Year: 2024
Type: article
Study design: Observational Study
Abstract: INTRODUCTION: While incident ischemic lesions (IILs) are not unusual on follow-up magnetic resonance imaging (MRI) following stroke, their risk factors and prognostic significance remain unknown. METHODS: In a prospective multicenter study of 503 acute stroke patients, we assessed IILs on registered MRI images at baseline and 6 months, analyzing risk factors and clinical outcomes across 36 months. RESULTS: At 6 months, 78 patients (15.5%) had IILs, mostly diffusion-weighted imaging-positive (72%) and clinically covert (91%). Older age and small vessel disease (SVD) lesions were baseline risk factors for IILs. IILs were associated with worse cognitive (beta for global cognition: -0.31, 95% confidence interval [CI]: -0.48 to -0.14) and functional outcomes (beta for modified Rankin scale [mRS]: 0.36, 95% CI: 0.14 to 0.58), and higher recurrent stroke risk (hazard ratio: 3.81, 95% CI: 1.35 to 10.69). IILs partially explained the relationship between SVD and poor cognition. DISCUSSION: IILs are common and are associated with worse cognitive and functional outcomes and stroke recurrence risk. Assessing IILs following stroke might aid prognostication. HIGHLIGHTS: Incident ischemic lesions (IILs) were assessed with registered baseline and 6-month magnetic resonance imaging (MRI) scans in a stroke cohort. IILs 6 months after stroke are present in one-sixth of patients and are mostly clinically silent. Small vessel disease burden is the main baseline risk factor for IILs. IILs are associated with cognitive and functional impairment and stroke recurrence. Assessing IILs by follow-up MRI aids long-term prognostication for stroke patients.
Source: Alzheimer s & Dementia
DOI: 10.1002/alz.14274
Authors: Rong Fang, Marco Duering, Felix J. Bode, Sebastian Stösser, Julius N. Meißner, Peter Hermann, Thomas G. Liman, Christian H. Nolte, Lucia Kerti, Benno Ikenberg, Kathleen Bernkopf, Wenzel Glanz, Daniel Janowitz, Michael Wagner, Katja Neumann, Oliver Speck, Emrah Düzel, Benno Gesierich, Anna Dewenter, Annika Spottke, Karin Waegemann, Michael Görtler, Silke Wunderlich, Inga Zerr, Gabor C. Petzold, Matthias Endres, Marios K. Georgakis, Martin Dichgans, the DEMDAS investigators
Institutions: LMU Klinikum, Institut für Schlaganfall- und Demenzforschung, Ludwig-Maximilians-Universität München, University of Basel, University of Bonn, University Hospital Bonn, German Center for Neurodegenerative Diseases, Universitätsmedizin Göttingen, Carl von Ossietzky Universität Oldenburg, Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, TUM Klinikum, Technical University of Munich, University Hospital Magdeburg, Otto-von-Guericke-Universität Magdeburg, Center for Behavioral Brain Sciences, Leibniz Institute for Neurobiology, German Centre for Cardiovascular Research, Deutsches Zentrum für Psychische Gesundheit, Broad Institute, Massachusetts Institute of Technology, Munich Cluster for Systems Neurology
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,000
Awards: G1580824357, G1680808902, G1789099517, G1923547659, G2044136217, G2268710391, International Network of Excellence on Brain Endothelium: A Nexus for Cerebral Small Vessel Disease, G2509747645, G2588154941, G2815027524, G3238537512, G3852840010, EXC 2145: Munich Cluster for Systems Neurology (SyNergy), G4510041740, G4915867694, G5698858471, G5861396597, TRR 295: Behandlung motorischer Netzwerkstörungen mittels Neuromodulation, EXC 2049: Comprehensive approaches to neurological and psychiatric disorders "NeuroCure", G6219790147, G6885968271, G7029823492, G7052595988, G7498749756, G7559397121, Multiomische Charakterisierung der Immunmechanismen der menschlichen Atheroprogression
OpenAlex ID: W4403490524