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

https://doi.org/10.1177/1747493020915251

Article information

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

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