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1دورية أكاديمية
المؤلفون: de Kort, Floor A S, Coenen, Mirthe, Weaver, Nick A, Kuijf, Hugo J, Aben, Hugo P, Bae, Hee-Joon, Bordet, Régis, Cammà, Guido, Chen, Christopher P L H, Dewenter, Anna, Duering, Marco, Fang, Rong, van der Giessen, Ruben S, Hamilton, Olivia K L, Hilal, Saima, Huenges Wajer, Irene M C, Kan, Cheuk Ni, Kim, Jonguk, Kim, Beom Joon, Köhler, Sebastian, de Kort, Paul L M, Koudstaal, Peter J, Lim, Jae-Sung, Lopes, Renaud, Mok, Vincent C T, Staals, Julie, Venketasubramanian, Narayanaswamy, Verhagen, Charlotte M, Verhey, Frans R J, Wardlaw, Joanna M, Xu, Xin, Yu, Kyung-Ho, Biesbroek, J Matthijs, Biessels, Geert Jan
المساهمون: Opleiding Neurologie, Beeldverwerking ISI, Brain, Cancer, Circulatory Health, Structure and Connections, Neurologie, Projectafdeling VCI, Neurologen
مصطلحات موضوعية: brain, cerebral small vessel diseases, cognition, infarcts, ischemic stroke, neuroimaging, Clinical Neurology, Cardiology and Cardiovascular Medicine, Advanced and Specialised Nursing, Journal Article
الوصف: BACKGROUND: White matter hyperintensities (WMH) are associated with cognitive dysfunction after ischemic stroke. Yet, uncertainty remains about affected domains, the role of other preexisting brain injury, and infarct types in the relation between WMH burden and poststroke cognition. We aimed to disentangle these factors in a large sample of patients with ischemic stroke from different cohorts. METHODS: We pooled and harmonized individual patient data (n=1568) from 9 cohorts, through the Meta VCI Map consortium (www.metavcimap.org). Included cohorts comprised patients with available magnetic resonance imaging and multidomain cognitive assessment <15 months poststroke. In this individual patient data meta-analysis, linear mixed models were used to determine the association between WMH volume and domain-specific cognitive functioning (Z scores; attention and executive functioning, processing speed, language and verbal memory) for the total sample and stratified by infarct type. Preexisting brain injury was accounted for in the multivariable models and all analyses were corrected for the study site as a random effect. RESULTS: In the total sample (67 years [SD, 11.5], 40% female), we found a dose-dependent inverse relationship between WMH volume and poststroke cognitive functioning across all 4 cognitive domains (coefficients ranging from -0.09 [SE, 0.04, P=0.01] for verbal memory to -0.19 [SE, 0.03, P<0.001] for attention and executive functioning). This relation was independent of acute infarct volume and the presence of lacunes and old infarcts. In stratified analyses, the relation between WMH volume and domain-specific functioning was also largely independent of infarct type. CONCLUSIONS: In patients with ischemic stroke, increasing WMH volume is independently associated with worse cognitive functioning across all major domains, regardless of old ischemic lesions and infarct type.
وصف الملف: application/pdf
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2دورية أكاديمية
المؤلفون: Exalto, Lieza G, Weaver, Nick A, Kuijf, Hugo J, Aben, Hugo P, Bae, Hee-Joon, Best, Jonathan G, Bordet, Régis, Chen, Christopher P L H, van der Giessen, Ruben S, Godefroy, Olivier, Gyanwali, Bibek, Hamilton, Olivia K L, Hilal, Saima, Huenges Wajer, Irene M C, Kim, Jonguk, Kappelle, L Jaap, Kim, Beom Joon, Köhler, Sebastian, de Kort, Paul L M, Koudstaal, Peter J, Lim, Jae-Sung, Makin, Stephen D J, Mok, Vincent C T, van Oostenbrugge, Robert J, Roussel, Martine, Staals, Julie, Valdés-Hernández, Maria Del C, Venketasubramanian, Narayanaswamy, Verhey, Frans R J, Wardlaw, Joanna M, Werring, David J, Xu, Xin, van Zandvoort, Martine J E, Biesbroek, J Matthijs, Chappell, Francesca M, Biessels, Geert Jan
المساهمون: Neurologen, Opleiding Neurologie, Beeldverwerking ISI, Brain, Cancer, Circulatory Health, Structure and Connections, Projectafdeling VCI, Neurologie, Neuropsychologie
مصطلحات موضوعية: cognition, ischemic stroke, men, survivors, women, Clinical Neurology, Cardiology and Cardiovascular Medicine, Advanced and Specialised Nursing
