Frontiers in Neurology | |
Rich-Club Organization: An Important Determinant of Functional Outcome After Acute Ischemic Stroke | |
Sofia Ira Ktena1  Anne-Katrin Giese3  Marco J. Nardin3  Natalia S. Rost3  Kathleen L. Donahue3  Mark R. Etherton3  Markus D. Schirmer4  Ona Wu5  | |
[1] Biomedical Image Analysis Group, Imperial College London, London, United Kingdom;Computer Science and Artificial Intelligence Lab, Massachusetts Institute of Technology, Cambridge, MA, United States;Department of Neurology, J. Philip Kistler Stroke Research Center, Harvard Medical School, Boston, MA, United States;Department of Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany;Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States; | |
关键词: acute ischemic stroke; outcome; rich-club; network topology; lesion; | |
DOI : 10.3389/fneur.2019.00956 | |
来源: DOAJ |
【 摘 要 】
Objective: To determine whether the rich-club organization, essential for information transport in the human connectome, is an important biomarker of functional outcome after acute ischemic stroke (AIS).Methods: Consecutive AIS patients (N = 344) with acute brain magnetic resonance imaging (MRI) (<48 h) were eligible for this study. Each patient underwent a clinical MRI protocol, which included diffusion weighted imaging (DWI). All DWIs were registered to a template on which rich-club regions have been defined. Using manual outlines of stroke lesions, we automatically counted the number of affected rich-club regions and assessed its effect on the National Institute of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS; obtained at 90 days post-stroke) scores through ordinal regression.Results: Of 344 patients (median age 65, inter-quartile range 54–76 years) with a median DWI lesion volume (DWIv) of 3cc, 64% were male. We established that an increase in number of rich-club regions affected by a stroke increases the odds of poor stroke outcome, measured by NIHSS (OR: 1.77, 95%CI 1.41–2.21) and mRS (OR: 1.38, 95%CI 1.11–1.73). Additionally, we demonstrated that the OR exceeds traditional markers, such as DWIv (ORNIHSS 1.08, 95%CI 1.06–1.11; ORmRS 1.05, 95%CI 1.03–1.07) and age (ORNIHSS 1.03, 95%CI 1.01–1.05; ORmRS 1.05, 95%CI 1.03–1.07).Conclusion: In this proof-of-concept study, the number of rich-club nodes affected by a stroke lesion presents a translational biomarker of stroke outcome, which can be readily assessed using standard clinical AIS imaging protocols and considered in functional outcome prediction models beyond traditional factors.
【 授权许可】
Unknown