Imaging and clinical predictors of acute constipation in patients with acute ischemic stroke
BackgroundConstipation symptoms are highly prevalent in acute ischemic stroke, but the clinical and neuroimaging predictors are unknown. This study aimed to identify lesions and clinical features associated with acute constipation.MethodsData from patients with acute ischemic stroke registered in a...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-09-01
|
| Series: | Frontiers in Neuroscience |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fnins.2023.1263693/full |
| _version_ | 1797687133491691520 |
|---|---|
| author | I Joon Han Ji-Eun Lee Ha-Na Song In-Young Baek Jongun Choi Jongun Choi Jong-Won Chung Oh Young Bang Gyeong-Moon Kim Woo-Keun Seo Woo-Keun Seo |
| author_facet | I Joon Han Ji-Eun Lee Ha-Na Song In-Young Baek Jongun Choi Jongun Choi Jong-Won Chung Oh Young Bang Gyeong-Moon Kim Woo-Keun Seo Woo-Keun Seo |
| author_sort | I Joon Han |
| collection | DOAJ |
| description | BackgroundConstipation symptoms are highly prevalent in acute ischemic stroke, but the clinical and neuroimaging predictors are unknown. This study aimed to identify lesions and clinical features associated with acute constipation.MethodsData from patients with acute ischemic stroke registered in a hospital-based stroke registry between January 2018 and December 2019 were analyzed. Clinical, laboratory, and imaging features were examined for associations with acute constipation. Using the topographic lesion on diffusion-weighted images, multivariate support vector regression-based lesion-symptom mapping (SVR-LSM) was conducted and compared between the non-constipation and acute constipation groups.ResultsA total of 256 patients (mean age 67 years, men: 64%) were included. Acute constipation was noted in 81 patients (32%). Initial stroke severity, represented by initial National Institutes of Health and Stroke Scale (NIHSS) scores, was associated with acute constipation. Laboratory parameters, including fibrin degradation products (FDP), fibrinogen, D-dimer, lipoprotein (a), and free fatty acid levels, also showed statistically significant differences between the non-constipation and constipation groups. FDP, D-dimer, and free fatty acid levels were independently associated with acute constipation in the logistic regression model after adjusting for initial NIHSS scores and potassium levels. SVR-LSM revealed that bilateral lesions in the precentral gyrus, insula, opercular part of the inferior frontal gyrus, the inferior parietal lobule, and lesions in the right middle frontal gyrus were significantly associated with acute constipation. The results were consistent after controlling for the initial NIHSS scores and poststroke potassium levels. When cardioembolic stroke subjects were excluded, the right insular and prefrontal cortex lesions lost their association with acute constipation.ConclusionAcute constipation symptoms after acute ischemic stroke are mainly related to bilateral lesions in the insula, precentral gyrus, postcentral gyrus, and inferior parietal lobule. Clinically important predictors of acute constipation include initial neurological severity and thromboembolic markers of stroke. |
| first_indexed | 2024-03-12T01:13:54Z |
| format | Article |
| id | doaj.art-9163c2286ba74873b7563ead2b12aa9d |
| institution | Directory Open Access Journal |
| issn | 1662-453X |
| language | English |
| last_indexed | 2024-03-12T01:13:54Z |
| publishDate | 2023-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neuroscience |
| spelling | doaj.art-9163c2286ba74873b7563ead2b12aa9d2023-09-13T21:44:30ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2023-09-011710.3389/fnins.2023.12636931263693Imaging and clinical predictors of acute constipation in patients with acute ischemic strokeI Joon Han0Ji-Eun Lee1Ha-Na Song2In-Young Baek3Jongun Choi4Jongun Choi5Jong-Won Chung6Oh Young Bang7Gyeong-Moon Kim8Woo-Keun Seo9Woo-Keun Seo10Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDepartment of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDepartment of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDepartment of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDepartment of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDepartment of Digital Health, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of KoreaDepartment of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDepartment of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDepartment of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDepartment of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDepartment of Digital Health, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of