RT Journal Article
SR Electronic
T1 Lesion-symptom mapping with NIHSS sub-scores in ischemic stroke patients
JF Stroke and Vascular Neurology
JO Stroke Vasc Neurol
FD BMJ Publishing Group Ltd
SP 124
OP 131
DO 10.1136/svn-2021-001091
VO 7
IS 2
A1 Rajashekar, Deepthi
A1 Wilms, Matthias
A1 MacDonald, M Ethan
A1 Schimert, Serena
A1 Hill, Michael D
A1 Demchuk, Andrew
A1 Goyal, Mayank
A1 Dukelow, Sean P
A1 Forkert, Nils Daniel
YR 2022
UL http://svn.bmj.com/content/7/2/124.abstract
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.