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1. The influence of MOGAD on diagnosis of multiple sclerosis using MRI

Author

Geraldes, Ruth, Arrambide, Georgina, Banwell, Brenda, Rovira, Àlex, Cortese, Rosa, Lassmann, Hans, Messina, Silvia, Rocca, Mara Assunta, Waters, Patrick, Chard, Declan, Gasperini, Claudio, Hacohen, Yael, Mariano, Romina, Paul, Friedemann, DeLuca, Gabriele C., Enzinger, Christian, Kappos, Ludwig, Leite, M. Isabel, Sastre-Garriga, Jaume, Yousry, Tarek, Ciccarelli, Olga, Filippi, Massimo, Barkhof, Frederik, and Palace, Jacqueline

Published
2024
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2. Amyloid pathology and vascular risk are associated with distinct patterns of cerebral white matter hyperintensities: A multicenter study in 3132 memory clinic patients

Author

Biesbroek, J Matthijs, Coenen, Mirthe, DeCarli, Charles, Fletcher, Evan M, Maillard, Pauline M, Initiative, Alzheimer's Disease Neuroimaging, Barkhof, Frederik, Barnes, Josephine, Benke, Thomas, Chen, Christopher PLH, Dal‐Bianco, Peter, Dewenter, Anna, Duering, Marco, Enzinger, Christian, Ewers, Michael, Exalto, Lieza G, Franzmeier, Nicolai, Hilal, Saima, Hofer, Edith, Koek, Huiberdina L, Maier, Andrea B, McCreary, Cheryl R, Papma, Janne M, Paterson, Ross W, Pijnenburg, Yolande AL, Rubinski, Anna, Schmidt, Reinhold, Schott, Jonathan M, Slattery, Catherine F, Smith, Eric E, Sudre, Carole H, Steketee, Rebecca ME, Teunissen, Charlotte E, van den Berg, Esther, van der Flier, Wiesje M, Venketasubramanian, Narayanaswamy, Venkatraghavan, Vikram, Vernooij, Meike W, Wolters, Frank J, Xin, Xu, Kuijf, Hugo J, and Biessels, Geert Jan

Subjects
Biomedical and Clinical Sciences, Neurosciences, Clinical Sciences, Vascular Cognitive Impairment/Dementia, Brain Disorders, Clinical Research, Acquired Cognitive Impairment, Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD), Alzheimer's Disease Related Dementias (ADRD), Aging, Dementia, Cerebrovascular, Alzheimer's Disease, Neurodegenerative, Neurological, Humans, Female, Middle Aged, Aged, Aged, 80 and over, Male, White Matter, Arteriolosclerosis, Amyloid beta-Peptides, Magnetic Resonance Imaging, amyloid pathology, arteriolosclerosis, dementia, lesion pattern, white matter hyperintensities, Alzheimer's Disease Neuroimaging Initiative, Geriatrics, Clinical sciences, Biological psychology
Abstract

IntroductionWhite matter hyperintensities (WMH) are associated with key dementia etiologies, in particular arteriolosclerosis and amyloid pathology. We aimed to identify WMH locations associated with vascular risk or cerebral amyloid-β1-42 (Aβ42)-positive status.MethodsIndividual patient data (n = 3,132; mean age 71.5 ± 9 years; 49.3% female) from 11 memory clinic cohorts were harmonized. WMH volumes in 28 regions were related to a vascular risk compound score (VRCS) and Aß42 status (based on cerebrospinal fluid or amyloid positron emission tomography), correcting for age, sex, study site, and total WMH volume.ResultsVRCS was associated with WMH in anterior/superior corona radiata (B = 0.034/0.038, p

Published
2024

10. Spatial distributions of white matter hyperintensities on brain MRI: A pooled analysis of individual participant data from 11 memory clinic cohorts

