Excessive White Matter Hyperintensity Increases Susceptibility to Poor Functional Outcomes After Acute Ischemic Stroke

• DOI: 10.3389/fneur.2021.700616
• Publication Date: 2021-09-29T15:36:33Z
• Authors: Sungmin Hong; Anne-Katrin Giese; Markus D. Schirmer; Anna K. Bonkhoff; Martin Bretzner; Pamela Rist; Adrian V. Dalca; Robert W. Regenhardt; Mark R. Etherton; Kathleen L. Donahue; Marco Nardin; Steven J. T. Mocking; Elissa C. McIntosh; John Attia; Oscar R. Benavente; John W. Cole; Amanda Donatti; Christoph J. Grie...; Laura Heitsch; Lukas Holmegaard; Katarina Jood; Jordi Jimenez-Conde; Jaume Roquer; Steven J. Kittner; Robin Lemmens; Christopher R. Levi; Caitrin W. McDonough; James F. Meschia; Chia-Ling Phuah; Arndt Rolfs; Stefan Ropele; Jonathan Rosand; Tatjana Rundek; Ralph L. Sacco; Reinhold Schmidt; Christian Enzinger; Pankaj Sharma; Agnieszka Slowik; Alessandro Sousa; Tara M. Stanne; Daniel Strbian; Turgut Tatlisumak; Vincent Thijs; Achala Vagal; Johan Wasselius; Daniel Woo; Ramin Zand; Patrick F. McArdle; Bradford B. Worrall; Ona Wu; Christina Jern; Arne G. Lindgren; Jane Maguire; Liisa Tomppo; Polina Golland; Natalia S. Rost
• Keywords: Stroke

Objective: To personalize the prognostication of post-stroke outcome using MRI-detected cerebrovascular pathology, we sought to investigate association between excessive white matter hyperintensity (WMH) burden unaccounted for by traditional stroke risk profile individual patients and their long-term functional outcomes after a stroke. Methods: We included 890 who survived an acute ischemic from MRI-Genetics Interface Exploration (MRI-GENIE) study, whom data on vascular factors (VRFs), including age, sex, atrial fibrillation, diabetes mellitus, hypertension, coronary artery disease, smoking, prior history, as well severity, 3- to−6-month modified Rankin Scale score (mRS), WMH, brain volumes, were available. defined WMH (uWMH) via modeling expected based VRF each patient. The uWMH mRS was analyzed linear regression analysis. odds ratios achieved full independence (mRS < 2) in trichotomized groups calculated pair-wise comparisons. Results: volume estimated with respect known VRFs. associated (β = 0.104, p 0.01). Excessive significantly reduced achieving compared low average [OR 0.4, 95% CI: (0.25, 0.63), 0.01 OR 0.61, (0.42, 0.87), 0.01, respectively]. Conclusion: amount worse outcomes. Further studies are needed evaluate lifetime injury reflected unrelated patient important factor recovery plausible indicator health.