| 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: |
Université de Lille; Inserm; CHU Lille; Lille Neurosciences & Cognition - U 1172 LilNCog |
| Publication Year: |
2024 |
| Collection: |
LillOA (Lille Open Archive - Université de Lille) |
| Subject Terms: |
acute ischaemic stroke; functional outcomes; sex differences; lesion patterns; Bayesian hierarchical modelling |
| Description: |
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. ; 4 |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/octet-stream; application/rdf+xml; charset=utf-8; application/pdf |
| Language: |
English |
| Relation: |
Brain Commun.; http://hdl.handle.net/20.500.12210/102012 |
| Availability: |
https://hdl.handle.net/20.500.12210/102012 |
| Rights: |
Attribution 3.0 United States ; info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.F948B281 |
| Database: |
BASE |