38 results on '"Wasselius, Johan"'
Search Results
2. Evaluation of CINA® LVO artificial intelligence software for detection of large vessel occlusion in brain CT angiography
- Author
-
Mellander, Helena, Hillal, Amir, Ullberg, Teresa, and Wassélius, Johan
- Published
- 2024
- Full Text
- View/download PDF
3. Brain volume: An important determinant of functional outcome after acute ischemic stroke
- Author
-
Schirmer, Markus D., Donahue, Kathleen L., Nardin, Marco J., Dalca, Adrian V., Giese, Anne-Katrin, Etherton, Mark R., Mocking, Steven J. T., McIntosh, Elissa C., Cole, John W., Holmegaard, Lukas, Jood, Katarina, Jimenez-Conde, Jordi, Kittner, Steven J., Lemmens, Robin, Meschia, James F., Rosand, Jonathan, Roquer, Jaume, Rundek, Tatjana, MD, Ralph L. Sacco, Schmidt, Reinhold, Sharma, Pankaj, Slowik, Agnieszka, Stanne, Tara M., Vagal, Achala, Wasselius, Johan, Woo, Daniel, Bevan, Stephen, Heitsch, Laura, Phuah, Chia-Ling, MD, Daniel Strbian, Tatlisumak, Turgut, Levi, Christopher R., Attia, John, McArdle, Patrick F., Worrall, Bradford B., Wu, Ona, Jern, Christina, Lindgren, Arne, Maguire, Jane, Thijs, Vincent, and Rost, Natalia S.
- Subjects
Quantitative Biology - Neurons and Cognition - Abstract
Objective: To determine whether brain volume is associated with functional outcome after acute ischemic stroke (AIS). Methods: We analyzed cross-sectional data of the multi-site, international hospital-based MRI-GENetics Interface Exploration (MRI-GENIE) study (July 1, 2014- March 16, 2019) with clinical brain magnetic resonance imaging (MRI) obtained on admission for index stroke and functional outcome assessment. Post-stroke outcome was determined using the modified Rankin Scale (mRS) score (0-6; 0: asymptomatic; 6 death) recorded between 60-190 days after stroke. Demographics and other clinical variables including acute stroke severity (measured as National Institutes of Health Stroke Scale score), vascular risk factors, and etiologic stroke subtypes (Causative Classification of Stroke) were recorded during index admission. Results: Utilizing the data from 912 acute ischemic stroke (AIS) patients (65+/-15 years of age, 58% male, 57% history of smoking, and 65% hypertensive) in a generalized linear model, brain volume (per 155.1cm^3 ) was associated with age (beta -0.3 (per 14.4 years)), male sex (beta 1.0) and prior stroke (beta -0.2). In the multivariable outcome model, brain volume was an independent predictor of mRS (beta -0.233), with reduced odds of worse long-term functional outcomes (OR: 0.8, 95% CI 0.7-0.9) in those with larger brain volumes. Conclusions: Larger brain volume quantified on clinical MRI of AIS patients at time of stroke purports a protective mechanism. The role of brain volume as a prognostic, protective biomarker has the potential to forge new areas of research and advance current knowledge of mechanisms of post-stroke recovery.
- Published
- 2020
- Full Text
- View/download PDF
4. Metal artifact reduction by virtual monoenergetic reconstructions from spectral brain CT
- Author
-
Mellander, Helena, Fransson, Veronica, Ydström, Kristina, Lätt, Jimmy, Ullberg, Teresa, Wassélius, Johan, and Ramgren, Birgitta
- Published
- 2023
- Full Text
- View/download PDF
5. Classifications of atherosclerotic plaque components with T1 and T2* mapping in 11.7 T MRI
- Author
-
Truong, My, Lennartsson, Finn, Bibic, Adnan, Sundius, Lena, Persson, Ana, Siemund, Roger, In’t Zandt, René, Goncalves, Isabel, and Wassélius, Johan
- Published
- 2021
- Full Text
- View/download PDF
6. Diagnostic accuracy and radiological validation of intracerebral hemorrhage diagnosis in the Swedish Stroke Register (Riksstroke).
- Author
-
Sultani, Gabriella, Hillal, Amir, Ramgren, Birgitta, Apostolaki‐Hansson, Trine, Norrving, Bo, Wasselius, Johan, and Ullberg, Teresa
- Subjects
INTRACRANIAL hemorrhage ,CEREBRAL hemorrhage ,STROKE ,SUBARACHNOID hemorrhage ,AGE groups - Abstract
Background and purpose: National quality registries for stroke care operate under the assumption that the included patients are correctly diagnosed. We aimed to validate the clinical diagnosis of spontaneous intracerebral hemorrhage (ICH) in Riksstroke (RS) by evaluating radiological data from a large, unselected ICH population. Methods: We conducted a retrospective, multicenter study including all ICH patients registered in RS between 2016 and 2020 residing in Skåne County in Sweden (1.41 million inhabitants). Radiological data from first imaging were evaluated for the presence of spontaneous ICH. Other types of bleeds were registered if a spontaneous ICH was not identified on imaging. The radiological evaluation was independently performed by one radiology fellow and one senior neuroradiologist. Results: Between 2016 and 2020, 1784 ICH cases were registered in RS, of which 1655 (92.8%) had a radiological diagnosis consistent with spontaneous ICH. In the 129 (7.2%) remaining cases, the radiological diagnosis was instead traumatic bleed (n = 80), subarachnoid hemorrhage (n = 15), brain tumor bleed (n = 14), ischemic lesion with hemorrhagic transformation (n = 14), ischemic lesion (n = 3), or no bleed at all (n = 3). There was a higher degree of incorrect coding in the older age groups. Conclusion: At radiological evaluation, 92.8% of ICH diagnoses in RS were consistent with spontaneous ICH, yielding a high rate of agreement that strengthens the validity of the diagnostic accuracy in the register, justifying the use of high coverage quality register data for epidemiological purposes. The most common coding error was traumatic bleeds that were classified as spontaneous ICH. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
7. Small vessel disease in primary familial brain calcification with novel truncating PDGFB variants
- Author
-
Yektay Farahmand, Maha, primary, Wasselius, Johan, additional, Englund, Elisabet, additional, Braverman, Irwin, additional, Puschmann, Andreas, additional, and Ilinca, Andreea, additional
- Published
- 2024
- Full Text
- View/download PDF
8. Iterative metal artifact reduction in aortic CTA after Onyx®-embolization
- Author
-
Lehti, Leena, Söderberg, Marcus, Mellander, Helena, and Wassélius, Johan
- Published
- 2020
- Full Text
- View/download PDF
9. The use of accelerometer bracelets to evaluate arm motor function over a stroke rehabilitation period – an explorative observational study.
- Author
-
Finn, Eric Lyckegård, Carlsson, Håkan, Ericson, Petter, Åström, Kalle, Brogårdh, Christina, and Wasselius, Johan
- Subjects
WRIST ,STROKE rehabilitation ,ACCELEROMETERS ,MOTORS ,BRACELETS ,ACCELEROMETRY ,SCIENTIFIC observation ,REHABILITATION - Abstract
Background: Assessments of arm motor function are usually based on clinical examinations or self-reported rating scales. Wrist-worn accelerometers can be a good complement to measure movement patterns after stroke. Currently there is limited knowledge of how accelerometry correlate to clinically used scales. The purpose of this study was therefore to evaluate the relationship between intermittent measurements of wrist-worn accelerometers and the patient's progression of arm motor function assessed by routine clinical outcome measures during a rehabilitation period. Methods: Patients enrolled in in-hospital rehabilitation following a stroke were invited. Included patients were asked to wear wrist accelerometers for 24 h at the start (T1) and end (T2) of their rehabilitation period. On both occasions arm motor function was assessed by the modified Motor Assessment Scale (M_MAS) and the Motor Activity Log (MAL). The recorded accelerometry was compared to M_MAS and MAL. Results: 20 patients were included, of which 18 completed all measurements and were therefore included in the final analysis. The resulting Spearman's rank correlation coefficient showed a strong positive correlation between measured wrist acceleration in the affected arm and M-MAS and MAL values at T1, 0.94 (p < 0.05) for M_MAS and 0.74 (p < 0.05) for the MAL values, and a slightly weaker positive correlation at T2, 0.57 (p < 0.05) for M_MAS and 0.46 − 0.45 (p = 0.06) for the MAL values. However, no correlation was seen for the difference between the two sessions. Conclusions: The results confirm that the wrist acceleration can differentiate between the affected and non-affected arm, and that there is a positive correlation between accelerometry and clinical measures. Many of the patients did not change their M-MAS or MAL scores during the rehabilitation period, which may explain why no correlation was seen for the difference between measurements during the rehabilitation period. Further studies should include continuous accelerometry throughout the rehabilitation period to reduce the impact of day-to-day variability. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
10. White matter hyperintensity quantification in large-scale clinical acute ischemic stroke cohorts – The MRI-GENIE study
- Author
-
Schirmer, Markus D., Dalca, Adrian V., Sridharan, Ramesh, Giese, Anne-Katrin, Donahue, Kathleen L., Nardin, Marco J., Mocking, Steven J.T., McIntosh, Elissa C., Frid, Petrea, Wasselius, Johan, Cole, John W., Holmegaard, Lukas, Jern, Christina, Jimenez-Conde, Jordi, Lemmens, Robin, Lindgren, Arne G., Meschia, James F., Roquer, Jaume, Rundek, Tatjana, Sacco, Ralph L., Schmidt, Reinhold, Sharma, Pankaj, Slowik, Agnieszka, Thijs, Vincent, Woo, Daniel, Vagal, Achala, Xu, Huichun, Kittner, Steven J., McArdle, Patrick F., Mitchell, Braxton D., Rosand, Jonathan, Worrall, Bradford B., Wu, Ona, Golland, Polina, and Rost, Natalia S.
- Published
- 2019
- Full Text
- View/download PDF
11. Radiomics-Derived Brain Age Predicts Functional Outcome After Acute Ischemic Stroke
- Author
-
Bretzner, Martin, Bonkhoff, Anna K., Schirmer, Markus D., Hong, Sungmin, Dalca, Adrian, Donahue, Kathleen, Giese, Anne-Katrin, Etherton, Mark R., Rist, Pamela M., Nardin, Marco, Regenhardt, Robert W., Leclerc, Xavier, Lopes, Renaud, Gautherot, Morgan, Wang, Clinton, Benavente, Oscar R., Cole, John W., Donatti, Amanda, Griessenauer, Christoph, Heitsch, Laura, Holmegaard, Lukas, Jood, Katarina, Jimenez-Conde, Jordi, Kittner, Steven J., Lemmens, Robin, Levi, Christopher R., Mcardle, Patrick F., Mcdonough, Caitrin W., Meschia, James F., Phuah, Chia-Ling, Rolfs, Arndt, Ropele, Stefan, Rosand, Jonathan, Roquer, Jaume, Rundek, Tatjana, Sacco, Ralph L., Schmidt, Reinhold, Sharma, Pankaj, Słowik, Agnieszka, Sousa, Alessandro, Stanne, Tara M., Strbian, Daniel, Tatlisumak, Turgut, Thijs, Vincent, Vagal, Achala, Wasselius, Johan, Woo, Daniel, Wu, Ona, Zand, Ramin, Worrall, Bradford B., Maguire, Jane, Lindgren, Arne G., Jern, Christina, Golland, Polina, Kuchcinski, Gregory, and Rost, Natalia S.
- Subjects
Neurology (clinical) ,Research Article - Abstract
Background and ObjectivesWhile chronological age is one of the most influential determinants of poststroke outcomes, little is known of the impact of neuroimaging-derived biological “brain age.” We hypothesized that radiomics analyses of T2-FLAIR images texture would provide brain age estimates and that advanced brain age of patients with stroke will be associated with cardiovascular risk factors and worse functional outcomes.MethodsWe extracted radiomics from T2-FLAIR images acquired during acute stroke clinical evaluation. Brain age was determined from brain parenchyma radiomics using an ElasticNet linear regression model. Subsequently, relative brain age (RBA), which expresses brain age in comparison with chronological age-matched peers, was estimated. Finally, we built a linear regression model of RBA using clinical cardiovascular characteristics as inputs and a logistic regression model of favorable functional outcomes taking RBA as input.ResultsWe reviewed 4,163 patients from a large multisite ischemic stroke cohort (mean age = 62.8 years, 42.0% female patients). T2-FLAIR radiomics predicted chronological ages (mean absolute error = 6.9 years,r= 0.81). After adjustment for covariates, RBA was higher and therefore described older-appearing brains in patients with hypertension, diabetes mellitus, a history of smoking, and a history of a prior stroke. In multivariate analyses, age, RBA, NIHSS, and a history of prior stroke were all significantly associated with functional outcome (respective adjusted odds ratios: 0.58, 0.76, 0.48, 0.55; allp-values < 0.001). Moreover, the negative effect of RBA on outcome was especially pronounced in minor strokes.DiscussionT2-FLAIR radiomics can be used to predict brain age and derive RBA. Older-appearing brains, characterized by a higher RBA, reflect cardiovascular risk factor accumulation and are linked to worse outcomes after stroke.
- Published
- 2022
- Full Text
- View/download PDF
12. Big Data Approaches to Phenotyping Acute Ischemic Stroke Using Automated Lesion Segmentation of Multi-Center Magnetic Resonance Imaging Data
- Author
-
Wu, Ona, Winzeck, Stefan, Giese, Anne-Katrin, Hancock, Brandon L., Etherton, Mark R., Bouts, Mark J.R.J., Donahue, Kathleen, Schirmer, Markus D., Irie, Robert E., Mocking, Steven J.T., McIntosh, Elissa C., Bezerra, Raquel, Kamnitsas, Konstantinos, Frid, Petrea, Wasselius, Johan, Cole, John W., Xu, Huichun, Holmegaard, Lukas, Jiménez-Conde, Jordi, Lemmens, Robin, Lorentzen, Eric, McArdle, Patrick F., Meschia, James F., Roquer, Jaume, Rundek, Tatjana, Sacco, Ralph L., Schmidt, Reinhold, Sharma, Pankaj, Slowik, Agnieszka, Stanne, Tara M., Thijs, Vincent, Vagal, Achala, Woo, Daniel, Bevan, Stephen, Kittner, Steven J., Mitchell, Braxton D., Rosand, Jonathan, Worrall, Bradford B., Jern, Christina, Lindgren, Arne G., Maguire, Jane, and Rost, Natalia S.
- Published
- 2019
- Full Text
- View/download PDF
13. Small vessel disease in primary familial brain calcification with novel truncating PDGFB variants.
- Author
-
Farahmand, Maha Yektay, Wasselius, Johan, Englund, Elisabet, Braverman, Irwin, Puschmann, Andreas, and Ilinca, Andreea
- Abstract
Introduction. Primary familial brain calcification (PFBC) is a neurodegenerative disease characterised by bilateral calcification in the brain, especially in the basal ganglia, leading to neurological and neuropsychiatric manifestations. White matter hyperintensities (WMH) have been described in patients with PFBC and pathogenic variants in the gene for platelet-derived growth factor beta polypeptide (PDGFB), suggesting a manifest cerebrovascular process. We present below the cases of two PFBC families with PDGFB variants and stroke or transient ischaemic attack (TIA) episodes. We examine the possible correlation between PFBC and vascular events as stroke/TIA, and evaluate whether signs for vascular disease in this condition are systemic or limited to the cerebral vessels. Material and methods. Two Swedish families with novel truncating PDGFB variants, p.Gln140* and p.Arg191*, are described clinically and radiologically. Subcutaneous capillary vessels in affected and unaffected family members were examined by light and electron microscopy. Results. All mutation carriers showed WMH and bilateral brain calcifications. The clinical presentations differed, with movement disorder symptoms dominating in family A, and psychiatric symptoms in family B. However, affected members of both families had stroke, TIA, and/or asymptomatic intracerebral ischaemic lesions. Only one of the patients had classical vascular risk factors. Skin microvasculature was normal. Conclusions. Patients with these PDGFB variants develop microvascular changes in the brain, but not the skin. PDGFB-related small vessel disease can manifest radiologically as cerebral haemorrhage or ischaemia, and may explain TIA or stroke in patients without other vascular risk factors. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
14. Accuracy of uncalibrated 2D digital subtraction angiography measurements on a novel biplane system compared to computed tomography angiography
- Author
-
Landström, Lovisa, primary and Wasselius, Johan A, additional
- Published
- 2023
- Full Text
- View/download PDF
15. sj-docx-1-ine-10.1177_15910199231171656 - Supplemental material for Accuracy of uncalibrated 2D digital subtraction angiography measurements on a novel biplane system compared to computed tomography angiography
- Author
-
Landström, Lovisa and Wasselius, Johan A
- Subjects
FOS: Clinical medicine ,110904 Neurology and Neuromuscular Diseases ,Neuroscience - Abstract
Supplemental material, sj-docx-1-ine-10.1177_15910199231171656 for Accuracy of uncalibrated 2D digital subtraction angiography measurements on a novel biplane system compared to computed tomography angiography by Lovisa Landstrom, and Johan A Wasselius in Interventional Neuroradiology
- Published
- 2023
- Full Text
- View/download PDF
16. Design and rationale for examining neuroimaging genetics in ischemic stroke: The MRI-GENIE study
- Author
-
Giese, Anne-Katrin, Schirmer, Markus D., Donahue, Kathleen L., Cloonan, Lisa, Irie, Robert, Winzeck, Stefan, Bouts, Mark J.R.J., McIntosh, Elissa C., Mocking, Steven J., Dalca, Adrian V., Sridharan, Ramesh, Xu, Huichun, Frid, Petrea, Giralt-Steinhauer, Eva, Holmegaard, Lukas, Roquer, Jaume, Wasselius, Johan, Cole, John W., McArdle, Patrick F., Broderick, Joseph P., Jimenez-Conde, Jordi, Jern, Christina, Kissela, Brett M., Kleindorfer, Dawn O., Lemmens, Robin, Lindgren, Arne, Meschia, James F., Rundek, Tatjana, Sacco, Ralph L., Schmidt, Reinhold, Sharma, Pankaj, Slowik, Agnieszka, Thijs, Vincent, Woo, Daniel, Worrall, Bradford B., Kittner, Steven J., Mitchell, Braxton D., Rosand, Jonathan, Golland, Polina, Wu, Ona, and Rost, Natalia S.
