Spatial Correlates of Dementia and Disability After Intracerebral Hemorrhage
Background Dementia and disability are highly prevalent after spontaneous intracerebral hemorrhage (ICH). Previous studies categorizing ICH by large anatomic boundaries have demonstrated that lobar ICH is associated with dementia, while ICH in the basal ganglia is associated with disability. This st...
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Wiley
2025-02-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.037930 |
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| author | Yutong Chen Cyprien A. Rivier Samantha A. Mora Victor Torres Lopez Sam Payabvash Kevin Sheth Andreas Harloff Guido J. Falcone Jonathan Rosand Ernst Mayerhofer Christopher D. Anderson |
| author_facet | Yutong Chen Cyprien A. Rivier Samantha A. Mora Victor Torres Lopez Sam Payabvash Kevin Sheth Andreas Harloff Guido J. Falcone Jonathan Rosand Ernst Mayerhofer Christopher D. Anderson |
| author_sort | Yutong Chen |
| collection | DOAJ |
| description | Background Dementia and disability are highly prevalent after spontaneous intracerebral hemorrhage (ICH). Previous studies categorizing ICH by large anatomic boundaries have demonstrated that lobar ICH is associated with dementia, while ICH in the basal ganglia is associated with disability. This study aims to refine our understanding of the association between ICH location and post‐ICH dementia and disability at a voxel level, which could improve the prognostic accuracy of these outcomes and provide mechanistic insights into post‐ICH functional outcomes. Methods and Results In this cohort study, we segmented the ICH lesions from the noncontrast computed tomography scans from 882 patients from the MGH‐ICH (Massachusetts General Hospital ICH Study) as the discovery data set and from 146 patients from the Yale‐ICH cohort as the validation data set. Using electronic health records and follow‐up telephone interviews, incident dementia (International Classification of Diseases, Ninth Revision [ICD‐9] codes of dementia or modified telephone interview for cognitive status <20) and disability (modified Rankin Scale score >2) were identified. The median follow‐up times of the MGH‐ICH and Yale‐ICH cohorts were 2.9 (interquartile range, 1.0–5.8) years and 1.0 (interquartile range, 0.6–1.0) years, respectively. Two techniques of lesion symptom mapping were applied on the ICH lesions: sparse canonical correlation analysis for neuroimaging and voxel‐based lesion symptom mappings. Dementia conversion after ICH was associated with ICH in the left temporo‐occipital region (mean hazard ratio [HR], 3.62 [95% CI, 2.71–4.63]) and left superior longitudinal fasciculus (mean HR, 2.91 [95% CI, 2.40–3.52]). Development of disability after ICH was linked to the right cerebral peduncle (mean HR, 3.10 [95% CI, 2.44–3.94]), right pallidum (mean HR, 2.96 [95% CI, 1.99–4.25]), and right posterior limb of the internal capsule (mean HR, 2.54 [95% CI, 1.88–3.96]). Conclusions Specific distribution of ICH lesions is linked to development of dementia and disability after ICH. These insights have the potential to enhance clinical prognostic models for patients with ICH, facilitating more precise predictions of outcomes based on hemorrhage location. |
| format | Article |
| id | doaj-art-efe8bb90c53948b3acded4af980c5b72 |
| institution | OA Journals |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Wiley |
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| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-efe8bb90c53948b3acded4af980c5b722025-08-20T02:16:45ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-02-0114410.1161/JAHA.124.037930Spatial Correlates of Dementia and Disability After Intracerebral HemorrhageYutong Chen0Cyprien A. Rivier1Samantha A. Mora2Victor Torres Lopez3Sam Payabvash4Kevin Sheth5Andreas Harloff6Guido J. Falcone7Jonathan Rosand8Ernst Mayerhofer9Christopher D. Anderson10Center for Genomic Medicine Massachusetts General Hospital Boston MA USADepartment of Neurology Yale School of Medicine New Haven CT USACenter for Genomic Medicine Massachusetts General Hospital Boston MA USADepartment of