Anna K.
• dc.contributor.author Jiménez Conde, Jordi
• dc.contributor.author Roquer, Jaume
• dc.contributor.author The International Stroke Genetics Consortium (ISGC)
• dc.date.accessioned 2022-08-02T15:35:15Z
• dc.date.available 2022-08-02T15:35:15Z
• dc.date.issued 2022
• 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.mimetype application/pdf
• dc.identifier.citation Bonkhoff AK, Bretzner M, Hong S, Schirmer MD, Cohen A, Regenhardt RW et al. Sex-specific lesion pattern of functional outcomes after stroke. Brain Commun. 2022 Feb 2;4(2):fcac020. DOI: 10.1093/braincomms/fcac020
• dc.identifier.doi http://dx.doi.org/10.1093/braincomms/fcac020
• dc.identifier.issn 2632-1297
• dc.identifier.uri http://hdl.handle.net/10230/53912
• dc.language.iso eng
• dc.publisher Oxford University Press
• dc.relation.ispartof Brain Commun. 2022 Feb 2;4(2):fcac020
• dc.rights © The Author(s) 2022. Published by Oxford University Press on behalf of the Guarantors of Brain. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri https://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword Bayesian hierarchical modelling
• dc.subject.keyword Acute ischaemic stroke
• dc.subject.keyword Functional outcomes
• dc.subject.keyword Lesion patterns
• dc.subject.keyword Sex differences
• dc.title Sex-specific lesion pattern of functional outcomes after stroke
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion