Evidence map›Paper›PMID 40657323›Full record

ArticlemedRxiv : the preprint server for health sciences2025

Magnetic Resonance Imaging Markers of Brain Health Improve Assessment of Functional Outcome After Acute Ischemic Stroke: A Quantitative Comparison Study.

Erik Lindgren, Luca Angeleri, Martin Bretzner, Anna K Bonkhoff, Christina Jern, Arne G Lindgren, Jane Maguire, Robert W Regenhardt, Natalia S Rost, Markus D Schirmer

Abstract readPreprint
In one paragraph

Article in medRxiv : the preprint server for health sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Erik LindgrenJ. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.ORCID 0000-0002-7628-5044
Luca AngeleriJ. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Martin BretznerLille University, Inserm, CHU Lille, U1172-LilNCog-Lille Neuroscience & Cognition, France.ORCID 0000-0002-7594-4159
Anna K BonkhoffJ. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.ORCID 0000-0002-5927-1089
Christina JernDepartment of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg.ORCID 0000-0002-7531-2354
Arne G LindgrenDepartment of Neurology, Skåne University Hospital; Department of Clinical Sciences Lund, Neurology, Lund University, Lund, Sweden.ORCID 0000-0003-1942-7330
Jane MaguireUniversity of Technology Sydney, Sydney, Australia.ORCID 0000-0001-5722-8311
Robert W RegenhardtJ. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.ORCID 0000-0003-2958-3484
Natalia S RostJ. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.ORCID 0000-0002-7056-8561
Markus D SchirmerJ. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.ORCID 0000-0001-9561-0239

Funding

DISCOVERY - Statistics and Analysis CoreU19NS115388 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI Steven M Greenberg, Natalia S Rost · 2019 to 2026
$75.4M
Neuroscience Resident Research ProgramR25NS065743 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI CASH, SYDNEY S, WILLIAMS, ZIV · 2009 to 2023
$11.8M
ERIS - Effective Reserve In StrokeR21AG083559 · NIA · MASSACHUSETTS GENERAL HOSPITAL · PI SCHIRMER, MARKUS D · 2023 to 2023
$454k
NIA NIH HHS R21 AG083559NINDS NIH HHS R25 NS065743NINDS NIH HHS U19 NS115388
6 · The paper itself

Abstract

Objectives: To compare quantitative MRI markers of brain health in their ability to predict functional outcome after acute ischemic stroke (AIS). Methods: We included AIS survivors from the international MRI-GENIE study (multicenter; 2003-2011) with acute T2-FLAIR imaging. Automated pipelines estimated white matter hyperintensity volume (WMHv), brain volume, and intracranial volume (ICV). Assessed brain health markers included: brain parenchymal fraction (brain volume relative to ICV); radiomics derived brain age; brain reserve (normal appearing brain volume relative to ICV), and effective Reserve (eR, latent variable based on age, WMH load and brain volume). We added the markers to a clinical reference model, comparing model performances between separate multivariable regression models in their prediction of unfavorable outcome (90-day modified Rankin Scale score 3-5), using Bayesian Information Criterion (BIC). Results: We analyzed 2,223 patients (median age 67 years, 45% female, 24% unfavorable outcome). All models using brain health markers outperformed the clinical reference model (ΔBIC > 10). The eR model showed the lowest BIC value (BIC=2171.8), providing strong statistical evidence to outperform the brain age model (BIC=2179.5, ΔBIC > 6), and very strong (ΔBIC > 10) statistical evidence to outperform all other models. Discussion: Quantitative MRI markers of brain health, especially eR, enhance personalized outcome prognostication after AIS.

Indexed as

acute ischemic strokebrain healthimagingoutcomestroke

Identifiers

PMID40657323
PMCPMC12248142

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.