Show simple item record

dc.contributor.authorHelenius, Johanna
dc.contributor.authorHenninger, Nils
dc.date2022-08-11T08:09:28.000
dc.date.accessioned2022-08-23T16:31:53Z
dc.date.available2022-08-23T16:31:53Z
dc.date.issued2015-07-01
dc.date.submitted2016-05-10
dc.identifier.citationStroke. 2015 Jul;46(7):1857-63. doi: 10.1161/STROKEAHA.115.009258. Epub 2015 May 21. <a href="http://dx.doi.org/10.1161/STROKEAHA.115.009258">Link to article on publisher's site</a>
dc.identifier.issn0039-2499 (Linking)
dc.identifier.doi10.1161/STROKEAHA.115.009258
dc.identifier.pmid25999386
dc.identifier.urihttp://hdl.handle.net/20.500.14038/37758
dc.descriptionCo-author Nils Henninger is a doctoral student in the Millennium PhD Program (MPP) in the Graduate School of Biomedical Sciences (GSBS) at UMass Medical School.
dc.description.abstractBACKGROUND AND PURPOSE: The National Institutes of Health Stroke Scale (NIHSS) provides a reliable, quantitative measure of ischemic stroke severity and is predicted by the infarct size. We sought to determine whether leukoaraiosis severity affects the association between infarct size and NIHSS. METHODS: NIHSS and diffusion-weighted imaging-defined infarct volumes from 312 prospectively enrolled patients with supratentorial, ischemic strokes were analyzed. Leukoaraiosis severity was graded according to the Fazekas scale and conceptually defined as absent (0; n=44), mild (1-2; n=106), moderate (3-4; n=105), and severe (5-6; n=57). ANCOVA was used to describe the effect of leukoaraiosis on the association between infarct volume and NIHSS. Multivariable linear regression models were constructed to assess whether the association of leukoaraiosis and infarct volume on NIHSS was independent of other clinically relevant covariates. RESULTS: Overall, there was a significant correlation between the infarct volume and NIHSS (r=0.591; P < 0.001). This correlation significantly attenuated with increasing leukoaraiosis severity from r=0.786 (P < 0.001; absent leukoaraiosis) to r=0.498 (P<0.001; severe leukoaraiosis) and as shown by ANCOVA (P<0.001). Leukoaraiosis (coefficient, 0.107; 95% confidence interval, 0.036-0.179; P=0.016) and infarct volume (coefficient, 0.360; 95% confidence interval, 0.305-0.416; P < 0.001) were independently associated with a greater NIHSS deficit in the fully adjusted multivariable model. CONCLUSIONS: Leukoaraiosis significantly modulates the association between infarct volume and NIHSS. The clinical implications of these findings need further exploration in prospective studies but may be relevant to mitigate outcome differences in patients with stroke by aiding treatment decisions that rely on the NIHSS.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=25999386&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1161/STROKEAHA.115.009258
dc.subjectAdult
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectBrain Ischemia
dc.subjectCerebral Infarction
dc.subject*Cost of Illness
dc.subjectFemale
dc.subjectHumans
dc.subjectLeukoaraiosis
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectNational Institutes of Health (U.S.)
dc.subjectProspective Studies
dc.subjectRetrospective Studies
dc.subject*Severity of Illness Index
dc.subjectStroke
dc.subjectUnited States
dc.subjectacute stroke
dc.subjectcerebral infarct
dc.subjectcerebral small vessel disease
dc.subjectdiffusion weighted MRI
dc.subjectleukoaraiosis
dc.subjectmagnetic resonance imaging
dc.subjectwhite matter
dc.subjectNervous System Diseases
dc.subjectNeurology
dc.titleLeukoaraiosis Burden Significantly Modulates the Association Between Infarct Volume and National Institutes of Health Stroke Scale in Ischemic Stroke
dc.typeJournal Article
dc.source.journaltitleStroke; a journal of cerebral circulation
dc.source.volume46
dc.source.issue7
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/neuro_pp/431
dc.identifier.contextkey8585883
html.description.abstract<p>BACKGROUND AND PURPOSE: The National Institutes of Health Stroke Scale (NIHSS) provides a reliable, quantitative measure of ischemic stroke severity and is predicted by the infarct size. We sought to determine whether leukoaraiosis severity affects the association between infarct size and NIHSS. METHODS: NIHSS and diffusion-weighted imaging-defined infarct volumes from 312 prospectively enrolled patients with supratentorial, ischemic strokes were analyzed. Leukoaraiosis severity was graded according to the Fazekas scale and conceptually defined as absent (0; n=44), mild (1-2; n=106), moderate (3-4; n=105), and severe (5-6; n=57). ANCOVA was used to describe the effect of leukoaraiosis on the association between infarct volume and NIHSS. Multivariable linear regression models were constructed to assess whether the association of leukoaraiosis and infarct volume on NIHSS was independent of other clinically relevant covariates. RESULTS: Overall, there was a significant correlation between the infarct volume and NIHSS (r=0.591; P < 0.001). This correlation significantly attenuated with increasing leukoaraiosis severity from r=0.786 (P < 0.001; absent leukoaraiosis) to r=0.498 (P<0.001; severe leukoaraiosis) and as shown by ANCOVA (P<0.001). Leukoaraiosis (coefficient, 0.107; 95% confidence interval, 0.036-0.179; P=0.016) and infarct volume (coefficient, 0.360; 95% confidence interval, 0.305-0.416; P < 0.001) were independently associated with a greater NIHSS deficit in the fully adjusted multivariable model. CONCLUSIONS: Leukoaraiosis significantly modulates the association between infarct volume and NIHSS. The clinical implications of these findings need further exploration in prospective studies but may be relevant to mitigate outcome differences in patients with stroke by aiding treatment decisions that rely on the NIHSS.</p>
dc.identifier.submissionpathneuro_pp/431
dc.contributor.departmentDepartment of Neurology
dc.source.pages1857-63


This item appears in the following Collection(s)

Show simple item record