Neuroimaging markers of patient-reported outcome measures in acute ischemic stroke.

Objectives:To determine the relationship between patient-reported outcome measures (PROMs) and volumetric imaging markers in acute ischemic stroke (AIS). Patients and Methods:Patients presenting at Massachusetts General Hospital between February 14, 2017 and February 5, 2020 with a confirmed AIS by MRI were eligible and underwent a telephone interview including PROM-10 questionnaires 3-15 months after stroke. White matter hyperintensity (V WMH ) and brain volumes (V Brain ) were automatically determined using admission clinical MRI. Stroke lesions were manually segmented and volumes calculated (V Lesion ). Multivariable and ordinal regression analyses were performed to identify associations between global and PROM-10 subscores with brain volumetrics and clinical variables. Results:Utilizing data from 167 patients (mean age: 64.7; 41.9% female), higher V WMH was associated with worse global physical (β=-0.6), global mental (β=-0.65), physical health (OR=0.68), social satisfaction (OR=0.66), fatigue (OR=0.69) and social activities (OR=0.59) scores. Higher V Lesion was associated with poorer global mental (β=-0.79), mental health (OR=0.68), physical (OR=0.66) and social activities (OR=0.55), and emotional distress (OR=0.68) scores. Higher V Brain was linked to better global mental (β=0.93), global physical (β=0.79), mental health (OR=1.54) and physical activities (OR=1.72) scores. Conclusions:Neuroimaging biomarkers were significantly associated with PROMs, where higher V WMH and V Lesion led to worse outcome, while higher V Brain was protective. The inclusion of neuroimaging analyses and PROMs in routine assessment provides enhanced understanding of post-stroke outcomes.