Structural Integrity of Normal Appearing White Matter and Sex-Specific Outcomes After Acute Ischemic Stroke
Structural Integrity of Normal Appearing White Matter and Sex-Specific Outcomes After Acute Ischemic Stroke
复制标题
DOI：
10.1161/strokeaha.117.019258
复制
发表时间：
2017-12-01
期刊：
影响因子：
8.3
通讯作者：
Rost, Natalia S.
中科院分区：
文献类型：
--
作者：
Etherton, Mark R.;Wu, Ona;Rost, Natalia S.
背景和目的——女性卒中后预后比男性差。我们评估了急性缺血性脑卒中后白质与功能恢复相关的性别特异性临床和神经影像学特征。方法：回顾性分析急性缺血性脑卒中患者入院时的脑MRI和3至6个月的改良Rankin量表评分。分别用液体衰减反转恢复和扩散张量成像MRI量化白质高强度和急性梗死体积。计算急性缺血对侧正常白质的扩散率各向异性指标。结果：在319例急性缺血性脑卒中患者中，女性年龄较大（68.0岁对62.7岁，P=0.004），房颤发病率增加（21.4%对12.2%，P=0.04），吸烟率较低（21.1%对35.9%，P=0.03）。在白质高密度体积、急性梗死体积、美国国立卫生研究院卒中量表、卒中前修正兰金量表评分或正常的白质弥散性各向异性指标上没有性别特异性差异。然而，女性不太可能有一个良好的结果（修改兰金量表评分）
Background and Purpose-Women have worse poststroke outcomes than men. We evaluated sex-specific clinical and neuroimaging characteristics of white matter in association with functional recovery after acute ischemic stroke.Methods-We performed a retrospective analysis of acute ischemic stroke patients with admission brain MRI and 3- to 6-month modified Rankin Scale score. White matter hyperintensity and acute infarct volume were quantified on fluid-attenuated inversion recovery and diffusion tensor imaging MRI, respectively. Diffusivity anisotropy metrics were calculated in normal appearing white matter contralateral to the acute ischemia.Results-Among 319 patients with acute ischemic stroke, women were older (68.0 versus 62.7 years; P=0.004), had increased incidence of atrial fibrillation (21.4% versus 12.2%; P=0.04), and lower rate of tobacco use (21.1% versus 35.9%; P=0.03). There was no sex-specific difference in white matter hyperintensity volume, acute infarct volume, National Institutes of Health Stroke Scale, prestroke modified Rankin Scale score, or normal appearing white matter diffusivity anisotropy metrics. However, women were less likely to have an excellent outcome (modified Rankin Scale score