Brain volume: An important determinant of functional outcome after acute ischemic stroke
Abstract
Objective: To determine whether brain volume is associated with functional outcome after acute ischemic stroke (AIS). Methods: We analyzed cross-sectional data of the multi-site, international hospital-based MRI-GENetics Interface Exploration (MRI-GENIE) study (July 1, 2014- March 16, 2019) with clinical brain magnetic resonance imaging (MRI) obtained on admission for index stroke and functional outcome assessment. Post-stroke outcome was determined using the modified Rankin Scale (mRS) score (0-6; 0: asymptomatic; 6 death) recorded between 60-190 days after stroke. Demographics and other clinical variables including acute stroke severity (measured as National Institutes of Health Stroke Scale score), vascular risk factors, and etiologic stroke subtypes (Causative Classification of Stroke) were recorded during index admission. Results: Utilizing the data from 912 acute ischemic stroke (AIS) patients (65+/-15 years of age, 58% male, 57% history of smoking, and 65% hypertensive) in a generalized linear model, brain volume (per 155.1cm^3 ) was associated with age (beta -0.3 (per 14.4 years)), male sex (beta 1.0) and prior stroke (beta -0.2). In the multivariable outcome model, brain volume was an independent predictor of mRS (beta -0.233), with reduced odds of worse long-term functional outcomes (OR: 0.8, 95% CI 0.7-0.9) in those with larger brain volumes. Conclusions: Larger brain volume quantified on clinical MRI of AIS patients at time of stroke purports a protective mechanism. The role of brain volume as a prognostic, protective biomarker has the potential to forge new areas of research and advance current knowledge of mechanisms of post-stroke recovery.
Keywords
Cite
@article{arxiv.2007.08374,
title = {Brain volume: An important determinant of functional outcome after acute ischemic stroke},
author = {Markus D. Schirmer and Kathleen L. Donahue and Marco J. Nardin and Adrian V. Dalca and Anne-Katrin Giese and Mark R. Etherton and Steven J. T. Mocking and Elissa C. McIntosh and John W. Cole and Lukas Holmegaard and Katarina Jood and Jordi Jimenez-Conde and Steven J. Kittner and Robin Lemmens and James F. Meschia and Jonathan Rosand and Jaume Roquer and Tatjana Rundek and Ralph L. Sacco MD and Reinhold Schmidt and Pankaj Sharma and Agnieszka Slowik and Tara M. Stanne and Achala Vagal and Johan Wasselius and Daniel Woo and Stephen Bevan and Laura Heitsch and Chia-Ling Phuah and Daniel Strbian MD and Turgut Tatlisumak and Christopher R. Levi and John Attia and Patrick F. McArdle and Bradford B. Worrall and Ona Wu and Christina Jern and Arne Lindgren and Jane Maguire and Vincent Thijs and Natalia S. Rost},
journal= {arXiv preprint arXiv:2007.08374},
year = {2020}
}