好色先生

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Abstract Details

Spatial Brain Health Patterns in Vascular Territories Differentially Affect Functional Outcomes in Acute Ischemic Stroke
Cerebrovascular Disease and Interventional Neurology
P11 - Poster Session 11 (8:00 AM-9:00 AM)
13-006
To evaluate how territory-specific brain health across distinct vascular territories, measured through effective reserve (eR), influence functional outcomes in patients with acute ischemic stroke (AIS).
Brain health is an important biomarker of post-stroke outcomes. While global measures of brain health are increasingly investigated, spatial differences affecting outcomes remain unknown.
We analyzed AIS survivors from the GASROS cohort (single center; 2003-2011) with white matter hyperintensity (WMH), combined gray and white matter (GMWM), and acute lesion outlines from available routine clinical imaging data. WMH and GMWM volumes were stratified by each supratentorial vascular territory (atlas based; anterior cerebral artery (ACA), middle cerebral artery (MCA), and posterior cerebral artery (PCA)). We quantified brain health through eR using structural equation modeling, incorporating GMWM and WMH volumes for each territory, as well as age. Contributions of each territory to eR were estimated using the path-coefficients for each territory’s volumetric markers. Ordinal regression models were fitted to assess the effect of territory-specific brain health on functional outcomes measured by the modified Rankin Scale (mRS; 0-5) at 90 days post-stroke, while accounting for acute lesion load, sex, hypertension, diabetes, and smoking. 

In total, 454 patients were included (median [interquartile range] age: 66 [55-76]; mRS: 1 [0-2]; 65% male). Higher eR across all territories was related to better functional outcome. eR in ACA and PCA territories showed similar odds ratios (OR [95% confidence interval]) related to mRS (ACA: 0.80 [0.65-0.98]; MCA: 0.76 [0.59-0.98]), with PCA having the largest protective effect on outcomes (0.61 [0.44-0.84]).
Spatial patterns of brain health significantly impact functional outcome following AIS, suggesting that territory-specific brain health metrics are key biomarkers for stroke prognostication models.
Authors/Disclosures
Markus D. Schirmer, PhD (Massachusetts General Hospital)
PRESENTER 		The institution of Dr. Schirmer has received research support from National Institute of Aging.
Erik Lindgren, MD, PhD The institution of Dr. Lindgren has received research support from The Swedish Research Council. Dr. Lindgren has received research support from The Swedish Heart and Lung Foundation.
Luca Angeleri, BS Mr. Angeleri has nothing to disclose.
Robert W. Regenhardt, MD, PhD Dr. Regenhardt has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genomadix. Dr. Regenhardt has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Rapid Medical. Dr. Regenhardt has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Johnson and Bell Trial Lawyers. Dr. Regenhardt has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Buckley, Theroux, Kline, & Cooley Trial Lawyers. The institution of Dr. Regenhardt has received research support from National Institutes of Health. The institution of Dr. Regenhardt has received research support from Society of Vascular and Interventional Neurology. The institution of Dr. Regenhardt has received research support from Heitman Foundation.
Natalia S. Rost, MD, MPH, FAAN, FAHA (Massachusetts General Hospital) Dr. Rost has received personal compensation in the range of $100,000-$499,999 for serving as an officer or member of the Board of Directors for 好色先生. Dr. Rost has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Stroke - AHA/ASA Journal. The institution of Dr. Rost has received research support from NIH. Dr. Rost has received publishing royalties from a publication relating to health care.