The relevance of rich club regions for functional outcome post-stroke is enhanced in women.
Bayesian hierarchical modeling
functional outcome
lesion-symptom mapping
rich club
sex differences
Journal
Human brain mapping
ISSN: 1097-0193
Titre abrégé: Hum Brain Mapp
Pays: United States
ID NLM: 9419065
Informations de publication
Date de publication:
03 2023
03 2023
Historique:
revised:
24
10
2022
received:
24
07
2022
accepted:
11
11
2022
pubmed:
29
11
2022
medline:
15
2
2023
entrez:
28
11
2022
Statut:
ppublish
Résumé
This study aimed to investigate the influence of stroke lesions in predefined highly interconnected (rich-club) brain regions on functional outcome post-stroke, determine their spatial specificity and explore the effects of biological sex on their relevance. We analyzed MRI data recorded at index stroke and ~3-months modified Rankin Scale (mRS) data from patients with acute ischemic stroke enrolled in the multisite MRI-GENIE study. Spatially normalized structural stroke lesions were parcellated into 108 atlas-defined bilateral (sub)cortical brain regions. Unfavorable outcome (mRS > 2) was modeled in a Bayesian logistic regression framework. Effects of individual brain regions were captured as two compound effects for (i) six bilateral rich club and (ii) all further non-rich club regions. In spatial specificity analyses, we randomized the split into "rich club" and "non-rich club" regions and compared the effect of the actual rich club regions to the distribution of effects from 1000 combinations of six random regions. In sex-specific analyses, we introduced an additional hierarchical level in our model structure to compare male and female-specific rich club effects. A total of 822 patients (age: 64.7[15.0], 39% women) were analyzed. Rich club regions had substantial relevance in explaining unfavorable functional outcome (mean of posterior distribution: 0.08, area under the curve: 0.8). In particular, the rich club-combination had a higher relevance than 98.4% of random constellations. Rich club regions were substantially more important in explaining long-term outcome in women than in men. All in all, lesions in rich club regions were associated with increased odds of unfavorable outcome. These effects were spatially specific and more pronounced in women.
Identifiants
pubmed: 36440953
doi: 10.1002/hbm.26159
pmc: PMC9921242
doi:
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1579-1592Subventions
Organisme : NINDS NIH HHS
ID : R01 NS082285
Pays : United States
Organisme : NINDS NIH HHS
ID : U01 NS100699
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS086905
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS103824
Pays : United States
Organisme : NINDS NIH HHS
ID : U19 NS115388
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS100417
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS114045
Pays : United States
Organisme : NINDS NIH HHS
ID : U01 NS110772
Pays : United States
Organisme : NINDS NIH HHS
ID : RF1 NS117643
Pays : United States
Informations de copyright
© 2022 The Authors. Human Brain Mapping published by Wiley Periodicals LLC.
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