الوصف: BACKGROUND: Poststroke cognitive impairment (PSCI) occurs in about half of stroke survivors. Cumulative evidence indicates that functional outcomes of stroke are worse in women than men. Yet it is unknown whether the occurrence and characteristics of PSCI differ between men and women. METHODS: Individual patient data from 9 cohorts of patients with ischemic stroke were harmonized and pooled through the Meta-VCI-Map consortium (n=2343, 38% women). We included patients with visible symptomatic infarcts on computed tomography/magnetic resonance imaging and cognitive assessment within 15 months after stroke. PSCI was defined as impairment in ≥1 cognitive domains on neuropsychological assessment. Logistic regression analyses were performed to compare men to women, adjusted for study cohort, to obtain odds ratios for PSCI and individual cognitive domains. We also explored sensitivity and specificity of cognitive screening tools for detecting PSCI, according to sex (Mini-Mental State Examination, 4 cohorts, n=1814; Montreal Cognitive Assessment, 3 cohorts, n=278). RESULTS: PSCI was found in 51% of both women and men. Men had a lower risk of impairment of attention and executive functioning (men: odds ratio, 0.76 [95% CI, 0.61-0.96]), and language (men: odds ratio, 0.67 [95% CI, 0.45-0.85]), but a higher risk of verbal memory impairment (men: odds ratio, 1.43 [95% CI, 1.17-1.75]). The sensitivity of Mini-Mental State Examination (<25) for PSCI was higher for women (0.53) than for men (0.27; P=0.02), with a lower specificity for women (0.80) than men (0.96; P=0.01). Sensitivity and specificity of Montreal Cognitive Assessment (<26.) for PSCI was comparable between women and men (0.91 versus 0.86; P=0.62 and 0.29 versus 0.28; P=0.86, respectively). CONCLUSIONS: Sex was not associated with PSCI occurrence but affected domains differed between men and women. The latter may explain why sensitivity of the Mini-Mental State Examination for detecting PSCI was higher in women with a lower specificity compared with men. ...
وصف الملف: application/pdf
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3دورية أكاديمية
المؤلفون: Schellekens, Mijntje M I, Springer, Ravi C S, Boot, Esther M, Verhoeven, Jamie I, Ekker, Merel S, van Alebeek, Mayte E, Brouwers, Paul J A M, Arntz, Renate M, van Dijk, Gert W, Gons, Rob A R, van Uden, Inge W M, den Heijer, Tom, van Tuijl, Julia H, de Laat, Karlijn F, van Norden, Anouk G W, Vermeer, Sarah E, van Zagten, Marian S G, Van Oostenbrugge, Robert J, Wermer, Marieke J H, Nederkoorn, Paul J, van Rooij, Frank G, van den Wijngaard, Ido R, de Kort, Paul L M, De Leeuw, Frank-Erik, Kessels, Roy P C, Tuladhar, Anil M
المصدر: Schellekens , M M I , Springer , R C S , Boot , E M , Verhoeven , J I , Ekker , M S , van Alebeek , M E , Brouwers , P J A M , Arntz , R M , van Dijk , G W , Gons , R A R , van Uden , I W M , den Heijer , T , van Tuijl , J H , de Laat , K F , van Norden , A G W , Vermeer , S E , van Zagten , M S G ....
الوصف: Background Limited data exists on cognitive recovery in young stroke patients. We aimed to investigate the longitudinal course of cognitive performance during the first year after stroke at young age and identify predictors for cognitive recovery. Methods We conducted a multicentre prospective cohort study between 2013 and 2021, enrolling patients aged 18–49 years with first-ever ischaemic stroke. Cognitive assessments were performed within 6 months and after 1 year following the index event, covering seven cognitive domains. Composite Z-scores using normative data determined cognitive impairment (Z-score<−1.5). A Reliable Change Index (RCI) assessed cognitive recovery (RCI>1.96) or decline (RCI<−1.96). Results 393 patients (median age 44.3 years, IQR 38.4–47.2) completed cognitive assessments with a median time interval of 403 days (IQR 364–474) between assessments. Based on RCI, a similar proportion of patients showed improvement and decline in each cognitive domain, while the majority exhibited no cognitive change. Among cognitively impaired patients at baseline, improvements were observed in processing speed (23.1%), visuoconstruction (40.1%) and executive functioning (20.0%). Younger age was associated with better cognitive recovery in visuoconstruction, and larger lesion volume was related to cognitive recovery in processing speed. No other predictors for cognitive recovery were identified. Conclusions Cognitive impairment remains prevalent in young stroke even 1 year after the event. Most patients showed no cognitive change, however, recovery may have occurred in the early weeks after stroke, which was not assessed in our study. Among initially cognitively impaired patients, cognitive recovery is observed in processing speed, visuoconstruction and executive functioning. It is still not possible to predict cognitive recovery in individual patients.
