• Markus D Schirmer, Kathleen L Donahue, Marco J Nardin, Adrian V Dalca, Anne-Katrin Giese, Mark R Etherton, Steven J T Mocking, Elissa C McIntosh, John W Cole, Lukas Holmegaard, Katarina Jood, Jordi Jimenez-Conde, Steven J Kittner, Robin Lemmens, James F Meschia, Jonathan Rosand, Jaume Roquer, Tatjana Rundek, Ralph L Sacco, Reinhold Schmidt, Pankaj Sharma, Agnieszka Slowik, Tara M Stanne, Achala Vagal, Johan Wasselius, Daniel Woo, Stephen Bevan, Laura Heitsch, Chia-Ling Phuah, Daniel Strbian, Turgut Tatlisumak, Christopher R Levi, John Attia, Patrick F McArdle, Bradford B Worrall, Ona Wu, Christina Jern, Arne Lindgren, Jane Maguire, Vincent Thijs, Natalia S Rost, and MRI-GENIE and GISCOME Investigators and the International Stroke Genetics Consortium.
• Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts General Hospital, Boston; Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Boston; Department of Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany. Electronic address: mschirmer1@mgh.harvard.edu.
• Mayo Clin. Proc. 2020 May 1; 95 (5): 955-965.

ObjectiveTo determine whether brain volume is associated with functional outcome after acute ischemic stroke (AIS).Patients And MethodsThis study was conducted between July 1, 2014, and March 16, 2019. We analyzed cross-sectional data of the multisite, international hospital-based MRI-Genetics Interface Exploration study with clinical brain magnetic resonance imaging obtained on admission for index stroke and functional outcome assessment. Poststroke outcome was determined using the modified Rankin Scale score (0-6; 0 = asymptomatic; 6 = death) recorded between 60 and 190 days after stroke. Demographic characteristics and other clinical variables including acute stroke severity (measured as National Institutes of Health Stroke Scale score), vascular risk factors, and etiologic stroke subtypes (Causative Classification of Stroke system) were recorded during index admission.ResultsUtilizing the data from 912 patients with AIS (mean ± SD age, 65.3±14.5 years; male, 532 [58.3%]; history of smoking, 519 [56.9%]; hypertension, 595 [65.2%]) in a generalized linear model, brain volume (per 155.1 cm3) was associated with age (β -0.3 [per 14.4 years]), male sex (β 1.0), and prior stroke (β -0.2). In the multivariable outcome model, brain volume was an independent predictor of modified Rankin Scale score (β -0.233), with reduced odds of worse long-term functional outcomes (odds ratio, 0.8; 95% CI, 0.7-0.9) in those with larger brain volumes.ConclusionLarger brain volume quantified on clinical magnetic resonance imaging of patients with AIS at the time of stroke purports a protective mechanism. The role of brain volume as a prognostic, protective biomarker has the potential to forge new areas of research and advance current knowledge of the mechanisms of poststroke recovery.Copyright © 2020. Published by Elsevier Inc.

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