Influence of Stroke Infarct Location on Functional Outcome Measured by the Modified Rankin Scale
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- 1 June 2014
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Stroke
- Vol. 45 (6), 1695-1702
- https://doi.org/10.1161/strokeaha.114.005152
Abstract
Background and Purpose— In the early days after ischemic stroke, information on structural brain damage from MRI supports prognosis of functional outcome. It is rated widely by the modified Rankin Scale that correlates only moderately with lesion volume. We therefore aimed to elucidate the influence of lesion location from early MRI (days 2–3) on functional outcome after 1 month using voxel-based lesion symptom mapping. Methods— We analyzed clinical and MRI data of patients from a prospective European multicenter stroke imaging study (I-KNOW). Lesions were delineated on fluid-attenuated inversion recovery images on days 2 to 3 after stroke onset. We generated statistic maps of lesion contribution related to clinical outcome (modified Rankin Scale) after 1 month using voxel-based lesion symptom mapping. Results— Lesion maps of 101 patients with middle cerebral artery infarctions were included for analysis (right-sided stroke, 47%). Mean age was 67 years, median admission National Institutes of Health Stroke Scale was 11. Mean infarct volumes were comparable between both sides (left, 37.5 mL; right, 43.7 mL). Voxel-based lesion symptom mapping revealed areas with high influence on higher modified Rankin Scale in regions involving the corona radiata, internal capsule, and insula. In addition, asymmetrically distributed impact patterns were found involving the right inferior temporal gyrus and left superior temporal gyrus. Conclusions— In this group of patients with stroke, characteristic lesion patterns in areas of motor control and areas involved in lateralized brain functions on early MRI were found to influence functional outcome. Our data provide a novel map of the impact of lesion localization on functional stroke outcome as measured by the modified Rankin Scale.Keywords
This publication has 44 references indexed in Scilit:
- Don’t neglect ‘neglect’- an update on post stroke neglectInternational Journal of Clinical Practice, 2013
- Damage to left anterior temporal cortex predicts impairment of complex syntactic processing: A lesion-symptom mapping studyHuman Brain Mapping, 2012
- The anatomy underlying acute versus chronic spatial neglect: a longitudinal studyBrain, 2010
- Dynamics of Regional Distribution of Ischemic Lesions in Middle Cerebral Artery Trunk Occlusion Relates to Collateral CirculationJournal of Cerebral Blood Flow & Metabolism, 2010
- Lesion Load of the Corticospinal Tract Predicts Motor Impairment in Chronic StrokeStroke, 2010
- Structural integrity of corticospinal motor fibers predicts motor impairment in chronic strokeNeurology, 2010
- Use of Magnetic Resonance Imaging to Predict Outcome after Stroke: A Review of Experimental and Clinical EvidenceJournal of Cerebral Blood Flow & Metabolism, 2010
- Interrater Agreement for Final Infarct MRI Lesion DelineationStroke, 2009
- Identification of critical areas for motor function recovery in chronic stroke subjects using voxel-based lesion symptom mappingNeuroImage, 2009
- The Real Estate FactorStroke, 2007