العلاقة: https://cris.maastrichtuniversity.nl/en/publications/bcc81ed7-aa0d-444a-b853-bd1e0bb9b03aTest
الإتاحة: https://doi.org/10.1136/jnnp-2023-332104Test
https://cris.maastrichtuniversity.nl/en/publications/bcc81ed7-aa0d-444a-b853-bd1e0bb9b03aTest -
4دورية أكاديمية
المؤلفون: de Kort, Floor A S, Coenen, Mirthe, Weaver, Nick A, Kuijf, Hugo J, Aben, Hugo P, Bae, Hee-Joon, Bordet, Régis, Cammà, Guido, Chen, Christopher P L H, Dewenter, Anna, Duering, Marco, Fang, Rong, van der Giessen, Ruben S, Hamilton, Olivia K L, Hilal, Saima, Huenges Wajer, Irene M C, Kan, Cheuk Ni, Kim, Jonguk, Kim, Beom Joon, Köhler, Sebastian, de Kort, Paul L M, Koudstaal, Peter J, Lim, Jae-Sung, Lopes, Renaud, Mok, Vincent C T, Staals, Julie, Venketasubramanian, Narayanaswamy, Verhagen, Charlotte M, Verhey, Frans R J, Wardlaw, Joanna M, Xu, Xin, Yu, Kyung-Ho, Biesbroek, J Matthijs, Biessels, Geert Jan
المصدر: de Kort , F A S , Coenen , M , Weaver , N A , Kuijf , H J , Aben , H P , Bae , H-J , Bordet , R , Cammà , G , Chen , C P L H , Dewenter , A , Duering , M , Fang , R , van der Giessen , R S , Hamilton , O K L , Hilal , S , Huenges Wajer , I M C , Kan , C N , Kim , J , Kim , B J , Köhler , S , ....
مصطلحات موضوعية: brain, cerebral small vessel diseases, cognition, infarcts, ischemic stroke, neuroimaging
الوصف: BACKGROUND: White matter hyperintensities (WMH) are associated with cognitive dysfunction after ischemic stroke. Yet, uncertainty remains about affected domains, the role of other preexisting brain injury, and infarct types in the relation between WMH burden and poststroke cognition. We aimed to disentangle these factors in a large sample of patients with ischemic stroke from different cohorts. METHODS: We pooled and harmonized individual patient data (n=1568) from 9 cohorts, through the Meta VCI Map consortium (www.metavcimap.org). Included cohorts comprised patients with available magnetic resonance imaging and multidomain cognitive assessment <15 months poststroke. In this individual patient data meta-analysis, linear mixed models were used to determine the association between WMH volume and domain-specific cognitive functioning ( scores; attention and executive functioning, processing speed, language and verbal memory) for the total sample and stratified by infarct type. Preexisting brain injury was accounted for in the multivariable models and all analyses were corrected for the study site as a random effect. RESULTS: In the total sample (67 years [SD, 11.5], 40% female), we found a dose-dependent inverse relationship between WMH volume and poststroke cognitive functioning across all 4 cognitive domains (coefficients ranging from -0.09 [SE, 0.04, =0.01] for verbal memory to -0.19 [SE, 0.03, <0.001] for attention and executive functioning). This relation was independent of acute infarct volume and the presence of lacunes and old infarcts. In stratified analyses, the relation between WMH volume and domain-specific functioning was also largely independent of infarct type. CONCLUSIONS: In patients with ischemic stroke, increasing WMH volume is independently associated with worse cognitive functioning across all major domains, regardless of old ischemic lesions and infarct type.
