Brain frailty associated with stroke events in anterior circulation large artery occlusion

Area of Science:

• Neurology
• Vascular Neurology
• Geriatric Neurology

Background:

• Brain frailty, characterized by white matter hyperintensity, old infarction lesions, and cerebral atrophy, is a growing concern in cerebrovascular diseases.
• Anterior circulation large artery occlusion (AC-LAO) represents a significant cause of stroke, and understanding associated risk factors and outcomes is crucial.

Purpose of the Study:

• To identify factors associated with brain frailty in patients with AC-LAO.
• To evaluate the effect of brain frailty on stroke events and short-term outcomes in AC-LAO patients.

Main Methods:

• Retrospective analysis of 1100 patients with AC-LVO.
• Brain frailty score calculated based on white matter hyperintensity, old infarction lesions, and cerebral atrophy from baseline neuroimaging.
• Statistical analyses including ANOVA, Mann-Whitney U test, and multiple linear regression were employed to assess associations.

Main Results:

• Brain frailty (score ≥ 1) was prevalent in 76.3% of AC-LAO participants.
• Factors independently associated with higher brain frailty scores included longer duration of hypertension (>5 years) and multiple vessel occlusions.
• Brain frailty score was independently associated with stroke events, with higher scores correlating with increased event rates; however, no independent effect on short-term outcomes was observed.

Conclusions:

• Older age, hypertension duration exceeding 5 years, and multiple vessel occlusions are key influencers of brain frailty in AC-LAO.
• Brain frailty is a significant independent predictor for the occurrence of stroke events in AC-LAO patients.
• Despite its association with stroke events, brain frailty does not independently impact the short-term outcomes of acute cerebral infarction in this population.