Neurology Yale School of Medicine New Haven CT USADepartment of Neurology Yale School of Medicine New Haven CT USADepartment of Neurology Yale School of Medicine New Haven CT USADepartment of Neurology and Neurophysiology, University Medical Center Freiburg, Faculty of Medicine University of Freiburg GermanyDepartment of Neurology Yale School of Medicine New Haven CT USACenter for Genomic Medicine Massachusetts General Hospital Boston MA USACenter for Genomic Medicine Massachusetts General Hospital Boston MA USACenter for Genomic Medicine Massachusetts General Hospital Boston MA USABackground Dementia and disability are highly prevalent after spontaneous intracerebral hemorrhage (ICH). Previous studies categorizing ICH by large anatomic boundaries have demonstrated that lobar ICH is associated with dementia, while ICH in the basal ganglia is associated with disability. This study aims to refine our understanding of the association between ICH location and post‐ICH dementia and disability at a voxel level, which could improve the prognostic accuracy of these outcomes and provide mechanistic insights into post‐ICH functional outcomes. Methods and Results In this cohort study, we segmented the ICH lesions from the noncontrast computed tomography scans from 882 patients from the MGH‐ICH (Massachusetts General Hospital ICH Study) as the discovery data set and from 146 patients from the Yale‐ICH cohort as the validation data set. Using electronic health records and follow‐up telephone interviews, incident dementia (International Classification of Diseases, Ninth Revision [ICD‐9] codes of dementia or modified telephone interview for cognitive status <20) and disability (modified Rankin Scale score >2) were identified. The median follow‐up times of the MGH‐ICH and Yale‐ICH cohorts were 2.9 (interquartile range, 1.0–5.8) years and 1.0 (interquartile range, 0.6–1.0) years, respectively. Two techniques of lesion symptom mapping were applied on the ICH lesions: sparse canonical correlation analysis for neuroimaging and voxel‐based lesion symptom mappings. Dementia conversion after ICH was associated with ICH in the left temporo‐occipital region (mean hazard ratio [HR], 3.62 [95% CI, 2.71–4.63]) and left superior longitudinal fasciculus (mean HR, 2.91 [95% CI, 2.40–3.52]). Development of disability after ICH was linked to the right cerebral peduncle (mean HR, 3.10 [95% CI, 2.44–3.94]), right pallidum (mean HR, 2.96 [95% CI, 1.99–4.25]), and right posterior limb of the internal capsule (mean HR, 2.54 [95% CI, 1.88–3.96]). Conclusions Specific distribution of ICH lesions is linked to development of dementia and disability after ICH. These insights have the potential to enhance clinical prognostic models for patients with ICH, facilitating more precise predictions of outcomes based on hemorrhage location.https://www.ahajournals.org/doi/10.1161/JAHA.124.037930dementiadisabilityintracerebral hemorrhagevoxel‐based lesion symptom mapping |
| spellingShingle | Yutong Chen Cyprien A. Rivier Samantha A. Mora Victor Torres Lopez Sam Payabvash Kevin Sheth Andreas Harloff Guido J. Falcone Jonathan Rosand Ernst Mayerhofer Christopher D. Anderson Spatial Correlates of Dementia and Disability After Intracerebral Hemorrhage Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease dementia disability intracerebral hemorrhage voxel‐based lesion symptom mapping |
| title | Spatial Correlates of Dementia and Disability After Intracerebral Hemorrhage |
| title_full | Spatial Correlates of Dementia and Disability After Intracerebral Hemorrhage |
| title_fullStr | Spatial Correlates of Dementia and Disability After Intracerebral Hemorrhage |
| title_full_unstemmed | Spatial Correlates of Dementia and Disability After Intracerebral Hemorrhage |
| title_short | Spatial Correlates of Dementia and Disability After Intracerebral Hemorrhage |
| title_sort | spatial correlates of dementia and disability after intracerebral hemorrhage |
| topic | dementia disability intracerebral hemorrhage voxel‐based lesion symptom mapping |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.037930 |
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