PT  - JOURNAL ARTICLE
AU  - Rajashekar, Deepthi
AU  - Wilms, Matthias
AU  - MacDonald, M Ethan
AU  - Schimert, Serena
AU  - Hill, Michael D
AU  - Demchuk, Andrew
AU  - Goyal, Mayank
AU  - Dukelow, Sean P
AU  - Forkert, Nils Daniel
TI  - Lesion-symptom mapping with NIHSS sub-scores in ischemic stroke patients
AID  - 10.1136/svn-2021-001091
DP  - 2022 Apr 01
TA  - Stroke and Vascular Neurology
PG  - 124--131
VI  - 7
IP  - 2
4099  - http://svn.bmj.com/content/7/2/124.short
4100  - http://svn.bmj.com/content/7/2/124.full
SO  - Stroke Vasc Neurol2022 Apr 01; 7
AB  - Background Lesion-symptom mapping (LSM) is a statistical technique to investigate the population-specific relationship between structural integrity and post-stroke clinical outcome. In clinical practice, patients are commonly evaluated using the National Institutes of Health Stroke Scale (NIHSS), an 11-domain clinical score to quantitate neurological deficits due to stroke. So far, LSM studies have mostly used the total NIHSS score for analysis, which might not uncover subtle structure–function relationships associated with the specific sub-domains of the NIHSS evaluation. Thus, the aim of this work was to investigate the feasibility to perform LSM analyses with sub-score information to reveal category-specific structure–function relationships that a total score may not reveal.Methods Employing a multivariate technique, LSM analyses were conducted using a sample of 180 patients with NIHSS assessment at 48-hour post-stroke from the ESCAPE trial. The NIHSS domains were grouped into six categories using two schemes. LSM was conducted for each category of the two groupings and the total NIHSS score.Results Sub-score LSMs not only identify most of the brain regions that are identified as critical by the total NIHSS score but also reveal additional brain regions critical to each function category of the NIHSS assessment without requiring extensive, specialised assessments.Conclusion These findings show that widely available sub-scores of clinical outcome assessments can be used to investigate more specific structure–function relationships, which may improve predictive modelling of stroke outcomes in the context of modern clinical stroke assessments and neuroimaging.Trial registration number NCT01778335.All data relevant to the study are included in the article or uploaded as supplemental information. Not applicable.