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Deep profiling of multiple ischemic lesions in a large, multi-center cohort

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Deep profiling of multiple ischemic lesions in a large, multi-center cohort : Frequency, spatial distribution, and associations to clinical characteristics. / Bonkhoff, Anna K; Ullberg, Teresa; Bretzner, Martin; Hong, Sungmin; Schirmer, Markus D; Regenhardt, Robert W; Donahue, Kathleen L; Nardin, Marco J; Dalca, Adrian V; Giese, Anne-Katrin; Etherton, Mark R; Hancock, Brandon L; Mocking, Steven J T; McIntosh, Elissa C; Attia, John; Cole, John W; Donatti, Amanda; Griessenauer, Christoph J; Heitsch, Laura; Holmegaard, Lukas; Jood, Katarina; Jimenez-Conde, Jordi; Kittner, Steven J; Lemmens, Robin; Levi, Christopher R; McDonough, Caitrin W; Meschia, James F; Phuah, Chia-Ling; Ropele, Stefan; Rosand, Jonathan; Roquer, Jaume; Rundek, Tatjana; Sacco, Ralph L; Schmidt, Reinhold; Sharma, Pankaj; Slowik, Agnieszka; Sousa, Alessandro; Stanne, Tara M; Strbian, Daniel; Tatlisumak, Turgut; Thijs, Vincent; Vagal, Achala; Woo, Daniel; Zand, Ramin; McArdle, Patrick F; Worrall, Bradford B; Jern, Christina; Lindgren, Arne G; Maguire, Jane; Wu, Ona; Frid, Petrea; Rost, Natalia S; Wasselius, Johan.

In: FRONT NEUROSCI-SWITZ, Vol. 16, 994458, 2022.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Bonkhoff, AK, Ullberg, T, Bretzner, M, Hong, S, Schirmer, MD, Regenhardt, RW, Donahue, KL, Nardin, MJ, Dalca, AV, Giese, A-K, Etherton, MR, Hancock, BL, Mocking, SJT, McIntosh, EC, Attia, J, Cole, JW, Donatti, A, Griessenauer, CJ, Heitsch, L, Holmegaard, L, Jood, K, Jimenez-Conde, J, Kittner, SJ, Lemmens, R, Levi, CR, McDonough, CW, Meschia, JF, Phuah, C-L, Ropele, S, Rosand, J, Roquer, J, Rundek, T, Sacco, RL, Schmidt, R, Sharma, P, Slowik, A, Sousa, A, Stanne, TM, Strbian, D, Tatlisumak, T, Thijs, V, Vagal, A, Woo, D, Zand, R, McArdle, PF, Worrall, BB, Jern, C, Lindgren, AG, Maguire, J, Wu, O, Frid, P, Rost, NS & Wasselius, J 2022, 'Deep profiling of multiple ischemic lesions in a large, multi-center cohort: Frequency, spatial distribution, and associations to clinical characteristics', FRONT NEUROSCI-SWITZ, vol. 16, 994458. https://doi.org/10.3389/fnins.2022.994458

APA

Bonkhoff, A. K., Ullberg, T., Bretzner, M., Hong, S., Schirmer, M. D., Regenhardt, R. W., Donahue, K. L., Nardin, M. J., Dalca, A. V., Giese, A-K., Etherton, M. R., Hancock, B. L., Mocking, S. J. T., McIntosh, E. C., Attia, J., Cole, J. W., Donatti, A., Griessenauer, C. J., Heitsch, L., ... Wasselius, J. (2022). Deep profiling of multiple ischemic lesions in a large, multi-center cohort: Frequency, spatial distribution, and associations to clinical characteristics. FRONT NEUROSCI-SWITZ, 16, [994458]. https://doi.org/10.3389/fnins.2022.994458

Vancouver

Bonkhoff AK, Ullberg T, Bretzner M, Hong S, Schirmer MD, Regenhardt RW et al. Deep profiling of multiple ischemic lesions in a large, multi-center cohort: Frequency, spatial distribution, and associations to clinical characteristics. FRONT NEUROSCI-SWITZ. 2022;16. 994458. https://doi.org/10.3389/fnins.2022.994458