Author

Coenen, Mirthe, Biessels, Geert Jan, DeCarli, Charles, Fletcher, Evan F, Maillard, Pauline M, Initiative, Alzheimer's Disease Neuroimaging, Barkhof, Frederik, Barnes, Josephine, Benke, Thomas, Boomsma, Jooske MF, Chen, Christopher PLH, Dal-Bianco, Peter, Dewenter, Anna, Duering, Marco, Enzinger, Christian, Ewers, Michael, Exalto, Lieza G, Franzmeier, Nicolai, Groeneveld, Onno, Hilal, Saima, Hofer, Edith, Koek, Huiberdina L, Maier, Andrea B, McCreary, Cheryl R, Papma, Janne M, Paterson, Ross W, Pijnenburg, Yolande AL, Rubinski, Anna, Schmidt, Reinhold, Schott, Jonathan M, Slattery, Catherine F, Smith, Eric E, Sudre, Carole H, Steketee, Rebecca ME, van den Berg, Esther, van der Flier, Wiesje M, Venketasubramanian, Narayanaswamy, Vernooij, Meike W, Wolters, Frank J, Xin, Xu, Biesbroek, J Matthijs, and Kuijf, Hugo J

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Alzheimer's Disease Related Dementias (ADRD), Cerebrovascular, Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD), Machine Learning and Artificial Intelligence, Clinical Research, Acquired Cognitive Impairment, Vascular Cognitive Impairment/Dementia, Aging, Neurodegenerative, Networking and Information Technology R&D (NITRD), Neurosciences, Brain Disorders, Dementia, Neurological, Humans, White Matter, Brain, Magnetic Resonance Imaging, Neuroimaging, Cognitive Dysfunction, Multicenter Studies as Topic, White matter hyperintensities, Brain MRI, Distribution frequencies, Lesion location, Alzheimer's Disease Neuroimaging Initiative, Biological psychology, Clinical and health psychology
Abstract

IntroductionThe spatial distribution of white matter hyperintensities (WMH) on MRI is often considered in the diagnostic evaluation of patients with cognitive problems. In some patients, clinicians may classify WMH patterns as "unusual", but this is largely based on expert opinion, because detailed quantitative information about WMH distribution frequencies in a memory clinic setting is lacking. Here we report voxel wise 3D WMH distribution frequencies in a large multicenter dataset and also aimed to identify individuals with unusual WMH patterns.MethodsIndividual participant data (N = 3525, including 777 participants with subjective cognitive decline, 1389 participants with mild cognitive impairment and 1359 patients with dementia) from eleven memory clinic cohorts, recruited through the Meta VCI Map Consortium, were used. WMH segmentations were provided by participating centers or performed in Utrecht and registered to the Montreal Neurological Institute (MNI)-152 brain template for spatial normalization. To determine WMH distribution frequencies, we calculated WMH probability maps at voxel level. To identify individuals with unusual WMH patterns, region-of-interest (ROI) based WMH probability maps, rule-based scores, and a machine learning method (Local Outlier Factor (LOF)), were implemented.ResultsWMH occurred in 82% of voxels from the white matter template with large variation between subjects. Only a small proportion of the white matter (1.7%), mainly in the periventricular areas, was affected by WMH in at least 20% of participants. A large portion of the total white matter was affected infrequently. Nevertheless, 93.8% of individual participants had lesions in voxels that were affected in less than 2% of the population, mainly located in subcortical areas. Only the machine learning method effectively identified individuals with unusual patterns, in particular subjects with asymmetric WMH distribution or with WMH at relatively rarely affected locations despite common locations not being affected.DiscussionAggregating data from several memory clinic cohorts, we provide a detailed 3D map of WMH lesion distribution frequencies, that informs on common as well as rare localizations. The use of data-driven analysis with LOF can be used to identify unusual patterns, which might serve as an alert that rare causes of WMH should be considered.

