Assessing Population-based Radiological brain health in Stroke Epidemiology (APRISE) Study

评估中风流行病学中基于人群的放射学脑健康 (APRISE) 研究

• 批准号: 10456166
• 负责人: BRETT M KISSELA
• 金额: $ 57.44万
• 依托单位: UNIVERSITY OF CINCINNATI
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-30 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10456166
• 关键词: Acute; Address; Ancillary Study; Area; Automobile Driving; Biometry; Black Populations; Blood Vessels; Brain hemorrhage; Carotid Stenosis; Cause of Death; Cerebrovascular Disorders; Cerebrum; Clinical; Collection; Data; Disease; Educational Intervention; Epidemiology; Event; Family; Fibrinolytic Agents; Funding; Future; Genetic; Goals; Guidelines; Image; Incidence; Individual; Infrastructure; Investigation; Ischemia; Ischemic Stroke; Kentucky; Lacunar Infarctions; Magnetic Resonance Imaging; Measures; Microvascular Dysfunction; Minor; Modeling; Modernization; Morbidity - disease rate; National Institute of Neurological Disorders and Stroke; Outcome; Pathway interactions; Patients; Population; Population Heterogeneity; Positioning Attribute; Predisposition; Prevalence; Public Health; Radiologic Finding; Radiology Specialty; Recording of previous events; Recurrence; Research Priority; Risk; Risk Factors; Role; Severities; Source; Stroke; Surveys; Time; Tissues; United States National Institutes of Health; Vascular Dementia; White Matter Hyperintensity; Work; base; biracial; brain health; career; cerebral atrophy; cerebrovascular; clinical care; clinical decision-making; clinical investigation; cohort; disability; epidemiology study; high risk; imaging biomarker; improved; innovation; mortality; multidisciplinary; novel; parent grant; population based; predictive modeling; racial disparity; racial diversity; spectrograph; stroke event; stroke patient; stroke risk; tool

DESCRIPTION/ABSTRACT: Stroke recurrence is a major public health problem. It has been understudied epidemiologically despite comprising ~25% of all stroke in the US, and leading to higher morbidity and mortality compared to initial events. Furthermore, compared to our understanding of the role of traditional risk factors for first stroke, we have limited understanding of the risk factors for recurrent stroke. Radiological measures of small vessel and large-vessel disease may provide a measure of a subject’s current “Brain Health” to predict future cerebrovascular events and vascular dementia. Understanding small vessel disease in particular—manifesting as white matter hyperintensity, microbleeds, lacunar infarcts, dilated perivascular spaces, and brain atrophy–is a top NINDS priority. Although the Framingham risk score is widely used for clinical decision-making, and the ABCD scores predict 90-day stroke risk among minor stroke/TIA patients, no clinical prediction tool in a broader ischemic or a hemorrhagic stroke population-based cohort has been established. A Framingham-like “Risk Function Tool for Secondary Stroke,” especially one incorporating the full gamut of modern imaging parameters developed in a racially diverse population, would likely identify high-risk patients for targeted education interventions, novel antithrombotics, and aggressive clinical care. Moreover, it may reveal novel causal pathways and risk factors for future investigation. We propose an ancillary study to the ongoing Greater Cincinnati/Northern Kentucky Stroke Study (GCKNSS) entitled APRISE (Assessing Population-based Radiological brain health in Stroke Epidemiology). Our objective is to build on the GCNKSS infrastructure to radiologically characterize the full stroke/TIA population of Greater Cincinnati/Northern Kentucky from 2015 and create the first modern, largely MRI-based characterization of brain health in a contemporary stroke/TIA population. Our specific aim is to create a prediction model of cerebrovascular disease recurrence (ischemic or hemorrhagic stroke) incorporating imaging parameters in a biracial, large-scale ischemic stroke/TIA population using state-of-the-art modeling approaches. We will achieve these goals by radiologically characterizing the stroke/TIA population (~2700 ischemic and ~525 hemorrhagic stroke, and ~1025 TIA patients) in the NIH-funded GCNKSS of a 1.4 million, biracial population. We will leverage the extensive GCNKSS infrastructure, which is already in place to detect recurrent stroke, placing us in a unique position to develop a recurrent stroke risk model using newly acquired radiologic data with remarkable efficiency. The proposed study will allow the first and only population-based characterization of the entire imaging spectrum of brain health in stroke/TIA patients. Our multi-disciplinary team with imaging, epidemiology, outcomes, and biostatistics expertise will address NINDS priority research areas with precision and innovation currently unavailable.

描述/摘要： 中风复发是一个主要的公共卫生问题。它已被理解为流行病学的需求 与初始相比 事件。此外，与我们对传统风险因素首次中风的作用的理解相比，我们 对复发性中风的危险因素的了解有限。小容器的放射学测量 大周期疾病可以提供对受试者当前的“大脑健康”的量度，以预测未来 脑血管事件和血管痴呆。特别是了解小血管疾病 - 作为白质高强度，微观的，lacunar梗塞，扩张的周围空间和脑萎缩 - 最高的Ninds优先级。尽管Framingham风险评分广泛用于临床决策，但 ABCD分数预测，次要中风/TIA患者的90天中风风险，没有临床预测工具 已经建立了更广泛的缺血性或出血性中风人群的同类群体。像弗雷明汉一样 “次级中风的风险功能工具”，尤其是一种融合了现代成像的全部 在大致多样化的人群中开发的参数可能会识别出针对性的高危患者 教育干预措施，新颖的抗血栓形成和积极的临床护理。而且，它可能揭示小说 未来投资的因果途径和风险因素。我们向正在进行的更大的辅助研究提出了一项辅助研究 辛辛那提/北肯塔基州中风研究（GCKNSS）标题为Aprise（评估基于人群的 中风流行病学中的放射学大脑健康）。我们的目标是建立在GCNKSS基础架构的基础上 在放射学上，从2015年开始的辛辛那提/北部北部的全部中风/TIA人口 并在当代中风/TIA中创建第一个现代的，主要基于MRI的大脑健康表征 人口。我们的具体目的是创建脑血管疾病复发的预测模型 （缺血性或出血性中风）将成像参数纳入混血症，大规模缺血 使用最先进的建模方法中风/TIA种群。我们将通过 放射学表征中风/TIA种群（〜2700缺血性和〜525个出血性中风，以及 〜1025例TIA患者）在140万混血儿人口的NIH资助的GCNKS中。我们将利用 广泛的GCNKSS基础架构已经存在，可以检测复发性中风，使我们处于独特之处 使用新获得的放射学数据开发复发性中风风险模型的位置 效率。拟议的研究将允许对整个人群的第一个也是唯一的基于人群的表征 中风/TIA患者大脑健康的成像范围。我们的多学科团队具有成像， 流行病学，成果和生物统计学专业知识将精确地解决NINDS优先研究领域 和创新目前不可用。

项目成果

Automated grading of enlarged perivascular spaces in clinical imaging data of an acute stroke cohort using an interpretable, 3D deep learning framework.

• DOI: 10.1038/s41598-021-04287-4
• 发表时间: 2022-01-17
• 期刊: Scientific reports
• 影响因子: 4.6
• 作者: Williamson BJ;Khandwala V;Wang D;Maloney T;Sucharew H;Horn P;Haverbusch M;Alwell K;Gangatirkar S;Mahammedi A;Wang LL;Tomsick T;Gaskill-Shipley M;Cornelius R;Khatri P;Kissela B;Vagal A
• 通讯作者: Vagal A