TY - JOUR
T1 - Early Brain Volume Changes After Stroke
T2 - Subgroup Analysis From the AXIS-2 Trial
AU - Bu, Ning
AU - Churilov, Leonid
AU - Khlif, Mohamed Salah
AU - Lemmens, Robin
AU - Wouters, Anke
AU - Fiebach, Jochen B.
AU - Chamorro, Angel
AU - Ringelstein, E. Bernd
AU - Norrving, Bo
AU - Laage, Rico
AU - Grond, Martin
AU - Wilms, Guido
AU - Brodtmann, Amy
AU - Thijs, Vincent
N1 - Funding Information:
The study was supported by the China National Scholarship fund. The Florey Institute of Neuroscience and Mental Health acknowledges the strong support from the Victorian Government and in particular the funding from the Operational Infrastructure Support Grant. RL is a Senior Clinical Investigator of FWO Flanders and is supported by grants from the European Union.
Publisher Copyright:
Copyright © 2022 Bu, Churilov, Khlif, Lemmens, Wouters, Fiebach, Chamorro, Ringelstein, Norrving, Laage, Grond, Wilms, Brodtmann and Thijs.
PY - 2022/1/28
Y1 - 2022/1/28
N2 - Background and Purpose: The evolution of total brain volume early after stroke is not well understood. We investigated the associations between age and imaging features and brain volume change in the first month after stroke. Methods: We retrospectively studied patients with acute ischemic stroke enrolled in the AXIS-2 trial. Total brain volume change from hyperacute MRI data to the first month after stroke was assessed using unified segmentation in SPM12. We hypothesized that age, ischemic brain lesion size, and white matter (WM) changes were associated with larger brain volume change. Enlarged perivascular spaces (EPVSs) and white matter hyperintensities (WMHs) were rated visually and the presence of lacunes was assessed. Results: We enrolled 173 patients with a mean age of 67 ± 11 years, 44% were women. There was a median 6 ml decrease in volume (25th percentile −1 ml to 75th percentile 21 ml) over time, equivalent to a median 0.5% (interquartile range [IQR], −0.07%−1.4%), decrease in brain volume. Age was associated with larger brain volume loss (per 10 years of age, 5 ml 95% CI 2–8 ml). Baseline diffusion weighted imaging (DWI) lesion volume was not associated with greater volume loss per 10 ml of lesion volume, change by 0 ml (95% CI −0.1 to 0.1 ml). Increasing Fazekas scores of deep WMH were associated with greater tissue loss (5 ml, 95% CI 1–10 ml). Conclusions: Total brain volume changes in a heterogenous fashion after stroke. Volume loss occurs over 1 month after stroke and is associated with age and deep WM disease. We did not find evidence that more severe strokes lead to increased early tissue loss.
AB - Background and Purpose: The evolution of total brain volume early after stroke is not well understood. We investigated the associations between age and imaging features and brain volume change in the first month after stroke. Methods: We retrospectively studied patients with acute ischemic stroke enrolled in the AXIS-2 trial. Total brain volume change from hyperacute MRI data to the first month after stroke was assessed using unified segmentation in SPM12. We hypothesized that age, ischemic brain lesion size, and white matter (WM) changes were associated with larger brain volume change. Enlarged perivascular spaces (EPVSs) and white matter hyperintensities (WMHs) were rated visually and the presence of lacunes was assessed. Results: We enrolled 173 patients with a mean age of 67 ± 11 years, 44% were women. There was a median 6 ml decrease in volume (25th percentile −1 ml to 75th percentile 21 ml) over time, equivalent to a median 0.5% (interquartile range [IQR], −0.07%−1.4%), decrease in brain volume. Age was associated with larger brain volume loss (per 10 years of age, 5 ml 95% CI 2–8 ml). Baseline diffusion weighted imaging (DWI) lesion volume was not associated with greater volume loss per 10 ml of lesion volume, change by 0 ml (95% CI −0.1 to 0.1 ml). Increasing Fazekas scores of deep WMH were associated with greater tissue loss (5 ml, 95% CI 1–10 ml). Conclusions: Total brain volume changes in a heterogenous fashion after stroke. Volume loss occurs over 1 month after stroke and is associated with age and deep WM disease. We did not find evidence that more severe strokes lead to increased early tissue loss.
KW - atrophy
KW - brain volume changes
KW - clinical trial
KW - edema
KW - hemorrhagic transformation
KW - ischemic stroke
UR - http://www.scopus.com/inward/record.url?scp=85124588431&partnerID=8YFLogxK
U2 - 10.3389/fneur.2021.747343
DO - 10.3389/fneur.2021.747343
M3 - Article
C2 - 35153972
AN - SCOPUS:85124588431
SN - 1664-2295
VL - 12
JO - Frontiers in Neurology
JF - Frontiers in Neurology
M1 - 747343
ER -