العلاقة: https://cris.maastrichtuniversity.nl/en/publications/a7719e2a-fade-46ee-84b7-8042fdf53120Test
الإتاحة: https://doi.org/10.1161/STROKEAHA.123.044297Test
https://cris.maastrichtuniversity.nl/en/publications/a7719e2a-fade-46ee-84b7-8042fdf53120Test -
5دورية أكاديمية
المؤلفون: Hund, Hajo M., Boodt, Nikki, Hansen, Daniel, Haffmans, Willem A., Lycklama à Nijeholt, Geert J., Hofmeijer, Jeannette, Dippel, Diederik W. J., van der Lugt, Aad, van Es, Adriaan C. G. M., van Beusekom, Heleen M. M., Majoie, Charles B. L. M., Roos, Yvo B. W. E. M., van Oostenbrugge, Robert J., van Zwam, Wim H., Boiten, Jelis, Vos, Jan Albert, Jansen, Ivo G. H., Mulder, Maxim J. H. L., Goldhoorn, Robert- Jan B., Compagne, Kars C. J., Kappelhof, Manon, Brouwer, Josje, den Hartog, Sanne J., Hinsenveld, Wouter H., Roozenbeek, Bob, Emmer, Bart J., Coutinho, Jonathan M., Schonewille, Wouter J., Wermer, Marieke J. H., van Walderveen, Marianne A. A., Staals, Julie, Martens, Jasper M., de Bruijn, Sebastiaan F., van Dijk, Lukas C., van der Worp, H. Bart, Lo, Rob H., van Dijk, Ewoud J., Boogaarts, Hieronymus D., de Vries, J., de Kort, Paul L. M., van Tuijl, Julia, Peluso, Jo P., Fransen, Puck, van den Berg, Jan S. P., van Hasselt, Boudewijn A. A. M., Aerden, Leo A. M., Dallinga, René J., Uyttenboogaart, Maarten, Eschgi, Omid, Bokkers, Reinoud P. H.
المصدر: Neuroradiology ; volume 65, issue 5, page 933-943 ; ISSN 0028-3940 1432-1920
مصطلحات موضوعية: Cardiology and Cardiovascular Medicine, Neurology (clinical), Radiology, Nuclear Medicine and imaging
الوصف: Purpose The composition of thrombi retrieved during endovascular thrombectomy (EVT) in acute ischemic stroke (AIS) due to large vessel occlusion (LVO) may differ depending on their origin. In this study, we investigated the association between thrombus composition and stroke etiology in a large population of patients from the Dutch MR CLEAN Registry treated with EVT in daily clinical practice. Methods The thrombi of 332 patients with AIS were histologically analyzed for red blood cells (RBC), fibrin/platelets (F/P), and white blood cells (leukocytes) using a machine learning algorithm. Stroke etiology was assessed using the Trial of Org 10,172 in acute stroke treatment (TOAST) classification. Results The thrombi of cardioembolic origin contained less RBC and more F/P than those of non-cardioembolic origin (25.8% vs 41.2% RBC [ p = 0.003] and 67.1% vs 54.5% F/P [ p = 0.004]). The likelihood of a non-cardioembolic source of stroke increased with increasing thrombus RBC content ( OR 1.02; [95% CI 1.00–1.06] for each percent increase) and decreased with a higher F/P content ( OR 1.02; [95% CI 1.00–1.06]). Thrombus composition in patients with a cardioembolic origin and undetermined origin was similar. Conclusion Thrombus composition is significantly associated with stroke etiology, with an increase in RBC and a decrease in F/P raising the odds for a non-cardioembolic cause. No difference between composition of cardioembolic thrombi and of undetermined origin was seen. This emphasizes the need for more extensive monitoring for arrhythmias and/or extended cardiac analysis in case of an undetermined origin.
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6دورية أكاديمية
المؤلفون: Coenen, Mirthe, de Kort, Floor A S, Weaver, Nick A, Kuijf, Hugo J, Aben, Hugo Paul, Bae, Hee-Joon, Bordet, Régis, Chen, Christopher Lh, Dewenter, Anna, Doeven, Thomas, Dondaine, Thibaut, Duering, Marco, Fang, Rong, van der Giessen, Ruben S, Kim, Jonguk, Kim, Beom Joon, de Kort, Paul L M, Koudstaal, Peter, Lee, Minwoo, Lim, Jae-Sung, Lopes, Renaud, van Oostenbrugge, Robert J, Staals, Julie, Yu, Kyung-Ho, Biessels, Geert Jan, Biesbroek, J Matthijs
المصدر: Coenen , M , de Kort , F A S , Weaver , N A , Kuijf , H J , Aben , H P , Bae , H-J , Bordet , R , Chen , C L , Dewenter , A , Doeven , T , Dondaine , T , Duering , M , Fang , R , van der Giessen , R S , Kim , J , Kim , B J , de Kort , P L M , Koudstaal , P , Lee , M , Lim , J-S , Lopes , R , van ....
