Neuroimaging features of antiphospholipid antibody-related stroke compared with atrial fibrillation-related stroke
Abstract Recognizing the lesion pattern of antiphospholipid antibody-related stroke (aPL-stroke) may contribute to establishing the cause in patients with cryptogenic stroke. We aimed to describe the neuroimaging features of aPL-stroke compared with atrial fibrillation-related stroke (AF-stroke), a...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2022-07-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-16019-3 |
| _version_ | 1811224201834528768 |
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| author | Wookjin Yang Dong-Wan Kang Jeong-Min Kim Keun-Hwa Jung Seung-Hoon Lee |
| author_facet | Wookjin Yang Dong-Wan Kang Jeong-Min Kim Keun-Hwa Jung Seung-Hoon Lee |
| author_sort | Wookjin Yang |
| collection | DOAJ |
| description | Abstract Recognizing the lesion pattern of antiphospholipid antibody-related stroke (aPL-stroke) may contribute to establishing the cause in patients with cryptogenic stroke. We aimed to describe the neuroimaging features of aPL-stroke compared with atrial fibrillation-related stroke (AF-stroke), a major hidden cause of cryptogenic stroke. Using a prospective stroke registry, we identified consecutive aPL- and AF-stroke patients without other potential causes of stroke. Neuroimaging features based on diffusion-weighted imaging and angiographic findings at admission were compared. A total of 56 and 333 patients were included in the aPL- and AF-stroke groups, respectively. aPL-stroke patients more often presented with single small lesions (aPL-stroke, 30.4% vs. AF-stroke, 7.5%, p < 0.001), while the predominant pattern in AF-stroke patients was large territorial lesions (26.8% vs. 56.5%, p < 0.001). aPL-stroke patients had smaller infarct volume (1.58 mL [0.45; 9.41] vs. 11.32 mL [2.82; 33.08], p < 0.001) and less experience of relevant artery occlusion (17.9% vs. 54.7%, p < 0.001). The proportion of multi-territory lesions, an embolic pattern, was similar between the two groups (28.6% vs. 22.8%, p = 0.44). In comparison only including patients with multi-territory lesions as well, aPL-stroke patients showed small lesion dominance and smaller infarct volume. Multivariate analyses showed independent associations between mild neuroimaging features (small lesion prevalence, smaller infarct volume, and absence of relevant artery occlusion) and aPL-stroke. Patterns of small lesion prevalence, small infarct volume, and absence of relevant artery occlusion were suggestive of aPL-stroke rather than AF-stroke. Cryptogenic stroke patients with such neuroimaging features may benefit from aPL testing for a precise diagnosis. |
| first_indexed | 2024-04-12T08:45:38Z |
| format | Article |
| id | doaj.art-e82f31e747284655af3cbb58719b03c0 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-12T08:45:38Z |
| publishDate | 2022-07-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-e82f31e747284655af3cbb58719b03c02022-12-22T03:39:44ZengNature PortfolioScientific Reports2045-23222022-07-011211810.1038/s41598-022-16019-3Neuroimaging features of antiphospholipid antibody-related stroke compared with atrial fibrillation-related strokeWookjin Yang0Dong-Wan Kang1Jeong-Min Kim2Keun-Hwa Jung3Seung-Hoon Lee4Department of Neurology, Seoul National University HospitalDepartment of Neurology, Seoul National University HospitalDepartment of Neurology, Seoul National University HospitalDepartment of Neurology, Seoul National University HospitalDepartment of Neurology, Seoul National University HospitalAbstract Recognizing the lesion pattern of antiphospholipid antibody-related stroke (aPL-stroke) may contribute to establishing the cause in patients with cryptogenic stroke. We aimed to describe the neuroimaging features of aPL-stroke compared with atrial fibrillation-related stroke (AF-stroke), a major hidden cause of cryptogenic stroke. Using a prospective stroke registry, we identified consecutive aPL- and AF-stroke patients without other potential causes of stroke. Neuroimaging features based on diffusion-weighted imaging and angiographic findings at admission were compared. A total of 56 and 333 patients were included in the aPL- and AF-stroke groups, respectively. aPL-stroke patients more often presented with single small lesions (aPL-stroke, 30.4% vs. AF-stroke, 7.5%, p < 0.001), while the predominant pattern in AF-stroke patients was large territorial lesions (26.8% vs. 56.5%, p < 0.001). aPL-stroke patients had smaller infarct volume (1.58 mL [0.45; 9.41] vs. 11.32 mL [2.82; 33.08], p < 0.001) and less experience of relevant artery occlusion (17.9% vs. 54.7%, p < 0.001). The proportion of multi-territory lesions, an embolic pattern, was similar between the two groups (28.6% vs. 22.8%, p = 0.44). In comparison only including patients with multi-territory lesions as well, aPL-stroke patients showed small lesion dominance and smaller infarct volume. Multivariate analyses showed independent associations between mild neuroimaging features (small lesion prevalence, smaller infarct volume, and absence of relevant artery occlusion) and aPL-stroke. Patterns of small lesion prevalence, small infarct volume, and absence of relevant artery occlusion were suggestive of aPL-stroke rather than AF-stroke. Cryptogenic stroke patients with such neuroimaging features may benefit from aPL testing for a precise diagnosis.https://doi.org/10.1038/s41598-022-16019-3 |
| spellingShingle | Wookjin Yang Dong-Wan Kang Jeong-Min Kim Keun-Hwa Jung Seung-Hoon Lee Neuroimaging features of antiphospholipid antibody-related stroke compared with atrial fibrillation-related stroke Scientific Reports |
| title | Neuroimaging features of antiphospholipid antibody-related stroke compared with atrial fibrillation-related stroke |
| title_full | Neuroimaging features of antiphospholipid antibody-related stroke compared with atrial fibrillation-related stroke |
| title_fullStr | Neuroimaging features of antiphospholipid antibody-related stroke compared with atrial fibrillation-related stroke |
| title_full_unstemmed | Neuroimaging features of antiphospholipid antibody-related stroke compared with atrial fibrillation-related stroke |
| title_short | Neuroimaging features of antiphospholipid antibody-related stroke compared with atrial fibrillation-related stroke |
| title_sort | neuroimaging features of antiphospholipid antibody related stroke compared with atrial fibrillation related stroke |
| url | https://doi.org/10.1038/s41598-022-16019-3 |
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