- Published
- 2017
- Full Text
- View/download PDF
17. Deep profiling of multiple ischemic lesions in a large, multi-center cohort: Frequency, spatial distribution, and associations to clinical characteristics
- Author
-
Bonkhoff, Anna K., primary, Ullberg, Teresa, additional, Bretzner, Martin, additional, Hong, Sungmin, additional, Schirmer, Markus D., additional, Regenhardt, Robert W., additional, Donahue, Kathleen L., additional, Nardin, Marco J., additional, Dalca, Adrian V., additional, Giese, Anne-Katrin, additional, Etherton, Mark R., additional, Hancock, Brandon L., additional, Mocking, Steven J. T., additional, McIntosh, Elissa C., additional, Attia, John, additional, Cole, John W., additional, Donatti, Amanda, additional, Griessenauer, Christoph J., additional, Heitsch, Laura, additional, Holmegaard, Lukas, additional, Jood, Katarina, additional, Jimenez-Conde, Jordi, additional, Kittner, Steven J., additional, Lemmens, Robin, additional, Levi, Christopher R., additional, McDonough, Caitrin W., additional, Meschia, James F., additional, Phuah, Chia-Ling, additional, Ropele, Stefan, additional, Rosand, Jonathan, additional, Roquer, Jaume, additional, Rundek, Tatjana, additional, Sacco, Ralph L., additional, Schmidt, Reinhold, additional, Sharma, Pankaj, additional, Slowik, Agnieszka, additional, Sousa, Alessandro, additional, Stanne, Tara M., additional, Strbian, Daniel, additional, Tatlisumak, Turgut, additional, Thijs, Vincent, additional, Vagal, Achala, additional, Woo, Daniel, additional, Zand, Ramin, additional, McArdle, Patrick F., additional, Worrall, Bradford B., additional, Jern, Christina, additional, Lindgren, Arne G., additional, Maguire, Jane, additional, Wu, Ona, additional, Frid, Petrea, additional, Rost, Natalia S., additional, and Wasselius, Johan, additional
- Published
- 2022
- Full Text
- View/download PDF
18. Sex-specific lesion pattern of functional outcomes after stroke
- Author
-
Bonkhoff, Anna K., Bretzner, Martin, Hong, Sungmin, Schirmer, Markus D., Cohen, Alexander, Regenhardt, Robert W., Donahue, Kathleen L., Nardin, Marco J., Dalca, Adrian Vasile, Giese, Anne-Katrin, Etherton, Mark R., Hancock, Brandon L., Mocking, Steven J. T., McIntosh, Elissa C., Attia, John, Benavente, Oscar R., Bevan, Stephen, Cole, John W., Donatti, Amanda, Griessenauer, Christoph J., Heitsch, Laura, Holmegaard, Lukas, Jood, Katarina, Jimenez-Conde, Jordi, Kittner, Steven J., Lemmens, Robin, Levi, Christopher R., McDonough, Caitrin W., Meschia, James F., Phuah, Chia-Ling, Rolfs, Arndt, Ropele, Stefan, Rosand, Jonathan, Roquer, Jaume, Rundek, Tatjana, Sacco, Ralph L., Schmidt, Reinhold, Sharma, Pankaj, Slowik, Agnieszka, Söderholm, Martin, Sousa, Alessandro, Stanne, Tara M., Strbian, Daniel, Tatlisumak, Turgut, Thijs, Vincent, Vagal, Achala, Wasselius, Johan, Woo, Daniel, Zand, Ramin, McArdle, Patrick F., Worrall, Bradford B., Jern, Christina, Lindgren, Arne G., Maguire, Jane, Fox, Michael D., Bzdok, Danilo, Wu, Ona, Rost, Natalia S., Universitat Autònoma de Barcelona, Neurologian yksikkö, and HUS Neurocenter
- Subjects
sex differences ,Science & Technology ,AREA ,General Engineering ,3112 Neurosciences ,Clinical Neurology ,Neurosciences ,lesion patterns ,3124 Neurology and psychiatry ,functional outcomes ,Bayesian hierarchical modelling ,Neurosciences & Neurology ,HUMAN CEREBRAL-CORTEX ,Life Sciences & Biomedicine ,acute ischaemic stroke - Abstract
Relying on neuroimaging and clinical data of 822 acute stroke patients, Bonkhoff et al. report substantially more detrimental effects of lesions in left-hemispheric posterior circulation regions on functional outcomes in women compared to men. These findings may motivate a sex-specific clinical stroke management to improve outcomes in the longer term. Stroke represents a considerable burden of disease for both men and women. However, a growing body of literature suggests clinically relevant sex differences in the underlying causes, presentations and outcomes of acute ischaemic stroke. In a recent study, we reported sex divergences in lesion topographies: specific to women, acute stroke severity was linked to lesions in the left-hemispheric posterior circulation. We here determined whether these sex-specific brain manifestations also affect long-term outcomes. We relied on 822 acute ischaemic patients [age: 64.7 (15.0) years, 39% women] originating from the multi-centre MRI-GENIE study to model unfavourable outcomes (modified Rankin Scale >2) based on acute neuroimaging data in a Bayesian hierarchical framework. Lesions encompassing bilateral subcortical nuclei and left-lateralized regions in proximity to the insula explained outcomes across men and women (area under the curve = 0.81). A pattern of left-hemispheric posterior circulation brain regions, combining left hippocampus, precuneus, fusiform and lingual gyrus, occipital pole and latero-occipital cortex, showed a substantially higher relevance in explaining functional outcomes in women compared to men [mean difference of Bayesian posterior distributions (men - women) = -0.295 (90% highest posterior density interval = -0.556 to -0.068)]. Once validated in prospective studies, our findings may motivate a sex-specific approach to clinical stroke management and hold the promise of enhancing outcomes on a population level.
- Published
- 2022
19. Deep profiling of multiple ischemic lesions in a large, multi-center cohort. Frequency, spatial distribution, and associations to clinical characteristics
- Author
-
Bonkhoff, Anna K., Jiménez Conde, Jordi, Roquer, Jaume, and Wasselius, Johan
- Subjects
Bayesian hierarchical regression ,Magnetic resonance imaging ,Lesion volume ,Acute ischemic stroke ,Multiple acute ischemic lesions ,Quantitative imaging - Abstract
Background purpose: a substantial number of patients with acute ischemic stroke (AIS) experience multiple acute lesions (MAL). We here aimed to scrutinize MAL in a large radiologically deep-phenotyped cohort. Materials and methods: analyses relied upon imaging and clinical data from the international MRI-GENIE study. Imaging data comprised both Fluid-attenuated inversion recovery (FLAIR) for white matter hyperintensity (WMH) burden estimation and diffusion-weighted imaging (DWI) sequences for the assessment of acute stroke lesions. The initial step featured the systematic evaluation of occurrences of MAL within one and several vascular supply territories. Associations between MAL and important imaging and clinical characteristics were subsequently determined. The interaction effect between single and multiple lesion status and lesion volume was estimated by means of Bayesian hierarchical regression modeling for both stroke severity and functional outcome. Results: we analyzed 2,466 patients (age = 63.4 ± 14.8, 39% women), 49.7% of which presented with a single lesion. Another 37.4% experienced MAL in a single vascular territory, while 12.9% featured lesions in multiple vascular territories. Within most territories, MAL occurred as frequently as single lesions (ratio ∼1:1). Only the brainstem region comprised fewer patients with MAL (ratio 1:4). Patients with MAL presented with a significantly higher lesion volume and acute NIHSS (7.7 vs. 1.7 ml and 4 vs. 3, p FDR < 0.001). In contrast, patients with a single lesion were characterized by a significantly higher WMH burden (6.1 vs. 5.3 ml, p FDR = 0.048). Functional outcome did not differ significantly between patients with single versus multiple lesions. Bayesian analyses suggested that the association between lesion volume and stroke severity between single and multiple lesions was the same in case of anterior circulation stroke. In case of posterior circulation stroke, lesion volume was linked to a higher NIHSS only among those with MAL. Conclusion: multiple lesions, especially those within one vascular territory, occurred more frequently than previously reported. Overall, multiple lesions were distinctly linked to a higher acute stroke severity, a higher total DWI lesion volume and a lower WMH lesion volume. In posterior circulation stroke, lesion volume was linked to a higher stroke severity in multiple lesions only.
- Published
- 2022
20. Detection of Unilateral Arm Paresis after Stroke by Wearable Accelerometers and Machine Learning
- Author
-
Wasselius, Johan, primary, Lyckegård Finn, Eric, additional, Persson, Emma, additional, Ericson, Petter, additional, Brogårdh, Christina, additional, Lindgren, Arne G., additional, Ullberg, Teresa, additional, and Åström, Kalle, additional
- Published
- 2021
- Full Text
- View/download PDF
21. Genome-wide association study of intracranial aneurysms identifies 17 risk loci and genetic overlap with clinical risk factors
- Author
-
Bakker, Mark K., van der Spek, Rick A.A., van Rheenen, Wouter, Morel, Sandrine, Bourcier, Romain, Hostettler, Isabel C., Alg, Varinder S., van Eijk, Kristel R., Koido, Masaru, Akiyama, Masato, Terao, Chikashi, Matsuda, Koichi, Walters, Robin G., Lin, Kuang, Li, Liming, Millwood, Iona Y., Chen, Zhengming, Rouleau, Guy A., Zhou, Sirui, Rannikmäe, Kristiina, Sudlow, Cathie L.M., Houlden, Henry, van den Berg, Leonard H., Dina, Christian, Naggara, Olivier, Gentric, Jean-Christophe, Shotar, Eimad, Eugène, François, Desal, Hubert, Winsvold, Bendik S., Børte, Sigrid, Johnsen, Marianne Bakke, Brumpton, Ben M., Sandvei, Marie Søfteland, Willer, Cristen J., Hveem, Kristian, Zwart, John-Anker, Verschuren, W. M. Monique, Friedrich, Christoph M., Hirsch, Sven, Schilling, Sabine, Dauvillier, Jérôme, Martin, Olivier, Martinsen, Amy E, Aamodt, Anne Hege, Skogholt, Anne Heidi, Sandset, Else Charlotte, Kristoffersen, Espen S, Ellekjaer, Hanne, Heuch, Ingrid, Nielsen, Jonas Bille, Hagen, Knut, Fritsche, Lars, Thomas, Laurent F., Pedersen, Linda, Gabrielsen, Maiken E, Vigeland, Maria Dehli, Holmen, Oddgeir, Zhou, Wei, Chen, Junshi, Chen (PI), Zhengming, Clarke, Robert, Collins, Rory, Guo, Yu, Li (PI), Liming, Liu, Depei, Lv, Jun, Peto, Richard, Walters, Robin, Avery, Daniel, Boxall, Ruth, Bennett, Derrick, Chang, Yumei, Chen, Yiping, Du, Huaidong, Gan, Wei, Gilbert, Simon, Hacker, Alex, Hill, Michael, Holmes, Michael, Iona, Andri, Kartsonaki, Christiana, Kerosi, Rene, Kong, Ling, Lancaster, Garry, Lewington, Sarah, McDonnell, John, Millwood, Iona, Nie, Qunhua, Ryder, Paul, Sansome, Sam, Schmidt-Valle, Dan, Sherliker, Paul, Sohoni, Rajani, Stevens, Becky, Turnbull, Iain, Wang, Lin, Wright, Neil, Yang, Ling, Yang, Xiaoming, Yao, Pang, Bian, Zheng, Han, Xiao, Hou, Can, Pei, Pei, Liu, Chao, Yu, Canqing, Pang, Zengchang, Gao, Ruqin, Li, Shanpeng, Wang, Shaojie, Liu, Yongmei, Du, Ranran, Cheng, Liang, Tian, Xiaocao, Zhang, Hua, Zhai, Yaoming, Ning, Feng, Sun, Xiaohui, Li, Feifei, Lv, Silu, Wang, Junzheng, Hou, Wei, Zou, Mingyuan, Yan, Shichun, Zhou, Xue, Yu, Bo, Li, Yanjie, Xu, Qinai, Kang, Quan, Guo, Ziyan, Wang, Dan, Hu, Ximin, Chen, Jinyan, Fu, Yan, Wang, Xiaohuan, Weng, Min, Guo, Zhendong, Wu, Shukuan, Li, Yilei, Li, Huimei, Wu, Ming, Zhou, Yonglin, Zhou, Jinyi, Tao, Ran, Yang, Jie, Su, Jian, liu, Fang, Zhang, Jun, Hu, Yihe, Lu, Yan, Ma, Liangcai, Tang, Aiyu, Hua, Yujie, Jin, Jianrong, Liu, Jingchao, Tang, Zhenzhu, Chen, Naying, Huang, Ying, Li, Mingqiang, Meng, Jinhuai, Pan, Rong, Jiang, Qilian, Lan, Jian, Liu, Yun, Wei, Liuping, Zhou, Liyuan, Chen, Ningyu, Wang, Ping, Meng, Fanwen, Qin Sisi Wang, Yulu, Wu, Xianping, Zhang, Ningmei, Chen, Xiaofang, Zhou, Weiwei, Luo, Guojin, Li, Jianguo, Zhong, Xunfu, Liu, Jiaqiu, Sun, Qiang, Ge, Pengfei, Ren, Xiaolan, Dong, Caixia, Zhang, Hui, Mao, Enke, Wang, Xiaoping, Wang, Tao, Zhang, Xi, Zhou, Ding Zhang, Zhou, Gang, Feng, Shixian, Chang, Ling, Fan, Lei, Gao, Yulian, He, Tianyou, Sun, Huarong, He, Pan, Hu, Chen, Zhang, Xukui, Wu, Huifang, Yu, Min, Hu, Ruying, Wang, Hao, Gong, Weiwei, Wang, Meng, Xie, Kaixu, Chen, Lingli, Pan, Dongxia, Gu, Qijun, Huang, Yuelong, Chen, Biyun, Yin, Li, Liu, Huilin, Fu, Zhongxi, Xu, Qiaohua, Xu, Xin, Zhang, Hao, Long, Huajun, Zhang, Libo, Nagai, Akiko, Muto, Kaori, Hirata, Makoto, Morisaki, Takayuki, Yamashita, Yasushi, Kamatani, Yoichiro, Kambara, Yoko, Murakami, Yoshinori, Masumoto, Akihide, Nagayama, Satoshi, Miki, Yoshio, Yoshimori, Kozo, Fujioka, Tomoaki, Takata, Ryo, Yamaji, Ken, Takahashi, Kazuhisa, Asai, Satoshi, Takahashi, Yasuo, Minami, Shiro, Yamaguchi, Hiroki, Koretsune, Yukihiro, Nishizawa, Yasuko, Kodama, Ken, Kutsumi, Hiromu, Suzuki, Takao, Sinozaki, Nobuaki, Murayama, Shigeo, Furukawa, Yoichi, Yamanashi, Yuji, Papagiannaki, Chrisanthi, Piotin, Michel, Trystram, Denis, Edjlali-Goujon, Myriam, Boulouis, Grégoire, Rodriguez, Christine, Hassen, Waghi Ben, Saleme, Suzanna, Mounayer, Charbel, Rouchaud, Aymeric, Levrier, Olivier, Aguettaz, Pierre, Combaz, Xavier, Pasco, Anne, l’Allinec, Vincent, Bintner, Marc, Molho, Marc, Pascale, Gauthier, Chivot, Cyril, Costalat, Vincent, Darganzil, Cyril, Bonafé, Alain, Januel, Anne Christine, Michelozzi, Caterina, Cognard, Christophe, Bonneville, Fabrice, Tall, Philippe, Darcourt, Jean, Biondi, Alessandra, Iosif, Cristina, Ferre, Jean Christophe, Gauvrit, Jean Yves, Eugene, François, Raoult, Hélène, Gentric, Jean Christophe, Ognard, Julien, Anxionnat, René, Gory, Benjamin, Bracard, Serge, Derelle, Anne Laure, Tonnelet, Romain, Spelle, Laurent, Ikka, Léon, Ozanne, Augustin, Gallas, Sophie, Caroff, Jildaz, Achour, Nidal Ben, Moret, Jacques, Chabert, Emmanuel, Berge, Jérôme, Marnat, Gaultier, Barreau, Xavier, Gariel, Florent, Clarencon, Frédéric, Aggour, Mohammed, Ricolfi, Frédéric, Chavent, Adrien, Thouant, Pierre, Lebidinsky, Pablo, Lemogne, Brivael, Herbreteau, Denis, Bibi, Richard, Janot, Kevin, Pierot, Laurent, Soize, Sébastien, Labeyrie, Marc Antoine, Vandendries, Christophe, Kazemi, Appoline, Leclerc, Xavier, Pruvo, Jean Pierre, Bricout, Nicolas, Velasco, Stéphane, Boucebci, Samy, Lemmens, Robin, Pandolfo, Massimo, Bodenant, Marie, Louillet, Fabien, Mas, Jean-Louis, Deltour, Sandrine, Leder, Sara, Léger, Anne, Canaple, Sandrine, Godefroy, Olivier, Giroud, Maurice, Jacquin, Agnès, Moulin, Thierry, Vuillier, Fabrice, Tzourio, Christophe, Santos, Michael Dos, Malik, Rainer, Hausser, Ingrid, Thomas-Feles, Constanze, Weber, Ralf, Grond-Ginsbach, Caspar, Hacke, Werner, Giossi, Alessia, Volonghi, Irene, Costa, Paolo, del Zotto, Elisabetta, Morotti, Andrea, Poli, Loris, Muiesan, Maria Lorenza, Salvetti, Massimo, Rosei, Enrico Agabiti, Lanfranconi, Silvia, Baron, Pierluigi, Ferrarese, Carlo, Susani, Emanuela, Giacalone, Giacomo, Paolucci, Stefano, Palmirotta, Raffaele, Guadagni, Fiorella, Paciaroni, Maurizio, Ballabio, Elena, Parati, Eugenio A., Fluri, Felix, Hatz, Florian, Gisler, Dominique, Amort, Margareth, Bevan, Steve, James, Tom, Olsson, Sandra, Holmegaard, Lukas, Altintas, Ayse, Martin, Juan