مصطلحات موضوعية: MRI, PSCI, White matter hyperintensities, ischemic stroke, post-stroke cognition, strategic lesion location
الوصف: BACKGROUND: Post-stroke cognitive impairment (PSCI) occurs in up to 50% of stroke survivors. Presence of pre-existing vascular brain injury, in particular the extent of white matter hyperintensities (WMH), is associated with worse cognitive outcome after stroke, but the role of WMH location in this association is unclear. AIM: We determined if WMH in strategic white matter tracts explain cognitive performance after stroke. METHODS: Individual patient data from 9 ischemic stroke cohorts with MRI were harmonized through the Meta VCI Map consortium. The association between WMH volumes in strategic tracts and domain-specific cognitive functioning (attention and executive functioning, information processing speed, language and verbal memory) was assessed using linear mixed models and lasso regression. We used a hypothesis-driven design, primarily addressing four white matter tracts known to be strategic in memory clinic patients: the left and right anterior thalamic radiation, forceps major and left inferior fronto-occipital fasciculus. RESULTS: The total study sample consisted of 1568 patients (39.9% female, mean age: 67.3 years). Total WMH volume was strongly related to cognitive performance on all four cognitive domains. WMH volume in the left anterior thalamic radiation was significantly associated with cognitive performance on attention and executive functioning and information processing speed, and WMH volume in the forceps major with information processing speed. The multivariable lasso regression showed that these associations were independent of age, sex, education, and total infarct volume and had larger coefficients than total WMH volume. CONCLUSIONS: These results show tract-specific relations between WMH volume and cognitive performance after ischemic stroke, independent of total WMH volume. This implies that the concept of strategic lesions in PSCI extends beyond acute infarcts and also involves pre-existing WMH. DATA AVAILABILITY: The Meta VCI Map consortium is dedicated to data sharing, following our ...
العلاقة: https://cris.maastrichtuniversity.nl/en/publications/cf705c34-6cfc-4ec6-b2a3-3f5083066170Test
الإتاحة: https://doi.org/10.1177/17474930241252530Test
https://cris.maastrichtuniversity.nl/en/publications/cf705c34-6cfc-4ec6-b2a3-3f5083066170Test -
7دورية أكاديمية
المؤلفون: Biesbroek, J Matthijs, Weaver, Nick A, Aben, Hugo P, Kuijf, Hugo J, Abrigo, Jill, Bae, Hee-Joon, Barbay, Mélanie, Best, Jonathan G, Bordet, Régis, Chappell, Francesca M, Chen, Christopher P L H, Dondaine, Thibaut, van der Giessen, Ruben S, Godefroy, Olivier, Gyanwali, Bibek, Hamilton, Olivia K L, Hilal, Saima, Huenges Wajer, Irene M C, Kang, Yeonwook, Kappelle, L Jaap, Kim, Beom Joon, Köhler, Sebastian, de Kort, Paul L M, Koudstaal, Peter J, Kuchcinski, Gregory, Lam, Bonnie Y K, Lee, Byung-Chul, Lee, Keon-Joo, Lim, Jae-Sung, Lopes, Renaud, Makin, Stephen D J, Mendyk, Anne-Marie, Mok, Vincent C T, Oh, Mi Sun, van Oostenbrugge, Robert J, Roussel, Martine, Shi, Lin, Staals, Julie, Valdés-Hernández, Maria Del C, Venketasubramanian, Narayanaswamy, Verhey, Frans R J, Wardlaw, Joanna M, Werring, David J, Xin, Xu, Yu, Kyung-Ho, van Zandvoort, Martine J E, Zhao, Lei, Biessels, Geert Jan
المساهمون: Projectafdeling VCI, Brain, Opleiding Neurologie, Beeldverwerking ISI, Circulatory Health, Cancer, Neurologie, Neurologen, Neuropsychologie, Structure and Connections
