- Title
- Sex-specific lesion pattern of functional outcomes after stroke
- Creator
- Bonkhoff, Anna K.; Bretzner, Martin; Etherton, Mark R.; Hancock, Brandon L.; Mocking, Steven J. T.; McIntosh, Elissa C.; Attia, John; Benavente, Oscar R.; Bevan, Stephen; Cole, John W.; Donatti, Amanda; Griessenauer, Christoph J.; Hong, Sungmin; Heitsch, Laura; Holmegaard, L; Jood, K; Jimenez-Conde, J; Kittner, SJ; Lemmens, R; Levi, Christopher R.; McDonough, CW; Meschia, JF; Phuah, C-L; Schirmer, Markus D.; Rolfs, A; Ropele, S; Rosand, J; Roquer, J; Rundek, T; Sacco, RL; Schmidt, R; Sharma, P; Slowik, A; Soderholm, M; Cohen, Alexander; Sousa, A; Stanne, TM; Strbian, D; Tatlisumak, T; Thijs, V; Vagal, A; Wasselius, J; Woo, D; Zand, R; McArdle, PF; Regenhardt, Robert W.; Worrall, BB; Jern, C; Lindgren, AG; Maguire, J; Fox, MD; Bzdok, D; Wu, O; Rost, NS; Donahue, Kathleen L.; Nardin, Marco J.; Dalca, Adrian V.; Giese, Anne-Katrin
- Relation
- Brain Communications Vol. 4, Issue 2, no. fcac020
- Publisher Link
- http://dx.doi.org/10.1093/braincomms/fcac020
- Publisher
- Oxford University Press
- Resource Type
- journal article
- Date
- 2022
- Description
- Stroke represents a considerable burden of disease for both men and women. However, a growing body of literature suggests clinically relevant sex differences in the underlying causes, presentations and outcomes of acute ischaemic stroke. In a recent study, we reported sex divergences in lesion topographies: specific to women, acute stroke severity was linked to lesions in the left-hemispheric posterior circulation. We here determined whether these sex-specific brain manifestations also affect long-term outcomes. We relied on 822 acute ischaemic patients [age: 64.7 (15.0) years, 39% women] originating from the multi-centre MRI-GENIE study to model unfavourable outcomes (modified Rankin Scale >2) based on acute neuroimaging data in a Bayesian hierarchical framework. Lesions encompassing bilateral subcortical nuclei and left-lateralized regions in proximity to the insula explained outcomes across men and women (area under the curve = 0.81). A pattern of left-hemispheric posterior circulation brain regions, combining left hippocampus, precuneus, fusiform and lingual gyrus, occipital pole and latero-occipital cortex, showed a substantially higher relevance in explaining functional outcomes in women compared to men [mean difference of Bayesian posterior distributions (men – women) = −0.295 (90% highest posterior density interval = −0.556 to −0.068)]. Once validated in prospective studies, our findings may motivate a sex-specific approach to clinical stroke management and hold the promise of enhancing outcomes on a population level.
- Subject
- acute ischaemic stroke; functional outcomes; sex differences; lesion patterns; Bayesian hierarchical modelling; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1485672
- Identifier
- uon:51667
- Identifier
- ISSN:2632-1297
- Rights
- x
- Language
- eng
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