José, Kittner, Steven, Mitchell, Braxton, Stine, Colin, O’Connell, Jeff, Dueker, Nicole, Koudstaal, Peter J., de Lau, Lonneke M.L., Hofman, Albert, Verhaaren, Benjamin F, Uitterlinden, Andre G, Montaner, Joan, Mendioroz, Maite, Yadav, Sunaina, Khan, Muhammad Saleem, Wilder, Michael, van Dijk, Ewoud, Maaijwee, Noortje, Rutten-Jacobs, Loes, Kramer, Jamie, Malik, Shaneela, Brott, Thomas G, Brown, Robert D, Singleton, Andrew, Hardy, John, Rich, Stephen S, Tanislav, Christian, Jungehülsing, Jan, Werring, David, Alg, Varinder, Hostettler, Isabel, Bonner, Stephen, Walsh, Daniel, Bulters, Diederik, Kitchen, Neil, Brown, Martin, Grieve, Joan, Roberts, Gareth, Jones, Timothy, Critchley, Giles, Sharma, Pankaj, Nelson, Richard, Whitfield, Peter, Ross, Stuart, Patel, Hiren, Eldridge, Paul, Saastamoinen, Kari, Patel, Umang, Lawrance, Enas, Vandabona, Subha, Mendelow, David, Teal, Rachel, Warner, Orlando, Kirkpatrick, Peter, Seshadri, Sudha, Kilarski, Laura, Hyacinth, Hyacinth I, Oliveira, Jamary, Marini, Sandro, Nyquist, Paul, Lewis, Cathryn, Norrving, Bo, Smith, Gustav, Rosand, Jonathan, Biffi, Alessandro, Kourkoulis, Christina, Anderson, Chris, Giese, Anne-Katrin, Bang, Oh Young, Chung, Jong-Won, Kim, Gyeong-Moon, Zhuang, Qishuai, Sheu, Wayne, Smalley, June, Howson, Joanna, Granata, Alessandra, Markus, Hugh, Wardlaw, Joanna, Cole, John, Thalamuthu, Anbupalam, Hopewell, Jemma, Worrall, Bradford, Bis, Josh, Tirschwell, David, Reiner, Alex, Dhar, Raj, Lee, Jin-Moo, Mortenson, Janne, Wassertheil-Smoller, Sylvia, Prasad, Kameshwar, Fisher, Mark, Traenka, Christopher, Wang, Xingwu, Wang, Yongjun, Rouanet, Francois, Sibon, Igor, Sarnowski, Chloé, Maillard, Pauline, Aparicio, Hugo Javier, Dupuis, Josee, Yang, Qiong, Luvizutto, Gustavo, Chasman, Daniel, Rexrode, Kathryn, Harriot, Andrea, Phuah, Chia-Ling, Santo, Gustavo, Gerard, Jen, Liu, Guiyou, Aaron, Sanjith, Christudass, Christhunesa S., Salomi, BSB, Sanghera, Dharambir, Boehme, Amelia, Elkind, Mitchell, Gretarsdottir, Solveig, Lange, Leslie, Rost, Natalia, James, Michael, Stewart, Jill, Goldstein, Larry, Waddy, Salina, Vojinovic, Dina, Ikram, Arfan, Thijs, Vincent, Parati, Eugenio, Boncoraglio, Giorgio, Kooperberg, Charles, Abboud, Sherrine, Zand, Ramin, Bijlenga, Philippe, Selim, Magdy, Happola, Olli, Strbian, Daniel, Tomppo, Liisa, Pathak, Abhishek, Pfeiffer, Dorothea, Aires, de Buenos, de Carvalho, Joao Jose Freitas, Ribeiro, Priscila, Torres, Nuria, Barboza, Miguel, Plomaritoglou, Androniki, Bjorkegren, Johan, Chan, Yu-Feng Yvonne, Gudnason, Villi, Jimenez-Conde, Jordi, Soriano, Carolina, Roquer, Jaume, Bentley, Paul, Tournier-Lasserve, Elisabeth, Dufouil, Carole, Debette, Stephanie, Mishra, Aniket, Wee, Lawrence, Siddiqi, Saima, Wu, Jer-Yuarn, Ko, Tai-Ming, Bione, Silvia, Jood, Katarina, Tatlisumak, Turgut, Arauz, Antonio, Korostynski, Michal, Launer, Lenore, Yue, Suo, bersano, anna, Juchniewicz, Karol Józef, Mateusz, Adamski, Pera, Joanna, Wnuk, Marcin, Levi, Christopher, Gusdon, Aaron, Kostulas, Konstantinos, Maxwell, Jessye, Duering, Marco, Jagiella, Jeremiasz, Hata, Jun, Ninomiya, Toshiharu, Nguyen, Vinh, Thorarinsson, Bjorn Logi, Lee, Tsong-Hai, Rakitko, Alexandr, Dichgans, Martin, Lindgren, Arne, Wasselius, Johan, Drake, Mattias, Stenman, Martin, Ilinca, Andreea, Staals, Julie, Sadr-Nabavi, Ariane, Crawford, Katherine, Lena, Umme, Mateen, Farrah, Ay, Hakan, Wu, Ona, Schirmer, Markus, Romero, Javier, Cramer, Steve, Golland, Polina, Mueller, Bertram, Brown, Robert, Meschia, James, Ross, Owen A., Pare, Guillaume, Chong, Mike, mansour, Ossama yassin, Karaszewski, Bartosz, Enzinger, Christian, Schmidt, Reinhold, Seiler, Stephan, Pichler, Alexander, Ovbiagele, Bruce, Yamada, Yoshiji, Rundek, Tatjana, Blanton, Susan, P, John, Chern, Joseph, O'Donnell, Chris, Corriveau, Roderick, Bhattacharya, Pallab, Gwinn, Katrina, CHANDRA, BHARATENDU, Chen, Christopher, Kalaria, Raj, Koenig, Jim, Singh, Om Prakash, Olugbodi, Akintomi, Giralt, Eva, Saleheen, Danish, de Leeuw, Frank-Erik, Klijn, Karin, Olesen, Jes, Kubo, Michiaki, Spence, David, Pedersen, Annie, Olsson, Maja, Martín, Juan José, Braga, Gabriel, Xu, Huichun, Assimes, Tim, Raskurazhev, Anton, Lee, Wei Ling, Burri, Philippe, Frid, Petrea, GmbH, Heilbronn, Deng, Zhen, Habibi-koolaee, Mahdi, Vijayan, Murali, Leung, Thomas, Wong, Lawrence, Mok, Vincent, Choy, Richard, Jern, Christina, Lebedeva, Elena, Farrall, Martin, Jiayuan, Xu, Loo, Keat Wei, Rinkel, Gabriel, Magnus, Rudolf, Goncalves, Anderson, Franca, Paulo, Cendes, Iscia, Carrera, Caty, Fernandez-Cadenas, Israel, Kim, Helen, Rolfs, Arndt, Owolabi, Mayowa, Bakker, Mark, Ruigrok, Ynte, Hauer, Allard, Pulit, Sara L., Algra, Ale, van der Laan, Sander W., Macleod, Mary, Howard, George, Tiwari, Hemant, Irvin, Ryan, Albright, Karen C., Perry, Rodney, Kidwell, Chelsea, Pavlovic, Aleksandra, Sargurupremraj, Murali, Schilling, Sabrina, Pezzini, Alessandro, Abd-Allah, Foad, DeCarli, Charles, Liebeskind, David, Traylor, Matthew, Tan, Rhea, Danesh, John, Larsson, Susanna C., Rutten, Loes, Donatti, Amanda, Avelar, Wagner, Broderick, Joseph, Woo, Daniel, Kissela, Brett, Ibenez, Laura Garcia, Salman, Rustam, Sudlow, Cathie, McDonough, Caitrin Wheeler, Silliman, Scott, Magvanjav, Oyunbileg, van Agtmael, Tom, Walters, Matthew, Lorentzen, Erik, Stanne, Tara, Olsson, Martina, Nakagawa, Kazuma, Akinyemi, Rufus, Cotlatciuc, Ioana, O'Connell, Jeff, Sparks, Mary, Sorkin, John, Dave, Tushar, Naylor, Jill, Brown, Devin, Du, Rose, Kulik, Tobias B., Attia, John, Faber, James E, Rothwell, Peter, Márquez, Elsa Valdés, Mancuso, Michelangelo, Souza, Doralina Brum, de Silva, Ranil, Vibo, Riina, Korv, Janika, Maguire, Jane, Fornage, Myriam, Illoh, Kachikwu, Milewicz, Dianna, Majersik, Jennifer, DeHavenon, Adam, Kalani, Yashar, Alexander, Matthew, Cushman, Mary, Sale, Michele, Owens, Debra, Keene, Keith, Rich, Stephe, Psaty, Bruce, Longstreth, Will, Atadzhanov, Masharip, Wolfe, Stacey Quintero, Langefeld, Carl, Bushnell, Cheryl, Cruchaga, Carlos, Konrad, Jan, Liu, Junfeng, Sheth, Kevin, Falcone, Guido, Donahue J, Kathleen, Jones, Gregory T., Bown, Matthew J., Ko, Nerissa U., Coleman, Jonathan R.I., Breen, Gerome, Zaroff, Jonathan G., Klijn, Catharina J.M., Sargurupremraj, Muralidharan, Amouyel, Philippe, Debette, Stéphanie, Rinkel, Gabriel J.E., Worrall, Bradford B., Slowik, Agnieszka, Gaál-Paavola, Emilia I., Niemelä, Mika, Jääskeläinen, Juha E., von Und Zu Fraunberg, Mikael, Lindgren, Antti, Broderick, Joseph P., Werring, David J., Redon, Richard, Veldink, Jan H., Ruigrok, Ynte M., Stroke, HUNT All-In, Group, China Kadoorie Biobank Collaborative, Consortium, BioBank Japan Project, Group, ICAN Study, Group, CADISP, investigators, Genetics and Observational Subarachnoid Haemorrhage (GOSH) Study, (ISGC), International Stroke Genetics Consortium, Morel, Sandrine, and Bijlenga, Philippe Alexandre Pierre
- Subjects
genetics [Blood Pressure] ,Medizin ,Genome-wide association study ,Blood Pressure ,Disease ,ddc:616.07 ,Bioinformatics ,616: Innere Medizin und Krankheiten ,0302 clinical medicine ,Risk Factors ,physiopathology [Hypertension] ,genetics [Genetic Predisposition to Disease] ,Genetic risk factor ,Stroke ,0303 health sciences ,Smoking ,genetics [Smoking] ,genetics [Intracranial Aneurysm] ,Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3] ,Cerebrovascular disorder ,3. Good health ,genetics [European Continental Ancestry Group] ,Hypertension ,genetics [Polymorphism, Single Nucleotide] ,Subarachnoid hemorrhage ,pathology [Intracranial Aneurysm] ,genetics [White People] ,Biology ,Genetic correlation ,pathology [Endothelial Cells] ,Polymorphism, Single Nucleotide ,Article ,White People ,03 medical and health sciences ,Aneurysm ,Asian People ,ddc:570 ,Genetics ,medicine ,Humans ,Genetic Predisposition to Disease ,cardiovascular diseases ,030304 developmental biology ,genetics [Subarachnoid Hemorrhage] ,genetics [Asian Continental Ancestry Group] ,572: Biochemie ,genetics [Asian People] ,pathology [Subarachnoid Hemorrhage] ,adverse effects [Smoking] ,Endothelial Cells ,Subarachnoid Hemorrhage ,medicine.disease ,Intracranial aneurysm ,Genetic architecture ,ddc:616.8 ,Case-Control Studies ,genetics [Hypertension] ,030217 neurology & neurosurgery ,Genome-Wide Association Study - Abstract
An author correction to this article published in December 2020 is available at https://doi.org/10.1038/s41588-020-00760-4. Rupture of an intracranial aneurysm leads to subarachnoid hemorrhage, a severe type of stroke. To discover new risk loci and the genetic architecture of intracranial aneurysms, we performed a cross-ancestry, genome-wide association study in 10,754 cases and 306,882 controls of European and East Asian ancestry. We discovered 17 risk loci, 11 of which are new. We reveal a polygenic architecture and explain over half of the disease heritability. We show a high genetic correlation between ruptured and unruptured intracranial aneurysms. We also find a suggestive role for endothelial cells by using gene mapping and heritability enrichment. Drug-target enrichment shows pleiotropy between intracranial aneurysms and antiepileptic and sex hormone drugs, providing insights into intracranial aneurysm pathophysiology. Finally, genetic risks for smoking and high blood pressure, the two main clinical risk factors, play important roles in intracranial aneurysm risk, and drive most of the genetic correlation between intracranial aneurysms and other cerebrovascular traits.
- Published
- 2021
- Full Text
- View/download PDF
22. MRI Radiomic Signature of White Matter Hyperintensities Is Associated With Clinical Phenotypes
- Author
-
Bretzner, Martin, primary, Bonkhoff, Anna K., additional, Schirmer, Markus D., additional, Hong, Sungmin, additional, Dalca, Adrian V., additional, Donahue, Kathleen L., additional, Giese, Anne-Katrin, additional, Etherton, Mark R., additional, Rist, Pamela M., additional, Nardin, Marco, additional, Marinescu, Razvan, additional, Wang, Clinton, additional, Regenhardt, Robert W., additional, Leclerc, Xavier, additional, Lopes, Renaud, additional, Benavente, Oscar R., additional, Cole, John W., additional, Donatti, Amanda, additional, Griessenauer, Christoph J., additional, Heitsch, Laura, additional, Holmegaard, Lukas, additional, Jood, Katarina, additional, Jimenez-Conde, Jordi, additional, Kittner, Steven J., additional, Lemmens, Robin, additional, Levi, Christopher R., additional, McArdle, Patrick F., additional, McDonough, Caitrin W., additional, Meschia, James F., additional, Phuah, Chia-Ling, additional, Rolfs, Arndt, additional, Ropele, Stefan, additional, Rosand, Jonathan, additional, Roquer, Jaume, additional, Rundek, Tatjana, additional, Sacco, Ralph L., additional, Schmidt, Reinhold, additional, Sharma, Pankaj, additional, Slowik, Agnieszka, additional, Sousa, Alessandro, additional, Stanne, Tara M., additional, Strbian, Daniel, additional, Tatlisumak, Turgut, additional, Thijs, Vincent, additional, Vagal, Achala, additional, Wasselius, Johan, additional, Woo, Daniel, additional, Wu, Ona, additional, Zand, Ramin, additional, Worrall, Bradford B., additional, Maguire, Jane M., additional, Lindgren, Arne, additional, Jern, Christina, additional, Golland, Polina, additional, Kuchcinski, Grégory, additional, and Rost, Natalia S., additional
- Published
- 2021
- Full Text
- View/download PDF
23. Brain Volume: An Important Determinant of Functional Outcome After Acute Ischemic Stroke
- Author
-
Schirmer, Markus D., primary, Donahue, Kathleen L., additional, Nardin, Marco J., additional, Dalca, Adrian V., additional, Giese, Anne-Katrin, additional, Etherton, Mark R., additional, Mocking, Steven J.T., additional, McIntosh, Elissa C., additional, Cole, John W., additional, Holmegaard, Lukas, additional, Jood, Katarina, additional, Jimenez-Conde, Jordi, additional, Kittner, Steven J., additional, Lemmens, Robin, additional, Meschia, James F., additional, Rosand, Jonathan, additional, Roquer, Jaume, additional, Rundek, Tatjana, additional, Sacco, Ralph L., additional, Schmidt, Reinhold, additional, Sharma, Pankaj, additional, Slowik, Agnieszka, additional, Stanne, Tara M., additional, Vagal, Achala, additional, Wasselius, Johan, additional, Woo, Daniel, additional, Bevan, Stephen, additional, Heitsch, Laura, additional, Phuah, Chia-Ling, additional, Strbian, Daniel, additional, Tatlisumak, Turgut, additional, Levi, Christopher R., additional, Attia, John, additional, McArdle, Patrick F., additional, Worrall, Bradford B., additional, Wu, Ona, additional, Jern, Christina, additional, Lindgren, Arne, additional, Maguire, Jane, additional, Thijs, Vincent, additional, and Rost, Natalia S., additional
- Published
- 2020
- Full Text
- View/download PDF
24. Abstract WP73: Automatic Classification of Clinical MRI Stroke Datasets With a Recurrent Convolutional Neural Network
- Author
-
Liu, Yichuan, primary, Hancock, Brandon L, additional, Hoang, Tri, additional, Etherton, Mark R, additional, Mocking, Steven J, additional, McIntosh, Elissa C, additional, Irie, Robert E, additional, Bouts, Mark J, additional, Broderick, Joseph P, additional, Cole, John W, additional, Donahue, Kathleen L, additional, Giese, Anne-Katrin, additional, Giralt-Steinhauer, Eva, additional, Jimenez-Conde, Jordi, additional, Jern, Christina, additional, Kittner, Steven J, additional, Kleindorfer, Dawn, additional, Lemmens, Robin, additional, McArdle, Patrick F, additional, Meschia, James F, additional, Lindgren, Arne G, additional, Rosand, Jonathan, additional, Rundek, Tatjana, additional, Sacco, Ralph L, additional, Schirmer, Markus D, additional, Schmidt, Reinhold, additional, Sharma, Pankaj, additional, Slowik, Agnieszka, additional, Thijs, Vincent, additional, Wasselius, Johan, additional, Worrall, Bradford B, additional, Rost, Natalia S, additional, and Wu, Ona, additional
- Published
- 2020
- Full Text
- View/download PDF
25. Big data approaches to phenotyping acute ischemic stroke using automated lesion segmentation of multi-center MRI data
- Author
-
Wu, Ona, Winzeck, Stefan, Giese, Anne-Katrin, Hancock, Brandon L., Etherton, Mark R., Bouts, Mark J. R. J., Donahue, Kathleen, Schirmer, Markus D., Irie, Robert E., Mocking, Steven J. T., McIntosh, Elissa C., Bezerra, Raquel, Kamnitsas, Konstantinos, Frid, Petrea, Wasselius, Johan, Cole, John W., Xu, Huichun, Holmegaard, Lukas, Jiménez-Conde, Jordi, Lemmens, Robin, Lorentzen, Eric, McArdle, Patrick F., Meschia, James F., Roquer, Jaume, Rundek, Tatjana, Sacco, Ralph L., Schmidt, Reinhold, Sharma, Pankaj, Slowik, Agnieszka, Stanne, Tara M., Thijs, Vincent, Vagal, Achala, Woo, Daniel, Bevan, Stephen, Kittner, Steven J., Mitchell, Braxton D., Rosand, Jonathan, Worrall, Bradford B., Jern, Christina, Lindgren, Arne G., Maguire, Jane, and Rost, Natalia S.
