Neuroimaging markers of patient-reported outcome measures in acute ischemic stroke

To determine the relationship between patient-reported outcome measures (PROMs) and volumetric imaging markers in acute ischemic stroke (AIS).

Patients presenting at Massachusetts General Hospital between February 14, 2017 and February 5, 2020 with a confirmed AIS by MRI were eligible and underwent a telephone interview including PROM-10 questionnaires 3-15 months after stroke. White matter hyperintensity (V_WMH) and brain volumes (V_Brain) were automatically determined using admission clinical MRI. Stroke lesions were manually segmented and volumes calculated (V_Lesion). Multivariable and ordinal regression analyses were performed to identify associations between global and PROM-10 subscores with brain volumetrics and clinical variables.

Utilizing data from 167 patients (mean age: 64.7; 41.9% female), higher V_WMH was associated with worse global physical (β=-0.6), global mental (β=-0.65), physical health (OR=0.68), social satisfaction (OR=0.66), fatigue (OR=0.69) and social activities (OR=0.59) scores. Higher V_Lesion was associated with poorer global mental (β=-0.79), mental health (OR=0.68), physical (OR=0.66) and social activities (OR=0.55), and emotional distress (OR=0.68) scores. Higher V_Brain was linked to better global mental (β=0.93), global physical (β=0.79), mental health (OR=1.54) and physical activities (OR=1.72) scores.

Neuroimaging biomarkers were significantly associated with PROMs, where higher V_WMH and V_Lesion led to worse outcome, while higher V_Brain was protective. The inclusion of neuroimaging analyses and PROMs in routine assessment provides enhanced understanding of post-stroke outcomes.