Development of a stroke risk score with MRI asymptomatic brain lesions attributes to evaluate prognostic vascular events

Kenichi Iwasa; Keiichi Onoda; Masahiro Takamura; Hiroyuki Takayoshi; Shingo Mitaki; Shuhei Yamaguchi; Atsushi Nagai

doi:10.1016/j.jns.2023.120642

Development of a stroke risk score with MRI asymptomatic brain lesions attributes to evaluate prognostic vascular events

J Neurol Sci. 2023 May 15:448:120642. doi: 10.1016/j.jns.2023.120642. Epub 2023 Apr 3.

Authors

Kenichi Iwasa¹, Keiichi Onoda², Masahiro Takamura³, Hiroyuki Takayoshi⁴, Shingo Mitaki³, Shuhei Yamaguchi⁴, Atsushi Nagai³

Affiliations

¹ Department of Neurology, Faculty of Medicine, Shimane University, Japan. Electronic address: ken1wasa@med.shimane-u.ac.jp.
² Department of Psychology, Faculty of Psychology, Otemon Gakuin University, Japan.
³ Department of Neurology, Faculty of Medicine, Shimane University, Japan.
⁴ Department of Neurology, Shimane Prefectural Central Hospital, Japan.

PMID: 37030186
DOI: 10.1016/j.jns.2023.120642

Abstract

Background: The use of a combination of stroke predictors, such as clinical factors and asymptomatic lesions on brain magnetic resonance imaging (MRI), may improve the accuracy of stroke risk prediction. Therefore, we attempted to develop a stroke risk score for healthy individuals.

Methods: We investigated the presence of cerebral stroke in 2365 healthy individuals who underwent brain dock screening at the Health Science Center in Shimane. We examined the factors that contributed to stroke and attempted to determine the risk of stroke by comparing background factors and MRI findings.

Results: The following items were found to be significant risk factors for stroke: age (≥60 years), hypertension, subclinical cerebral infarction, deep white matter lesion, and microbleeds. Each item was scored with 1 point, and the hazard ratios for the risk of developing stroke based on the group with 0 points were 17.2 (95% confidence interval [CI] 2.31-128) for 3 points, 18.1 (95% CI 2.03-162) for 4 points, and 102 (95% CI 12.6-836) for 5 points.

Conclusions: A precise stroke prediction score biomarker can be obtained by combining MRI findings and clinical factors.

Keywords: Hypertension; Ischemia; MRI; Microangiopathy; Prediction; Stroke.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Brain / diagnostic imaging
Brain / pathology
Brain Ischemia* / pathology
Humans
Magnetic Resonance Imaging
Middle Aged
Prognosis
Risk Factors
Stroke* / diagnostic imaging
Stroke* / etiology
Stroke* / pathology