- Subjects
Adult ,Aged, 80 and over ,Big Data ,Male ,Observer Variation ,Middle Aged ,Article ,Brain Ischemia ,Machine Learning ,Stroke ,Diffusion Magnetic Resonance Imaging ,Phenotype ,Socioeconomic Factors ,Risk Factors ,Image Processing, Computer-Assisted ,Humans ,Female ,Neural Networks, Computer ,Algorithms ,Aged ,Retrospective Studies - Abstract
BACKGROUND AND PURPOSE: We evaluated deep learning algorithms’ segmentation of acute ischemic lesions on heterogeneous multi-center clinical diffusion-weighted (DWI) datasets and explored the potential role of this tool for phenotyping acute ischemic stroke. METHODS: Ischemic stroke data sets from the MRI-GENetics Interface Exploration (MRI-GENIE) repository consisting of 12 international genetic research centers were retrospectively analyzed using an automated deep learning segmentation algorithm consisting of an ensemble of 3D convolutional neural networks (CNNs). Three ensembles were trained using data from: (1) 267 patients from an independent single-center cohort, (2) 267 patients from MRI-GENIE, and (3) mixture of (1) and (2). The algorithms’ performances were compared against manual outlines from a separate 383 patient subset from MRI-GENIE. Univariable and multivariable logistic regression with respect to demographics, stroke subtypes and vascular risk factors were performed to identify phenotypes associated with large acute DWI volumes and greater stroke severity in 2770 MRI-GENIE patients. Stroke topography was investigated. RESULTS: The ensemble consisting of a mixture of MRI-GENIE and single-center CNNs performed best. Subset analysis comparing automated and manual lesion volumes in 383 patients found excellent correlation (ρ=0.92, p
- Published
- 2019
26. Genetic and lifestyle risk factors for MRI-defined brain infarcts in a population-based setting
- Author
-
Chauhan, Ganesh, Adams, Hieab H H, Jian, Xueqiu, Sharma, Pankaj, Sudlow, Cathie L M, Rosand, Jonathan, Woo, Daniel, Cole, John W, Meschia, James F, Slowik, Agnieszka, Thijs, Vincent, Lindgren, Arne, Melander, Olle, Malik, Rainer, Grewal, Raji P, Rundek, Tatjana, Rexrode, Kathy, Rothwell, Peter M, Arnett, Donna K, Jern, Christina, Johnson, Julie A, Benavente, Oscar R, Wasssertheil-Smoller, Sylvia, Lee, Jin-Moo, Traylor, Matthew, Wong, Quenna, Mitchell, Braxton D, Rich, Stephen S, McArdle, Patrick F, Geerlings, Mirjam I, van der Graaf, Yolanda, de Bakker, Paul I W, Asselbergs, Folkert W, Srikanth, Velandai, Thomson, Russell, Pulit, Sara L, McWhirter, Rebekah, Moran, Chris, Callisaya, Michele, Phan, Thanh, Rutten-Jacobs, Loes C A, Bevan, Steve, Tzourio, Christophe, Mather, Karen A, Sachdev, Perminder S, van Duijn, Cornelia M, Amouyel, Philippe, Worrall, Bradford B, Dichgans, Martin, Kittner, Steven J, Markus, Hugh S, Ikram, Mohammad A, Fornage, Myriam, Launer, Lenore J, Seshadri, Sudha, Longstreth, W. T., Debette, Stéphanie, Mazoyer, Bernard, Network, Stroke Genetics, Almgren, Peter, Anderson, Christopher D, Attia, John, Ay, Hakan, Brown, Robert D, Bustamante, Mariana, Zhu, Yi-Cheng, Cheng, Yu-Ching, Cotlarciuc, Ioana, Cruchaga, Carlos, de Bakker, Paul Iw, Delavaran, Hossein, Engström, Gunnar, Kaffashian, Sara, Heitsch, Laura, Holliday, Elizabeth, Ibanez, Laure, Ilinca, Andreea, Irvin, Marguerite R, Jackson, Rebecca D, Jimenez-Conde, Jordi, Jood, Katarina, Schilling, Sabrina, Kissela, Brett M, Kleindorfer, Dawn O, Labovitz, Daniel, Laurie, Cathy C, Lemmens, Robin, Levi, Christopher, Li, Linxin, Lindgren, Arne G, Beecham, Gary W, Maguire, Jane, Müller-Nurasyid, Martina, Norrving, Bo, Peddareddygari, Leema Reddy, Pera, Joanna, Satizabal, Claudia L, Montine, Thomas J, Rexrode, Kathryn, Ribasés, Marta, Roquer, Jaume, Rost, Natalia S, Sacco, Ralph L, Schmidt, Reinhold, Schellenberg, Gerard D, Soriano-Tárraga, Carolina, Stanne, Tara, Stauch, Konstantin, Stine, O. C., Sudlow, Cathie Lm, Thijs, Vincent N S, Weir, David, Williams, Stephen R, Kjartansson, Olafur, Xu, Huichun, Hyacinth, Hyacinth I, Marini, Sandro, Nyquist, Paul, Lewis, Cathryn, Hansen, Bjorn, Guðnason, Vilmundur, Biffi, Alessandro, Kourkoulis, Christina, Anderson, Chris, Giese, Anne-Katrin, Sacco, Ralph, Chung, Jong-Won, Kim, Gyeong-Moon, Knopman, David S, Lubitz, Steven, Bourcier, Romain, Howson, Joanna, Granata, Alessandra, Drazyk, Anna, Markus, Hugh, Wardlaw, Joanna, Mitchell, Braxton, Cole, John, Hopewell, Jemma, Griswold, Michael E, Walters, Robin, Turnbull, Iain, Worrall, Bradford, Bis, Josh, Reiner, Alex, Dhar, Raj, Prasad, Kameshwar, Sarnowski, Chloé, Windham, B Gwen, Aparicio, Hugo Javier, Yang, Qiong, Chasman, Daniel, Phuah, Chia-Ling, Liu, Guiyou, Elkind, Mitchell, Lange, Leslie, Rost, Natalia, James, Michael, Gottesman, Rebecca F, Stewart, Jill, Vojinovic, Dina, Parati, Eugenio, Boncoraglio, Giorgio, Zand, Ramin, Bijlenga, Philippe, Selim, Magdy, Grond-Ginsbach, Caspar, Strbian, Daniel, Mosley, Thomas H, Tomppo, Liisa, Sallinen, Hanne, Pfeiffer, Dorothea, Torres, Nuria, Barboza, Miguel, Laarman, Melanie, Carriero, Roberta, Soriano, Carolina, Gill, Dipender, Debette, Stephanie, Mishra, Aniket, Wu, Jer-Yuarn, Ko, Tai-Ming, Bione, Silvia, Tatlisumak, Turgut, Holmegaard, Lukas, Yue, Suo, Bis, Joshua C, Saba, Yasaman, Bersano, Anna, Schlicht, Kristina, Ninomiya, Toshiharu, Oberstein, Saskia Lesnik, Lee, Tsong-Hai, Schmidt, Helena, Wasselius, Johan, Drake, Mattias, Stenman, Martin, Crawford, Katherine, Lena, Umme, Mateen, Farrah, Takeuchi, Fumihiko, Wu, Ona, Schirmer, Markus, Cramer, Steve, Golland, Polina, Brown, Robert, Meschia, James, Ross, Owen A, Pare, Guillaume, Chong, Mike, Yamaguchi, Shuhei, Gwinn, Katrina, Chen, Christopher, Koenig, Jim, Giralt, Eva, Saleheen, Danish, de Leeuw, Frank-Erik, Klijn, Karin, Kamatani, Yoichiro, Kubo, Michiaki, Nabika, Toru, Okada, Yukinori, Pedersen, Annie, Olsson, Maja, Martín, Juan José, Tan, Eng King, Frid, Petrea, Lee, Chaeyoung, Tregouet, David, Leung, Thomas, Kato, Norihiro, Choy, Richard, Loo, Keat Wei, Rinkel, Gabriel, Franca, Paulo, Cendes, Iscia, Carrera, Caty, Fernandez-Cadenas, Israel, Montaner, Joan, Kim, Helen, Rajan, Kumar B, Owolabi, Mayowa, Sofat, Reecha, Bakker, Mark, Ruigrok, Ynte, Hauer, Allard, van der Laan, Sander W, Irvin, Ryan, Sargurupremraj, Murali, Pezzini, Alessandro, Aggarwal, Neelum T, Abd-Allah, Foad, Liebeskind, David, Tan, Rhea, Danesh, John, Donatti, Amanda, Avelar, Wagner, Broderick, Joseph, Sudlow, Cathie, De Jager, Philip L, Rannikmae, Kristiina, McDonough, Caitrin Wheeler, van Agtmael, Tom, Walters, Matthew, Söderholm, Martin, Lorentzen, Erik, Olsson, Sandra, Olsson, Martina, Akinyemi, Rufus, Evans, Denis A, Cotlatciuc, Ioana, McArdle, Patrick, Dave, Tushar, Kittner, Steven, Faber, James E, Millwood, Iona, Márquez, Elsa Valdés, Mancuso, Michelangelo, Vibo, Riina, Teumer, Alexander, Psaty, Bruce M, Korv, Janika, Majersik, Jennifer, DeHavenon, Adam, Alexander, Matthew, Sale, Michele, Southerland, Andrew, Owens, Debra, Psaty, Bruce, Rotter, Jerome I, Wolfe, Stacey Quintero, Langefeld, Carl, Konrad, Jan, Sheth, Kevin, Falcone, Guido, Donahue, Kathleen, Simpkins, Alexis N, Liang Byorn, Tan Wei, Rice, Kenneth, Chan, Bernard, Clatworthy, Phil, Florez, Jose, Harshfield, Eric, Hozawa, Atsushi, Hsu, Chung, Hu, Chaur-Jong, Ihara, Masafumi, Lange, Marcos, Lopez, Oscar L, Lee, Soo Ji, Lee, I-Hui, Musolino, Patricia, Nakatomi, Hirofumi, Park, Kwang-Yeol, Riley, Chris, Sung, Joohon, Suzuki, Hideaki, Vo, Katie, Liao, Jiemin, Washida, Kazuo, Ibenez, Laura Garcia, Hofman, Albert, Algra, Ale, Reiner, Alex P, Doney, Alexander S F, Gschwendtner, Andreas, Vicente, Astrid M, Nordestgaard, Børge G, Carty, Cara L, Cheng, Ching-Yu, Palmer, Colin N A, Gamble, Dale M, Ringelstein, E Bernd, Valdimarsson, Einar, Davies, Gail, Wong, Tien Y, Pasterkamp, Gerard, Kuhlenbäumer, Gregor, Thorleifsson, Gudmar, Falcone, Guido J, Pare, Guillame, Ikram, Mohammad K, Aparicio, Hugo J, Deary, Ian, Hopewell, Jemma C, Liu, Jingmin, van der Lee, Sven J, Attia, John R, Ferro, Jose M, Bis, Joshua, Furie, Karen, Stefansson, Kari, Berger, Klaus, Kostulas, Konstantinos, Rannikmae, Kristina, Ikram, M Arfan, Sargurupremraj, Muralidharan, Amin, Najaf, Benn, Marianne, Farrall, Martin, Pandolfo, Massimo, Nalls, Mike, van Zuydam, Natalie R, Chouraki, Vincent, Abrantes, Patricia, Higgins, Peter, Lichtner, Peter, DeStefano, Anita L, Clarke, Robert, Abboud, Sherine, Oliveira, Sofia A, Gretarsdottir, Solveig, Mosley, Thomas, Battey, Thomas Wk, Thorsteinsdottir, Unnur, Thijs, Vincent Ns, Zhao, Wei, Chen, Wei-Min, Romero, Jose R, Albert, Marilyn S, Albin, Roger L, Apostolova, Liana G, Arnold, Steven E, Asthana, Sanjay, Atwood, Craig S, Baldwin, Clinton T, Barmada, M Michael, Barnes, Lisa L, Maillard, Pauline, Barral, Sandra, Beach, Thomas G, Becker, James T, Beekly, Duane, Bennett, David A, Bigio, Eileen H, Bird, Thomas D, Blacker, Deborah, Boeve, Bradley F, DeCarli, Charles, Boxer, Adam, Burke, James R, Burns, Jeffrey M, Buxbaum, Joseph D, Byrd, Goldie S, Cai, Guiqing, Cairns, Nigel J, Cantwell, Laura B, Cao, Chuanhai, Carlsson, Cynthia M, Wardlaw, Joanna M, Carney, Regina M, Carrasquillo, Minerva M, Carroll, Steven L, Chui, Helena C, Clark, David G, Cribbs, David H, Crocco, Elizabeth A, Hernández, Maria Del C Valdés, Demirci, F Yesim, Dick, Malcolm, Dickson, Dennis W, Duara, Ranjan, Ertekin-Taner, Nilufer, Faber, Kelley M, Fallin, M Daniele, Fallon, Kenneth B, Fardo, David W, Luciano, Michelle, Farlow, Martin R, Farrer, Lindsay A, Ferris, Steven, Foroud, Tatiana M, Frosch, Matthew P, Galasko, Douglas R, Gearing, Marla, Geschwind, Daniel H, Ghetti, Bernardino, Gilbert, John R, Hofer, Edith, Liewald, David, Go, Rodney C P, Goate, Alison M, Graff-Radford, Neill R, Green, Robert C, Griffith, Patrick, Growdon, John H, Haines, Jonathan L, Hakonarson, Hakon, Hamilton, Ronald L, Hamilton-Nelson, Kara L, Deary, Ian J, Haroutunian, Vahram, Harrell, Lindy E, Honig, Lawrence S, Huebinger, Ryan M, Hulette, Christine M, Hyman, Bradley T, Jicha, Gregory A, Jin, Lee-Way, Jun, Gyungah, Kamboh, M Ilyas, Starr, John M, Karydas, Anna, Kauwe, John S K, Kaye, Jeffrey A, Kim, Ronald, Kowall, Neil W, Kramer, Joel H, Kukull, Walter A, Kunkle, Brian W, LaFerla, Frank M, Lah, James J, Bastin, Mark E, Lang-Walker, Rosalyn, Larson, Eric B, Leverenz, James B, Levey, Allan I, Li, Ge, Lieberman, Andrew P, Logue, Mark W, Lunetta, Kathryn L, Lyketsos, Constantine G, Muñoz Maniega, Susana, Mack, Wendy J, Manly, Jennifer J, Marson, Daniel C, Martin, Eden R, Martiniuk, Frank, Mash, Deborah C, Masliah, Eliezer, Mayeux, Richard, McKee, Ann C, Mesulam, Marsel, Slagboom, P Eline, Miller, Bruce L, Miller, Carol A, Miller, Joshua W, Morris, John C, Murrell, Jill R, Naj, Adam C, Obisesan, Thomas O, Olichney, John M, Pankratz, Vernon S, Beekman, Marian, Parisi, Joseph E, Partch, Amanda, Paulson, Henry L, Pericak-Vance, Margaret A, Perry, William, Peskind, Elaine, Petersen, Ronald C, Pierce, Aimee, Poon, Wayne W, Potter, Huntington, Deelen, Joris, Quinn, Joseph F, Raj, Ashok, Raj, Towfique, Raskind, Murray, Reiman, Eric M, Reisberg, Barry, Reitz, Christiane, Ringman, John M, Roberson, Erik D, Rosen, Howard J, Uh, Hae-Won, Rosenberg, Roger N, Sager, Mark A, Sano, Mary, Saykin, Andrew J, Schneider, Julie A, Schneider, Lon S, Seeley, William W, Smith, Amanda G, Sonnen, Joshua A, Spina, Salvatore, Stern, Robert A, Swerdlow, Russell H, Tanzi, Rudolph E, Thornton-Wells, Tricia A, Trojanowski, John Q, Troncoso, Juan C, Tsuang, Debby W, Valladares, Otto, Van Deerlin, Vivianna M, Trompet, Stella, Brodaty, Henry, Van Eldik, Linda J, Vardarajan, Badri N, Vinters, Harry V, Vonsattel, Jean Paul, Wang, Li-San, Weintraub, Sandra, Welsh-Bohmer, Kathleen A, Williamson, Jennifer, Wingo, Thomas S, Wishnek, Sarah, Wright, Margaret J, Woltjer, Randall L, Wright, Clinton B, Younkin, Steven G, Yu, Chang-En, Yu, Lei, Chu, Audrey Y, Havulinna, Aki S, Ames, David, Smith, Albert Vernon, Choi, Seung Hoan, Garcia, Melissa E, Manichaikul, Ani, Gustafsson, Stefan, Bartz, Traci M, Boncoraglio, Giorgio B, Bellenguez, Céline, Vidal, Jean Sebastien, Wiggins, Kerri L, Xue, Flora, Ripatti, Samuli, Liu, Yongmei, Hoed, Marcel den, Heckbert, Susan R, Smith, Nicholas L, Buring, Julie E, Ridker, Paul M, Berr, Claudine, Dartigues, Jean-François, Beecham, Ashley H, Hamsten, Anders, Magnusson, Patrik K, Pedersen, Nancy L, Lannfelt, Lars, Lind, Lars, Lindgren, Cecilia M, Morris, Andrew P, Koudstaal, Peter J, Portegies, Marileen Lp, Blanton, Susan H, Uitterlinden, André G, de Craen, Anton Jm, Ford, Ian, Jukema, J Wouter, Stott, David J, Allen, Norrina B, Sale, Michele M, Johnson, Andrew D, White, Charles C, Paulista Markus, Marcello Ricardo, Nalls, Michael A, Beiser, Alexa, Vartiainen, Erkki, French, Curtis R, Kurth, Tobias, Harris, Tamara B, deStefano, Anita L, Schmidt, Carsten Oliver, Salomaa, Veikko, Wen, Wei, Ingelsson, Erik, Chasman, Daniel I, Verhaaren, Benjamin F J, Hilal, Saima, Thalamuthu, Anbupalam, Smith, Jennifer A, Ikram, M Kamran, Adams, Hieab H, Lopez, Lorna M, van Buchem, Mark A, Armstrong, Nicola J, van der Grond, Jeroen, Smith, Albert V, Hegenscheid, Katrin, de Andrade, Mariza, Atkinson, Elizabeth J, Beiser, Alexa S, Boerwinkle, Eric, Chong, Elizabeth, Brickman, Adam M, Bryan, R Nick, Chen, Christopher P L H, de Craen, Anton J M, Crivello, Fabrice, Schofield, Peter R, Dufouil, Carole, Elkind, Mitchell S V, Freudenberger, Paul, Habes, Mohamad, Heiss, Gerardo, Kwok, John B, Ibrahim-Verbaas, Carla A, Lewis, Cora E, Liewald, David C M, van der Lugt, Aad, Martinez, Oliver O, Nauck, Matthias, Niessen, Wiro J, Oostra, Ben A, Rice, Kenneth M, von Sarnowski, Bettina, Schreiner, Pamela J, Schuur, Maaike, Sidney, Stephen S, Sigurdsson, Sigurdur, Stott, David J M, van Swieten, John C, Töglhofer, Anna Maria, Turner, Stephen T, Vernooij, Meike W, Wang, Jing J, Wolf, Christiane, Zijdenbos, Alex, Kardia, Sharon L R, DeCarli, Charles C, Seshadri, Sudha S, Kavousi, Maryam, Franceschini, Nora, Isaacs, Aaron, Abecasis, Gonçalo R, Schminke, Ulf, Post, Wendy, Cupples, L Adrienne, Huffman, Jennifer E, Lehtimäki, Terho, Baumert, Jens, Münzel, Thomas, Dehghan, Abbas, North, Kari, Oostra, Ben, Stoegerer, Eva-Maria, Hayward, Caroline, Raitakari, Olli, Meisinger, Christa, Schillert, Arne, Sanna, Serena, Völzke, Henry, Thorsson, Bolli, Fox, Caroline S, Wittfeld, Katharina, Rivadeneira, Fernando, Nambi, Vijay, Halperin, Eran, Petrovic, Katja E, Peltonen, Leena, Wichmann, H Erich, Schnabel, Renate B, Dörr, Marcus, Parsa, Afshin, Aspelund, Thor, Grabe, Hans J, Demissie, Serkalem, Kathiresan, Sekar, Reilly, Muredach P, Taylor, Kent, Uitterlinden, Andre, Couper, David J, Sitzer, Matthias, Kähönen, Mika, Illig, Thomas, Wild, Philipp S, Hosten, Norbert, Orru, Marco, Lüdemann, Jan, Shuldiner, Alan R, Eiriksdottir, Gudny, Seissler, Jochen, Zeller, Tanja, Usala, Gianluca, Ernst, Florian, D'Agostino, Ralph B, O'Leary, Daniel H, Ballantyne, Christie, Thiery, Joachim, Ziegler, Andreas, Lakatta, Edward G, Chilukoti, Ravi Kumar, Völker, Uwe, Wolf, Philip A, Polak, Joseph F, Li, Xia, Rathmann, Wolfgang, Uda, Manuela, Klopp, Norman, Wilson, James F, Viikari, Jorma, Koenig, Wolfgang, Blankenberg, Stefan, Newman, Anne B, Witteman, Jacqueline, van Duijn, Cornelia, Scuteri, Angelo, Homuth, Georg, Gudnason, Vilmundur, O'Donnell, Christopher J, Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Lund University [Lund], Stroke Genetics Network (SiGN), METASTROKE, Alzheimer’s Disease Genetics Consortium (ADGC), Neurology Working Group of the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium, Peter Almgren, MSC, Christopher D. Anderson, MD, Donna K. Arnett, PhD, MSPH, John Attia, MD, PhD, FRACP, FRCPC, Hakan Ay, MD, Oscar R. Benavente, MD, Steve Bevan, PhD, Robert D. Brown, MD, Mariana Bustamante, PhD, Yu-Ching Cheng, PhD, John W. Cole, MD, MS, Ioana Cotlarciuc, PhD, Carlos Cruchaga, PhD, Paul IW. de Bakker, PhD, Hossein Delavaran, MD, PhD, Martin Dichgans, MD, Gunnar Engström, MD, PHD, PROF, Myriam Fornage, PhD, Raji P. Grewal, MD, Laura Heitsch, MD, Elizabeth Holliday, MSc, PhD, Laure Ibanez, PhD, Andreea