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Record W4284973430 · doi:10.1212/wnl.0000000000200926

Association of Stroke Lesion Pattern and White Matter Hyperintensity Burden With Stroke Severity and Outcome

2022· article· en· W4284973430 on OpenAlexfundno aff
Anna K. Bonkhoff, Sung‐Min Hong, Martin Bretzner, Markus D. Schirmer, Robert W. Regenhardt, Ethem Murat Arsava, Kathleen Donahue, Marco Nardin, Adrian V. Dalca, Anne‐Katrin Giese, Mark R. Etherton, Brandon L. Hancock, Steven J. T. Mocking, Elissa C. McIntosh, John Attia, Oscar Benavente, John W. Cole, Amanda Donatti, Christoph J. Griessenauer, Laura Heitsch, Lukas Holmegaard, Katarina Jood, Jordi Jiménez-Conde, Steven J. Kittner, Robin Lemmens, Christopher Levi, Caitrin W. McDonough, James F. Meschia, Chia‐Ling Phuah, Arndt Rolfs, Stefan Ropele, Jonathan Rosand, Jaume Roquer, Tatjana Rundek, Ralph L. Sacco, Reinhold Schmidt, Pankaj Sharma, Agnieszka Słowik, Martin Soederholm, Alessandro Sousa, Tara M. Stanne, Daniel Strbian, Turgut Tatlisumak, Vincent Thijs, Achala Vagal, Johan Wassélius, Daniel Woo, Ramin Zand, Patrick F. McArdle, Bradford B. Worrall, Christina Jern, Arne Lindgren, Jane Maguire, Polina Golland, Danilo Bzdok, Ona Wu, Natalia S. Rost

Bibliographic record

VenueNeurology · 2022
Typearticle
Languageen
FieldMedicine
TopicAcute Ischemic Stroke Management
Canadian institutionsnot available
FundersNational Institute of Biomedical Imaging and BioengineeringNational Institute of Neurological Disorders and StrokeCanadian Institutes of Health Research
KeywordsStroke (engine)LesionHyperintensityMedicineModified Rankin ScaleNeuroimagingFluid-attenuated inversion recoveryMagnetic resonance imagingCardiologyWhite matterDiffusion MRIInternal medicineLogistic regressionRadiologyPhysical medicine and rehabilitationIschemic strokeSurgeryPsychiatryIschemia

Abstract

fetched live from OpenAlex

BACKGROUND AND OBJECTIVES: To examine whether high white matter hyperintensity (WMH) burden is associated with greater stroke severity and worse functional outcomes in lesion pattern-specific ways. METHODS: , sex, total DWI lesion and WMH volumes, and comorbidities. Data were split into derivation and validation cohorts. RESULTS: A total of 928 patients with AIS contributed to acute stroke severity analyses (age: 64.8 [14.5] years, 40% women) and 698 patients to long-term functional outcome analyses (age: 65.9 [14.7] years, 41% women). Stroke severity was mainly explained by lesions focused on bilateral subcortical and left hemispherically pronounced cortical regions across patients with both a high and low WMH burden. Lesions centered on left-hemispheric insular, opercular, and inferior frontal regions and lesions affecting right-hemispheric temporoparietal regions had more pronounced effects on stroke severity in case of high compared with low WMH burden. Unfavorable outcomes were predominantly explained by lesions in bilateral subcortical regions. In difference to the lesion location-specific WMH effects on stroke severity, higher WMH burden increased the odds of unfavorable outcomes independent of lesion location. DISCUSSION: Higher WMH burden may be associated with an increased stroke severity in case of stroke lesions involving left-hemispheric insular, opercular, and inferior frontal regions (potentially linked to language functions) and right-hemispheric temporoparietal regions (potentially linked to attention). Our findings suggest that patients with specific constellations of WMH burden and lesion locations may have greater benefits from acute recanalization treatments. Future clinical studies are warranted to systematically assess this assumption and guide more tailored treatment decisions.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.011
Threshold uncertainty score0.360

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.012
GPT teacher head0.232
Teacher spread0.220 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations57
Published2022
Admission routes1
Has abstractyes

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