@article {679136,
	title = {Sex-specific differences in white matter microvascular integrity after ischaemic stroke},
	journal = {Stroke Vasc Neurol},
	volume = {4},
	number = {4},
	year = {2019},
	month = {2019 Dec},
	pages = {198-205},
	abstract = {Background and purpose: Functional outcomes after ischaemic stroke are worse in women, despite adjusting for differences in comorbidities and treatment approaches. White matter microvascular integrity represents one risk factor for poor long-term functional outcomes after ischaemic stroke. The aim of the study is to characterise sex-specific differences in microvascular integrity in individuals with acute ischaemic stroke.

Methods: A retrospective analysis of subjects with acute ischaemic stroke and brain MRI with diffusion-weighted (DWI) and dynamic-susceptibility contrast-enhanced (DSC) perfusion-weighted imaging obtained within 9 hours of last known well was performed. In the hemisphere contralateral to the acute infarct, normal-appearing white matter (NAWM) microvascular integrity was measured using the K 2 coefficient and apparent diffusion coefficient (ADC) values. Regression analyses for predictors of K 2 coefficient, DWI volume and good outcome (90-day modified Rankin scale (mRS) score \<2) were performed.

Results: 105 men and 79 women met inclusion criteria for analysis. Despite no difference in age, women had increased NAWM K 2 coefficient (1027.4 vs 692.7{\texttimes}10-6/s; p=0.006). In women, atrial fibrillation (β=583.6; p=0.04) and increasing NAWM ADC (β=4.4; p=0.02) were associated with increased NAWM K 2 coefficient. In multivariable regression analysis, the K 2 coefficient was an independent predictor of DWI volume in women (β=0.007; p=0.01) but not men.

Conclusions: In women with acute ischaemic stroke, increased NAWM K 2 coefficient is associated with increased infarct volume and chronic white matter structural integrity. Prospective studies investigating sex-specific differences in white matter microvascular integrity are needed.},
	keywords = {Aged, Aged, 80 and over, Cerebrovascular Circulation, Diffusion Magnetic Resonance Imaging, Female, Humans, Ischemic Stroke, Male, Microcirculation, Microvessels, Middle Aged, Perfusion Imaging, Predictive Value of Tests, Prognosis, Retrospective Studies, Risk Assessment, Risk Factors, Sex Factors, White Matter},
	issn = {2059-8696},
	doi = {10.1136/svn-2019-000268},
	author = {Etherton, Mark R and Wu, Ona and Cougo, Pedro and Lorenzano, Svetlana and Li, Hua and Cloonan, Lisa and Bouts, Mark J R J and Arne Lauer and Arai, Ken and Lo, Eng H and Feske, Steve K and Furie, Karen L and Rost, Natalia S}
}