Ilinca, MD, Marguerite R. Irvin, PhD, Rebecca D. Jackson, MD, Christina Jern, MD, PhD, Jordi Jimenez-Conde, MD, PhD, Julie A. Johnson, PharmD, Katarina Jood, MD, PhD, Brett M. Kissela, MD, MS, Steven J. Kittner, MD, Dawn O. Kleindorfer, MD, MS, Daniel Labovitz, MD, Cathy C. Laurie, PhD, Jin-Moo Lee, MD, PhD, Robin Lemmens, MD PhD, Christopher Levi, MBBS B Med Sci FRACP, Linxin Li, DPhil, Arne G. Lindgren, MD, PhD, Jane Maguire, PhD, Hugh S. Markus, FRCP, Patrick F. McArdle, PhD, Olle Melander, MD, PHD, PROF, James F. Meschia, MD, Braxton D. Mitchell, PhD, Martina Müller-Nurasyid, PhD, Bo Norrving, MD, PhD, Leema Reddy Peddareddygari, MD, Joanna Pera, MD, PhD, Sara L. Pulit, PhD, Kathryn Rexrode, MD, MPH, Marta Ribasés, PhD, BSc, Jaume Roquer, MD, PhD, Natalia S. Rost, MD, Peter M. Rothwell, FMedSci, Tatjana Rundek, MD PhD, Ralph L. Sacco, MD MS, Reinhold Schmidt, MD, Pankaj Sharma, MD PhD, Agnieszka Slowik, MD, PhD, Carolina Soriano-Tárraga, BSc, PhD, Tara Stanne, PhD, Konstantin Stauch, PhD, O C. Stine, PhD, Cathie LM. Sudlow, BMBCh, MSc, DPhil, FRCP (Ed), Vincent N.S. Thijs, MD, PhD, Sylvia Wasssertheil-Smoller, PhD, David Weir, PhD, Stephen R. Williams, PhD, Quenna Wong, PhD, Daniel Woo, MD, MS, Bradford B. Worrall, MD, MSc, Huichun Xu, MD, PhD, Sudha Seshadri, MD, Hyacinth I Hyacinth, MD, Sandro Marini, MD, Paul Nyquist, MD, PhD, Cathryn Lewis, PhD, Bjorn Hansen, MD, Bo Norrving, MD, PhD, Jonathan Rosand, MD, Alessandro Biffi, MD, Christina Kourkoulis, Bachelor, Chris Anderson, MD, MMSc, Anne-Katrin Giese, MD, Ralph Sacco, MD, MS, Pankaj Sharma, MD, PhD, Jong-Won Chung, MD, MSc, Gyeong-Moon Kim, MD, Steven Lubitz, MD, MPH, Romain Bourcier, MD, Joanna Howson, PhD, Alessandra Granata, PhD, Anna Drazyk, MRCPI, Hugh Markus, MD, Joanna Wardlaw, MD, Braxton Mitchell, MPH, PHD, John Cole, MD, MS, Jemma Hopewell, PhD, FESC, Robin Walters, MA, PhD, PgDip, Iain Turnbull, BA(Hons) MB BChir MRCP(UK) MRCGP, Bradford Worrall, MD, MSc, Josh Bis, PhD, Alex Reiner, MD, MSc, Raj Dhar, MD, Laura Heitsch, MD, Jin-Moo Lee, MD, PhD, Kameshwar Prasad, MD, DM, MMSc, FRCP(Edin), FAMS, Chloé Sarnowski, PhD, Hugo Javier Aparicio, MD, Qiong Yang, PhD, Daniel Chasman, PhD, Kathryn Rexrode, MD, MPH, Chia-Ling Phuah, MD, Guiyou Liu, PhD, Mitchell Elkind, MD, MSc, Leslie Lange, PhD, Natalia Rost, MD, Michael James, MD, Jill Stewart, PhD, Dina Vojinovic, MD, MS, Vincent Thijs, MD, PhD, Eugenio Parati, MD, Giorgio Boncoraglio, MD, Ramin Zand, MD, Philippe Bijlenga, MD, PhD, Magdy Selim, MD, PhD, Caspar Grond-Ginsbach, PhD, Daniel Strbian, MD, PhD, Liisa Tomppo, MD, Hanne Sallinen, MD, Dorothea Pfeiffer, MD, Nuria Torres, MSc, Miguel Barboza, MD, Melanie Laarman, PhD candidate, Roberta Carriero, PhD, Elizabeth Holliday, PhD, Jordi Jimenez-Conde, MD, PhD, Carolina Soriano, BSc, PhD, Dipender Gill, PhD, Stephanie Debette, MD, PhD, Aniket Mishra, PhD, Jer-Yuarn Wu, PhD, Tai-Ming Ko, PhD, Silvia Bione, PhD, Katarina Jood, MD, PhD, Turgut Tatlisumak, MD, PhD, Lukas Holmegaard, PhD, Suo Yue, system engineer, Anna bersano, MD, PhD, Joanna Pera, MD, PhD, Agnieszka Slowik, MD, PhD, Christopher Levi, MBBS B Med Sci FRACP, Kristina Schlicht, Dipl. Biol., Robin Lemmens, MD, PhD, Toshiharu Ninomiya, MD, PhD, Saskia Lesnik Oberstein, PhD, Tsong-Hai Lee, MD, PhD, Rainer Malik, PhD, Martin Dichgans, MD, Arne Lindgren, MD, PhD, Johan Wasselius, MD, PhD, Mattias Drake, student, Olle Melander, MD, PHD, Martin Stenman, MD, Andreea Ilinca, MD, Katherine Crawford, BS, Umme Lena, Bachelors of Arts, Farrah Mateen, MD, PhD, Hakan Ay, MD, Ona Wu, PhD, Markus Schirmer, PhD, Steve Cramer, MD, Polina Golland, PhD, Robert Brown, MD, MPH, James Meschia, MD, Owen A. Ross, PhD, Guillaume Pare, MD, MSc, FRCPC, Mike Chong, MSc, Tatjana Rundek, MD PhD, Katrina Gwinn, MD, Christopher Chen, BMBCh (Oxon), MRCP, FRCP, Jim Koenig, PhD, Eva Giralt, PhD, Danish Saleheen, MBBS, PhD, Frank-Erik de Leeuw, MD, PhD, Karin Klijn, MD, PhD, Yoichiro Kamatani, MD, PhD, Michiaki Kubo, MD, PhD, Yukinori Okada, MD, PhD, Annie Pedersen, MD, Maja Olsson, PhD, Juan José Martín, MD, Huichun Xu, MD, PhD, Eng King Tan, MD, Petrea Frid, MD, Chaeyoung Lee, PhD, David Tregouet, PhD, Thomas Leung, MB, ChB, MRCP, FHKCP, FHKAM, Richard Choy, BSc (Brad.), MSc(Med) (Birm.), PhD (CUHK), Christina Jern, MD, PhD, Keat Wei Loo, BSc, PhD, Gabriel Rinkel, MD, Paulo Franca, PhD, Iscia Cendes, MD, PhD, Caty Carrera, MD, Israel Fernandez-Cadenas, PhD, Joan Montaner, MD, PhD, Helen Kim, PhD, Mayowa Owolabi, MBBS, MSc, DrM, MWACP, FMCP, FAAN, FAS, Reecha Sofat, MD, Mark Bakker, PhD, Ynte Ruigrok, MD, PhD, Allard Hauer, PhD candidate, Sara L. Pulit, PhD, Sander W. van der Laan, PhD, Ryan Irvin, PhD, Murali Sargurupremraj, PhD, Alessandro Pezzini, MD, Foad Abd-Allah, MD, David Liebeskind, MD, Matthew Traylor, PhD, Rhea Tan, BSc (Hons), John Danesh, MD, DPhil, Loes Rutten-Jacobs, PhD, Amanda Donatti, PhD, student, Wagner Avelar, PhD, Joseph Broderick, MD, Daniel Woo, MD, MS, Cathie Sudlow, BMBCh, MSc, DPhil, FRCP, Kristiina Rannikmae, MD, Caitrin Wheeler McDonough, PhD, Tom van Agtmael, PhD, Matthew Walters, MD, MBChB, FRCP, Martin Söderholm, MD, PhD, Erik Lorentzen, Ph.Lic., Sandra Olsson, PhD, MSc, Tara Stanne, PhD, Martina Olsson, MSc, Rufus Akinyemi, PhD, MSc, MWACP, FMCP, Ioana Cotlatciuc, PhD, Patrick McArdle, PhD, Tushar Dave, MSc, Steven Kittner, MD, MPH, John Attia, MD, PhD, James E Faber, PhD, Iona Millwood, DPhil, Elsa Valdés Márquez, PhD, Michelangelo Mancuso, MD, PhD, Riina Vibo, MD, PhD, Janika Korv, MD, PhD, FESO, Jane Maguire, PhD, BN (Hons), BA, RN, Myriam Fornage, PhD, Jennifer Majersik, MD, Adam DeHavenon, MD, Matthew Alexander, MD, Michele Sale, PhD, Andrew Southerland, MD, MSc, Debra Owens, NNP, Bruce Psaty, MD, PhD, W. T. Longstreth, Jr, MD, MPH, Stacey Quintero Wolfe, MD, FAANS, Carl Langefeld, PhD, Carlos Cruchaga, PhD, Jan Konrad, administrative coordinator, Kevin Sheth, MD, Guido Falcone, MD, ScD, MPH, Kathleen Donahue, BS, Alexis N Simpkins, MD, PhD, Tan Wei Liang Byorn, MMBS, student, Bernard Chan, MD, Phil Clatworthy, MD, PhD, Jose Florez, MD, Eric Harshfield, PhD, Atsushi Hozawa, MD, Chung Hsu, MD, PhD, Chaur-Jong Hu, MD, PhD, Laure Ibanez, PhD, Masafumi Ihara, MD, PhD, FACP, Marcos Lange, PhD, Soo Ji Lee, PhD, MPH, I-Hui Lee, MD, PhD, Patricia Musolino, MD, PhD, Hirofumi Nakatomi, MD, PhD, Kwang-Yeol Park, MD, Stephen S Rich, PhD, Chris Riley, MBA, Joohon Sung, MD, PhD, Hideaki Suzuki, MD, PhD, Katie Vo, MD, Kazuo Washida, MD, PhD, Laura Garcia Ibenez, PhD, Agnieszka Slowik, MD, PhD, Albert Hofman, MD, PhD, Ale Algra, MD, MSc, Alex P Reiner, MD, MSc, Alexander S F Doney, PhD, Andreas Gschwendtner, MD, Andreea Ilinca, MD, Anne-Katrin Giese, MD, Arne Lindgren, MD, PhD, Astrid M Vicente, PhD, Bo Norrving, MD, PhD, Børge G Nordestgaard, MD, PhD, DMSc, Braxton D Mitchell, PhD, Bradford B Worrall, MD, MSc, Bruce M Psaty, MD, PhD, Cara L Carty, PhD, Cathie Sudlow, BMBCh, MSc, DPhil, FRCP, Christopher D Anderson, MD, Christopher Levi, MBBS B Med Sci FRACP, Claudia L Satizabal, PhD, Colin N A Palmer, PhD, Dale M Gamble, CCRP, Daniel Woo, MD, MS, Danish Saleheen, MBBS, PhD, E Bernd Ringelstein, MD, FAHA, Einar Valdimarsson, MD, Elizabeth Holliday, PhD, Gail Davies, PhD, Ganesh Chauhan, PhD, Gerard Pasterkamp, MD, PhD, Giorgio Boncoraglio, MD, Gregor Kuhlenbäumer, MD, PhD, Gudmar Thorleifsson, PhD, Guido J Falcone, MD, ScD, MPH, Guillame Pare, MD, MSc, FRCPC, Helena Schmidt, MD, PhD, Hossein Delavaran, MD, PhD, Hugh S Markus, MD, Hugo J Aparicio, MD, Ian Deary, PhD, Ioana Cotlarciuc, PhD, Israel Fernandez-Cadenas, PhD, James Meschia, MD, Jemma C Hopewell, PhD, FESC, Jingmin Liu, MSc, Joan Montaner, MD, PhD, Joanna Pera, MD, PhD, John Cole, MD, MS, John R Attia, MD, PhD, FRACP, FRCPC, Jonathan Rosand, MD, MSc, Jose M Ferro, MD, PhD, Joshua Bis, PhD, Karen Furie, MD, Kari Stefansson, MD, Klaus Berger, MD, PhD, Konstantinos Kostulas, MD, PhD, Kristina Rannikmae, MD, M Arfan Ikram, MD, PhD, Marianne Benn, MD, PhD, Martin Dichgans, MD, Martin Farrall, FRCPath, Massimo Pandolfo, MD, Matthew Traylor, PhD, Matthew Walters, MD, MBChB, FRCP, Michele Sale, PhD, Mike Nalls, PhD, Myriam Fornage, PhD, Natalie R van Zuydam, PhD, Pankaj Sharma, MD, PhD, Patricia Abrantes, PhD, Paul IW de Bakker, PhD, Peter Higgins, FRCP, Peter Lichtner, PhD, Peter M Rothwell, FMedSci, Philippe Amouyel, MD, PhD, Qiong Yang, PhD, Rainer Malik, PhD, Reinhold Schmidt, MD, Robert Clarke, MD, MRCP, FRCP, FFPH, Robin Lemmens, MD, PhD, Sander W van der Laan, PhD, Sara L Pulit, PhD, Sherine Abboud, MD, PhD, Sofia A Oliveira, PhD, Solveig Gretarsdottir, PhD, Stephanie Debette, MD, PhD, Stephen R Williams, PhD, Steve Bevan, BSc, PhD, Steven J Kittner, MD, Sudha Seshadri, MD, Thomas Mosley, PhD, Thomas WK Battey, BS, Turgut Tatlisumak, MD, PhD, Unnur Thorsteinsdottir, PhD, Vincent NS Thijs, MD, PhD, W T Longstreth, MD, Wei Zhao, MD, PhD, Wei-Min Chen, PhD, Yu-Ching Cheng, PhD, Marilyn S. Albert, PhD, Roger L. Albin, MD, Liana G. Apostolova, MD, Steven E. Arnold, MD, Sanjay Asthana, MD, Craig S. Atwood, PhD, Clinton T. Baldwin, PhD, M. Michael Barmada, PhD, Lisa L. Barnes, PhD, Sandra Barral, PhD, Thomas G. Beach, MD, PhD, James T. Becker, PhD, Gary W. Beecham, PhD, Duane Beekly, BS, David A. Bennett, MD, Eileen H. Bigio, MD, Thomas D. Bird, MD, Deborah Blacker, MD, ScD, Bradley F. Boeve, MD, Adam Boxer, MD, PhD, James R. Burke, MD, PhD, Jeffrey M. Burns, MD, MS, Joseph D. Buxbaum, PhD, Goldie S. Byrd, PhD, Guiqing Cai, MD, PhD, Nigel J. Cairns, PhD FRCPath, Laura B. Cantwell, MPH, Chuanhai Cao, PhD, Cynthia M. Carlsson, MD, MS, Regina M. Carney, MD, Minerva M. Carrasquillo, PhD, Steven L. Carroll, MD, PhD, Helena C. Chui, PhD, David G. Clark, MD, David H. Cribbs, PhD, Elizabeth A. Crocco, MD, Carlos Cruchaga, PhD, Philip L. De Jager, MD, PhD, Charles DeCarli, MD, F. Yesim Demirci, MD, Malcolm Dick, Dennis W. Dickson, MD, Ranjan Duara, Md, Nilufer Ertekin-Taner, MD, PhD, Denis A. Evans, MD, Kelley M. Faber, MS, M. Daniele Fallin, PhD, Kenneth B. Fallon, MD, David W. Fardo, PhD, Martin R. Farlow, MD, Lindsay A. Farrer, PhD, Steven Ferris, PhD, Tatiana M. Foroud, PhD, Matthew P. Frosch, MD, PhD, Douglas R. Galasko, MD, Marla Gearing, PhD, Daniel H. Geschwind, MD, PhD, Bernardino Ghetti, MD, John R. Gilbert, PhD, Rodney C.P. Go, PhD, Alison M. Goate, DPhil, Neill R. Graff-Radford, MD, Robert C. Green, MD, MPH, Patrick Griffith, MD, John H. Growdon, MD, Jonathan L. Haines, PhD, Hakon Hakonarson, MD, PhD, Ronald L. Hamilton, MD, Kara L. Hamilton-Nelson, MPH, Vahram Haroutunian, PhD, Lindy E. Harrell, MD, PhD, Lawrence S. Honig, MD, PhD, Ryan M. Huebinger, PhD, Christine M. Hulette, MD, Bradley T. Hyman, MD, PhD, Gregory A. Jicha, MD, PhD, Lee-Way Jin, MD, PhD, Gyungah Jun, PhD, M. Ilyas Kamboh, PhD, Anna Karydas, BA, John S.K. Kauwe, PhD, Jeffrey A. Kaye, MD, Ronald Kim, MD, Neil W. Kowall, MD, Joel H. Kramer, PsyD, Walter A. Kukull, PhD, Brian W. Kunkle, PhD, Frank M. LaFerla, PhD, James J. Lah, MD, PhD, Rosalyn Lang-Walker, PhD, Eric B. Larson, MD, MPH, James B. Leverenz, MD, Allan I. Levey, MD, PhD, Ge Li, MD, PhD, Andrew P. Lieberman, MD, PhD, Mark W. Logue, PhD, Oscar L. Lopez, MD, Kathryn L. Lunetta, PhD, Constantine G. Lyketsos, MD, Wendy J. Mack, PhD, Jennifer J. Manly, PhD, Daniel C. Marson, JD, PhD, Eden R. Martin, PhD, Frank Martiniuk, PhD, Deborah C. Mash, PhD, Eliezer Masliah, MD, Richard Mayeux, MD, Ann C. McKee, MD, Marsel Mesulam, MD, Bruce L. Miller, MD, Carol A. Miller, MD, Joshua W. Miller, PhD, Thomas J. Montine, MD, PhD, John C. Morris, MD, Jill R. Murrell, PhD, Adam C. Naj, PhD, Thomas O. Obisesan, MD, John M. Olichney, MD, Vernon S. Pankratz, PhD, Joseph E. Parisi, MD, Amanda Partch, MS, Henry L. Paulson, MD, PhD, Margaret A. Pericak-Vance, PhD, William Perry, BS, Elaine Peskind, MD, Ronald C. Petersen, MD, PhD, Aimee Pierce, MD, Wayne W. Poon, PhD, Huntington Potter, PhD, Joseph F. Quinn, MD, Ashok Raj, MD, Towfique Raj, PhD, Murray Raskind, MD, Eric M. Reiman, MD, Barry Reisberg, MD, Christiane Reitz, MD, PhD, John M. Ringman, MD, MS, Erik D. Roberson, MD, PhD, Howard J. Rosen, MD, Roger N. Rosenberg, MD, Mark A. Sager, MD, Mary Sano, PhD, Andrew J. Saykin, PsyD, Gerard D. Schellenberg, PhD, Julie A. Schneider, MD, MS, Lon S. Schneider, MD, MS, William W. Seeley, MD, Amanda G. Smith, MD, Joshua A. Sonnen, MD, Salvatore Spina, MD, Robert A. Stern, PhD, Russell H. Swerdlow, MD, Rudolph E. Tanzi, PhD, Tricia A. Thornton-Wells, PhD, John Q. Trojanowski, MD, PhD, Juan C. Troncoso, MD, Debby W. Tsuang, MD, Otto Valladares, MS, Vivianna M. Van Deerlin, MD, PhD, Linda J. Van Eldik, PhD, Badri N. Vardarajan, PhD, MS, Harry V. Vinters, MD, Jean Paul Vonsattel, MD, Li-San Wang, PhD, Sandra Weintraub, PhD, Kathleen A. Welsh-Bohmer, PhD, Jennifer Williamson, MS, MPH, Thomas S. Wingo, MD, Sarah Wishnek, MPH, Randall L. Woltjer, MD, PhD, Clinton B. Wright, MD, MS, Steven G. Younkin, MD, PhD, Chang-En Yu, PhD, Lei Yu, PhD, Ganesh Chauhan, PhD, Audrey Y. Chu, PhD, Myriam Fornage, PhD, Joshua C. Bis, PhD, Aki S. Havulinna, DSc, Muralidharan Sargurupremraj, PhD, Albert Vernon Smith, PhD, Hieab H.H. Adams, MSc, Seung Hoan Choi, MA, Stella Trompet, PhD, Melissa E. Garcia, MPH, Ani Manichaikul, PhD, Alexander Teumer, PhD, Stefan Gustafsson, PhD, Traci M. Bartz, MS, Céline Bellenguez, PhD, Jean Sebastien Vidal, MD, Xueqiu Jian, PhD, Olafur Kjartansson, MD, Kerri L. Wiggins, MS, Claudia L. Satizabal, PhD, Flora Xue, MS, Samuli Ripatti, PhD, Yongmei Liu, PhD, Joris Deelen, PhD, Marcel den Hoed, PhD, Susan R. Heckbert, MD, Kenneth Rice, PhD, Nicholas L. Smith, PhD, Quenna Wong, MS, Hugo J. Aparicio, MD, Julie E. Buring, ScD, Paul M Ridker, MD, Claudine Berr, MD, Jean-François Dartigues, MD, Anders Hamsten, MD, Patrik K. Magnusson, PhD, Nancy L. Pedersen, PhD, Lars Lannfelt, MD, Lars Lind, MD, Cecilia M. Lindgren, PhD, Andrew P. Morris, PhD, Albert Hofman, MD, Peter J. Koudstaal, MD, Marileen LP. Portegies, MD, André G. Uitterlinden, PhD, Anton JM de Craen, PhD, Ian Ford, MD, J. Wouter Jukema, MD, David J Stott, MD, Norrina B. Allen, PhD, Michele M. Sale, PhD, Andrew D Johnson, PhD, David A. Bennett, MD, Philip L. De Jager, MD, PhD, Charles C. White, PhD, Hans Jörgen Grabe, MD, Marcello Ricardo Paulista Markus, MD, Oscar L Lopez, MD, Jerome I. Rotter, MD, Michael A. Nalls, PhD, Rebecca F. Gottesman, MD, Michael E. Griswold, PhD, David S. Knopman, MD, B. Gwen Windham, MD, Alexa Beiser, PhD, Erkki Vartiainen, MD, Curtis R. French, PhD, Tobias Kurth, MD, Bruce M. Psaty, MD, Tamara B. Harris, MD, Stephen S Rich, PhD, Anita L. deStefano, PhD, Carsten Oliver Schmidt, PhD, Veikko Salomaa, MD, Thomas H. Mosley, PhD, Erik Ingelsson, MD, PhD, Cornelia M. van Duijn, PhD, Christophe Tzourio, MD, Lenore J Launer, PhD, M. Arfan Ikram, MD, Daniel I. Chasman, PhD, W. T. Longstreth, Jr, MD, MPH, Sudha Seshadri, MD, Stéphanie Debette, MD, Benjamin F.J. Verhaaren, MD, PhD, Stéphanie Debette, MD, PhD, Joshua C. Bis, PhD, Jennifer A. Smith, PhD, MPH, MA, M. Kamran Ikram, MD, PhD, Hieab H. Adams, MSc, Ashley H. Beecham, MSc, Kumar B. Rajan, PhD, Lorna M. Lopez, PhD, Sandra Barral, PhD, Mark A. van Buchem, MD, PhD, Jeroen van der Grond, PhD, Albert V. Smith, PhD, Katrin Hegenscheid, MD, Neelum T. Aggarwal, MD, Mariza de Andrade, PhD, Elizabeth J. Atkinson, PhD, Marian Beekman, PhD, Alexa S. Beiser, PhD, Susan H. Blanton, PhD, Eric Boerwinkle, PhD, Adam M. Brickman, PhD, R. Nick Bryan, MD, PhD, Ganesh Chauhan, PhD, Christopher P.L.H. Chen, FRCP, Vincent Chouraki, MD, PhD, Anton J.M. de Craen, PhD, Fabrice Crivello, PhD, Ian J. Deary, PhD, Joris Deelen, MSc, Philip L. De Jager, MD, PhD, Carole Dufouil, PhD, Mitchell S.V. Elkind, MD, MSc, Denis A. Evans, MD, Paul Freudenberger, MSc, Rebecca F. Gottesman, MD, PhD, Vilmundur Guðnason, MD, PhD, Mohamad Habes, PhD, Susan R. Heckbert, MD, PhD, Gerardo Heiss, MD, Saima Hilal, MBBS, Edith Hofer, PhD, Albert Hofman, MD, PhD, Carla A. Ibrahim-Verbaas, MD, David S. Knopman, MD, Cora E. Lewis, MD, MSPH, Jiemin