مصطلحات موضوعية: Brain connectomics, Dementia, Diffusion-weighted imaging, Ischaemic stroke, Post-stroke cognitive impairment, Radiology Nuclear Medicine and imaging, Neurology, Clinical Neurology, Cognitive Neuroscience
الوصف: BACKGROUND: Post-stroke cognitive impairment (PSCI) is a common consequence of stroke. Accurate prediction of PSCI risk is challenging. The recently developed network impact score, which integrates information on infarct location and size with brain network topology, may improve PSCI risk prediction. AIMS: To determine if the network impact score is an independent predictor of PSCI, and of cognitive recovery or decline. METHODS: We pooled data from patients with acute ischemic stroke from 12 cohorts through the Meta VCI Map consortium. PSCI was defined as impairment in ≥ 1 cognitive domain on neuropsychological examination, or abnormal Montreal Cognitive Assessment. Cognitive recovery was defined as conversion from PSCI < 3 months post-stroke to no PSCI at follow-up, and cognitive decline as conversion from no PSCI to PSCI. The network impact score was related to serial measures of PSCI using Generalized Estimating Equations (GEE) models, and to PSCI stratified according to post-stroke interval (<3, 3-12, 12-24, >24 months) and cognitive recovery or decline using logistic regression. Models were adjusted for age, sex, education, prior stroke, infarct volume, and study site. RESULTS: We included 2341 patients with 4657 cognitive assessments. PSCI was present in 398/844 patients (47%) <3 months, 709/1640 (43%) at 3-12 months, 243/853 (28%) at 12-24 months, and 208/522 (40%) >24 months. Cognitive recovery occurred in 64/181 (35%) patients and cognitive decline in 26/287 (9%). The network impact score predicted PSCI in the univariable (OR 1.50, 95%CI 1.34-1.68) and multivariable (OR 1.27, 95%CI 1.10-1.46) GEE model, with similar ORs in the logistic regression models for specified post-stroke intervals. The network impact score was not associated with cognitive recovery or decline. CONCLUSIONS: The network impact score is an independent predictor of PSCI. As such, the network impact score may contribute to a more precise and individualized cognitive prognostication in patients with ischemic stroke. ...
وصف الملف: application/pdf
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8دورية أكاديمية
المؤلفون: Biesbroek, J Matthijs, Weaver, Nick A, Aben, Hugo P, Kuijf, Hugo J, Abrigo, Jill, Bae, Hee-Joon, Barbay, Mélanie, Best, Jonathan G, Bordet, Régis, Chappell, Francesca M, Chen, Christopher P L H, Dondaine, Thibaut, van der Giessen, Ruben S, Godefroy, Olivier, Gyanwali, Bibek, Hamilton, Olivia K L, Hilal, Saima, Huenges Wajer, Irene M C, Kang, Yeonwook, Kappelle, L Jaap, Kim, Beom Joon, Köhler, Sebastian, de Kort, Paul L M, Koudstaal, Peter J, Kuchcinski, Gregory, Lam, Bonnie Y K, Lee, Byung-Chul, Lee, Keon-Joo, Lim, Jae-Sung, Lopes, Renaud, Makin, Stephen D J, Mendyk, Anne-Marie, Mok, Vincent C T, Oh, Mi Sun, van Oostenbrugge, Robert J, Roussel, Martine, Shi, Lin, Staals, Julie, Valdés-Hernández, Maria Del C, Venketasubramanian, Narayanaswamy, Verhey, Frans R J, Wardlaw, Joanna M, Werring, David J, Xin, Xu, Yu, Kyung-Ho, van Zandvoort, Martine J E, Zhao, Lei, Biessels, Geert Jan
المصدر: Biesbroek , J M , Weaver , N A , Aben , H P , Kuijf , H J , Abrigo , J , Bae , H-J , Barbay , M , Best , J G , Bordet , R , Chappell , F M , Chen , C P L H , Dondaine , T , van der Giessen , R S , Godefroy , O , Gyanwali , B , Hamilton , O K L , Hilal , S , Huenges Wajer , I M C , Kang , Y , Kappelle , L J , Kim ....