Published
2023

19. Burden of intracerebral haemorrhage in Europe: forecasting incidence and mortality between 2019 and 2050

Author

Veltkamp, Roland, Harvey, Kirsten H., Korompoki, Eleni, D’Anna, Lucio, Halse, Omid, Harvey, Emily R., Hügen, Klemens, Malzahn, Uwe, Ullmann, Sabine, Schuhmann, Carolin, Todd, Gabriele Putz, Brinz, Hannes, Fiessler, Cornelia, Heuschmann, Peter U., Haas, Kirsten, Rücker, Viktoria, Enzinger, Christian, Ropele, Stefan, Pinter, Daniela, Haidegger, Melanie, Gattringer, Thomas, Fandler-Höfler, Simon, Wolfe, Charles D.A., Wang, Yanzhong, Wafa, Hatem A., Montaner, Joan, Palà, Elena, Penalba, Anna, Vallverdu, Marcel Lamana, Pilco, Daisy Guaman, Debette, Stéphanie, Sibon, Igor, Renou, Pauline, Lachaize, Morgane, Milan, Léa, Heyvang, Nathalie, Ledure, Sylvain, Michel, Pascale, Conhoc, Johanna, Donnadieu, Léa, Hyves, Kelly, Caso, Valeria, Mosconi, Maria Giulia, Graziani, Mara, Cancelloni, Virginia, Marchini, Laura, Koehler, Bianca Emanuela, Nielsen, Peter Brønnum, Larsen, Torben Bjerregaard, Lip, Gregory Y.H., Horstmann, Solveigh, Purrucker, Jan, Ringleb, Peter, Haffa, Mariam, Klein, Sabrina, Taylor, Lenka, Hoppe-Tichy, Torsten, Haefeli, Walter E., Seidling, Hanna M., Burhenne, Jürgen, Foerster, Kathrin I., Wurmbach, Viktoria, Marquart, Claudia, Lane, Deirdre A., Ivany, Elena, Lotto, Robyn, Marshall, Iain, Xie, Wanqing, and Johnson, Catherine O.

Published
2024
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23. Non-linear fitting with joint spatial regularization in Arterial Spin Labeling

Author

Maier, Oliver, Spann, Stefan M, Pinter, Daniela, Gattringer, Thomas, Hinteregger, Nicole, Thallinger, Gerhard G., Enzinger, Christian, Pfeuffer, Josef, Bredies, Kristian, and Stollberger, Rudolf

Subjects
Electrical Engineering and Systems Science - Image and Video Processing, Electrical Engineering and Systems Science - Signal Processing, 92C55, 68U10, 94A12
Abstract

Multi-Delay single-shot arterial spin labeling (ASL) imaging provides accurate cerebral blood flow (CBF) and, in addition, arterial transit time (ATT) maps but the inherent low SNR can be challenging. Especially standard fitting using non-linear least squares often fails in regions with poor SNR, resulting in noisy estimates of the quantitative maps. State-of-the-art fitting techniques improve the SNR by incorporating prior knowledge in the estimation process which typically leads to spatial blurring. To this end, we propose a new estimation method with a joint spatial total generalized variation regularization on CBF and ATT. This joint regularization approach utilizes shared spatial features across maps to enhance sharpness and simultaneously improves noise suppression in the final estimates. The proposed method is evaluated at three levels, first on synthetic phantom data including pathologies, followed by in vivo acquisitions of healthy volunteers, and finally on patient data following an ischemic stroke. The quantitative estimates are compared to two reference methods, non-linear least squares fitting and a state-of-the-art ASL quantification algorithm based on Bayesian inference. The proposed joint regularization approach outperforms the reference implementations, substantially increasing the SNR in CBF and ATT while maintaining sharpness and quantitative accuracy in the estimates., Comment: 35 pages, 20 figures, 3 tables, including supplementary material; submitted to Medical Image Analysis

Published
2020
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25. Effects of oral anticoagulation in people with atrial fibrillation after spontaneous intracranial haemorrhage (COCROACH): prospective, individual participant data meta-analysis of randomised trials

