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Outcome after acute ischemic stroke is linked to sex-specific lesion patterns

Author

Listed:
  • Anna K. Bonkhoff

    (J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School)

  • Markus D. Schirmer

    (J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School
    Clinic for Neuroradiology, University Hospital Bonn)

  • Martin Bretzner

    (J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School
    Univ. Lille, Inserm, CHU Lille, U1171 – LilNCog (JPARC) – Lille Neurosciences & Cognition, F-59000)

  • Sungmin Hong

    (J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School)

  • Robert W. Regenhardt

    (J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School)

  • Mikael Brudfors

    (School of Biomedical Engineering & Imaging Sciences, King’s College London)

  • Kathleen L. Donahue

    (J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School)

  • Marco J. Nardin

    (J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School)

  • Adrian V. Dalca

    (Computer Science and Artificial Intelligence Lab, Massachusetts Institute of Technology
    Massachusetts General Hospital)

  • Anne-Katrin Giese

    (University Medical Center Hamburg‐Eppendorf)

  • Mark R. Etherton

    (J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School)

  • Brandon L. Hancock

    (Massachusetts General Hospital)

  • Steven J. T. Mocking

    (Massachusetts General Hospital)

  • Elissa C. McIntosh

    (Massachusetts General Hospital)

  • John Attia

    (Hunter Medical Research Institute
    School of Medicine and Public Health, University of Newcastle)

  • Oscar R. Benavente

    (University of British Columbia)

  • Stephen Bevan

    (School of Life Sciences, University of Lincoln)

  • John W. Cole

    (University of Maryland School of Medicine and Veterans Affairs Maryland Health Care System)

  • Amanda Donatti

    (School of Medical Sciences, University of Campinas (UNICAMP) and the Brazilian Institute of Neuroscience and Neurotechnology (BRAINN))

  • Christoph J. Griessenauer

    (Geisinger
    Research Institute of Neurointervention, Paracelsus Medical University)

  • Laura Heitsch

    (Washington University School of Medicine
    Washington University School of Medicine & Barnes-Jewish Hospital)

  • Lukas Holmegaard

    (University of Gothenburg
    Sahlgrenska University Hospital)

  • Katarina Jood

    (University of Gothenburg
    Sahlgrenska University Hospital)

  • Jordi Jimenez-Conde

    (Universitat Autonoma de Barcelona)

  • Steven J. Kittner

    (University of Maryland School of Medicine and Veterans Affairs Maryland Health Care System)

  • Robin Lemmens

    (Experimental Neurology and Leuven Research Institute for Neuroscience and Disease (LIND)
    University Hospitals Leuven, Department of Neurology)

  • Christopher R. Levi

    (University of Newcastle
    John Hunter Hospital)

  • Caitrin W. McDonough

    (University of Florida)

  • James F. Meschia

    (Mayo Clinic)

  • Chia-Ling Phuah

    (Washington University School of Medicine & Barnes-Jewish Hospital)

  • Arndt Rolfs

    (Centogene AG)

  • Stefan Ropele

    (Medical University Graz)

  • Jonathan Rosand

    (J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School
    Massachusetts General Hospital
    Center for Genomic Medicine, Massachusetts General Hospital)

  • Jaume Roquer

    (Universitat Autonoma de Barcelona)

  • Tatjana Rundek

    (University of Miami)

  • Ralph L. Sacco

    (University of Miami)

  • Reinhold Schmidt

    (Medical University Graz)

  • Pankaj Sharma

    (Institute of Cardiovascular Research, Royal Holloway University of London (ICR2UL)
    St Peter’s and Ashford Hospitals)

  • Agnieszka Slowik

    (Jagiellonian University Medical College)

  • Martin Söderholm

    (Lund University
    Skåne University Hospital)

  • Alessandro Sousa

    (School of Medical Sciences, University of Campinas (UNICAMP) and the Brazilian Institute of Neuroscience and Neurotechnology (BRAINN))

  • Tara M. Stanne

    (the Sahlgrenska Academy at University of Gothenburg)

  • Daniel Strbian

    (Helsinki University Hospital and University of Helsinki)

  • Turgut Tatlisumak

    (Sahlgrenska Academy at University of Gothenburg
    Sahlgrenska University Hospital)

  • Vincent Thijs

    (Florey Institute of Neuroscience and Mental Health
    Austin Health)

  • Achala Vagal

    (University of Cincinnati College of Medicine)

  • Johan Wasselius

    (Lund University
    Skåne University Hospital)

  • Daniel Woo

    (University of Cincinnati College of Medicine)

  • Ramin Zand

    (Geisinger)

  • Patrick F. McArdle

    (University of Maryland School of Medicine)

  • Bradford B. Worrall

    (University of Virginia)

  • Christina Jern

    (the Sahlgrenska Academy at University of Gothenburg
    Sahlgrenska University Hospital)

  • Arne G. Lindgren

    (Skåne University Hospital
    Lund University)

  • Jane Maguire

    (University of Technology Sydney)

  • Danilo Bzdok

    (McGill University
    Mila - Quebec Artificial Intelligence Institute)

  • Ona Wu

    (Massachusetts General Hospital)

  • Natalia S. Rost

    (J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School)

Abstract

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.

Suggested Citation

  • Anna K. Bonkhoff & Markus D. Schirmer & Martin Bretzner & Sungmin Hong & Robert W. Regenhardt & Mikael Brudfors & Kathleen L. Donahue & Marco J. Nardin & Adrian V. Dalca & Anne-Katrin Giese & Mark R. , 2021. "Outcome after acute ischemic stroke is linked to sex-specific lesion patterns," Nature Communications, Nature, vol. 12(1), pages 1-14, December.
    • Handle: RePEc:nat:natcom:v:12:y:2021:i:1:d:10.1038_s41467-021-23492-3
    DOI: 10.1038/s41467-021-23492-3
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