مصطلحات موضوعية: ANATOMY, Brain connectomics, DISEASE, Dementia, Diffusion-weighted imaging, HUBS, Ischaemic stroke, LOCATIONS, Post-stroke cognitive impairment, RISK
الوصف: BACKGROUND: Post-stroke cognitive impairment (PSCI) is a common consequence of stroke. Accurate prediction of PSCI risk is challenging. The recently developed network impact score, which integrates information on infarct location and size with brain network topology, may improve PSCI risk prediction. AIMS: To determine if the network impact score is an independent predictor of PSCI, and of cognitive recovery or decline. METHODS: We pooled data from patients with acute ischemic stroke from 12 cohorts through the Meta VCI Map consortium. PSCI was defined as impairment in ≥ 1 cognitive domain on neuropsychological examination, or abnormal Montreal Cognitive Assessment. Cognitive recovery was defined as conversion from PSCI < 3 months post-stroke to no PSCI at follow-up, and cognitive decline as conversion from no PSCI to PSCI. The network impact score was related to serial measures of PSCI using Generalized Estimating Equations (GEE) models, and to PSCI stratified according to post-stroke interval (<3, 3-12, 12-24, >24 months) and cognitive recovery or decline using logistic regression. Models were adjusted for age, sex, education, prior stroke, infarct volume, and study site. RESULTS: We included 2341 patients with 4657 cognitive assessments. PSCI was present in 398/844 patients (47%) <3 months, 709/1640 (43%) at 3-12 months, 243/853 (28%) at 12-24 months, and 208/522 (40%) >24 months. Cognitive recovery occurred in 64/181 (35%) patients and cognitive decline in 26/287 (9%). The network impact score predicted PSCI in the univariable (OR 1.50, 95%CI 1.34-1.68) and multivariable (OR 1.27, 95%CI 1.10-1.46) GEE model, with similar ORs in the logistic regression models for specified post-stroke intervals. The network impact score was not associated with cognitive recovery or decline. CONCLUSIONS: The network impact score is an independent predictor of PSCI. As such, the network impact score may contribute to a more precise and individualized cognitive prognostication in patients with ischemic stroke. ...
الإتاحة: https://doi.org/10.1016/j.nicl.2022.103018Test
https://cris.maastrichtuniversity.nl/en/publications/05dcb9a1-cfa3-428a-83f7-b5d5e9b6c7f2Test -
9دورية أكاديمية
المؤلفون: Compagne, Kars C J, Kappelhof, Manon, Hinsenveld, Wouter H, Brouwer, Josje, Goldhoorn, Robert-Jan B, Uyttenboogaart, Maarten, Bokkers, Reinoud P H, Schonewille, Wouter J, Martens, Jasper M, Hofmeijer, Jeannette, van der Worp, H Bart, Lo, Rob T H, Keizer, Koos, Yo, Lonneke S F, Lycklama À Nijeholt, Geert J, den Hertog, Heleen M, Sturm, Emiel J C, Brouwers, Paul J A M, van Walderveen, Marianne A A, Wermer, Marieke J H, de Bruijn, Sebastiaan F, van Dijk, Lukas C, Boogaarts, Hieronymus D, van Dijk, Ewout J, van Tuijl, Julia H, Peluso, Jo P P, de Kort, Paul L M, van Hasselt, Boudewijn A A M, Fransen, Puck S, Schreuder, Tobien H C M L, Heijboer, Roel J J, Jenniskens, Sjoerd F M, Sprengers, Marieke E S, Ghariq, Elias, van den Wijngaard, Ido R, Roosendaal, Stefan D, Meijer, Anton F J A, Beenen, Ludo F M, Postma, Alida A, van den Berg, René, Yoo, Albert J, van Doormaal, Pieter Jan, van Proosdij, Marc P, Krietemeijer, Menno G M, Gerrits, Dick G, Hammer, Sebastiaan, Vos, Jan Albert, Boiten, Jelis, van Zwam, Wim H, van Oostenbrugge, Robert J
المصدر: Compagne , K C J , Kappelhof , M , Hinsenveld , W H , Brouwer , J , Goldhoorn , R-J B , Uyttenboogaart , M , Bokkers , R P H , Schonewille , W J , Martens , J M , Hofmeijer , J , van der Worp , H B , Lo , R T H , Keizer , K , Yo , L S F , Lycklama À Nijeholt , G J , den Hertog , H M , Sturm , E J C , Brouwers , P J A M , van Walderveen ....
مصطلحات موضوعية: GUIDELINES, IMPUTATION, MANAGEMENT, OUTCOMES, RELIABILITY, REPERFUSION, SCALE, SOCIETY, SYSTEMATIC EVALUATION, THROMBECTOMY, groin odds, puncture, ratio, registry
الوصف: BACKGROUND: We evaluated data from all patients in the Netherlands who underwent endovascular treatment for acute ischemic stroke in the past 3.5 years, to identify nationwide trends in time to treatment and procedural success, and assess their effect on clinical outcomes. METHODS: We included patients with proximal occlusions of the anterior circulation from the second and first cohorts of the MR CLEAN (Multicenter Randomized Clinical trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) Registry (March 2014 to June 2016; June 2016 to November 2017, respectively). We compared workflow times and rates of successful reperfusion (defined as an extended thrombolysis in cerebral infarction score of 2B-3) between cohorts and chronological quartiles (all included patients stratified in chronological quartiles of intervention dates to create equally sized groups over the study period). Multivariable ordinal logistic regression was used to assess differences in the primary outcome (ordinal modified Rankin Scale at 90 days). RESULTS: Baseline characteristics were similar between cohorts (second cohort n=1692, first cohort n=1488) except for higher age, poorer collaterals, and less signs of early ischemia on computed tomography in the second cohort. Time from stroke onset to groin puncture and reperfusion were shorter in the second cohort (median 185 versus 210 minutes; P<0.001 and 236 versus 270 minutes; P<0.001, respectively). Successful reperfusion was achieved more often in the second than in the first cohort (72% versus 66%; P<0.001). Functional outcome significantly improved (adjusted common odds ratio 1.23 [95% CI, 1.07-1.40]). This effect was attenuated by adjustment for time from onset to reperfusion (adjusted common odds ratio, 1.12 [95% CI, 0.98-1.28]) and successful reperfusion (adjusted common odds ratio, 1.13 [95% CI, 0.99-1.30]). Outcomes were consistent in the analysis per chronological quartile. CONCLUSIONS: Clinical outcomes after endovascular treatment for acute ischemic ...
