| Title: |
Sex-specific lesion pattern of functional outcomes after stroke |
| Authors: |
Bonkhoff, A. K.; Bretzner, Martin; Hong, S. M.; Schirmer, M. D.; Cohen, A.; Regenhardt, R. W.; Donahue, K. L.; Nardin, M. J.; Dalca, A. V.; Giese, A. K.; Etherton, M. R.; Hancock, B. L.; Mocking, S. J. T.; Mcintosh, E. C.; Attia, J.; Benavente, O. R.; Bevan, S.; Cole, J. W.; Donatti, A.; Griessenauer, C. J.; Heitsch, L.; Holmegaard, L.; Jood, K.; Jimenez-Conde, J.; Kittner, S. J.; Lemmens, R.; Levi, C. R.; Mcdonough, C. W.; Meschia, J. F.; Phuah, C. L.; Rolfs, A.; Ropele, S.; Rosand, J.; Roquer, J.; Rundek, T.; Sacco, R. L.; Schmidt, R.; Sharma, P.; Slowik, A.; Soderholm, M.; Sousa, A.; Stanne, T. M.; Strbian, D.; Tatlisumak, T.; Thijs, V.; Vagal, A.; Wasselius, J.; Woo, D.; Zand, R.; Mcardle, P. F.; Worrall, B. B.; Jern, C.; Lindgren, A. G.; Maguire, J.; Fox, M. D.; Bzdok, D.; Wu, O. N.; Rost, N. S. |
| Contributors: |
Lille Neurosciences & Cognition - U 1172 (LilNCog); Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire CHU Lille (CHRU Lille); Centre Hospitalier Régional Universitaire CHU Lille (CHRU Lille); MRI-GENIE and GISCOME Investigators and the International Stroke Genetics Consortium: Anna K Bonkhoff, Martin Bretzner, Sungmin Hong, Markus D Schirmer, Alexander Cohen, Robert W Regenhardt, Kathleen L Donahue, Marco J Nardin, Adrian V Dalca, Anne-Katrin Giese, Mark R Etherton, Brandon L Hancock, Steven J T Mocking, Elissa C McIntosh, John Attia, Oscar R Benavente, Stephen Bevan, John W Cole, Amanda Donatti, Christoph J Griessenauer, Laura Heitsch, Lukas Holmegaard, Katarina Jood, Jordi Jimenez-Conde, Steven J Kittner, Robin Lemmens, Christopher R Levi, Caitrin W McDonough, James F Meschia, Chia-Ling Phuah, Arndt Rolfs, Stefan Ropele, Jonathan Rosand, Jaume Roquer, Tatjana Rundek, Ralph L Sacco, Reinhold Schmidt, Pankaj Sharma, Agnieszka Slowik, Martin Söderholm, Alessandro Sousa, Tara M Stanne, Daniel Strbian, Turgut Tatlisumak, Vincent Thijs, Achala Vagal, Johan Wasselius, Daniel Woo, Ramin Zand, Patrick F McArdle, Bradford B Worrall, Christina Jern, Arne G Lindgren, Jane Maguire, Michael D Fox, Danilo Bzdok, Ona Wu, Natalia S Rost |
| Source: |
ISSN: 2632-1297 ; Brain Communications ; https://hal.univ-lille.fr/hal-04809974 ; Brain Communications, 2023, Brain Commun., 4 (2), pp.fcac020. ⟨10.1093/braincomms/fcac020⟩. |
| Publisher Information: |
CCSD; Oxford University Press on behalf of the Guarantors of Brain |
| Publication Year: |
2023 |
| Collection: |
LillOA (HAL Lille Open Archive, Université de Lille) |
| Subject Terms: |
sex differences; lesion patterns; Bayesian hierarchical modelling; functional outcomes; acute ischaemic stroke; [SDV]Life Sciences [q-bio] |
| Description: |
International audience ; 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. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/35282166; PUBMED: 35282166; PUBMEDCENTRAL: PMC8914504 |
| DOI: |
10.1093/braincomms/fcac020 |
| Availability: |
https://hal.univ-lille.fr/hal-04809974; https://hal.univ-lille.fr/hal-04809974v1/document; https://hal.univ-lille.fr/hal-04809974v1/file/fcac020.pdf; https://doi.org/10.1093/braincomms/fcac020 |
| Rights: |
http://creativecommons.org/licenses/by/ ; info:eu-repo/semantics/OpenAccess |
| Accession Number: |
edsbas.41F60ADD |
| Database: |
BASE |