Rich-Club Organization: An Important Determinant of Functional Outcome After Acute Ischemic Stroke
Objective: To determine whether the rich-club organization, essential for information transport in the human connectome, is an important biomarker of functional outcome after acute ischemic stroke (AIS).Methods: Consecutive AIS patients (N = 344) with acute brain magnetic resonance imaging (MRI) (&a...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2019-09-01
|
| Series: | Frontiers in Neurology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2019.00956/full |
| _version_ | 1818174154879270912 |
|---|---|
| author | Markus D. Schirmer Markus D. Schirmer Markus D. Schirmer Sofia Ira Ktena Marco J. Nardin Kathleen L. Donahue Anne-Katrin Giese Mark R. Etherton Ona Wu Natalia S. Rost |
| author_facet | Markus D. Schirmer Markus D. Schirmer Markus D. Schirmer Sofia Ira Ktena Marco J. Nardin Kathleen L. Donahue Anne-Katrin Giese Mark R. Etherton Ona Wu Natalia S. Rost |
| author_sort | Markus D. Schirmer |
| collection | DOAJ |
| description | Objective: To determine whether the rich-club organization, essential for information transport in the human connectome, is an important biomarker of functional outcome after acute ischemic stroke (AIS).Methods: Consecutive AIS patients (N = 344) with acute brain magnetic resonance imaging (MRI) (<48 h) were eligible for this study. Each patient underwent a clinical MRI protocol, which included diffusion weighted imaging (DWI). All DWIs were registered to a template on which rich-club regions have been defined. Using manual outlines of stroke lesions, we automatically counted the number of affected rich-club regions and assessed its effect on the National Institute of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS; obtained at 90 days post-stroke) scores through ordinal regression.Results: Of 344 patients (median age 65, inter-quartile range 54–76 years) with a median DWI lesion volume (DWIv) of 3cc, 64% were male. We established that an increase in number of rich-club regions affected by a stroke increases the odds of poor stroke outcome, measured by NIHSS (OR: 1.77, 95%CI 1.41–2.21) and mRS (OR: 1.38, 95%CI 1.11–1.73). Additionally, we demonstrated that the OR exceeds traditional markers, such as DWIv (ORNIHSS 1.08, 95%CI 1.06–1.11; ORmRS 1.05, 95%CI 1.03–1.07) and age (ORNIHSS 1.03, 95%CI 1.01–1.05; ORmRS 1.05, 95%CI 1.03–1.07).Conclusion: In this proof-of-concept study, the number of rich-club nodes affected by a stroke lesion presents a translational biomarker of stroke outcome, which can be readily assessed using standard clinical AIS imaging protocols and considered in functional outcome prediction models beyond traditional factors. |
| first_indexed | 2024-12-11T19:39:54Z |
| format | Article |
| id | doaj.art-b0e558d42b7e4e399d51ba0cd98fb669 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-11T19:39:54Z |
| publishDate | 2019-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-b0e558d42b7e4e399d51ba0cd98fb6692022-12-22T00:53:02ZengFrontiers Media S.A.Frontiers in Neurology1664-22952019-09-011010.3389/fneur.2019.00956479083Rich-Club Organization: An Important Determinant of Functional Outcome After Acute Ischemic StrokeMarkus D. Schirmer0Markus D. Schirmer1Markus D. Schirmer2Sofia Ira Ktena3Marco J. Nardin4Kathleen L. Donahue5Anne-Katrin Giese6Mark R. Etherton7Ona Wu8Natalia S. Rost9Department of Neurology, J. Philip Kistler Stroke Research Center, Harvard Medical School, Boston, MA, United StatesComputer Science and Artificial Intelligence Lab, Massachusetts Institute of Technology, Cambridge, MA, United StatesDepartment of Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, GermanyBiomedical Image Analysis Group, Imperial College London, London, United KingdomDepartment of Neurology, J. Philip Kistler Stroke Research Center, Harvard Medical School, Boston, MA, United StatesDepartment of Neurology, J. Philip Kistler Stroke Research Center, Harvard Medical School, Boston, MA, United StatesDepartment of Neurology, J. Philip Kistler Stroke Research Center, Harvard Medical School, Boston, MA, United StatesDepartment of Neurology, J. Philip Kistler Stroke Research Center, Harvard Medical School, Boston, MA, United StatesDepartment