Ischemic lesion volume correlates with long-term functional outcome and quality of life of middle cerebral artery stroke survivors.
OBJECTIVE
Previous studies investigating relationships between stroke lesion volume and outcome were restricted to short follow-up periods (3-6 months) and outcome measures of stroke severity and activities only, whereas functional improvement has been found to extend far beyond six months. Therefore, this study investigated relationships between infarct volume and a broad range of outcomes of stroke survivors at a long follow-up period.


METHODS
Correlations between lesion volumes (determined by conventional MRI scans in the second week post-stroke) and outcomes after one year of 75 first-ever ischemic stroke survivors were investigated.


RESULTS
Moderate Spearman Rank correlation coefficients were found between lesion volume and motor impairment (Motricity Index (MI): -0.43, p < 0.01; Fugl Meyer Motor Assessment Scale (FM): -0.43; p < 0.01). Correlation coefficients with activities of daily living were moderate but low associated with Barthel Index (r(s) = 0.30; p < 0.01), modified Rankin Scale (r(s) = 0.39; p < 0.01) and Frenchay Activities Index (r(s) = -0.35; p < 0.01). Lesion volume had a significant but low association (r(s) = 0.27; p = 0.02) with patient's health status measured with Sickness Impact Profile 68 (SIP68)) and a moderate correlation with well-being assessed with Life Satisfaction Questionnaire (LSQ; r(s) = -0.45; p < 0.01). Found correlation coefficients were slightly stronger after correction for mixed (cortical/subcortical) and purely subcortical lesion location.


CONCLUSIONS
It can be concluded that infarct volume moderately correlates with long-term motor impairment, functional outcome and quality of life of patients surviving stroke.
Schiemanck
S K
SK
Center of Excellence for Rehabilitation Medicine, Rehabilitation Center De Hoogstraat Utrecht, The Netherlands. Schiemanck@dehoogstraat.nl
Post
M W M
MW
Kwakkel
G
G
Witkamp
Th D
TD
Kappelle
L J
LJ
Prevo
A J H
AJ
D000203:Activities of Daily Living / Q000523:psychology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001810:Blood Volume / Q000502:physiology; D004185:Disability Evaluation; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000473:pathology / Q000503:physiopathology* / Q000523:psychology; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000473:pathology*; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011788:Quality of Life; D012189:Retrospective Studies; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D013534:Survival