Author

Klug, Didier, Casolla, Barbara, Puy, Laurent, Coffee, Morgane, Kuchcinski, Grégory, Labreuche, Julien, van Nieuwenhuizen, Koen M., Algra, Ale, van Gelder, Isabelle C., Kappelle, L. Jaap, Rinkel, Gabriel J.E., Schutgens, Roger E.G., Khatri, Pooja, Conwit, Robin, Falcone, Guido, Elm, Jordan, Anderson, Craig S., Song, Lili, Pandian, Jeyaraj, Hart, Robert G., Sharma, Mukul, Aref, Hany, Tarhuni, Wadea, Fabregas, Joan Marti, Diener, Hans-Christoph, Endres, Matthias, Lemmens, Robin, Kwon, Sun U., Lee, Byung-Chul, Ameriso, Sebastian, Milling, Truman J., Kasner, Scott E., Mikulik, Robert, Xavier, Denis, Beer, Ronny, Toni, Danilo, Eckstein, Jens, Seiffge, David, Ferro, Jose M., Tsivgoulis, Georgios, Sharma, Sanjib K., Wei-Liou, Chia, Hohnloser, Stefan H., Katsanos, Aristeidis, Bosch, Jackie, Healey, Jeff, Eikelboom, John, Khaw, Alexander, Gladstone, David, Pikula, Aleksandra, Coutts, Shelagh, Smith, Eric E., Butcher, Ken, Field, Thalia, Gioia, Laura, Stapf, Christian, Halse, Omid, Ringleb, Peter, Enzinger, Christian, Sibon, Igor, Montaner, Joan, Caso, Valeria, Heuschmann, Peter, Lip, Gregory Y.H., Haefeli, Walter, Debette, Stefanie, Dennis, Martin S., Wyller, Torgeir Bruun, Rønning, Ole M., Eilertsen, Helle, Ihle-Hansen, Hege, Sandset, Else Charlotte, Pennlert, Johanna, Glader, Eva-Lotta, Kruuse, Christina, Wester, Per, Carlsson, Maria, Forfang, Elisabeth, Al-Shahi Salman, Rustam, Stephen, Jacqueline, Tierney, Jayne F, Lewis, Steff C, Newby, David E, Parry-Jones, Adrian R, White, Philip M, Connolly, Stuart J, Benavente, Oscar R, Dowlatshahi, Dar, Cordonnier, Charlotte, Viscoli, Catherine M, Sheth, Kevin N, Kamel, Hooman, Veltkamp, Roland, Larsen, Kristin T, Hofmeijer, Jeannette, Kerkhoff, Henk, Schreuder, Floris H B M, Shoamanesh, Ashkan, Klijn, Catharina J M, and van der Worp, H Bart

Published
2023
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28. Altered cellular immune response to vaccination against SARS-CoV-2 in patients suffering from autoimmunity with B-cell depleting therapy

Author

Hodl, Isabel, Sallegger, Clarissa, Forstner, Patrick, Sareban, Nazanin, Moritz, Martina, Dreo, Barbara, Schulz, Eduard, Lackner, Angelika, Kleinhappl, Barbara, Hatzl, Stefan, Moazedi-Fürst, Florentine, Seifert-Held, Thomas, Heschl, Bettina, Khalil, Michael, Enzinger, Christian, Greinix, Hildegard, Stradner, Martin H., Steinmetz, Ivo, Schlenke, Peter, and Fessler, Johannes

Published
2023
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35. MRI-Based Prediction of Macrovascular Causes of Intracerebral Hemorrhage: The MACRO Score.

Author

Fandler-Höfler, Simon, Ambler, Gareth, Goeldlin, Martina B., Obergottsberger, Lena, Wünsch, Gerit, Kneihsl, Markus, Zhang, Wenpeng, Du, Yang, Locatelli, Martina, Ozkan, Hatice, Nash, Philip S., Nistl, Oliver, Panteleienko, Larysa, Mendel, Rom, Thiankhaw, Kitti, Simister, Robert J., Jäger, Hans Rolf, Enzinger, Christian, Seiffge, David J., and Gattringer, Thomas

Published
2024
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36. Temporal and Spatial Clustering of Intracerebral Hemorrhage in Cerebral Amyloid Angiopathy.

