好色先生

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Abstract Details

Preserved Structural Brain Health Reduces the Probability of Clinical Symptoms in Acute Ischemic Stroke
Cerebrovascular Disease and Interventional Neurology
P10 - Poster Session 10 (8:00 AM-9:00 AM)
5-007

To assess whether structural brain health influences the probability of clinical symptoms at acute hospital admission in ischemic stroke (IS).

Structural brain health may facilitate resilience to detrimental functional consequences of a parenchymal injury, but this relationship has not been investigated in acute IS.

We included patients with imaging-verified IS from the GASROS (single center; 2003-2011) and MRI-GENIE (international multicenter; 2003-2011) cohorts. From MRI obtained at hospital admission, white matter hyperintensity (WMH) and brain volume were measured on T2-FLAIR, and acute infarct volume on DWI. Infarct and WMH volumes were normalized by brain volume, creating lesion load and WMH load for each patient. We quantified structural brain health using effective reserve (eR), defined as a latent variable based on age, WMH load, and normal appearing brain volume. Clinical symptoms were assessed at acute hospital admission using the NIHSS. In logistic regression, we model the probability of symptoms (NIHSS ≥1) as a function of infarct load across groups categorized as low (Q1), medium (Q2-Q3) and high (Q4) brain health based on eR values from the entire cohort. We calculated estimated marginal means and Tukey-adjusted pairwise comparisons to test group differences.

We included 1,036 patients with median age 67 (IQR 56-77) years (62% male). At admission, median NIHSS was 3 (IQR 1-7) and 904 (87%) patients had clinical symptoms (NIHSS ≥1). The mean predicted probability of clinical symptoms was significantly lower in the group with high brain health (0.81, 95%CI 0.76-0.86), compared to the medium (0.90, 95%CI 0.87-0.92, p<0.001) and low brain health groups (0.89, 95%CI 0.85-0.93, p=0.002). We observed no difference in probability of symptoms between the low and medium brain health groups.

High structural brain health, quantified using the biomarker eR, decreases the probability of parenchymal injury being expressed as clinical symptoms at acute hospital admission in patients with IS.

Authors/Disclosures
Erik Lindgren, MD, PhD
PRESENTER 		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.
Kenda Alhadid, MD (Massachussets General Hospital) Dr. Alhadid has nothing to disclose.
Christina Jern, MD, PhD Prof. Jern has nothing to disclose.
Arne Lindgren, MD, PhD Prof. Lindgren has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Arega. Prof. Lindgren has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurologi i Sverige Journal. Prof. Lindgren has received publishing royalties from a publication relating to health care. Prof. Lindgren has received publishing royalties from a publication relating to health care. Prof. Lindgren has received publishing royalties from a publication relating to health care.
Jane Maguire (University of Technology Sydney) No disclosure on file
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.
Markus D. Schirmer, PhD (Massachusetts General Hospital) The institution of Dr. Schirmer has received research support from National Institute of Aging.