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Individual Patient Data Meta-Analysis of Dynamic Cerebral Autoregulation and Functional Outcome After Ischemic Stroke
Lucy Beishon1,2, Terrie Vasilopoulos3, Angela S M Salinet4
1Department of Cardiovascular Sciences, University of Leicester, United Kingdom (L.B., S.B., E.H., P.R., J.S.M., T.G.R., R.B.P.).
Stroke
|March 21, 2024
Summary
Higher dynamic cerebral autoregulation (dCA) phase is linked to better functional outcomes after acute ischemic stroke (AIS). These dCA parameters, especially in the early stages, may help predict recovery after stroke.
Area of Science:
- Neurology
- Cardiovascular Science
- Medical Imaging
Background:
- The prognostic value of dynamic cerebral autoregulation (dCA) for functional outcomes following acute ischemic stroke (AIS) remains incompletely understood.
- Existing research is constrained by limited sample sizes and methodological heterogeneity.
Purpose of the Study:
- To investigate the association between dCA parameters and functional outcomes in patients with AIS.
- To address limitations of previous studies through a large-scale, individual patient data meta-analysis.
Main Methods:
- A 1-stage individual patient data meta-analysis was conducted, pooling data from 7 centers.
- Dynamic cerebral autoregulation (dCA) was assessed using transfer function analysis (phase, gain, coherence, autoregulation index) at low-frequency and very low-frequency bands.
- Functional outcome at 3 months post-AIS was evaluated using the modified Rankin Scale (mRS), analyzed as both dichotomized and ordinal outcomes.
Main Results:
- The study included 384 patients with AIS, predominantly nonlacunar stroke.
- Higher phase values in the affected hemisphere, particularly at very low-frequency bands, were significantly associated with better functional outcomes at <24 hours and 24-72 hours post-AIS.
- Increased phase at low-frequency bands also predicted improved functional outcome at 3 months, even after adjusting for covariates.
Conclusions:
- Greater transfer function analysis-derived phase demonstrates a significant association with improved functional outcomes at 3 months following AIS.
- dCA parameters assessed in the early phase after AIS hold potential as predictive markers for functional recovery.