Author

Fandler-Höfler, Simon, Ambler, Gareth, Banerjee, Gargi, Nash, Philip S., Obergottsberger, Lena, Wünsch, Gerit, Kiss, Christian, Fabisch, Linda, Kneihsl, Markus, Wenpeng Zhang, Ozkan, Hatice, Locatelli, Martina, Yang Du, Panteleienko, Larysa, Mendel, Rom, Thiankhaw, Kitti, Simister, Robert J., Jäger, Hans Rolf, Enzinger, Christian, and Gattringer, Thomas

Published
2024
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37. Three‐dimensional EPI with shot‐selective CAIPIRIHANA for rapid high‐resolution quantitative susceptibility mapping at 3 T.

Author

Tourell, Monique, Jin, Jin, Bachrata, Beata, Stewart, Ashley, Ropele, Stefan, Enzinger, Christian, Bollmann, Saskia, Bollmann, Steffen, Robinson, Simon Daniel, O'Brien, Kieran, and Barth, Markus

Subjects
BRAIN injuries, BRAIN tumors, NEURODEGENERATION
Abstract

Purpose: QSM provides insight into healthy brain aging and neuropathologies such as multiple sclerosis (MS), traumatic brain injuries, brain tumors, and neurodegenerative diseases. Phase data for QSM are usually acquired from 3D gradient‐echo (3D GRE) scans with long acquisition times that are detrimental to patient comfort and susceptible to patient motion. This is particularly true for scans requiring whole‐brain coverage and submillimeter resolutions. In this work, we use a multishot 3D echo plannar imaging (3D EPI) sequence with shot‐selective 2D CAIPIRIHANA to acquire high‐resolution, whole‐brain data for QSM with minimal distortion and blurring. Methods: To test clinical viability, the 3D EPI sequence was used to image a cohort of MS patients at 1‐mm isotropic resolution at 3 T. Additionally, 3D EPI data of healthy subjects were acquired at 1‐mm, 0.78‐mm, and 0.65‐mm isotropic resolution with varying echo train lengths (ETLs) and compared with a reference 3D GRE acquisition. Results: The appearance of the susceptibility maps and the susceptibility values for segmented regions of interest were comparable between 3D EPI and 3D GRE acquisitions for both healthy and MS participants. Additionally, all lesions visible in the MS patients on the 3D GRE susceptibility maps were also visible on the 3D EPI susceptibility maps. The interplay among acquisition time, resolution, echo train length, and the effect of distortion on the calculated susceptibility maps was investigated. Conclusion: We demonstrate that the 3D EPI sequence is capable of rapidly acquiring submillimeter resolutions and providing high‐quality, clinically relevant susceptibility maps. [ABSTRACT FROM AUTHOR]

Published
2024
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45. 2021 MAGNIMS–CMSC–NAIMS consensus recommendations on the use of MRI in patients with multiple sclerosis

Author

Wattjes, Mike P, Ciccarelli, Olga, de Stefano, Nicola, Enzinger, Christian, Fazekas, Franz, Filippi, Massimo, Frederiksen, Jette, Gasperini, Claudio, Hacohen, Yael, Kappos, Ludwig, Mankad, Kshitij, Montalban, Xavier, Palace, Jacqueline, Rocca, María A, Sastre-Garriga, Jaume, Tintore, Mar, Vrenken, Hugo, Yousry, Tarek, Barkhof, Frederik, Rovira, Alex, Li, David K B, Traboulsee, Anthony, Newsome, Scott D, Banwell, Brenda, Oh, Jiwon, Reich, Daniel S, Rocca, Maria A, Tintoré, Mar, and Rovira, Àlex

Published
2021
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46. A Novel Way to Measure and Predict Development: A Heuristic Approach to Facilitate the Early Detection of Neurodevelopmental Disorders

Author

Marschik, Peter B, Pokorny, Florian B, Peharz, Robert, Zhang, Dajie, O’Muircheartaigh, Jonathan, Roeyers, Herbert, Bölte, Sven, Spittle, Alicia J, Urlesberger, Berndt, Schuller, Björn, Poustka, Luise, Ozonoff, Sally, Pernkopf, Franz, Pock, Thomas, Tammimies, Kristiina, Enzinger, Christian, Krieber, Magdalena, Tomantschger, Iris, Bartl-Pokorny, Katrin D, Sigafoos, Jeff, Roche, Laura, Esposito, Gianluca, Gugatschka, Markus, Nielsen-Saines, Karin, Einspieler, Christa, Kaufmann, Walter E, and The BEE-PRI Study Group

