Influence of stroke infarct location on quality of life assessed in a multivariate lesion-symptom mapping study

• Published in: Scientific reports Vol. 11; no. 1; p. 13490
• Main Authors: Königsberg, Alina, DeMarco, Andrew T., Mayer, Carola, Wouters, Anke, Schlemm, Eckhard, Ebinger, Martin, Cho, Tae-Hee, Endres, Matthias, Fiebach, Jochen B., Fiehler, Jens, Galinovic, Ivana, Puig, Josep, Thijs, Vincent, Lemmens, Robin, Muir, Keith W., Nighoghossian, Norbert, Pedraza, Salvador, Simonsen, Claus Z., Gerloff, Christian, Thomalla, Götz, Cheng, Bastian
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 29.06.2021; Nature Publishing Group; Nature Portfolio
• Subjects: 631/378; 692/308; 692/617; Aged; Brain; Brain - diagnostic imaging; Brain Infarction - diagnostic imaging; Brain Infarction - mortality; Brain injury; Double-Blind Method; Female; Humanities and Social Sciences; Humans; Learning algorithms; Lesions; Life Sciences; Machine learning; Magnetic Resonance Imaging; Male; Mapping; Middle Aged; multidisciplinary; Multivariate analysis; Neuroimaging; Putamen; Quality of Life; Science; Science (multidisciplinary); Stroke; Substantia alba
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-021-92865-x

Stroke has a deleterious impact on quality of life. However, it is less well known if stroke lesions in different brain regions are associated with reduced quality of life (QoL). We therefore investigated this association by multivariate lesion-symptom mapping. We analyzed magnetic resonance imaging and clinical data from the WAKE-UP trial. European Quality of Life 5 Dimensions (EQ-5D) 3 level questionnaires were completed 90 days after stroke. Lesion symptom mapping was performed using a multivariate machine learning algorithm (support vector regression) based on stroke lesions 22–36 h after stroke. Brain regions with significant associations were explored in reference to white matter tracts. Of 503 randomized patients, 329 were included in the analysis (mean age 65.4 years, SD 11.5; median NIHSS = 6, IQR 4–9; median EQ-5D score 90 days after stroke 1, IQR 0–4, median lesion volume 3.3 ml, IQR 1.1–16.9 ml). After controlling for lesion volume, significant associations between lesions and EQ-5D score were detected for the right putamen, and internal capsules of both hemispheres. Multivariate lesion inference analysis revealed an association between injuries of the cortico-spinal tracts with worse self-reported quality of life 90 days after stroke in comparably small stroke lesions, extending previous reports of the association of striato-capsular lesions with worse functional outcome. Our findings are of value to identify patients at risk of impaired QoL after stroke.