TY - JOUR
T1 - Outcome after acute ischemic stroke is linked to sex-specific lesion patterns
AU - MRI-GENIE and GISCOME Investigators and the International Stroke Genetics Consortium
AU - Bonkhoff, Anna K.
AU - Schirmer, Markus D.
AU - Bretzner, Martin
AU - Hong, Sungmin
AU - Regenhardt, Robert W.
AU - Brudfors, Mikael
AU - Donahue, Kathleen L.
AU - Nardin, Marco J.
AU - Dalca, Adrian V.
AU - Giese, Anne Katrin
AU - Etherton, Mark R.
AU - Hancock, Brandon L.
AU - Mocking, Steven J.T.
AU - McIntosh, Elissa C.
AU - Attia, John
AU - Benavente, Oscar R.
AU - Bevan, Stephen
AU - Cole, John W.
AU - Donatti, Amanda
AU - Griessenauer, Christoph J.
AU - Heitsch, Laura
AU - Holmegaard, Lukas
AU - Jood, Katarina
AU - Jimenez-Conde, Jordi
AU - Kittner, Steven J.
AU - Lemmens, Robin
AU - Levi, Christopher R.
AU - McDonough, Caitrin W.
AU - Meschia, James F.
AU - Phuah, Chia Ling
AU - Rolfs, Arndt
AU - Ropele, Stefan
AU - Rosand, Jonathan
AU - Roquer, Jaume
AU - Rundek, Tatjana
AU - Sacco, Ralph L.
AU - Schmidt, Reinhold
AU - Sharma, Pankaj
AU - Slowik, Agnieszka
AU - Söderholm, Martin
AU - Sousa, Alessandro
AU - Stanne, Tara M.
AU - Strbian, Daniel
AU - Tatlisumak, Turgut
AU - Thijs, Vincent
AU - Vagal, Achala
AU - Wasselius, Johan
AU - Woo, Daniel
AU - Zand, Ramin
AU - McArdle, Patrick F.
N1 - Publisher Copyright: © 2021, The Author(s).
PY - 2021/12/1
Y1 - 2021/12/1
N2 - 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.
AB - 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.
UR - https://www.scopus.com/pages/publications/85108133400
U2 - 10.1038/s41467-021-23492-3
DO - 10.1038/s41467-021-23492-3
M3 - Article
C2 - 34078897
SN - 2041-1723
VL - 12
JO - Nature Communications
JF - Nature Communications
IS - 1
M1 - 3289
ER -