Hypoperfusion regions linked to National Institutes of Health Stroke Scale scores in acute stroke

IF 3.4 2区医学 Q2 NEUROIMAGING

Neuroimage-Clinical Pub Date : 2025-01-01 DOI:10.1016/j.nicl.2025.103761

Hana Kim , Alex Teghipco , Chris Rorden , Julius Fridriksson , Mathew Chaves , Argye E. Hillis

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引用次数: 0

Abstract

Background

The National Institutes of Health Stroke Scale (NIHSS) is widely used to assess stroke severity. While prior studies have identified subcortical regions where infarcts correlate with NIHSS scores, stroke symptoms can also arise from hypoperfusion, not just infarcts. Understanding the potential for neurological recovery post-reperfusion is essential for guiding treatment decisions. The goal of this study was to identify brain regions where hypoperfusion correlates with NIHSS scores, using computed tomography perfusion (CTP) scans in cases of acute ischemic stroke.

Methods

In this prospective observational study, we analyzed CTP scans and NIHSS scores from 89 patients in the acute phase. We employed a unique support vector regression approach to overcome limitations of traditional mass univariate analyses. Additionally, we used stability selection to identify the most consistent features across subsets, reducing overfitting and ensuring robust predictive models. We verified the consistency of results through nested cross-validation.

Results

Both cortical and subcortical areas, including white matter tracts, showed associations with NIHSS scores. These regions aligned with functions such as language, spatial attention, sensory, and motor skills, all assessed by the NIHSS.

Conclusions

Our findings reveal that hypoperfusion in specific brain regions, including previously underreported cortical areas, contributes to NIHSS scores in acute stroke. Moreover, this study introduces a novel brain mapping approach using CTP imaging and stability selection, offering a more comprehensive view of acute stroke impairments and the potential for recovery before structural reorganization occurs.

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来源期刊

Neuroimage-Clinical NEUROIMAGING-

CiteScore

7.50

自引率

4.80%

发文量

368

审稿时长

52 days

期刊介绍： NeuroImage: Clinical, a journal of diseases, disorders and syndromes involving the Nervous System, provides a vehicle for communicating important advances in the study of abnormal structure-function relationships of the human nervous system based on imaging. The focus of NeuroImage: Clinical is on defining changes to the brain associated with primary neurologic and psychiatric diseases and disorders of the nervous system as well as behavioral syndromes and developmental conditions. The main criterion for judging papers is the extent of scientific advancement in the understanding of the pathophysiologic mechanisms of diseases and disorders, in identification of functional models that link clinical signs and symptoms with brain function and in the creation of image based tools applicable to a broad range of clinical needs including diagnosis, monitoring and tracking of illness, predicting therapeutic response and development of new treatments. Papers dealing with structure and function in animal models will also be considered if they reveal mechanisms that can be readily translated to human conditions.