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Preserved structural connectivity mediates the clinical effect of thrombolysis in patients with anterior-circulation stroke

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Preserved structural connectivity mediates the clinical effect of thrombolysis in patients with anterior-circulation stroke. / Schlemm, Eckhard; Ingwersen, Thies; Königsberg, Alina; Boutitie, Florent; Ebinger, Martin; Endres, Matthias; Fiebach, Jochen B.; Fiehler, Jens; Galinovic, Ivana; Lemmens, Robin; Muir, Keith W.; Nighoghossian, Norbert; Pedraza, Salvador; Puig, Josep; Simonsen, Claus Ziegler; Thijs, Vincent N; Wouters, Anke; Gerloff, Christian; Thomalla, Götz; Cheng, Bastian.

in: NAT COMMUN, Jahrgang 12, Nr. 1, 10.05.2021, S. 2590.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Schlemm, E, Ingwersen, T, Königsberg, A, Boutitie, F, Ebinger, M, Endres, M, Fiebach, JB, Fiehler, J, Galinovic, I, Lemmens, R, Muir, KW, Nighoghossian, N, Pedraza, S, Puig, J, Simonsen, CZ, Thijs, VN, Wouters, A, Gerloff, C, Thomalla, G & Cheng, B 2021, 'Preserved structural connectivity mediates the clinical effect of thrombolysis in patients with anterior-circulation stroke', NAT COMMUN, Jg. 12, Nr. 1, S. 2590. https://doi.org/10.1038/s41467-021-22786-w

APA

Schlemm, E., Ingwersen, T., Königsberg, A., Boutitie, F., Ebinger, M., Endres, M., Fiebach, J. B., Fiehler, J., Galinovic, I., Lemmens, R., Muir, K. W., Nighoghossian, N., Pedraza, S., Puig, J., Simonsen, C. Z., Thijs, V. N., Wouters, A., Gerloff, C., Thomalla, G., & Cheng, B. (2021). Preserved structural connectivity mediates the clinical effect of thrombolysis in patients with anterior-circulation stroke. NAT COMMUN, 12(1), 2590. https://doi.org/10.1038/s41467-021-22786-w

Vancouver

Schlemm E, Ingwersen T, Königsberg A, Boutitie F, Ebinger M, Endres M et al. Preserved structural connectivity mediates the clinical effect of thrombolysis in patients with anterior-circulation stroke. NAT COMMUN. 2021 Mai 10;12(1):2590. https://doi.org/10.1038/s41467-021-22786-w

Bibtex

@article{dc8fdffa0ac74557989c39aabfb91780,
title = "Preserved structural connectivity mediates the clinical effect of thrombolysis in patients with anterior-circulation stroke",
abstract = "Thrombolysis with recombinant tissue plasminogen activator in acute ischemic stroke aims to restore compromised blood flow and prevent further neuronal damage. Despite the proven clinical efficacy of this treatment, little is known about the short-term effects of systemic thrombolysis on structural brain connectivity. In this secondary analysis of the WAKE-UP trial, we used MRI-derived measures of infarct size and estimated structural network disruption to establish that thrombolysis is associated not only with less infarct growth, but also with reduced loss of large-scale connectivity between grey-matter areas after stroke. In a causal mediation analysis, infarct growth mediated a non-significant 8.3% (CI95% [-8.0, 32.6]%) of the clinical effect of thrombolysis on functional outcome. The proportion mediated jointly through infarct growth and change of structural connectivity, especially in the border zone around the infarct core, however, was as high as 33.4% (CI95% [8.8, 77.4]%). Preservation of structural connectivity is thus an important determinant of treatment success and favourable functional outcome in addition to lesion volume. It might, in the future, serve as an imaging endpoint in clinical trials or as a target for therapeutic interventions.",
author = "Eckhard Schlemm and Thies Ingwersen and Alina K{\"o}nigsberg and Florent Boutitie and Martin Ebinger and Matthias Endres and Fiebach, {Jochen B.} and Jens Fiehler and Ivana Galinovic and Robin Lemmens and Muir, {Keith W.} and Norbert Nighoghossian and Salvador Pedraza and Josep Puig and Simonsen, {Claus Ziegler} and Thijs, {Vincent N} and Anke Wouters and Christian Gerloff and G{\"o}tz Thomalla and Bastian Cheng",
year = "2021",
month = may,
day = "10",
doi = "10.1038/s41467-021-22786-w",
language = "English",
volume = "12",
pages = "2590",
journal = "NAT COMMUN",
issn = "2041-1723",
publisher = "NATURE PUBLISHING GROUP",
number = "1",

