Outcome after acute ischemic stroke is linked to sex-specific lesion patterns
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Published:2021-06-02
Issue:1
Volume:12
Page:
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ISSN:2041-1723
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Container-title:Nature Communications
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language:en
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Short-container-title:Nat Commun
Author:
Bonkhoff Anna K.ORCID, Schirmer Markus D., Bretzner MartinORCID, Hong Sungmin, Regenhardt Robert W.ORCID, Brudfors Mikael, Donahue Kathleen L., Nardin Marco J., Dalca Adrian V., Giese Anne-Katrin, Etherton Mark R., Hancock Brandon L., Mocking Steven J. T., McIntosh Elissa C., Attia JohnORCID, Benavente Oscar R., Bevan Stephen, Cole John W., Donatti Amanda, Griessenauer Christoph J., Heitsch Laura, Holmegaard Lukas, Jood Katarina, Jimenez-Conde Jordi, Kittner Steven J., Lemmens Robin, Levi Christopher R., McDonough Caitrin W., Meschia James F.ORCID, Phuah Chia-Ling, Rolfs Arndt, Ropele StefanORCID, Rosand Jonathan, Roquer Jaume, Rundek Tatjana, Sacco Ralph L., Schmidt Reinhold, Sharma Pankaj, Slowik Agnieszka, Söderholm Martin, Sousa Alessandro, Stanne Tara M., Strbian DanielORCID, Tatlisumak Turgut, Thijs Vincent, Vagal Achala, Wasselius Johan, Woo Daniel, Zand Ramin, McArdle Patrick F., Worrall Bradford B.ORCID, Jern Christina, Lindgren Arne G., Maguire Jane, Bzdok DaniloORCID, Wu Ona, Rost Natalia S.,
Abstract
AbstractAcute 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.
Publisher
Springer Science and Business Media LLC
Subject
General Physics and Astronomy,General Biochemistry, Genetics and Molecular Biology,General Chemistry
Reference87 articles.
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