The relevance of rich club regions for functional outcome post-stroke is enhanced in women
Anna K. Bonkhoff
(1, 2)
,
M. D. Schirmer
(1, 2)
,
Martin Bretzner
(3, 1, 2, 4)
,
S. M. Hong
(1, 2)
,
R. W. Regenhardt
(1, 2)
,
K. L. Donahue
(1, 2)
,
M. J. Nardin
(1, 2)
,
A. V. Dalca
(5, 2, 6)
,
A. K. Giese
(7)
,
M. R. Etherton
(1, 2)
,
B. L. Hancock
(6, 2)
,
S. J. T. Mocking
(6, 2)
,
E. C. Mcintosh
(8)
,
J. Attia
(9, 10)
,
J. W. Cole
(11)
,
A. Donatti
(12)
,
C. J. Griessenauer
(13, 14)
,
L. Heitsch
(15)
,
L. Holmegaard
(16, 17)
,
K. Jood
(16, 17)
,
J. Jimenez-Conde
(18, 19)
,
S. J. Kittner
(11)
,
R. Lemmens
(20, 21)
,
C. R. Levi
(10, 22)
,
C. W. Mcdonough
(23)
,
J. F. Meschia
(24)
,
C. L. Phuah
(15)
,
S. Ropele
(25)
,
J. Rosand
(2, 1, 6)
,
J. Roquer
(18, 19)
,
T. Rundek
(26)
,
R. L. Sacco
(26)
,
R. Schmidt
(25)
,
P. Sharma
(27, 28)
,
A. Slowik
(29)
,
A. Sousa
(12)
,
T. M. Stanne
(16)
,
D. Strbian
(30, 31)
,
T. Tatlisumak
(16, 17)
,
V. Thijs
(32, 33)
,
A. Vagal
(34)
,
J. Wasselius
(35, 36)
,
D. Woo
(34)
,
R. Zand
(37)
,
P. F. Mcardle
(11)
,
B. B. Worrall
(38)
,
C. Jern
(29, 17)
,
A. G. Lindgren
(36, 35)
,
J. Maguire
(39)
,
O. Wu
(2, 6)
,
N. S. Rost
(2, 1)
1
HMS -
Harvard Medical School [Boston]
2 Massachusetts General Hospital [Boston]
3 LilNCog - Lille Neurosciences & Cognition - U 1172
4 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
5 MIT - Massachusetts Institute of Technology
6 Athinoula A. Martinos Center for Biomedical Imaging
7 UKE - Universitaetsklinikum Hamburg-Eppendorf = University Medical Center Hamburg-Eppendorf [Hamburg]
8 Johns Hopkins University School of Medicine [Baltimore]
9 Hunter Medical Research Institute
10 UoN - University of Newcastle [Callaghan, Australia]
11 University of Maryland School of Medicine
12 UNICAMP - Universidade Estadual de Campinas = University of Campinas
13 PMU - Paracelsus Medizinische Privatuniversität = Paracelsus Medical University
14 ADMI - Geisinger Autism & Developmental Medicine Institute [Danville, PA, USA]
15 Washington University School of Medicine [Saint Louis, MO]
16 GU - Göteborgs Universitet = University of Gothenburg
17 Sahlgrenska University Hospital [Gothenburg]
18 IMIM-Hospital del Mar
19 UPF - Universitat Pompeu Fabra [Barcelona]
20 KU Leuven - Catholic University of Leuven = Katholieke Universiteit Leuven
21 LIND - Leuven research Institute for Neuroscience and Disease [Leuven, Belgium]
22 JHH - John Hunter Hospital
23 UF - University of Florida [Gainesville]
24 Mayo Clinic [Jacksonville]
25 Medical University of Graz = Medizinische Universität Graz
26 UMMSM - University of Miami Leonard M. Miller School of Medicine
27 RHUL - Royal Holloway [University of London]
28 Ashford University
29 UJ - Uniwersytet Jagielloński w Krakowie = Jagiellonian University
30 HUS - Helsinki University Hospital [Finland]
31 Helsingin yliopisto = Helsingfors universitet = University of Helsinki
32 The Florey Institute of Neuroscience and Mental Health
33 Austin Health
34 University of Cincinnati College of Medicine
35 Lund University
36 Skane University Hospital [Lund]
37 Penn State - Pennsylvania State University
38 University of Virginia
39 UTS - University of Technology Sydney
2 Massachusetts General Hospital [Boston]
3 LilNCog - Lille Neurosciences & Cognition - U 1172
4 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
5 MIT - Massachusetts Institute of Technology
6 Athinoula A. Martinos Center for Biomedical Imaging
7 UKE - Universitaetsklinikum Hamburg-Eppendorf = University Medical Center Hamburg-Eppendorf [Hamburg]
8 Johns Hopkins University School of Medicine [Baltimore]
9 Hunter Medical Research Institute
10 UoN - University of Newcastle [Callaghan, Australia]
11 University of Maryland School of Medicine
12 UNICAMP - Universidade Estadual de Campinas = University of Campinas
13 PMU - Paracelsus Medizinische Privatuniversität = Paracelsus Medical University
14 ADMI - Geisinger Autism & Developmental Medicine Institute [Danville, PA, USA]
15 Washington University School of Medicine [Saint Louis, MO]
16 GU - Göteborgs Universitet = University of Gothenburg
17 Sahlgrenska University Hospital [Gothenburg]
18 IMIM-Hospital del Mar
19 UPF - Universitat Pompeu Fabra [Barcelona]
20 KU Leuven - Catholic University of Leuven = Katholieke Universiteit Leuven
21 LIND - Leuven research Institute for Neuroscience and Disease [Leuven, Belgium]
22 JHH - John Hunter Hospital
23 UF - University of Florida [Gainesville]
24 Mayo Clinic [Jacksonville]
25 Medical University of Graz = Medizinische Universität Graz
26 UMMSM - University of Miami Leonard M. Miller School of Medicine
27 RHUL - Royal Holloway [University of London]
28 Ashford University
29 UJ - Uniwersytet Jagielloński w Krakowie = Jagiellonian University
30 HUS - Helsinki University Hospital [Finland]
31 Helsingin yliopisto = Helsingfors universitet = University of Helsinki
32 The Florey Institute of Neuroscience and Mental Health
33 Austin Health
34 University of Cincinnati College of Medicine
35 Lund University
36 Skane University Hospital [Lund]
37 Penn State - Pennsylvania State University
38 University of Virginia
39 UTS - University of Technology Sydney
S. M. Hong
- Fonction : Auteur
J. Attia
- Fonction : Auteur
- PersonId : 939430
- IdHAL : joel-attia
- ORCID : 0000-0002-6003-8698
- IdRef : 13271552X
N. S. Rost
- Fonction : Auteur
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.
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