KoreaBackgroundConstipation symptoms are highly prevalent in acute ischemic stroke, but the clinical and neuroimaging predictors are unknown. This study aimed to identify lesions and clinical features associated with acute constipation.MethodsData from patients with acute ischemic stroke registered in a hospital-based stroke registry between January 2018 and December 2019 were analyzed. Clinical, laboratory, and imaging features were examined for associations with acute constipation. Using the topographic lesion on diffusion-weighted images, multivariate support vector regression-based lesion-symptom mapping (SVR-LSM) was conducted and compared between the non-constipation and acute constipation groups.ResultsA total of 256 patients (mean age 67 years, men: 64%) were included. Acute constipation was noted in 81 patients (32%). Initial stroke severity, represented by initial National Institutes of Health and Stroke Scale (NIHSS) scores, was associated with acute constipation. Laboratory parameters, including fibrin degradation products (FDP), fibrinogen, D-dimer, lipoprotein (a), and free fatty acid levels, also showed statistically significant differences between the non-constipation and constipation groups. FDP, D-dimer, and free fatty acid levels were independently associated with acute constipation in the logistic regression model after adjusting for initial NIHSS scores and potassium levels. SVR-LSM revealed that bilateral lesions in the precentral gyrus, insula, opercular part of the inferior frontal gyrus, the inferior parietal lobule, and lesions in the right middle frontal gyrus were significantly associated with acute constipation. The results were consistent after controlling for the initial NIHSS scores and poststroke potassium levels. When cardioembolic stroke subjects were excluded, the right insular and prefrontal cortex lesions lost their association with acute constipation.ConclusionAcute constipation symptoms after acute ischemic stroke are mainly related to bilateral lesions in the insula, precentral gyrus, postcentral gyrus, and inferior parietal lobule. Clinically important predictors of acute constipation include initial neurological severity and thromboembolic markers of stroke.https://www.frontiersin.org/articles/10.3389/fnins.2023.1263693/fullstrokeconstipationdiffusion magnetic resonance imagingvoxel-wise lesion symptom mappingthromboembolism |
| spellingShingle | I Joon Han Ji-Eun Lee Ha-Na Song In-Young Baek Jongun Choi Jongun Choi Jong-Won Chung Oh Young Bang Gyeong-Moon Kim Woo-Keun Seo Woo-Keun Seo Imaging and clinical predictors of acute constipation in patients with acute ischemic stroke Frontiers in Neuroscience stroke constipation diffusion magnetic resonance imaging voxel-wise lesion symptom mapping thromboembolism |
| title | Imaging and clinical predictors of acute constipation in patients with acute ischemic stroke |
| title_full | Imaging and clinical predictors of acute constipation in patients with acute ischemic stroke |
| title_fullStr | Imaging and clinical predictors of acute constipation in patients with acute ischemic stroke |
| title_full_unstemmed | Imaging and clinical predictors of acute constipation in patients with acute ischemic stroke |
| title_short | Imaging and clinical predictors of acute constipation in patients with acute ischemic stroke |
| title_sort | imaging and clinical predictors of acute constipation in patients with acute ischemic stroke |
| topic | stroke constipation diffusion magnetic resonance imaging voxel-wise lesion symptom mapping thromboembolism |
| url | https://www.frontiersin.org/articles/10.3389/fnins.2023.1263693/full |
| work_keys_str_mv | AT ijoonhan imagingandclinicalpredictorsofacuteconstipationinpatientswithacuteischemicstroke AT jieunlee imagingandclinicalpredictorsofacuteconstipationinpatientswithacuteischemicstroke AT hanasong imagingandclinicalpredictorsofacuteconstipationinpatientswithacuteischemicstroke AT inyoungbaek imagingandclinicalpredictorsofacuteconstipationinpatientswithacuteischemicstroke AT jongunchoi imagingandclinicalpredictorsofacuteconstipationinpatientswithacuteischemicstroke AT jongunchoi imagingandclinicalpredictorsofacuteconstipationinpatientswithacuteischemicstroke AT jongwonchung imagingandclinicalpredictorsofacuteconstipationinpatientswithacuteischemicstroke AT ohyoungbang imagingandclinicalpredictorsofacuteconstipationinpatientswithacuteischemicstroke AT gyeongmoonkim imagingandclinicalpredictorsofacuteconstipationinpatientswithacuteischemicstroke AT wookeunseo imagingandclinicalpredictorsofacuteconstipationinpatientswithacuteischemicstroke AT wookeunseo imagingandclinicalpredictorsofacuteconstipationinpatientswithacuteischemicstroke |