of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United StatesDepartment of Neurology, J. Philip Kistler Stroke Research Center, Harvard Medical School, Boston, MA, United StatesObjective: To determine whether the rich-club organization, essential for information transport in the human connectome, is an important biomarker of functional outcome after acute ischemic stroke (AIS).Methods: Consecutive AIS patients (N = 344) with acute brain magnetic resonance imaging (MRI) (<48 h) were eligible for this study. Each patient underwent a clinical MRI protocol, which included diffusion weighted imaging (DWI). All DWIs were registered to a template on which rich-club regions have been defined. Using manual outlines of stroke lesions, we automatically counted the number of affected rich-club regions and assessed its effect on the National Institute of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS; obtained at 90 days post-stroke) scores through ordinal regression.Results: Of 344 patients (median age 65, inter-quartile range 54–76 years) with a median DWI lesion volume (DWIv) of 3cc, 64% were male. We established that an increase in number of rich-club regions affected by a stroke increases the odds of poor stroke outcome, measured by NIHSS (OR: 1.77, 95%CI 1.41–2.21) and mRS (OR: 1.38, 95%CI 1.11–1.73). Additionally, we demonstrated that the OR exceeds traditional markers, such as DWIv (ORNIHSS 1.08, 95%CI 1.06–1.11; ORmRS 1.05, 95%CI 1.03–1.07) and age (ORNIHSS 1.03, 95%CI 1.01–1.05; ORmRS 1.05, 95%CI 1.03–1.07).Conclusion: In this proof-of-concept study, the number of rich-club nodes affected by a stroke lesion presents a translational biomarker of stroke outcome, which can be readily assessed using standard clinical AIS imaging protocols and considered in functional outcome prediction models beyond traditional factors.https://www.frontiersin.org/article/10.3389/fneur.2019.00956/fullacute ischemic strokeoutcomerich-clubnetwork topologylesion |
| spellingShingle | Markus D. Schirmer Markus D. Schirmer Markus D. Schirmer Sofia Ira Ktena Marco J. Nardin Kathleen L. Donahue Anne-Katrin Giese Mark R. Etherton Ona Wu Natalia S. Rost Rich-Club Organization: An Important Determinant of Functional Outcome After Acute Ischemic Stroke Frontiers in Neurology acute ischemic stroke outcome rich-club network topology lesion |
| title | Rich-Club Organization: An Important Determinant of Functional Outcome After Acute Ischemic Stroke |
| title_full | Rich-Club Organization: An Important Determinant of Functional Outcome After Acute Ischemic Stroke |
| title_fullStr | Rich-Club Organization: An Important Determinant of Functional Outcome After Acute Ischemic Stroke |
| title_full_unstemmed | Rich-Club Organization: An Important Determinant of Functional Outcome After Acute Ischemic Stroke |
| title_short | Rich-Club Organization: An Important Determinant of Functional Outcome After Acute Ischemic Stroke |
| title_sort | rich club organization an important determinant of functional outcome after acute ischemic stroke |
| topic | acute ischemic stroke outcome rich-club network topology lesion |
| url | https://www.frontiersin.org/article/10.3389/fneur.2019.00956/full |
| work_keys_str_mv | AT markusdschirmer richcluborganizationanimportantdeterminantoffunctionaloutcomeafteracuteischemicstroke AT markusdschirmer richcluborganizationanimportantdeterminantoffunctionaloutcomeafteracuteischemicstroke AT markusdschirmer richcluborganizationanimportantdeterminantoffunctionaloutcomeafteracuteischemicstroke AT sofiairaktena richcluborganizationanimportantdeterminantoffunctionaloutcomeafteracuteischemicstroke AT marcojnardin richcluborganizationanimportantdeterminantoffunctionaloutcomeafteracuteischemicstroke AT kathleenldonahue richcluborganizationanimportantdeterminantoffunctionaloutcomeafteracuteischemicstroke AT annekatringiese richcluborganizationanimportantdeterminantoffunctionaloutcomeafteracuteischemicstroke AT markretherton richcluborganizationanimportantdeterminantoffunctionaloutcomeafteracuteischemicstroke AT onawu richcluborganizationanimportantdeterminantoffunctionaloutcomeafteracuteischemicstroke AT nataliasrost richcluborganizationanimportantdeterminantoffunctionaloutcomeafteracuteischemicstroke |