Liao, MSc, David C.M. Liewald, BSc, Michelle Luciano, PhD, Aad van der Lugt, MD, PhD, Oliver O. Martinez, PhD, Richard Mayeux, MD, MSc, Bernard Mazoyer, MD, PhD, Mike Nalls, PhD, Matthias Nauck, MD, Wiro J. Niessen, PhD, Ben A. Oostra, PhD, Bruce M. Psaty, MD, PhD, Kenneth M. Rice, PhD, Jerome I. Rotter, MD, Bettina von Sarnowski, MD, Helena Schmidt, MD, PhD, Pamela J. Schreiner, PhD, Maaike Schuur, MD, PhD, Stephen S. Sidney, MD, MPH, Sigurdur Sigurdsson, MSc, P. Eline Slagboom, PhD, David J.M. Stott, MD, John C. van Swieten, MD, PhD, Alexander Teumer, PhD, Anna Maria Töglhofer, MSc, Matthew Traylor, PhD, Stella Trompet, PhD, Stephen T. Turner, MD, Christophe Tzourio, MD, PhD, Hae-Won Uh, PhD, André G. Uitterlinden, PhD, Meike W. Vernooij, MD, PhD, Jing J. Wang, PhD, Tien Y. Wong, MD, PhD, Joanna M. Wardlaw, MD, B. Gwen Windham, MD, Katharina Wittfeld, MS, Christiane Wolf, PhD, Clinton B. Wright, MD, Qiong Yang, PhD, Wei Zhao, MD, PhD, Alex Zijdenbos, PhD, J. Wouter Jukema, MD, PhD, Ralph L. Sacco, MD, Sharon L.R. Kardia, PhD, Philippe Amouyel, MD, PhD, Thomas H. Mosley, PhD, W. T. Longstreth, Jr, MD, MPH, Charles C. DeCarli, MD, Cornelia M. van Duijn, PhD, Reinhold Schmidt, MD, Lenore J. Launer, PhD, Hans J. Grabe, MD, Sudha S. Seshadri, MD, M. Arfan Ikram, MD, PhD, Myriam Fornage, PhD, Joshua C. Bis, PhD, Maryam Kavousi, MD, MSc, Nora Franceschini, MD, MPH, Aaron Isaacs, PhD, Gonçalo R Abecasis, PhD, Ulf Schminke, MD, Wendy Post, MD, Albert V. Smith, PhD, L. Adrienne Cupples, PhD, Hugh S Markus, MD, Reinhold Schmidt, MD, Jennifer E. Huffman, MSc, Terho Lehtimäki, MD, PhD, Jens Baumert, PhD, Thomas Münzel, MD, Susan R. Heckbert, MD, PhD, Abbas Dehghan, MD, PhD, Kari North, PhD, Ben Oostra, PhD, Steve Bevan, PhD, Eva-Maria Stoegerer, MD, Caroline Hayward, PhD, Olli Raitakari, MD, PhD, Christa Meisinger, MD, MPH, Arne Schillert, PhD, Serena Sanna, PhD, Henry Völzke, MD, Yu-Ching Cheng, PhD, Bolli Thorsson, MD, Caroline S. Fox, MD, MS, Kenneth Rice, PhD, Fernando Rivadeneira, MD, PhD, Vijay Nambi, MD, Eran Halperin, PhD, Katja E. Petrovic, MSc, Leena Peltonen, MD, PhD, H. Erich Wichmann, MD, PhD, Renate B. Schnabel, MD, MSc, Marcus Dörr, MD, Afshin Parsa, MD, MPH, Thor Aspelund, PhD, Serkalem Demissie, PhD, Sekar Kathiresan, MD, Muredach P. Reilly, MBBCH, MSCE, Kent Taylor, PhD, Andre Uitterlinden, PhD, David J. Couper, PhD, Matthias Sitzer, MD, Mika Kähönen, MD, PhD, Thomas Illig, PhD, Philipp S. Wild, MD, Marco Orru, MD, Jan Lüdemann, PhD, Alan R. Shuldiner, MD, Gudny Eiriksdottir, MSc, Charles C. White, MPH, Jerome I. Rotter, MD, Albert Hofman, MD, PhD, Jochen Seissler, MD, Tanja Zeller, PhD, Gianluca Usala, PhD, Florian Ernst, PhD, Lenore J. Launer, PhD, Ralph B. D'Agostino, Sr, PhD, Daniel H. O'Leary, MD, Christie Ballantyne, MD, Joachim Thiery, MD, MBA, Andreas Ziegler, Dr. rer. nat. habil., Edward G. Lakatta, MD, Ravi Kumar Chilukoti, MSc, Tamara B. Harris, MD, PhD, Philip A. Wolf, MD, Bruce M. Psaty, MD, PhD, Joseph F Polak, MD, MPH, Xia Li, MD, MPH, Wolfgang Rathmann, MD, MSPH, Manuela Uda, PhD, Eric Boerwinkle, PhD, Norman Klopp, PhD, Helena Schmidt, MD PhD, James F Wilson, DPhil, Jorma Viikari, MD, PhD, Wolfgang Koenig, MD, Stefan Blankenberg, Prof Dr med, Anne B. Newman, MD, MPH, Jacqueline Witteman, PhD, Gerardo Heiss, MD, PhD, Cornelia van Duijn, PhD, Angelo Scuteri, MD, PhD, Georg Homuth, PhD, Braxton D. Mitchell, PhD, Vilmundur Gudnason, MD, PhD, and Christopher J. O’Donnell, MD, MPH, Læknadeild (HÍ), Faculty of Medicine (UI), Heilbrigðisvísindasvið (HÍ), School of Health Sciences (UI), Háskóli Íslands, University of Iceland, and Berr, Claudine
- Subjects
Neurology & Neurosurgery ,[SDV]Life Sciences [q-bio] ,Heilaskaði ,Clinical Neurology ,Stroke Genetics Network (SiGN), the International Stroke Genetics Consortium (ISGC), METASTROKE, Alzheimer's Disease Genetics Consortium (ADGC), and the Neurology Working Group of the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium ,R1 ,Article ,[SDV] Life Sciences [q-bio] ,Taugasjúkdómar ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,Meta-analyses ,Brain infarcts ,GWAS ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,ddc:610 ,Erfðarannsóknir ,MRI - Abstract
Publisher's version (útgefin grein), Objective: To explore genetic and lifestyle risk factors of MRI-defined brain infarcts (BI) in large population-based cohorts. Methods We performed meta-analyses of genome-wide association studies (GWAS) and examined associations of vascular risk factors and their genetic risk scores (GRS) with MRI-defined BI and a subset of BI, namely, small subcortical BI (SSBI), in 18 population-based cohorts (n=20,949) from 5 ethnicities (3,726 with BI, 2,021 with SSBI). Top loci were followed up in 7 population-based cohorts (n = 6,862; 1,483 with BI, 630 with SBBI), and we tested associations with related phenotypes including ischemic stroke and pathologically defined BI. Results: The mean prevalence was 17.7% for BI and 10.5% for SSBI, steeply rising after age 65. Two loci showed genome-wide significant association with BI: FBN2, p = 1.77 × 10-8; and LINC00539/ZDHHC20, p = 5.82 × 10-9. Both have been associated with blood pressure (BP)-related phenotypes, but did not replicate in the smaller follow-up sample or show associations with related phenotypes. Age- and sex-adjusted associations with BI and SSBI were observed for BP traits (p value for BI, p[BI] = 9.38 × 10-25; p [SSBI] = 5.23 × 10-14 for hypertension), smoking (p[BI]= 4.4 × 10-10; p [SSBI] = 1.2 × 10 -4), diabetes (p[BI] = 1.7 × 10 -8; p [SSBI] = 2.8 × 10 -3), previous cardiovascular disease (p [BI] = 1.0 × 10-18; p [SSBI] = 2.3 × 10-7), stroke (p [BI] = 3.9 × 10-69; p [SSBI] = 3.2 × 10 -24), and MRI-defined white matter hyperintensity burden (p [BI]=1.43 × 10-157; p [SSBI] = 3.16 × 10-106), but not with body mass index or cholesterol. GRS of BP traits were associated with BI and SSBI (p ≤ 0.0022), without indication of directional pleiotropy. Conclusion: In this multiethnic GWAS meta-analysis, including over 20,000 population-based participants, we identified genetic risk loci for BI requiring validation once additional large datasets become available. High BP, including genetically determined, was the most significant modifiable, causal risk factor for BI., CHAP: R01-AG-11101, R01-AG-030146, NIRP-14-302587. SMART: This study was supported by a grant from the Netherlands Organization for Scientific Research–Medical Sciences (project no. 904-65–095). LBC: The authors thank the LBC1936 participants and the members of the LBC1936 research team who collected and collated the phenotypic and genotypic data. The LBC1936 is supported by Age UK (Disconnected Mind Programme grant). The work was undertaken by The University of Edinburgh Centre for Cognitive Ageing and Cognitive Epidemiology, part of the cross-council Lifelong Health and Wellbeing Initiative (MR/K026992/1). The brain imaging was performed in the Brain Research Imaging Centre (https://www.ed.ac.uk/clinical-sciences/edinburgh-imaging), a center in the SINAPSE Collaboration (sinapse.ac.uk) supported by the Scottish Funding Council and Chief Scientist Office. Funding from the UK Biotechnology and Biological Sciences Research Council (BBSRC) and the UK Medical Research Council is acknowledged. Genotyping was supported by a grant from the BBSRC (ref. BB/F019394/1). PROSPER: The PROSPER study was supported by an investigator-initiated grant obtained from Bristol-Myers Squibb. Prof. Dr. J.W. Jukema is an Established Clinical Investigator of the Netherlands Heart Foundation (grant 2001 D 032). Support for genotyping was provided by the seventh framework program of the European commission (grant 223004) and by the Netherlands Genomics Initiative (Netherlands Consortium for Healthy Aging grant 050-060-810). SCES and SiMES: National Medical Research Council Singapore Centre Grant NMRC/CG/013/2013. C.-Y.C. is supported by the National Medical Research Council, Singapore (CSA/033/2012), Singapore Translational Research Award (STaR) 2013. Dr. Kamran Ikram received additional funding from the Singapore Ministry of Health's National Medical Research Council (NMRC/CSA/038/2013). SHIP: SHIP is part of the Community Medicine Research net of the University of Greifswald, Germany, which is funded by the Federal Ministry of Education and Research (grants no. 01ZZ9603, 01ZZ0103, and 01ZZ0403), the Ministry of Cultural Affairs, as well as the Social Ministry of the Federal State of Mecklenburg–West Pomerania, and the network “Greifswald Approach to Individualized Medicine (GANI_MED)” funded by the Federal Ministry of Education and Research (grant 03IS2061A). Genome-wide data have been supported by the Federal Ministry of Education and Research (grant no. 03ZIK012) and a joint grant from Siemens Healthineers, Erlangen, Germany, and the Federal State of Mecklenburg–West Pomerania. Whole-body MRI was supported by a joint grant from Siemens Healthineers, Erlangen, Germany, and the Federal State of Mecklenburg–West Pomerania. The University of Greifswald is a member of the Caché Campus program of the InterSystems GmbH. OATS (Older Australian Twins Study): OATS was supported by an Australian National Health and Medical Research Council (NHRMC)/Australian Research Council (ARC) Strategic Award (ID401162) and by a NHMRC grant (ID1045325). OATS was facilitated via access to the Australian Twin Registry, which is supported by the NHMRC Enabling Grant 310667. The OATS genotyping was partly supported by a Commonwealth Scientific and Industrial Research Organisation Flagship Collaboration Fund Grant. NOMAS: The Northern Manhattan Study is funded by the NIH grant “Stroke Incidence and Risk Factors in a Tri-Ethnic Region” (NINDS R01NS 29993). TASCOG: NHMRC and Heart Foundation. AGES: The study was funded by the National Institute on Aging (NIA) (N01-AG-12100), Hjartavernd (the Icelandic Heart Association), and the Althingi (the Icelandic Parliament), with contributions from the Intramural Research Programs at the NIA, the National Heart, Lung, and Blood Institute (NHLBI), and the National Institute of Neurological Disorders and Stroke (NINDS) (Z01 HL004607-08 CE). ERF: The ERF study as a part of European Special Populations Research Network (EUROSPAN) was supported by European Commission FP6 STRP grant no. 018947 (LSHG-CT-2006-01947) and also received funding from the European Community's Seventh Framework Programme (FP7/2007–2013)/grant agreement HEALTH-F4-2007-201413 by the European Commission under the programme “Quality of Life and Management of the Living Resources” of 5th Framework Programme (no. QLG2-CT-2002-01254). High-throughput analysis of the ERF data was supported by a joint grant from Netherlands Organization for Scientific Research and the Russian Foundation for Basic Research (NWO-RFBR 047.017.043). Exome sequencing analysis in ERF was supported by the ZonMw grant (project 91111025). Najaf Amin is supported by the Netherlands Brain Foundation (project no. F2013[1]-28). ARIC: The Atherosclerosis Risk in Communities study was performed as a collaborative study supported by NHLBI contracts (HHSN268201100005C, HSN268201100006C, HSN268201100007C, HHSN268201100008C, HHSN268201100009C, HHSN268201100010C, HHSN268201100011C, and HHSN268201100012C), R01HL70825, R01HL087641, R01HL59367, and R01HL086694; National Human Genome Research Institute contract U01HG004402; and NIH contract HHSN268200625226C. Infrastructure was partly supported by grant no. UL1RR025005, a component of the NIH and NIH Roadmap for Medical Research. This project was also supported by NIH R01 grant NS087541 to M.F. FHS: This work was supported by the National Heart, Lung and Blood Institute's Framingham Heart Study (contracts no. N01-HC-25195 and no. HHSN268201500001I), and its contract with Affymetrix, Inc. for genotyping services (contract no. N02-HL-6-4278). A portion of this research utilized the Linux Cluster for Genetic Analysis (LinGA-II) funded by the Robert Dawson Evans Endowment of the Department of Medicine at Boston University School of Medicine and Boston Medical Center. This study was also supported by grants from the NIA (R01s AG033040, AG033193, AG054076, AG049607, AG008122, and U01-AG049505) and the NINDS (R01-NS017950, UH2 NS100605). Dr. DeCarli is supported by the Alzheimer's Disease Center (P30 AG 010129). ASPS: The research reported in this article was funded by the Austrian Science Fund (FWF) grant nos. P20545-P05, P13180, and P20545-B05, by the Austrian National Bank Anniversary Fund, P15435, and the Austrian Ministry of Science under the aegis of the EU Joint Programme–Neurodegenerative Disease Research (JPND) (jpnd.eu). LLS: The Leiden Longevity Study has received funding from the European Union's Seventh Framework Programme (FP7/2007–2011) under grant agreement no. 259679. This study was supported by a grant from the Innovation-Oriented Research Program on Genomics (SenterNovem IGE05007), the Centre for Medical Systems Biology, and the Netherlands Consortium for Healthy Ageing (grant 050-060-810), all in the framework of the Netherlands Genomics Initiative, Netherlands Organization for Scientific Research (NWO), UnileverColworth, and by BBMRI-NL, a Research Infrastructure financed by the Dutch government (NWO 184.021.007). CHS: This CHS research was supported by contracts HHSN268201200036C, HHSN268200800007C, N01HC55222, N01HC85079, N01HC85080, N01HC85081, N01HC85082, N01HC85083, N01HC85086, N01HC15103, and HHSN268200960009C and grants U01HL080295, R01HL087652, R01HL105756, R01HL103612, R01HL120393, R01HL085251, and R01HL130114 from the NHLBI with additional contribution from NINDS. Additional support was provided through R01AG023629 from the NIA. A full list of principal CHS investigators and institutions can be found at CHS-NHLBI.org. The provision of genotyping data was supported in part by the National Center for Advancing Translational Sciences, CTSI grant UL1TR001881, and the National Institute of Diabetes and Digestive and Kidney Disease Diabetes Research Center grant DK063491 to the Southern California Diabetes Endocrinology Research Center. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Rotterdam Study: The generation and management of GWAS genotype data for the Rotterdam Study is supported by the Netherlands Organisation of Scientific Research (NWO) Investments (no. 175.010.2005.011, 911-03-012). This study is funded by the Research Institute for Diseases in the Elderly (014-93-015; RIDE2), the Netherlands Genomics Initiative (NGI)/NWO project no. 050-060-810. The Rotterdam Study is funded by Erasmus MC Medical Center and Erasmus MC University, Rotterdam, Netherlands Organization for Health Research and Development (ZonMw), the Research Institute for Diseases in the Elderly (RIDE), the Ministry of Education, Culture and Science, the Ministry for Health, Welfare and Sports, the European Commission (DG XII), and the Municipality of Rotterdam. M.A.I. is supported by an NWO Veni grant (916.13.054). The 3-City Study: The 3-City Study is conducted under a partnership agreement among the Institut National de la Santé et de la Recherche Médicale (INSERM), the University of Bordeaux, and Sanofi-Aventis. The Fondation pour la Recherche Médicale funded the preparation and initiation of the study. The 3C Study is also supported by the Caisse Nationale Maladie des Travailleurs Salariés, Direction Générale de la Santé, Mutuelle Générale de l’Education Nationale (MGEN), Institut de la Longévité, Conseils Régionaux of Aquitaine and Bourgogne, Fondation de France, and Ministry of Research–INSERM Programme “Cohortes et collections de données biologiques.” C.T. and S.D. have received investigator-initiated research funding from the French National Research Agency (ANR) and from the Fondation Leducq. S.D. is supported by a starting grant from the European Research Council (SEGWAY), a grant from the Joint Programme of Neurodegenerative Disease research (BRIDGET), from the European Union's Horizon 2020 research and innovation programme under grant agreements No 643417 & No 640643, and by the Initiative of Excellence of Bordeaux University. Part of the computations were performed at the Bordeaux Bioinformatics Center (CBiB), University of Bordeaux. This work was supported by the National Foundation for Alzheimer's Disease and Related Disorders, the Institut Pasteur de Lille, the Labex DISTALZ, and the Centre National de Génotypage. ADGC: The Alzheimer Disease Genetics Consortium is supported by NIH. NIH-NIA supported this work through the following grants: ADGC, U01 AG032984, RC2 AG036528; NACC, U01 AG016976; NCRAD, U24 AG021886; NIA LOAD, U24 AG026395, U24 AG026390; Banner Sun Health Research Institute, P30 AG019610; Boston University, P30 AG013846, U01 AG10483, R01 CA129769, R01 MH080295, R01 AG017173, R01 AG025259, R01AG33193; Columbia University, P50 AG008702, R37 AG015473; Duke University, P30 AG028377, AG05128; Emory University, AG025688; Group Health Research Institute, UO1 AG06781, UO1 HG004610; Indiana University, P30 AG10133; Johns Hopkins University, P50 AG005146, R01 AG020688; Massachusetts General Hospital, P50 AG005134; Mayo Clinic, P50 AG016574; Mount Sinai School of Medicine, P50 AG005138, P01 AG002219; New York University, P30 AG08051, MO1RR00096, UL1 RR029893, 5R01AG012101, 5R01AG022374, 5R01AG013616, 1RC2AG036502, 1R01AG035137; Northwestern University, P30 AG013854; Oregon Health & Science University, P30 AG008017, R01 AG026916; Rush University, P30 AG010161, R01 AG019085, R01 AG15819, R01 AG17917, R01 AG30146; TGen, R01 NS059873; University of Alabama at Birmingham, P50 AG016582, UL1RR02777; University of Arizona, R01 AG031581; University of California, Davis, P30 AG010129; University of California, Irvine, P50 AG016573, P50, P50 AG016575, P50 AG016576, P50 AG016577; University of California, Los Angeles, P50 AG016570; University of California, San Diego, P50 AG005131; University of California, San Francisco, P50 AG023501, P01 AG019724; University of Kentucky, P30 AG028383, AG05144; University of Michigan, P50 AG008671; University of Pennsylvania, P30 AG010124; University of Pittsburgh, P50 AG005133, AG030653; University of Southern California, P50 AG005142; University of Texas Southwestern, P30 AG012300; University of Miami, R01 AG027944, AG010491, AG027944, AG021547, AG019757; University of Washington, P50 AG005136; Vanderbilt University, R01 AG019085; and Washington University, P50 AG005681, P01 AG03991. The Kathleen Price Bryan Brain Bank at Duke University Medical Center is funded by NINDS grant NS39764, NIMH MH60451, and by GlaxoSmithKline. Genotyping of the TGEN2 cohort was supported by Kronos Science. The TGen series was also funded by NIA grant AG041232, the Banner Alzheimer's Foundation, The Johnnie B. Byrd Sr. Alzheimer's Institute, the Medical Research Council, and the state of Arizona and also includes samples from the following sites: Newcastle Brain Tissue Resource (funding via the Medical Research Council [MRC], local NHS trusts, and Newcastle University), MRC London Brain Bank for Neurodegenerative Diseases (funding via the Medical Research Council), South West Dementia Brain Bank (funding via numerous sources including the Higher Education Funding Council for England [HEFCE], Alzheimer's Research Trust [ART], BRACE, as well as North Bristol NHS Trust Research and Innovation Department and DeNDRoN), The Netherlands Brain Bank (funding via numerous sources including Stichting MS Research, Brain Net Europe, Hersenstichting Nederland Breinbrekend Werk, International Parkinson Fonds, Internationale Stiching Alzheimer Onderzoek), Institut de Neuropatologia, Servei Anatomia Patologica, and Universitat de Barcelona). ADNI: Funding for ADNI is through the Northern California Institute for Research and Education by grants from Abbott, AstraZeneca AB, Bayer Schering Pharma AG, Bristol-Myers Squibb, Eisai Global Clinical Development, Elan Corporation, Genentech, GE Healthcare, GlaxoSmithKline, Innogenetics, Johnson & Johnson, Eli Lilly and Co., Medpace, Inc., Merck and Co., Inc., Novartis AG, Pfizer Inc, F. Hoffman-La Roche, Schering-Plough, Synarc, Inc., Alzheimer's Association, Alzheimer's Drug Discovery Foundation, the Dana Foundation, and the National Institute of Biomedical Imaging and Bioengineering and NIA grants U01 AG024904, RC2 AG036535, and K01 AG030514. Support was also provided by the Alzheimer's Association (LAF, IIRG-08-89720; MAP-V, IIRG-05-14147) and the US Department of Veterans Affairs Administration, Office of Research and Development, Biomedical Laboratory Research Program. SiGN: Stroke Genetic Network (SiGN) was supported in part by award nos. U01NS069208 and R01NS100178 from NINDS. Genetics of Early-Onset Stroke (GEOS) Study was supported by the NIH Genes, Environment and Health Initiative (GEI) grant U01 HG004436, as part of the GENEVA consortium under GEI, with additional support provided by the Mid-Atlantic Nutrition and Obesity Research Center (P30 DK072488); and the Office of Research and Development, Medical Research Service, and the Baltimore Geriatrics Research, Education, and Clinical Center of the Department of Veterans Affairs. Genotyping services were provided by the Johns Hopkins University Center for Inherited Disease Research (CIDR), which is fully funded through a federal contract from the NIH to Johns Hopkins University (contract no. HHSN268200782096C). Assistance with data cleaning was provided by the GENEVA Coordinating Center (U01 HG 004446; PI Bruce S. Weir). Study recruitment and assembly of datasets were supported by a Cooperative Agreement with the Division of Adult and Community Health, Centers for Disease Control and Prevention, and by grants from NINDS and the NIH Office of Research on Women's Health (R01 NS45012, U01 NS069208-01). METASTROKE: ASGC: Australian population control data were derived from the Hunter Community Study. This research was funded by grants from the Australian National and Medical Health Research Council (NHMRC Project Grant ID: 569257), the Australian National Heart Foundation (NHF Project Grant ID: G 04S 1623), the University of Newcastle, the Gladys M Brawn Fellowship scheme, and the Vincent Fairfax Family Foundation in Australia. E.G.H. was supported by a Fellowship from the NHF and National Stroke Foundation of Australia (ID: 100071). J.M. was supported by an Australian Postgraduate Award. BRAINS: Bio-Repository of DNA in Stroke (BRAINS) is partly funded by a Senior Fellowship from the Department of Health (UK) to P.S., the Henry Smith Charity, and the UK-India Education Research Institutive (UKIERI) from the British Council. GEOS: Genetics of Early Onset Stroke (GEOS) Study, Baltimore, was supported by GEI Grant U01 HG004436, as part of the GENEVA consortium under GEI, with additional support provided by the Mid-Atlantic Nutrition and Obesity Research Center (P30 DK072488), and the Office of Research and Development, Medical Research Service, and the Baltimore Geriatrics Research, Education, and Clinical Center of the Department of Veterans Affairs. Genotyping services were provided by the Johns Hopkins University Center for Inherited Disease Research (CIDR), which is fully funded through a federal contract from the NIH to the Johns Hopkins University (contract no. HHSN268200782096C). Assistance with data cleaning was provided by the GENEVA Coordinating Center (U01 HG 004446; PI Bruce S. Weir). Study recruitment and assembly of datasets were supported by a Cooperative Agreement with the Division of Adult and Community Health, Centers for Disease Control and Prevention, and by grants from NINDS and the NIH Office of Research on Women's Health (R01 NS45012, U01 NS069208-01). HPS: Heart Protection Study (HPS) (ISRCTN48489393) was supported by the UK MRC, British Heart Foundation, Merck and Co. (manufacturers of simvastatin), and Roche Vitamins Ltd. (manufacturers of vitamins). Genotyping was supported by a grant to Oxford University and CNG from Merck and Co. J.C.H. acknowledges support from the British Heart Foundation (FS/14/55/30806). ISGS: Ischemic Stroke Genetics Study (ISGS)/Siblings With Ischemic Stroke Study (SWISS) was supported in part by the Intramural Research Program of the NIA, NIH project Z01 AG-000954-06. ISGS/SWISS used samples and clinical data from the NIH-NINDS Human Genetics Resource Center DNA and Cell Line Repository (ccr.coriell.org/ninds), human subjects protocol nos. 2003-081 and 2004-147. ISGS/SWISS used stroke-free participants from the Baltimore Longitudinal Study of Aging (BLSA) as controls. The inclusion of BLSA samples was supported in part by the Intramural Research Program of the NIA, NIH project Z01 AG-000015-50, human subjects protocol no. 2003-078. The ISGS study was funded by NIH-NINDS Grant R01 NS-42733 (J.F.M.). The SWISS study was funded by NIH-NINDS Grant R01 NS-39987 (J.F.M.). This study used the high-performance computational capabilities of the Biowulf Linux cluster at the NIH (biowulf.nih.gov). MGH-GASROS: MGH Genes Affecting Stroke Risk and Outcome Study (MGH-GASROS) was supported by NINDS (U01 NS069208), the American Heart Association/Bugher Foundation Centers for Stroke Prevention Research 0775010N, the NIH and NHLBI's STAMPEED genomics research program (R01 HL087676), and a grant from the National Center for Research Resources. The Broad Institute Center for Genotyping and Analysis is supported by grant U54 RR020278 from the National Center for Research resources. Milan: Milano–Besta Stroke Register Collection and genotyping of the Milan cases within CEDIR were supported by the Italian Ministry of Health (grant nos.: RC 2007/LR6, RC 2008/LR6; RC 2009/LR8; RC 2010/LR8; GR-2011-02347041), FP6 LSHM-CT-2007-037273 for the PROCARDIS control samples. WTCCC2: Wellcome Trust Case-Control Consortium 2 (WTCCC2) was principally funded by the Wellcome Trust, as part of the Wellcome Trust Case Control Consortium 2 project (085475/B/08/Z and 085475/Z/08/Z and WT084724MA). The Stroke Association provided additional support for collection of some of the St George's, London cases. The Oxford cases were collected as part of the Oxford Vascular Study, which is funded by the MRC, Stroke Association, Dunhill Medical Trust, National Institute of Health Research (NIHR), and the NIHR Biomedical Research Centre, Oxford. The Edinburgh Stroke Study was supported by the Wellcome Trust (clinician scientist award to C.L.M.S.) and the Binks Trust. Sample processing occurred in the Genetics Core Laboratory of the Wellcome Trust Clinical Research Facility, Western General Hospital, Edinburgh. Much of the neuroimaging occurred in the Scottish Funding Council Brain Imaging Research Centre (https://www.ed.ac.uk/clinical-sciences/edinburgh-imaging), Division of Clinical Neurosciences, University of Edinburgh, a core area of the Wellcome Trust Clinical Research Facility, and part of the SINAPSE (Scottish Imaging Network: A Platform for Scientific Excellence) collaboration (sinapse.ac.uk), funded by the Scottish Funding Council and the Chief Scientist Office. Collection of the Munich cases and data analysis was supported by the Vascular Dementia Research Foundation. This project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreements no. 666881, SVDs@target (to M.D.) and no. 667375, CoSTREAM (to M.D.); the DFG as part of the Munich Cluster for Systems Neurology (EXC 1010 SyNergy) and the CRC 1123 (B3) (to M.D.); the Corona Foundation (to M.D.); the Fondation Leducq (Transatlantic Network of Excellence on the Pathogenesis of Small Vessel Disease of the Brain) (to M.D.); the e:Med program (e:AtheroSysMed) (to M.D.) and the FP7/2007-2103 European Union project CVgenes@target (grant agreement no. Health-F2-2013-601456) (to M.D.). M.F. and A.H. acknowledge support from the BHF Centre of Research Excellence in Oxford and the Wellcome Trust core award (090532/Z/09/Z). VISP: The GWAS component of the Vitamin Intervention for Stroke Prevention (VISP) study was supported by the US National Human Genome Research Institute (NHGRI), grant U01 HG005160 (PI Michèle Sale and Bradford Worrall), as part of the Genomics and Randomized Trials Network (GARNET). Genotyping services were provided by the Johns Hopkins University Center for Inherited Disease Research (CIDR), which is fully funded through a federal contract from the NIH to Johns Hopkins University. Assistance with data cleaning was provided by the GARNET Coordinating Center (U01 HG005157; PI Bruce S. Weir). Study recruitment and collection of datasets for the VISP clinical trial were supported by an investigator-initiated research grant (R01 NS34447; PI James Toole) from the US Public Health Service, NINDS, Bethesda, MD. Control data obtained through the database of genotypes and phenotypes (dbGAP) maintained and supported by the United States National Center for Biotechnology Information, US National Library of Medicine. WHI: Funding support for WHI-GARNET was provided through the NHGRI GARNET (grant no. U01 HG005152). Assistance with phenotype harmonization and genotype cleaning, as well as with general study coordination, was provided by the GARNET Coordinating Center (U01 HG005157). Funding support for genotyping, which was performed at the Broad Institute of MIT and Harvard, was provided by the GEI (U01 HG004424). R.L. is a senior clinical investigator of FWO Flanders. F.W.A. is supported by a Dekker scholarship-Junior Staff Member 2014T001–Netherlands Heart Foundation and UCL Hospitals NIHR Biomedical Research Centre.
- Published
- 2019
- Full Text
- View/download PDF
27. DETECTION OF EARLY CEREBRAL CORTICAL ISCHEMIA USING MONOENERGETIC IMAGES COMPARED TO CONVENTIONAL POLYENERGETIC IMAGES
- Author
-
Wasselius, Johan
- Abstract
Background and PurposeEarly cortical ischemic changes may be difficult to detect on conventional computer tomography (CT), but virtual monoenergetic images (VMIs) may improve detection rates through increased soft tissue contrast. We compared the ability of VMIs to detect early cerebral ischemia in patients with acute ischemic stroke to conventional polyenergetic images (CIs).MethodsWe screened all patients at our department who underwent brain CT in a Philips dual-layer IQon Spectral CT examined for clinical suspicion of acute stroke, last seen well
- Published
- 2017
28. STROKE DETECTION BY WEARABLE ACCELEROMETERS u2013PROOF OF CONCEPT OF A STROKE ALARM
- Author
-
Wasselius, Johan
- Abstract
Background and PurposeRecent advances in stroke treatment has provided effective tools to successfully treat ischemic stroke, but still the most common patient is the one not treated due to late arrival to hospital. Early detection may improve treatment outcome and facilitate expansion of reperfusion treatment to a larger portion of stroke patients. This prospective study was conducted to assess the capability to detect stroke within clinically relevant times by using bilateral bracelet accelerometers.Methods: Motion data were collected by wearable 3-axis bracelet accelerometer for 24 hours on 30 stroke patients with unilateral arm motor impairment and 30 healthy subjects. Accelerometer data were analysed using machine-learning algorithms. Results: The sensitivity and specificity for detection of stroke-affected arms are shown by the Receiver Operating Characteristic (ROC) curves by analysing periods between 3 seconds up to 100 minutes. The Area Under the Curve (AUC) increased from 0.7136 for 3s analysis, 0.9490 for 25 minutes, and 0.9881 for 100 minutes. Conclusions: The 3-axis bracelet accelerometer shows a high detection rate with a low false positives rate at time-samples less than 30 minutes, thereby providing a wearable easy-to-use stroke detection system. We suggest that such a stroke alarm may be reasonable and cost-effective to ensure early detection in the event of a stroke in high-risk patients with recent TIA, stroke or atrial fibrillation.
