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Dynamic Evolution of Infarct Volumes at MRI in Ischemic Stroke Due to Large Vessel Occlusion

dc.rights.licenseopenen_US
hal.structure.identifierNeurocentre Magendie : Physiopathologie de la Plasticité Neuronale [U1215 Inserm - UB]
dc.contributor.authorMUNSCH, Fanny
dc.contributor.authorPLANES, David
dc.contributor.authorFUKUTOMI, Hikaru
dc.contributor.authorMARNAT, Gaultier
dc.contributor.authorCOURRET, Thomas
dc.contributor.authorMICARD, Emilien
dc.contributor.authorCHEN, Bailiang
dc.contributor.authorSENERS, Pierre
dc.contributor.authorDUBOS, Johanna
hal.structure.identifierInstitut des Maladies Neurodégénératives [Bordeaux] [IMN]
dc.contributor.authorPLANCHE, Vincent
hal.structure.identifierLaboratoire Bordelais de Recherche en Informatique [LaBRI]
dc.contributor.authorCOUPÉ, Pierrick
hal.structure.identifierNeurocentre Magendie : Physiopathologie de la Plasticité Neuronale [U1215 Inserm - UB]
dc.contributor.authorDOUSSET, Vincent
dc.contributor.authorLAPERGUE, Bertrand
dc.contributor.authorOLIVOT, Jean Marc
hal.structure.identifierCHU de Bordeaux Pellegrin [Bordeaux]
dc.contributor.authorSIBON, Igor
hal.structure.identifierUniversité de Bordeaux [UB]
dc.contributor.authorDE SCHOTTEN, Michel Thiebaut
hal.structure.identifierNeurocentre Magendie : Physiopathologie de la Plasticité Neuronale [U1215 Inserm - UB]
dc.contributor.authorTOURDIAS, Thomas
dc.date.accessioned2025-06-13T09:58:04Z
dc.date.available2025-06-13T09:58:04Z
dc.date.issued2024-06-25
dc.identifier.issn0028-3878en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/206907
dc.description.abstractEnBackground and Objectives The typical infarct volume trajectories in stroke patients, categorized as slow or fast progressors, remain largely unknown. This study aimed to reveal the characteristic spatiotemporal evolutions of infarct volumes caused by large vessel occlusion (LVO) and show that such growth charts help anticipate clinical outcomes.MethodsWe conducted a secondary analysis from prospectively collected databases (FRAME, 2017-2019; ETIS, 2015-2022). We selected acute MRI data from anterior LVO stroke patients with witnessed onset, which were divided into training and independent validation datasets. In the training dataset, using Gaussian mixture analysis, we classified the patients into 3 growth groups based on their rate of infarct growth (diffusion volume/time-to-imaging). Subsequently, we extrapolated pseudo-longitudinal models of infarct growth for each group and generated sequential frequency maps to highlight the spatial distribution of infarct growth. We used these charts to attribute a growth group to the independent patients from the validation dataset. We compared their 3-month modified Rankin scale (mRS) with the predicted values based on a multivariable regression model from the training dataset that used growth group as an independent variable.ResultsWe included 804 patients (median age 73.0 years [interquartile range 61.2-82.0 years]; 409 men). The training dataset revealed nonsupervised clustering into 11% (74/703) slow, 62% (437/703) intermediate, and 27% (192/703) fast progressors. Infarct volume evolutions were best fitted with a linear (r = 0.809; p < 0.001), cubic (r = 0.471; p < 0.001), and power (r = 0.63; p < 0.001) function for the slow, intermediate, and fast progressors, respectively. Notably, the deep nuclei and insular cortex were rapidly affected in the intermediate and fast groups with further cortical involvement in the fast group. The variable growth group significantly predicted the 3-month mRS (multivariate odds ratio 0.51; 95% CI 0.37-0.72, p < 0.0001) in the training dataset, yielding a mean area under the receiver operating characteristic curve of 0.78 (95% CI 0.66-0.88) in the independent validation dataset.DiscussionWe revealed spatiotemporal archetype dynamic evolutions following LVO stroke according to 3 growth phenotypes called slow, intermediate, and fast progressors, providing insight into anticipating clinical outcome. We expect this could help in designing neuroprotective trials aiming at modulating infarct growth before EVT. © American Academy of Neurology.
dc.language.isoENen_US
dc.subjectAged 80 and over
dc.subjectDisease Progression
dc.subject.enAged
dc.subject.enFemale
dc.subject.enHumans
dc.subject.enIschemic Stroke
dc.subject.enDiagnostic imaging
dc.subject.enMagnetic Resonance Imaging
dc.subject.enMale
dc.subject.enMiddle Aged
dc.title.enDynamic Evolution of Infarct Volumes at MRI in Ischemic Stroke Due to Large Vessel Occlusion
dc.title.alternativeNeurologyen_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1212/WNL.0000000000209427en_US
dc.subject.halSciences du Vivant [q-bio]/Neurosciences [q-bio.NC]en_US
dc.identifier.pubmed38815232en_US
dc.description.sponsorshipEuropeEuropean Union’s Horizon 2020en_US
bordeaux.journalNeurologyen_US
bordeaux.volume102en_US
bordeaux.hal.laboratoriesNeurocentre Magendie - U1215en_US
bordeaux.issue12en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.teamRelations glie-neuroneen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
bordeaux.identifier.funderIDMinistère de la Santéen_US
hal.identifierhal-05111150
hal.version1
hal.date.transferred2025-06-13T09:58:08Z
hal.popularnonen_US
hal.audienceInternationaleen_US
hal.exporttrue
dc.rights.ccPas de Licence CCen_US
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