Bibtex

@article{0449085cf9ca446e8a38906da53799a8,
title = "Deep profiling of multiple ischemic lesions in a large, multi-center cohort: Frequency, spatial distribution, and associations to clinical characteristics",
abstract = "BACKGROUND PURPOSE: A substantial number of patients with acute ischemic stroke (AIS) experience multiple acute lesions (MAL). We here aimed to scrutinize MAL in a large radiologically deep-phenotyped cohort.MATERIALS AND METHODS: Analyses relied upon imaging and clinical data from the international MRI-GENIE study. Imaging data comprised both Fluid-attenuated inversion recovery (FLAIR) for white matter hyperintensity (WMH) burden estimation and diffusion-weighted imaging (DWI) sequences for the assessment of acute stroke lesions. The initial step featured the systematic evaluation of occurrences of MAL within one and several vascular supply territories. Associations between MAL and important imaging and clinical characteristics were subsequently determined. The interaction effect between single and multiple lesion status and lesion volume was estimated by means of Bayesian hierarchical regression modeling for both stroke severity and functional outcome.RESULTS: We analyzed 2,466 patients (age = 63.4 ± 14.8, 39% women), 49.7% of which presented with a single lesion. Another 37.4% experienced MAL in a single vascular territory, while 12.9% featured lesions in multiple vascular territories. Within most territories, MAL occurred as frequently as single lesions (ratio ∼1:1). Only the brainstem region comprised fewer patients with MAL (ratio 1:4). Patients with MAL presented with a significantly higher lesion volume and acute NIHSS (7.7 vs. 1.7 ml and 4 vs. 3, p FDR < 0.001). In contrast, patients with a single lesion were characterized by a significantly higher WMH burden (6.1 vs. 5.3 ml, p FDR = 0.048). Functional outcome did not differ significantly between patients with single versus multiple lesions. Bayesian analyses suggested that the association between lesion volume and stroke severity between single and multiple lesions was the same in case of anterior circulation stroke. In case of posterior circulation stroke, lesion volume was linked to a higher NIHSS only among those with MAL.CONCLUSION: Multiple lesions, especially those within one vascular territory, occurred more frequently than previously reported. Overall, multiple lesions were distinctly linked to a higher acute stroke severity, a higher total DWI lesion volume and a lower WMH lesion volume. In posterior circulation stroke, lesion volume was linked to a higher stroke severity in multiple lesions only.",
author = "Bonkhoff, {Anna K} and Teresa Ullberg and Martin Bretzner and Sungmin Hong and Schirmer, {Markus D} and Regenhardt, {Robert W} and Donahue, {Kathleen L} and Nardin, {Marco J} and Dalca, {Adrian V} and Anne-Katrin Giese and Etherton, {Mark R} and Hancock, {Brandon L} and Mocking, {Steven J T} and McIntosh, {Elissa C} and John Attia and Cole, {John W} and Amanda Donatti and Griessenauer, {Christoph J} and Laura Heitsch and Lukas Holmegaard and Katarina Jood and Jordi Jimenez-Conde and Kittner, {Steven J} and Robin Lemmens and Levi, {Christopher R} and McDonough, {Caitrin W} and Meschia, {James F} and Chia-Ling Phuah and Stefan Ropele and Jonathan Rosand and Jaume Roquer and Tatjana Rundek and Sacco, {Ralph L} and Reinhold Schmidt and Pankaj Sharma and Agnieszka Slowik and Alessandro Sousa and Stanne, {Tara M} and Daniel Strbian and Turgut Tatlisumak and Vincent Thijs and Achala Vagal and Daniel Woo and Ramin Zand and McArdle, {Patrick F} and Worrall, {Bradford B} and Christina Jern and Lindgren, {Arne G} and Jane Maguire and Ona Wu and Petrea Frid and Rost, {Natalia S} and Johan Wasselius",
note = "Copyright {\textcopyright} 2022 Bonkhoff, Ullberg, Bretzner, Hong, Schirmer, Regenhardt, Donahue, Nardin, Dalca, Giese, Etherton, Hancock, Mocking, McIntosh, Attia, Cole, Donatti, Griessenauer, Heitsch, Holmegaard, Jood, Jimenez-Conde, Kittner, Lemmens, Levi, McDonough, Meschia, Phuah, Ropele, Rosand, Roquer, Rundek, Sacco, Schmidt, Sharma, Slowik, Sousa, Stanne, Strbian, Tatlisumak, Thijs, Vagal, Woo, Zand, McArdle, Worrall, Jern, Lindgren, Maguire, Wu, Frid, Rost and Wasselius.",
year = "2022",
doi = "10.3389/fnins.2022.994458",
language = "English",
volume = "16",
journal = "FRONT NEUROSCI-SWITZ",
issn = "1662-453X",
publisher = "Frontiers Media S. A.",

