Stroke-Related Visceral Alterations: A Voxel-Based Neuroanatomic Localization Study

Area of Science:

• Neuroscience
• Cardiology
• Internal Medicine

Background:

• Extracranial organ changes can follow acute brain injury, but their specific brain correlates are not fully understood.
• Cardiac and systemic abnormalities (CSAs) are common post-stroke, yet the precise neuroanatomic origins remain unclear.

Purpose of the Study:

• To investigate the hypothesis that brain infarcts are associated with specific cardiac and systemic abnormalities (CSAs) in a regionally dependent manner.
• To identify the neuroanatomic correlates of post-stroke CSAs, including cardiac troponin T elevation, QTc prolongation, acute stress hyperglycemia, and infection.

Main Methods:

• Analysis of voxelwise p value maps of brain infarcts in 1,208 acute ischemic stroke patients.
• Examination of the relationship between infarct location and CSAs (cardiac troponin T, QTc prolongation, acute stress hyperglycemia, infection) using a permutation-based approach.
• Identification of significant, spatially segregated voxel clusters associated with CSAs.

Main Results:

• Distinct, spatially segregated voxel clusters were identified for each CSA.
• Troponin elevation and QTc prolongation clusters were primarily located in the right hemisphere.
• Acute stress hyperglycemia clusters were predominantly in the left hemisphere, while infection clusters (pneumonia, UTI) were found in both hemispheres.
• The association between infarct location and CSAs remained significant after adjusting for infarct volume.

Conclusions:

• Discrete brain infarct regions are specifically associated with different CSAs.
• These findings may aid in developing new markers to distinguish between neurogenic and non-neurogenic causes of post-stroke CSAs.
• Understanding these regional brain-body interactions is crucial for optimizing stroke care and management.