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Background: Stroke is a major cause of mortality and long-term disability worldwide. Whether the associations between brain imaging-derived phenotypes (IDPs) and stroke are causal is uncertain.
Methods: We performed two-sample bidirectional Mendelian randomization (MR) analyses to explore the causal associations between IDPs and stroke. Summary data of 587 brain IDPs (up to 33,224 individuals) from the UK Biobank and five stroke types (sample size range from 301,663 to 446,696, case number range from 5,386 to 40,585) from the MEGASTROKE consortium were used.
Results: Forward MR indicated 14 IDPs belong to projection fibers or association fibers were associated with stroke. For example, higher genetically determined mean diffusivity (MD) in the right external capsule was causally associated with an increased risk of small vessel stroke (IVW OR = 2.76, 95% CI 2.07 to 3.68, P = 5.87 × 10). Reverse MR indicated that genetically determined higher risk of any ischemic stroke was associated with increased isotropic or free water volume fraction (ISOVF) in body of corpus callosum (IVW β = 0.23, 95% CI 0.14 to 0.33, P = 3.22 × 10). This IDP is a commissural fiber and it is not included in the IDPs identified by forward MR.
Conclusions: We identified 14 IDPs with statistically significant evidence of causal effects on stroke or stroke subtypes. We also identified potential causal effects of stroke on one IDP of commissural fiber. These findings might guide further work toward identifying preventative strategies at the brain imaging levels.
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http://dx.doi.org/10.1186/s12916-023-02982-9 | DOI Listing |
Stroke
September 2025
Brain Language Laboratory, Freie Universität Berlin, Germany (A.-T.P.J., M.R.O., A.S., F.P.).
Background: Intensive language-action therapy treats language deficits and depressive symptoms in chronic poststroke aphasia, yet the underlying neural mechanisms remain underexplored. Long-range temporal correlations (LRTCs) in blood oxygenation level-dependent signals indicate persistence in brain activity patterns and may relate to learning and levels of depression. This observational study investigates blood oxygenation level-dependent LRTC changes alongside therapy-induced language and mood improvements in perisylvian and domain-general brain areas.
View Article and Find Full Text PDFStroke
September 2025
Department of Medicine, University of Melbourne, Parkville, Victoria, Australia. (V.Y., B.C.V.C., L.C., L.O., M.W.P.).
Background: To assess the efficacy and safety of tenecteplase in patients presenting within 24 hours of symptom onset with a large vessel occlusion and target mismatch on perfusion computed tomography.
Methods: ETERNAL-LVO was a prospective, randomized, open-label, blinded end point, phase 3, superiority trial where adult participants with a large vessel occlusion, presenting within 24 hours of onset with salvageable tissue on computed tomography perfusion, were randomized to tenecteplase 0.25 mg/kg or standard care across 11 primary and comprehensive stroke centers in Australia.
Stroke
September 2025
Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China (H.Z., K.H., Q.G.).
Background: Poststroke cognitive impairment (PSCI) affects 30% to 50% of stroke survivors, severely impacting functional outcomes and quality of life. This study uses functional near-infrared spectroscopy (fNIRS) to assess task-evoked brain activation and its potential for stratifying the severity in patients with PSCI.
Method: A cross-sectional study was conducted at Nanchong Central Hospital between June 2023 and April 2024.
Stroke
September 2025
Department of Neurology, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University.
Background: Risk stratification in posterior circulation ischemic stroke (PCIS) is challenging. Although the Posterior Circulation Ischemic Stroke Outcome Score (PCISOS) was developed to address this, its utility in minor PCIS and in identifying homogeneous populations for clinical trials or treatment-responsive subgroups remains uncertain.
Methods: CHANCE-2 (Clopidogrel in High-Risk Patients With Acute Non-disabling Cerebrovascular Events-II) was a multicenter, randomized trial that enrolled patients with minor stroke or high-risk transient ischemic attack who carried CYP2C19 loss-of-function alleles.
Stroke
September 2025
Division of Neonatology, Department of Pediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Center, the Netherlands. (B.O.v.O., M.R., M.S.S., E.L., L.S.d.V., S.J.S.).
Background: Monochorionic twins, characterized by placental sharing and vascular anastomoses, carry a high risk of brain injury, including perinatal arterial ischemic stroke (PAIS). However, the pathophysiology and timing-related risk factors of PAIS remain unclear.
Methods: Retrospective cohort of all monochorionic twins with neuroimaging-confirmed PAIS born from 2005 to 2024 and evaluated at a Dutch national referral center.