4.8 Article

Outcome after acute ischemic stroke is linked to sex-specific lesion patterns

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NATURE COMMUNICATIONS
卷 12, 期 1, 页码 -

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NATURE PORTFOLIO
DOI: 10.1038/s41467-021-23492-3

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资金

  1. Societe Francaise de Neuroradiologie
  2. Societe Francaise de Radiologie
  3. Fondation ISITE-ULNE
  4. NIH-NINDS [R01 NS103824, RF1 NS117643, R01 NS100417, U01NS100699, U01NS110772, R01NS082285, R01NS086905, U19NS115388]
  5. Swedish Research Council [2018-02543, 2019-01757]
  6. Swedish government [ALFGBG-720081]
  7. Swedish county councils, the ALF agreement [ALFGBG-720081]
  8. Swedish Heart and Lung Foundation [20190203]
  9. Swedish Government (Avtal om Lakarutbildning och Medicinsk Forskning, ALF)
  10. Region Skane
  11. Lund University
  12. Skane University Hospital
  13. Sparbanks-stiftelsen Fars och Frosta
  14. Fremasons Lodge of Instruction Eos in Lund
  15. NIH [1R01NS114045-01]
  16. Brain Canada Foundation, through the Canada Brain Research Fund
  17. National Institutes of Health [NIH R01 AG068563A]
  18. Canadian Institute of Health Research [CIHR 438531]
  19. Healthy Brains Healthy Lives initiative (Canada First Research Excellence fund)
  20. Google
  21. CIFAR Artificial Intelligence Chairs program (Canada Institute for Advanced Research)
  22. Swedish Heart and Lung Foundation
  23. Health Canada

向作者/读者索取更多资源

Acute ischemic stroke affects men and women differently, with women experiencing higher severity than men. Different lesion patterns are linked to stroke severity in men and women, with female patients showing more widespread lesion patterns. Women with higher stroke severity tend to have left hemisphere lesions near the posterior circulation. Sex-specific functional cerebral asymmetries may play a role in future investigations of sex-stratified approaches to managing acute ischemic stroke.
Acute ischemic stroke affects men and women differently. In particular, women are often reported to experience higher acute stroke severity than men. We derived a low-dimensional representation of anatomical stroke lesions and designed a Bayesian hierarchical modeling framework tailored to estimate possible sex differences in lesion patterns linked to acute stroke severity (National Institute of Health Stroke Scale). This framework was developed in 555 patients (38% female). Findings were validated in an independent cohort (n=503, 41% female). Here, we show brain lesions in regions subserving motor and language functions help explain stroke severity in both men and women, however more widespread lesion patterns are relevant in female patients. Higher stroke severity in women, but not men, is associated with left hemisphere lesions in the vicinity of the posterior circulation. Our results suggest there are sex-specific functional cerebral asymmetries that may be important for future investigations of sex-stratified approaches to management of acute ischemic stroke. Acute ischemic stroke impacts men and women differently. Here, the authors show how different lesion patterns in men and women are linked to the extent of stroke severity.

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