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 - Funding Information:
M.E. has received personal fees for consulting from Astra Zeneca and WorldCare Clinical Group. C.G. has received consulting honoraria from Microvention and Strykere, and research funding from Medtronic and Penumbra. A.V. has received research funding from Cerenovus. A.G.L. has received personal fees from Bayer, Astra Zeneca, BMS Pfizer, and Portola. N.S.R. has received compensation as scientific advisory consultant from Omniox, Sanofi Genzyme, and AbbVie Inc. All other authors declare no competing interests.
Funding Information:
We are grateful to our colleagues at the J. Philip Kistler Stroke Research Center for valuable support and discussions and would like to specifically acknowledge valuable comments by Parashkev Nachev, M.D., Ph.D. on previous versions on this manuscript. Furthermore, we are grateful to our research participants without whom this work would not have been possible. M.B. acknowledges support from the Société Française de Neuroradiologie, Société Française de Radiologie, and Fondation ISITE-ULNE. A.V. is in part supported by NIH-NINDS (R01 NS103824, RF1 NS117643, R01 NS100417, U01NS100699, and U01NS110772). C.J. acknowledges support from the Swedish Research Council (2018-02543), the Swedish state under the agreement between the Swedish government and the county councils, the ALF agreement (ALFGBG-720081); the Swedish Heart and Lung Foundation (20190203). A.G.L. acknowledges support from the Swedish Research Council (2019-01757), The Swedish Government (under the “Avtal om Läkarutbildning och Medicinsk Forskning, ALF”), The Swedish Heart and Lung Foundation, Region Skåne, Lund University, Skåne University Hospital, Sparbanks-stiftelsen Färs och Frosta, Fremasons Lodge of Instruction Eos in Lund and NIH (1R01NS114045-01). D.B. has been funded by the Brain Canada Foundation, through the Canada Brain Research Fund, with the financial support of Health Canada, National Institutes of Health (NIH R01 AG068563A), the Canadian Institute of Health Research (CIHR 438531), the Healthy Brains Healthy Lives initiative (Canada First Research Excellence fund), Google (Research Award, Teaching Award), and by the CIFAR Artificial Intelligence Chairs program (Canada Institute for Advanced Research). N.S.R. is in part supported by NIH-NINDS (R01NS082285, R01NS086905, and U19NS115388).
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 - http://www.scopus.com/inward/record.url?scp=85108133400&partnerID=8YFLogxK
U2 - 10.1038/s41467-021-23492-3
DO - 10.1038/s41467-021-23492-3
M3 - Article
C2 - 34078897
AN - SCOPUS:85108133400
SN - 2041-1723
VL - 12
JO - Nature Communications
JF - Nature Communications
IS - 1
M1 - 3289
ER -