}

RIS

TY - JOUR

T1 - Deep profiling of multiple ischemic lesions in a large, multi-center cohort

T2 - Frequency, spatial distribution, and associations to clinical characteristics

AU - Bonkhoff, Anna K

AU - Ullberg, Teresa

AU - Bretzner, Martin

AU - Hong, Sungmin

AU - Schirmer, Markus D

AU - Regenhardt, Robert W

AU - Donahue, Kathleen L

AU - Nardin, Marco J

AU - Dalca, Adrian V

AU - Giese, Anne-Katrin

AU - Etherton, Mark R

AU - Hancock, Brandon L

AU - Mocking, Steven J T

AU - McIntosh, Elissa C

AU - Attia, John

AU - Cole, John W

AU - Donatti, Amanda

AU - Griessenauer, Christoph J

AU - Heitsch, Laura

AU - Holmegaard, Lukas

AU - Jood, Katarina

AU - Jimenez-Conde, Jordi

AU - Kittner, Steven J

AU - Lemmens, Robin

AU - Levi, Christopher R

AU - McDonough, Caitrin W

AU - Meschia, James F

AU - Phuah, Chia-Ling

AU - Ropele, Stefan

AU - Rosand, Jonathan

AU - Roquer, Jaume

AU - Rundek, Tatjana

AU - Sacco, Ralph L

AU - Schmidt, Reinhold

AU - Sharma, Pankaj

AU - Slowik, Agnieszka

AU - Sousa, Alessandro

AU - Stanne, Tara M

AU - Strbian, Daniel

AU - Tatlisumak, Turgut

AU - Thijs, Vincent

AU - Vagal, Achala

AU - Woo, Daniel

AU - Zand, Ramin

AU - McArdle, Patrick F

AU - Worrall, Bradford B

AU - Jern, Christina

AU - Lindgren, Arne G

AU - Maguire, Jane

AU - Wu, Ona

AU - Frid, Petrea

AU - Rost, Natalia S

AU - Wasselius, Johan

N1 - Copyright © 2022 Bonkhoff, Ullberg, Bretzner, Hong, Schirmer, Regenhardt, Donahue, Nardin, Dalca, Giese, Etherton, Hancock, Mocking, McIntosh, Attia, Cole, Donatti, Griessenauer, Heitsch, Holmegaard, Jood, Jimenez-Conde, Kittner, Lemmens, Levi, McDonough, Meschia, Phuah, Ropele, Rosand, Roquer, Rundek, Sacco, Schmidt, Sharma, Slowik, Sousa, Stanne, Strbian, Tatlisumak, Thijs, Vagal, Woo, Zand, McArdle, Worrall, Jern, Lindgren, Maguire, Wu, Frid, Rost and Wasselius.