الإتاحة: https://doi.org/10.1161/STROKEAHA.121.034919Test
https://cris.maastrichtuniversity.nl/en/publications/48d4c2a6-2f3d-4d9a-9af2-20b04d6dd767Test -
10دورية أكاديمية
المؤلفون: den Hartog, Sanne J., Lingsma, Hester F., van Doormaal, Pieter‐Jan, Hofmeijer, Jeannette, Yo, Lonneke S. F., Majoie, Charles B. L. M., Dippel, Diederik W. J., van der Lugt, Aad, Roozenbeek, Bob, Roos, Yvo B. W. E. M., van Oostenbrugge, Robert J., van Zwam, Wim H., Boiten, Jelis, Vos, Jan Albert, Jansen, Ivo G. H., Mulder, Maxim J. H. L., Goldhoorn, Robert‐ Jan B., Compagne, Kars C. J., Kappelhof, Manon, Brouwer, Josje, Hinsenveld, Wouter H., van Es, Adriaan C. G. M., Emmer, Bart J., Coutinho, Jonathan M., Schonewille, Wouter J., Wermer, Marieke J. H., van Walderveen, Marianne A. A., Staals, Julie, Martens, Jasper M., Lycklama à Nijeholt, Geert J., de Bruijn, Sebastiaan F., van Dijk, Lukas C., van der Worp, H. Bart, Lo, Rob H., van Dijk, Ewoud J., Boogaarts, Hieronymus D., de Vries, J., de Kort, Paul L. M., van Tuijl, Julia, Peluso, Jo P., Fransen, Puck, van den Berg, Jan S. P., van Hasselt, Boudewijn A. A. M., Aerden, Leo A. M.
المصدر: Journal of the American Heart Association ; volume 11, issue 1 ; ISSN 2047-9980
الوصف: Background Time to reperfusion in patients with ischemic stroke is strongly associated with functional outcome and may differ between hospitals and between patients within hospitals. Improvement in time to reperfusion can be guided by between‐hospital and within‐hospital comparisons and requires insight in specific targets for improvement. We aimed to quantify the variation in door‐to‐reperfusion time between and within Dutch intervention hospitals and to assess the contribution of different time intervals to this variation. Methods and Results We used data from the MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) Registry. The door‐to‐reperfusion time was subdivided into time intervals, separately for direct patients (door‐to‐computed tomography, computed tomography‐to‐computed tomography angiography [CTA], CTA‐to‐groin, and groin‐to‐reperfusion times) and for transferred patients (door‐to‐groin and groin‐to‐reperfusion times). We used linear mixed models to distinguish the variation in door‐to‐reperfusion time between hospitals and between patients. The proportional change in variance was used to estimate the amount of variance explained by each time interval. We included 2855 patients of 17 hospitals providing endovascular treatment. Of these patients, 44% arrived directly at an endovascular treatment hospital. The between‐hospital variation in door‐to‐reperfusion time was 9%, and the within‐hospital variation was 91%. The contribution of case‐mix variables on the variation in door‐to‐reperfusion time was marginal (2%–7%). Of the between‐hospital variation, CTA‐to‐groin time explained 83%, whereas groin‐to‐reperfusion time explained 15%. Within‐hospital variation was mostly explained by CTA‐to‐groin time (33%) and groin‐to‐reperfusion time (42%). Similar results were found for transferred patients. Conclusions Door‐to‐reperfusion time varies between, but even more within, hospitals providing endovascular treatment for ischemic stroke. ...
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