Morphological associations between white matter disease and index stroke lesion

Abstract

The aim of the research is to investigate the associations between white matter disease (WMD) parameters and index stroke lesion characteristics in patients with acute stroke. There are a number of studies that have examined the effect of WMD on the consequences of cerebral stroke, but few of them have addressed the issues of its effect on stroke focus parameters. The aim of the study is to establish relationships between WMD parameters and stroke focus characteristics in patients with acute cerebral stroke. 294 consecutive patients with acute stroke were enrolled. All participants underwent magnetic resonance imaging (MRI) and computed tomography (CT). Assessment for WMD markers and index stroke lesion parameters as well as clinical-neurological testing were performed. Statistical analysis was performed using the jamovi project (2022). Jamovi (Version 2.2.5) [Computer Software]. Sydney, Australia. In the multivariable analysis, WMD grade 3 significantly associated with stroke volume (b = 30.0; 95% CI 3.6 - 56.5, p =0.026), more severe brain edema (OR = 2.4; 95% CI 1.0 - 5.8, p = 0.047). Irregular shape of WMD associated with brain edema (b =0.4; 95% CI 0.1 - 0.7, p = 0.019) and ischemic penumbra growth (b = -0.7; 95% CI 1.2 - -0.1, p = 0.014). Patients with severe WMD had significantly higher prevalence of hemorrhagic transformation: 2 (3%) vs 29 (13%), p < 0.05 and more often had neuroimaging evidence of previous stroke lesions: 3 (5%) vs 34 (32%), p <0.001. Thus, WMD characteristics are independent predictors of larger index stroke volume, brain edema growth, early ischemic changes preceding thrombolytic therapy and hemorrhagic transformation of ischemic stroke lesion, which is important for better prognosis and preventive strategies.