- Published
- 2017
29. ESTIMATED POTENTIAL OUTCOME AUGMENTATION AND HEALTH ECONOMIC BENEFITS OF A WEARABLE STROKE ALARM
- Author
-
Wasselius, Johan
- Abstract
Background and PurposeAlthough recent advances have provided effective treatments for ischemic stroke, a majority of patients are not treated due arrival beyond the time window for reperfusion treatment. Based on a health-economic model, we estimated the potential improvement of outcomes and cost reduction attained by shortening the time to thrombectomy for stroke patients with Large Vessel Occlusions (LVO) using bilateral accelerometers worn in bracelets that can detect stroke within 30 minutes of onset. Methods: Outcome data for thrombectomy patients with anterior circulation LVO were obtained from a meta-analysis of several recent randomized trials (HERMES collaboration). Outcome data for untreated LVO patients (controls) were obtained from the DEFUSE3 trial. Health economic effects were based on costs estimation (including QALY-estimations) for each level of the MRS-scale by Mangla et al 2016. Results: The potential treatment outcome benefit for ischemic stroke patients with anterior circulation LVO is substantial if treatment could be done within 3h of onset instead of within 8h, which may be possible by detection within 30-60 minutes of onset. The average cost reduction would be 481.470 USD/patient for the pooled populations within the HERMES collaboration. However, the greatest effect would come from allowing patients that are otherwise not treated due to late arrival to hospital to be treated within 3h of onset. The average cost reduction in this group would be 1.162.000 USD/patient.Conclusions: Early stroke detection using a wearable stroke alarm that detects major stroke within 30 minutes would potentially augment thrombectomy outcome profoundly, with substantial positive health economic effects.
- Published
- 2017
30. Accuracy of uncalibrated 2D digital subtraction angiography measurements on a novel biplane system compared to computed tomography angiography
- Author
-
Landström, Lovisa and Wasselius, Johan A
- Abstract
Background 2D digital subtraction angiography (DSA) images are the gold standard for neuroradiological vascular assessment and the basis of interventional procedures such as mechanical thrombectomy and cerebral aneurysm coiling. However, length measurements in projected DSA images are affected by the distance between the x-ray source, the object, and the detector. Precise coordination between all integrated parts of a novel biplane system makes it possible to accurately measure DSA distances without manual calibration. The aim of this study was to compare vascular diameter measurements in uncalibrated DSA images with computed tomography angiography (CTA).Methods Consecutive patients undergoing interventional neuroradiological procedures were retrospectively included. Vascular diameter measurements in the image isocenter and periphery were performed. These measurements were repeated in picture archiving and communication system (PACS) on DSA images and maximum intensity pixel (MIP) CTA images.Results Forty-two (42) consecutive patients with adequate DSA and CTA images were included in the final analysis. The correlation between vessel diameter measurements in the image isocenter (R2= 0.81/0.85, p < 0.0001/p < 0.0001 [Reader1/Reader2]), periphery (R2= 0.85/0.82, p < 0.0001/p < 0.0001 [Reader1/Reader2]), and all measurements combined (R2= 0.87/0.87, p < 0.0001/p < 0.0001 [Reader1/Reader2]) on DSA and CTA were strong and statistically significant. The interclass correlation coefficient for measurements performed by two independent reviewers was strong (ICC = 0.96, 95% CI 0.92–0.98).Conclusions The correlations between uncalibrated DSA measurements and CTA for vessel diameter were strong. In addition, there were strong correlations between these image types for repeated measurements in the image isocenter as well as image periphery for vessel diameter. Consequently, endovascular devices can be sized correctly without the need for pre-operative non-invasive imaging.
- Published
- 2024
- Full Text
- View/download PDF
31. Gadofosveset-enhanced magnetic resonance venography in patients with venous pathology of the lower limbs - Comparison of diagnostic image quality and inter-rater variability with gadobutrol venography and computed tomography venography.
- Author
-
Åkesson, Michael, Lehti, Leena, Höglund, Peter, Åkeson, Per, Wasselius, Johan, Åkesson, Michael, Lehti, Leena, Höglund, Peter, Åkeson, Per, and Wasselius, Johan
- Abstract
This study was performed to compare the diagnostic quality of Gadofosveset-enhanced magnetic resonance venography with Gadobutrol-enhanced magnetic resonance venography and computed tomography venography for the deep veins of the lower extremities in patients with iliocaval venous pathology.
- Published
- 2015
32. Cystatin C in the anterior segment of rat and mouse eyes.
- Author
-
Wasselius, Johan, Håkansson, Katarina, Abrahamson, Magnus, Ehinger, Berndt, Wasselius, Johan, Håkansson, Katarina, Abrahamson, Magnus, and Ehinger, Berndt
- Abstract
Purpose: Cystatin C is a mammalian cysteine protease inhibitor. This study describes the localization of cystatin C in the anterior segment of normal rat and mouse eyes. Cysteine proteases play an important role in protein degradation (e.g. of photoreceptor outer segments in the retinal pigment epithelium) and the balance between these proteases and their specific inhibitors is therefore of great interest. Methods: Cells containing cystatin C were identified by immunohistochemistry and quantified by ELISA. Messenger RNA levels were analysed by quantitative real-time polymerase chain reaction. Results: Cystatin C is present at biologically significant levels in the corneal epithelium, endothelium and stromal keratinocytes, lens epithelium, epithelial cells in the ciliary processes, aqueous humour and iris stromal cells. In the rat anterior segment, the highest cystatin C concentrations were found in the ciliary epithelium. Conclusions: Cystatin C is present in several cell types and is probably locally produced. The inhibitor is likely to be an important regulator of cysteine proteases in the retinal pigment epithelium, ciliary epithelium, aqueous humour, lens epithelium and in the corneal endothelium and epithelium.
- Published
- 2004
33. Treatment of mesenteric vein thrombosis with transjugular mechanical thrombectomy and subsequent simultaneous arterial and venous thrombolysis
- Author
-
Wassélius, Johan, Sonesson, Björn, Elf, Johan, Ahlström, Martin, Malina, Martin, and Dias, Nuno
- Published
- 2014
- Full Text
- View/download PDF
34. Abstract TP100: Frequency, Spatial Distribution And Associations To Clinical Characteristics Of Multiple Lesions In A Large Multi-center Dataset Of Acute Ischemic Stroke Patients
- Author
-
Bonkhoff, Anna K, Hong, Sungmin, Bretzner, Martin, Schirmer, Markus D, Giese, Anne-Katrin, Donahue, Kathleen, Nardin, Marco, Etherton, Mark R, Regenhardt, Robert, Wu, Ona, Jern, Christina, Lindgren, Arne, Maguire, Jane, Ullberg, Teresa, Frid, Petrea, Rost, Natalia S, and Wasselius, Johan
- Abstract
Introduction:About ~10% of acute ischemic stroke (AIS) patients experience multiple acute lesions (MAL). However, the spatial distribution and clinical implications of such MAL are incompletely understood. Here, we scrutinized MAL in a large, radiologically deep-phenotyped cohort of AIS patients.Methods:We analyzed imaging and clinical data of 2.485 AIS patients [age: 63.3±14.8, 39%women] of the multi-site MRI-GENIE study. We computed occurrences of (i) MAL within one and, (ii) MAL in several vascular supply territories (with single or multiple lesions within single territories). We furthermore evaluated associations between the presence of MAL in multiple territories and stroke severity, white matter hyperintensity (WMH) and stroke lesion volumes, etiology, age and sex.Results:Half of all patients, i.e., 49.7%, presented with a single lesion. Another 37.3% experienced MAL in a single vascular territory, while 13% featured lesions in multiple vascular territories. For most vascular territories (anterior, middle and posterior cerebral artery, cerebellum) the ratio between single to multiple lesions in that territory equaled ~52%, only the brainstem region comprised fewer multiple compared to single lesions (19%). Combinations of anterior and posterior circulation lesions occurred in 5.6% of all patients, bilateral stroke in the anterior circulation in 3.4%. When comparing patients with lesions in only one compared to in more than one territory, there were no significant differences in WMH or lesion volume, stroke severity, age or sex (pFDR-corrected>0.05). Patients with lesions in multiple territories had a significantly lower frequency of small vessel occlusions, but a significantly higher frequency of stroke of undetermined etiology. Differences in cardioembolic stroke frequency were only significant before correction for multiple comparisons (puncorrected=0.025). Frequencies of large vessel occlusions did not differ between the groups.Conclusions:Multiple lesions, especially those within one vascular territory, occurred frequently. Overall, there were no significant associations between MAL and stroke severity or cardioembolic stroke. Future studies are warranted to explore these findings in greater detail.
- Published
- 2022
- Full Text
- View/download PDF
35. The relevance of rich club regions for functional outcome post-stroke is enhanced in women.
- Author
-
Bonkhoff AK, Schirmer MD, Bretzner M, Hong S, Regenhardt RW, Donahue KL, Nardin MJ, Dalca AV, Giese AK, Etherton MR, Hancock BL, Mocking SJT, McIntosh EC, Attia J, Cole JW, Donatti A, Griessenauer CJ, Heitsch L, Holmegaard L, Jood K, Jimenez-Conde J, Kittner SJ, Lemmens R, Levi CR, McDonough CW, Meschia JF, Phuah CL, Ropele S, Rosand J, Roquer J, Rundek T, Sacco RL, Schmidt R, Sharma P, Slowik A, Sousa A, Stanne TM, Strbian D, Tatlisumak T, Thijs V, Vagal A, Wasselius J, Woo D, Zand R, McArdle PF, Worrall BB, Jern C, Lindgren AG, Maguire J, Wu O, and Rost NS
- Subjects
- Female, Humans, Male, Middle Aged, Bayes Theorem, Brain, Models, Neurological, Ischemic Stroke diagnostic imaging, Ischemic Stroke pathology, Stroke
- Abstract
This study aimed to investigate the influence of stroke lesions in predefined highly interconnected (rich-club) brain regions on functional outcome post-stroke, determine their spatial specificity and explore the effects of biological sex on their relevance. We analyzed MRI data recorded at index stroke and ~3-months modified Rankin Scale (mRS) data from patients with acute ischemic stroke enrolled in the multisite MRI-GENIE study. Spatially normalized structural stroke lesions were parcellated into 108 atlas-defined bilateral (sub)cortical brain regions. Unfavorable outcome (mRS > 2) was modeled in a Bayesian logistic regression framework. Effects of individual brain regions were captured as two compound effects for (i) six bilateral rich club and (ii) all further non-rich club regions. In spatial specificity analyses, we randomized the split into "rich club" and "non-rich club" regions and compared the effect of the actual rich club regions to the distribution of effects from 1000 combinations of six random regions. In sex-specific analyses, we introduced an additional hierarchical level in our model structure to compare male and female-specific rich club effects. A total of 822 patients (age: 64.7[15.0], 39% women) were analyzed. Rich club regions had substantial relevance in explaining unfavorable functional outcome (mean of posterior distribution: 0.08, area under the curve: 0.8). In particular, the rich club-combination had a higher relevance than 98.4% of random constellations. Rich club regions were substantially more important in explaining long-term outcome in women than in men. All in all, lesions in rich club regions were associated with increased odds of unfavorable outcome. These effects were spatially specific and more pronounced in women., (© 2022 The Authors. Human Brain Mapping published by Wiley Periodicals LLC.)
- Published
- 2023
- Full Text
- View/download PDF
36. Sex-specific lesion pattern of functional outcomes after stroke.
- Author
-
Bonkhoff AK, Bretzner M, Hong S, Schirmer MD, Cohen A, Regenhardt RW, Donahue KL, Nardin MJ, Dalca AV, Giese AK, Etherton MR, Hancock BL, Mocking SJT, McIntosh EC, Attia J, Benavente OR, Bevan S, Cole JW, Donatti A, Griessenauer CJ, Heitsch L, Holmegaard L, Jood K, Jimenez-Conde J, Kittner SJ, Lemmens R, Levi CR, McDonough CW, Meschia JF, Phuah CL, Rolfs A, Ropele S, Rosand J, Roquer J, Rundek T, Sacco RL, Schmidt R, Sharma P, Slowik A, Söderholm M, Sousa A, Stanne TM, Strbian D, Tatlisumak T, Thijs V, Vagal A, Wasselius J, Woo D, Zand R, McArdle PF, Worrall BB, Jern C, Lindgren AG, Maguire J, Fox MD, Bzdok D, Wu O, and Rost NS
- Abstract
Stroke represents a considerable burden of disease for both men and women. However, a growing body of literature suggests clinically relevant sex differences in the underlying causes, presentations and outcomes of acute ischaemic stroke. In a recent study, we reported sex divergences in lesion topographies: specific to women, acute stroke severity was linked to lesions in the left-hemispheric posterior circulation. We here determined whether these sex-specific brain manifestations also affect long-term outcomes. We relied on 822 acute ischaemic patients [age: 64.7 (15.0) years, 39% women] originating from the multi-centre MRI-GENIE study to model unfavourable outcomes (modified Rankin Scale >2) based on acute neuroimaging data in a Bayesian hierarchical framework. Lesions encompassing bilateral subcortical nuclei and left-lateralized regions in proximity to the insula explained outcomes across men and women (area under the curve = 0.81). A pattern of left-hemispheric posterior circulation brain regions, combining left hippocampus, precuneus, fusiform and lingual gyrus, occipital pole and latero-occipital cortex, showed a substantially higher relevance in explaining functional outcomes in women compared to men [mean difference of Bayesian posterior distributions (men - women) = -0.295 (90% highest posterior density interval = -0.556 to -0.068)]. Once validated in prospective studies, our findings may motivate a sex-specific approach to clinical stroke management and hold the promise of enhancing outcomes on a population level., (© The Author(s) 2022. Published by Oxford University Press on behalf of the Guarantors of Brain.)
- Published
- 2022
- Full Text
- View/download PDF
37. Excessive White Matter Hyperintensity Increases Susceptibility to Poor Functional Outcomes After Acute Ischemic Stroke.
- Author
-
Hong S, Giese AK, Schirmer MD, Bonkhoff AK, Bretzner M, Rist P, Dalca AV, Regenhardt RW, Etherton MR, Donahue KL, Nardin M, Mocking SJT, McIntosh EC, Attia J, Benavente OR, Cole JW, Donatti A, Griessenauer CJ, Heitsch L, Holmegaard L, Jood K, Jimenez-Conde J, Roquer J, Kittner SJ, Lemmens R, Levi CR, McDonough CW, Meschia JF, Phuah CL, Rolfs A, Ropele S, Rosand J, Rundek T, Sacco RL, Schmidt R, Enzinger C, Sharma P, Slowik A, Sousa A, Stanne TM, Strbian D, Tatlisumak T, Thijs V, Vagal A, Wasselius J, Woo D, Zand R, McArdle PF, Worrall BB, Wu O, Jern C, Lindgren AG, Maguire J, Tomppo L, Golland P, and Rost NS
- Abstract
Objective: To personalize the prognostication of post-stroke outcome using MRI-detected cerebrovascular pathology, we sought to investigate the association between the excessive white matter hyperintensity (WMH) burden unaccounted for by the traditional stroke risk profile of individual patients and their long-term functional outcomes after a stroke. Methods: We included 890 patients who survived after an acute ischemic stroke from the MRI-Genetics Interface Exploration (MRI-GENIE) study, for whom data on vascular risk factors (VRFs), including age, sex, atrial fibrillation, diabetes mellitus, hypertension, coronary artery disease, smoking, prior stroke history, as well as acute stroke severity, 3- to-6-month modified Rankin Scale score (mRS), WMH, and brain volumes, were available. We defined the unaccounted WMH (uWMH) burden via modeling of expected WMH burden based on the VRF profile of each individual patient. The association of uWMH and mRS score was analyzed by linear regression analysis. The odds ratios of patients who achieved full functional independence (mRS < 2) in between trichotomized uWMH burden groups were calculated by pair-wise comparisons. Results: The expected WMH volume was estimated with respect to known VRFs. The uWMH burden was associated with a long-term functional outcome (β = 0.104, p < 0.01). Excessive uWMH burden significantly reduced the odds of achieving full functional independence after a stroke compared to the low and average uWMH burden [OR = 0.4, 95% CI: (0.25, 0.63), p < 0.01 and OR = 0.61, 95% CI: (0.42, 0.87), p < 0.01, respectively]. Conclusion: The excessive amount of uWMH burden unaccounted for by the traditional VRF profile was associated with worse post-stroke functional outcomes. Further studies are needed to evaluate a lifetime brain injury reflected in WMH unrelated to the VRF profile of a patient as an important factor for stroke recovery and a plausible indicator of brain health., Competing Interests: AR was employed by Centogene AG, Germany. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Hong, Giese, Schirmer, Bonkhoff, Bretzner, Rist, Dalca, Regenhardt, Etherton, Donahue, Nardin, Mocking, McIntosh, Attia, Benavente, Cole, Donatti, Griessenauer, Heitsch, Holmegaard, Jood, Jimenez-Conde, Roquer, Kittner, Lemmens, Levi, McDonough, Meschia, Phuah, Rolfs, Ropele, Rosand, Rundek, Sacco, Schmidt, Enzinger, Sharma, Slowik, Sousa, Stanne, Strbian, Tatlisumak, Thijs, Vagal, Wasselius, Woo, Zand, McArdle, Worrall, Wu, Jern, Lindgren, Maguire, Tomppo, Golland, Rost and the MRI-GENIE and GISCOME Investigators and the International Stroke Genetics Consortium.)
- Published
- 2021
- Full Text
- View/download PDF
38. Outcome after acute ischemic stroke is linked to sex-specific lesion patterns.
- Author
-
Bonkhoff AK, Schirmer MD, Bretzner M, Hong S, Regenhardt RW, Brudfors M, Donahue KL, Nardin MJ, Dalca AV, Giese AK, Etherton MR, Hancock BL, Mocking SJT, McIntosh EC, Attia J, Benavente OR, Bevan S, Cole JW, Donatti A, Griessenauer CJ, Heitsch L, Holmegaard L, Jood K, Jimenez-Conde J, Kittner SJ, Lemmens R, Levi CR, McDonough CW, Meschia JF, Phuah CL, Rolfs A, Ropele S, Rosand J, Roquer J, Rundek T, Sacco RL, Schmidt R, Sharma P, Slowik A, Söderholm M, Sousa A, Stanne TM, Strbian D, Tatlisumak T, Thijs V, Vagal A, Wasselius J, Woo D, Zand R, McArdle PF, Worrall BB, Jern C, Lindgren AG, Maguire J, Bzdok D, Wu O, and Rost NS
- Subjects
- Aged, Aged, 80 and over, Bayes Theorem, Brain Mapping, Brain Stem blood supply, Brain Stem diagnostic imaging, Cerebral Revascularization methods, Cohort Studies, Female, Humans, Image Processing, Computer-Assisted, Ischemic Stroke diagnostic imaging, Ischemic Stroke therapy, Magnetic Resonance Imaging, Male, Middle Aged, Risk Factors, Sensorimotor Cortex blood supply, Sensorimotor Cortex diagnostic imaging, Severity of Illness Index, Sex Factors, Thalamus blood supply, Thalamus diagnostic imaging, Treatment Outcome, Brain Stem pathology, Ischemic Stroke pathology, Sensorimotor Cortex pathology, Thalamus pathology
- Abstract
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.
- Published
- 2021
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.