Deans' stroke musings: Structural integrity of white matter tracts as a predictor of acute ischemic stroke outcome

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, July 21, 2020

Structural integrity of white matter tracts as a predictor of acute ischemic stroke outcome

In what fucking universe do you live in where survivors care one whit about predictions that predict they won't recover because THERE ARE ZERO REHAB PROTOCOLS? Do the research that fixes those problems of structural integrity of white matter tracts. I would fire anyone involved in any sort of stroke recovery prediction. Predictions are useless. Hell, I can predict that 90% of stroke survivors won't fully recover. Is that of any use to anybody? Leaders fix problems, they don't predict failure and wash their hands of the problem. Are you a leader or a mouse?

Structural integrity of white matter tracts as a predictor of acute ischemic stroke outcome

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Deepthi Rajashekar

, Pauline Mouchès, Jens Fiehler, ...

First Published March 31, 2020 Research Article

Abstract

Background and purpose

Clinical assessment scores in acute ischemic stroke are only moderately correlated with lesion volume since lesion location is an important confounding factor. Many studies have investigated gray matter indicators of stroke severity, but the understanding of white matter tract involvement is limited in the early phase after stroke. This study aimed to measure and model the involvement of white matter tracts with respect to 24-h post-stroke National Institutes of Health Stroke Scale (NIHSS).

Material and methods

A total of 96 patients (50 females, mean age 66.4 ± 14.0 years, median NIHSS 5, interquartile range: 2–9.5) with follow-up fluid-attenuated inversion recovery magnetic resonance imaging data sets acquired one to seven days after acute ischemic stroke onset due to proximal anterior circulation occlusion were included. Lesions were semi-automatically segmented and non-linearly registered to a common reference atlas. The lesion overlap and tract integrity were determined for each white matter tract in the AALCAT atlas and used to model NIHSS outcomes using a supervised linear-kernel support vector regression method, which was evaluated using leave-one-patient-out cross validation.

Results

The support vector regression model using the tract integrity and tract lesion overlap measurements predicted the 24-h NIHSS score with a high correlation value of r = 0.7. Using the tract overlap and tract integrity feature improved the modeling accuracy of NIHSS significantly by 6% (p < 0.05) compared to using overlap measures only.

Conclusion

White matter tract integrity and lesion load are important predictors for clinical outcome(WHAT SURVIVOR CARES ABOUT YOUR PREDICTION OF POOR CLINICAL OUTCOME? Have you ever talked to a survivor?) after an acute ischemic stroke as measured by the NIHSS and should be integrated for predictive modeling.

Keywords Acute ischemic stroke, computer-assisted image analysis, distance mapping transform, white matter, support vector machines