Sex-specific lesion pattern of functional outcomes after stroke

Area of Science:

• Neuroscience
• Neurology
• Medical Imaging

Background:

• Stroke is a major health burden with known sex differences in causes and outcomes.
• Previous research indicated sex-specific lesion topographies in acute ischemic stroke, particularly in women.

Purpose of the Study:

• To investigate if sex-specific brain lesion patterns in acute ischemic stroke influence long-term functional outcomes.
• To identify neuroimaging markers predicting stroke outcomes in a sex-specific manner.

Main Methods:

• Analysis of neuroimaging data from 822 acute ischemic stroke patients (39% women) from the multi-centre MRI-GENIE study.
• Utilized a Bayesian hierarchical framework to model unfavorable outcomes (modified Rankin Scale >2) based on acute lesion locations.
• Compared the predictive relevance of lesion patterns between men and women.

Main Results:

• Lesions in bilateral subcortical nuclei and left insular regions predicted outcomes in both sexes (AUC = 0.81).
• A specific pattern of left-hemispheric posterior circulation lesions (hippocampus, precuneus, occipital regions) was more relevant for predicting outcomes in women than in men.
• The difference in predictive relevance for this pattern was statistically significant between sexes.

Conclusions:

• Sex-specific lesion patterns in acute ischemic stroke impact long-term functional outcomes.
• Findings suggest a potential need for sex-specific approaches in stroke management and rehabilitation.
• Further validation in prospective studies is warranted to refine clinical applications.