}

RIS

TY - JOUR

T1 - Preserved structural connectivity mediates the clinical effect of thrombolysis in patients with anterior-circulation stroke

AU - Schlemm, Eckhard

AU - Ingwersen, Thies

AU - Königsberg, Alina

AU - Boutitie, Florent

AU - Ebinger, Martin

AU - Endres, Matthias

AU - Fiebach, Jochen B.

AU - Fiehler, Jens

AU - Galinovic, Ivana

AU - Lemmens, Robin

AU - Muir, Keith W.

AU - Nighoghossian, Norbert

AU - Pedraza, Salvador

AU - Puig, Josep

AU - Simonsen, Claus Ziegler

AU - Thijs, Vincent N

AU - Wouters, Anke

AU - Gerloff, Christian

AU - Thomalla, Götz

AU - Cheng, Bastian

PY - 2021/5/10

Y1 - 2021/5/10

N2 - Thrombolysis with recombinant tissue plasminogen activator in acute ischemic stroke aims to restore compromised blood flow and prevent further neuronal damage. Despite the proven clinical efficacy of this treatment, little is known about the short-term effects of systemic thrombolysis on structural brain connectivity. In this secondary analysis of the WAKE-UP trial, we used MRI-derived measures of infarct size and estimated structural network disruption to establish that thrombolysis is associated not only with less infarct growth, but also with reduced loss of large-scale connectivity between grey-matter areas after stroke. In a causal mediation analysis, infarct growth mediated a non-significant 8.3% (CI95% [-8.0, 32.6]%) of the clinical effect of thrombolysis on functional outcome. The proportion mediated jointly through infarct growth and change of structural connectivity, especially in the border zone around the infarct core, however, was as high as 33.4% (CI95% [8.8, 77.4]%). Preservation of structural connectivity is thus an important determinant of treatment success and favourable functional outcome in addition to lesion volume. It might, in the future, serve as an imaging endpoint in clinical trials or as a target for therapeutic interventions.

AB - Thrombolysis with recombinant tissue plasminogen activator in acute ischemic stroke aims to restore compromised blood flow and prevent further neuronal damage. Despite the proven clinical efficacy of this treatment, little is known about the short-term effects of systemic thrombolysis on structural brain connectivity. In this secondary analysis of the WAKE-UP trial, we used MRI-derived measures of infarct size and estimated structural network disruption to establish that thrombolysis is associated not only with less infarct growth, but also with reduced loss of large-scale connectivity between grey-matter areas after stroke. In a causal mediation analysis, infarct growth mediated a non-significant 8.3% (CI95% [-8.0, 32.6]%) of the clinical effect of thrombolysis on functional outcome. The proportion mediated jointly through infarct growth and change of structural connectivity, especially in the border zone around the infarct core, however, was as high as 33.4% (CI95% [8.8, 77.4]%). Preservation of structural connectivity is thus an important determinant of treatment success and favourable functional outcome in addition to lesion volume. It might, in the future, serve as an imaging endpoint in clinical trials or as a target for therapeutic interventions.

UR - https://doi.org/10.1038/s41467-021-22786-w

U2 - 10.1038/s41467-021-22786-w

DO - 10.1038/s41467-021-22786-w

M3 - SCORING: Journal article

VL - 12

SP - 2590

JO - NAT COMMUN

JF - NAT COMMUN

SN - 2041-1723

IS - 1

ER -