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Outcome after acute ischemic stroke is linked to sex-specific lesion patterns
Anna K Bonkhoff1, Markus D Schirmer2,3, Martin Bretzner2,4
1J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. abonkhoff@mgh.harvard.edu.
Nature Communications
|June 3, 2021
Summary
Women with acute ischemic stroke show higher severity, linked to specific left hemisphere lesions. Understanding these sex-specific brain patterns is crucial for tailored stroke management strategies.
Area of Science:
- Neuroscience
- Neurology
- Medical Imaging
Background:
- Acute ischemic stroke exhibits sex-based disparities, with women often experiencing greater stroke severity.
- Existing research indicates potential differences in lesion patterns between sexes following stroke.
Purpose of the Study:
- To investigate sex differences in anatomical stroke lesion patterns associated with acute stroke severity.
- To develop and apply a Bayesian hierarchical model for analyzing lesion-severity relationships stratified by sex.
Main Methods:
- Derived a low-dimensional representation of anatomical stroke lesions.
- Employed a Bayesian hierarchical modeling framework to analyze lesion patterns and stroke severity (National Institute of Health Stroke Scale).
- Validated findings in two independent cohorts totaling 1058 patients (38-41% female).
Main Results:
- Motor and language functional regions are implicated in stroke severity for both sexes.
- Female patients exhibited more widespread lesion patterns correlating with higher stroke severity.
- Higher stroke severity in women, but not men, was linked to left hemisphere lesions near the posterior circulation.
Conclusions:
- Sex-specific functional cerebral asymmetries may influence acute ischemic stroke severity.
- Findings highlight the importance of considering sex-stratified approaches in acute stroke management.
- Further research into sex-specific lesion patterns can refine diagnostic and therapeutic strategies.
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