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Temporal lobe atrophy as a potential predictor of functional outcome in older adults with acute ischemic stroke

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Abstract

Background

To explore whether temporal lobe atrophy predicts 3-month functional outcome in a population of patients with anterior circulation acute ischemic stroke (AIS) treated with mechanical thrombectomy (MT).

Methods

We retrospectively selected patients > 65 years from our prospective endovascular stroke registry between June 2013 and August 2018. According to 3-month modified Rankin Scale (mRS), patients were divided in two groups, named good (mRS ≤ 2) and poor (mRS > 2) outcome. Measures of temporal lobe atrophy (i.e., interuncal distance [IUD], medial temporal lobe thickness [mTLT] and radial width of temporal horn [rWTH]) were assessed on pre-treatment CT scan. Cutoff values for good outcome were obtained for IUD, mTLT and rWTH by means of non-parametric ROC curve analysis. Multivariate analysis was performed to identify predictors of outcome. Ordinal shift analysis based on cutoff values was built to evaluate differences in 3-month mRS.

Results

Among 340 patients, 130 (38.2%) had good and 210 (61.8%) had poor outcome. We found the following cutoff values for good outcome: < 25 mm for IUD, > 15 mm for mTLT and < 4 mm for rWTH. Lower IUD (OR 0.71; 95% CI 0.63–0.80; p < 0.0001) and rWTH (OR 0.73; 95% CI 0.61–0.87; p < 0.0001) and higher mTLT (OR 1.30; 95% CI 1.14–1.49; p < 0.0001) were independently associated with good outcome. Ordinal shift analysis based on cutoff values revealed significant differences in the rate of good outcome for rWTH (49 vs 27%; p < 0.0001), mTLT (52 vs 21%; p < 0.0001) and IUD (57 vs 17%; p < 0.0001).

Conclusions

Assessment of temporal lobe atrophy may predict functional outcome in patients with AIS treated with MT.

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Data availability

The data that support the findings of this study are available upon reasonable request from any qualified investigator.

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Authors and Affiliations

  1. Comprehensive Stroke Center, Department of Systems Medicine, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy

    Fabrizio Sallustio, Alfredo Paolo Mascolo, Federico Marrama, Federica D’Agostino, Fana Alemseged, Alessandro Martorana & Marina Diomedi

  2. Department of Clinical and Behavioural Neurology, Santa Lucia Foundation IRCCS, 0039, Rome, Italy

    Fabrizio Sallustio & Giacomo Koch

  3. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy

    Marco Proietti

  4. Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

    Marco Proietti

  5. Diagnostic Neuroradiology Unit, Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy

    Laura Greco, Francesca Di Giuliano & Roberto Gandini

  6. Department of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, Australia

    Fana Alemseged

  7. Department of Psychology, eCampus University, Novedrate, Italy

    Giacomo Koch

Authors
  1. Fabrizio Sallustio
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  2. Alfredo Paolo Mascolo
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  3. Federico Marrama
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  4. Federica D’Agostino
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  11. Marina Diomedi
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  12. Giacomo Koch
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Correspondence to Fabrizio Sallustio.

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Sallustio, F., Mascolo, A.P., Marrama, F. et al. Temporal lobe atrophy as a potential predictor of functional outcome in older adults with acute ischemic stroke. Acta Neurol Belg 123, 1291–1299 (2023). https://doi.org/10.1007/s13760-022-02167-w

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  • DOI: https://doi.org/10.1007/s13760-022-02167-w

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