Subjects
Paediatrics, Biomedical and Clinical Sciences, Pediatric, Clinical Research, Neurosciences, Clinical Trials and Supportive Activities, 4.1 Discovery and preclinical testing of markers and technologies, Detection, screening and diagnosis, Biomarkers, Early Diagnosis, Humans, Neurodevelopmental Disorders, BEE-PRI Study Group, Computer vision, Diagnosis, Early human development, Intelligent vocalisation analysis, Multidimensional assessment, Neurodevelopmental disorders, Clinical Sciences, Neurology & Neurosurgery, Biological psychology
Abstract

Purpose of reviewSubstantial research exists focusing on the various aspects and domains of early human development. However, there is a clear blind spot in early postnatal development when dealing with neurodevelopmental disorders, especially those that manifest themselves clinically only in late infancy or even in childhood.Recent findingsThis early developmental period may represent an important timeframe to study these disorders but has historically received far less research attention. We believe that only a comprehensive interdisciplinary approach will enable us to detect and delineate specific parameters for specific neurodevelopmental disorders at a very early age to improve early detection/diagnosis, enable prospective studies and eventually facilitate randomised trials of early intervention. In this article, we propose a dynamic framework for characterising neurofunctional biomarkers associated with specific disorders in the development of infants and children. We have named this automated detection 'Fingerprint Model', suggesting one possible approach to accurately and early identify neurodevelopmental disorders.

Published
2017

47. Multiple Sklerose Therapie Konsensus Gruppe (MSTKG): Positionspapier zur verlaufsmodifizierenden Therapie der Multiplen Sklerose 2021 (White Paper)

Author

Wiendl, Heinz, Gold, Ralf, Berger, Thomas, Derfuss, Tobias, Linker, Ralf, Mäurer, Mathias, Stangel, Martin, Aktas, Orhan, Baum, Karl, Berghoff, Martin, Bittner, Stefan, Chan, Andrew, Czaplinski, Adam, Deisenhammer, Florian, Di Pauli, Franziska, Du Pasquier, Renaud, Enzinger, Christian, Fertl, Elisabeth, Gass, Achim, Gehring, Klaus, Gobbi, Claudio, Goebels, Norbert, Guger, Michael, Haghikia, Aiden, Hartung, Hans‑Peter, Heidenreich, Fedor, Hoffmann, Olaf, Hunter, Zoë R., Kallmann, Boris, Kleinschnitz, Christoph, Klotz, Luisa, Leussink, Verena, Leutmezer, Fritz, Limmroth, Volker, Lünemann, Jan D., Lutterotti, Andreas, Meuth, Sven G., Meyding-Lamadé, Uta, Platten, Michael, Rieckmann, Peter, Schmidt, Stephan, Tumani, Hayrettin, Weber, Martin S., Weber, Frank, Zettl, Uwe K., Ziemssen, Tjalf, and Zipp, Frauke

Published
2021
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49. Enhancing Cognitive Performance Prediction through White Matter Hyperintensity Connectivity Assessment: A Multicenter Lesion Network Mapping Analysis of 3,485 Memory Clinic Patients