PY - 2022

Y1 - 2022

N2 - BACKGROUND PURPOSE: A substantial number of patients with acute ischemic stroke (AIS) experience multiple acute lesions (MAL). We here aimed to scrutinize MAL in a large radiologically deep-phenotyped cohort.MATERIALS AND METHODS: Analyses relied upon imaging and clinical data from the international MRI-GENIE study. Imaging data comprised both Fluid-attenuated inversion recovery (FLAIR) for white matter hyperintensity (WMH) burden estimation and diffusion-weighted imaging (DWI) sequences for the assessment of acute stroke lesions. The initial step featured the systematic evaluation of occurrences of MAL within one and several vascular supply territories. Associations between MAL and important imaging and clinical characteristics were subsequently determined. The interaction effect between single and multiple lesion status and lesion volume was estimated by means of Bayesian hierarchical regression modeling for both stroke severity and functional outcome.RESULTS: We analyzed 2,466 patients (age = 63.4 ± 14.8, 39% women), 49.7% of which presented with a single lesion. Another 37.4% experienced MAL in a single vascular territory, while 12.9% featured lesions in multiple vascular territories. Within most territories, MAL occurred as frequently as single lesions (ratio ∼1:1). Only the brainstem region comprised fewer patients with MAL (ratio 1:4). Patients with MAL presented with a significantly higher lesion volume and acute NIHSS (7.7 vs. 1.7 ml and 4 vs. 3, p FDR < 0.001). In contrast, patients with a single lesion were characterized by a significantly higher WMH burden (6.1 vs. 5.3 ml, p FDR = 0.048). Functional outcome did not differ significantly between patients with single versus multiple lesions. Bayesian analyses suggested that the association between lesion volume and stroke severity between single and multiple lesions was the same in case of anterior circulation stroke. In case of posterior circulation stroke, lesion volume was linked to a higher NIHSS only among those with MAL.CONCLUSION: Multiple lesions, especially those within one vascular territory, occurred more frequently than previously reported. Overall, multiple lesions were distinctly linked to a higher acute stroke severity, a higher total DWI lesion volume and a lower WMH lesion volume. In posterior circulation stroke, lesion volume was linked to a higher stroke severity in multiple lesions only.

AB - BACKGROUND PURPOSE: A substantial number of patients with acute ischemic stroke (AIS) experience multiple acute lesions (MAL). We here aimed to scrutinize MAL in a large radiologically deep-phenotyped cohort.MATERIALS AND METHODS: Analyses relied upon imaging and clinical data from the international MRI-GENIE study. Imaging data comprised both Fluid-attenuated inversion recovery (FLAIR) for white matter hyperintensity (WMH) burden estimation and diffusion-weighted imaging (DWI) sequences for the assessment of acute stroke lesions. The initial step featured the systematic evaluation of occurrences of MAL within one and several vascular supply territories. Associations between MAL and important imaging and clinical characteristics were subsequently determined. The interaction effect between single and multiple lesion status and lesion volume was estimated by means of Bayesian hierarchical regression modeling for both stroke severity and functional outcome.RESULTS: We analyzed 2,466 patients (age = 63.4 ± 14.8, 39% women), 49.7% of which presented with a single lesion. Another 37.4% experienced MAL in a single vascular territory, while 12.9% featured lesions in multiple vascular territories. Within most territories, MAL occurred as frequently as single lesions (ratio ∼1:1). Only the brainstem region comprised fewer patients with MAL (ratio 1:4). Patients with MAL presented with a significantly higher lesion volume and acute NIHSS (7.7 vs. 1.7 ml and 4 vs. 3, p FDR < 0.001). In contrast, patients with a single lesion were characterized by a significantly higher WMH burden (6.1 vs. 5.3 ml, p FDR = 0.048). Functional outcome did not differ significantly between patients with single versus multiple lesions. Bayesian analyses suggested that the association between lesion volume and stroke severity between single and multiple lesions was the same in case of anterior circulation stroke. In case of posterior circulation stroke, lesion volume was linked to a higher NIHSS only among those with MAL.CONCLUSION: Multiple lesions, especially those within one vascular territory, occurred more frequently than previously reported. Overall, multiple lesions were distinctly linked to a higher acute stroke severity, a higher total DWI lesion volume and a lower WMH lesion volume. In posterior circulation stroke, lesion volume was linked to a higher stroke severity in multiple lesions only.

U2 - 10.3389/fnins.2022.994458

DO - 10.3389/fnins.2022.994458

M3 - SCORING: Journal article

C2 - 36090258

VL - 16

JO - FRONT NEUROSCI-SWITZ

JF - FRONT NEUROSCI-SWITZ

SN - 1662-453X

M1 - 994458

ER -