Author

Opleiding Neurologie, Beeldverwerking ISI, Brain, Cancer, Projectafdeling VCI, Neurologen, MS Geriatrie, Circulatory Health, Petersen, Marvin, Coenen, Mirthe, DeCarli, Charles, De Luca, Alberto, van der Lelij, Ewoud, Barkhof, Frederik, Benke, Thomas, Chen, Christopher P L H, Dal-Bianco, Peter, Dewenter, Anna, Duering, Marco, Enzinger, Christian, Ewers, Michael, Exalto, Lieza G, Fletcher, Evan F, Franzmeier, Nicolai, Hilal, Saima, Hofer, Edith, Koek, Huiberdina L, Maier, Andrea B, Maillard, Pauline M, McCreary, Cheryl R, Papma, Janne M, Pijnenburg, Yolande A L, Schmidt, Reinhold, Smith, Eric E, Steketee, Rebecca M E, van den Berg, Esther, van der Flier, Wiesje M, Venkatraghavan, Vikram, Venketasubramanian, Narayanaswamy, Vernooij, Meike W, Wolters, Frank J, Xu, Xin, Horn, Andreas, Patil, Kaustubh R, Eickhoff, Simon B, Thomalla, Götz, Biesbroek, J Matthijs, Biessels, Geert Jan, Cheng, Bastian, Alzheimer's Disease Neuroimaging Initiative, Opleiding Neurologie, Beeldverwerking ISI, Brain, Cancer, Projectafdeling VCI, Neurologen, MS Geriatrie, Circulatory Health, Petersen, Marvin, Coenen, Mirthe, DeCarli, Charles, De Luca, Alberto, van der Lelij, Ewoud, Barkhof, Frederik, Benke, Thomas, Chen, Christopher P L H, Dal-Bianco, Peter, Dewenter, Anna, Duering, Marco, Enzinger, Christian, Ewers, Michael, Exalto, Lieza G, Fletcher, Evan F, Franzmeier, Nicolai, Hilal, Saima, Hofer, Edith, Koek, Huiberdina L, Maier, Andrea B, Maillard, Pauline M, McCreary, Cheryl R, Papma, Janne M, Pijnenburg, Yolande A L, Schmidt, Reinhold, Smith, Eric E, Steketee, Rebecca M E, van den Berg, Esther, van der Flier, Wiesje M, Venkatraghavan, Vikram, Venketasubramanian, Narayanaswamy, Vernooij, Meike W, Wolters, Frank J, Xu, Xin, Horn, Andreas, Patil, Kaustubh R, Eickhoff, Simon B, Thomalla, Götz, Biesbroek, J Matthijs, Biessels, Geert Jan, Cheng, Bastian, and Alzheimer's Disease Neuroimaging Initiative

Published
2024

50. Management of delirium in acute stroke patients: a position paper by the Austrian Stroke Society on prevention, diagnosis, and treatment.

Author

Kneihsl, Markus, Berger, Natalie, Sumerauer, Stefan, Asenbaum-Nan, Susanne, Höger, Franz Stefan, Gattringer, Thomas, Enzinger, Christian, Aigner, Martin, Ferrari, Julia, and Lang, Wilfried

Subjects
STROKE patients, DELIRIUM, STROKE units, DIAGNOSIS, THERAPEUTICS, STROKE
Abstract

Delirium is a common complication in acute stroke patients, occurring in 15–35% of all stroke unit admissions and is associated with prolonged hospital stay and a poor post-stroke prognosis. Managing delirium in acute stroke patients necessitates an intensive and multiprofessional therapeutic approach, placing a significant burden on healthcare staff. However, dedicated practical recommendations for delirium management developed for the population of acute stroke patients are lacking. For this purpose, the Austrian Stroke Society, in cooperation with the Austrian Society of Neurology, the Austrian Society of Neurorehabilitation, and the Austrian Society of Psychiatry, Psychotherapy, and Psychosomatics has formulated an evidence-based position paper addressing the management of delirium in acute stroke patients. The paper outlines practical recommendations on the three pillars of care in stroke patients with delirium: (a) Key aspects of delirium prevention including stroke-specific delirium risk factors and delirium prediction scores are described. Moreover, a non-pharmacological delirium prevention bundle is presented. (b) The paper provides recommendations on timing and frequency of delirium screening to ensure early diagnosis of delirium in acute stroke patients. Moreover, it reports on the use of different delirium screening tools in stroke populations. (c) An overview of non-pharmacological and pharmacological treatment strategies in patients with delirium and acute stroke is presented and summarized as key recommendation statements. [ABSTRACT FROM AUTHOR]

Published
2024
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