Publications by authors named "Bradford Worrall"
Background: Epilepsy is highly heritable, with numerous known genetic risk loci. However, the genetic predisposition's role in poststroke epilepsy (PSE) remains understudied. This study assesses whether a higher genetic predisposition to epilepsy raises poststroke survivor's risk of PSE.
View Article and Find Full Text PDFObjective: Although stroke incidence is decreasing in older ages, it is increasing in young adults. While these divergent trends in stroke incidence are at least partially attributable to diverging prevalence trends in stoke risk factors, age-dependent differences in the impact of stroke risk factors on stroke may also contribute. To address this issue, we utilized Mendelian Randomization (MR) to assess differences in the association of stroke risk factors between early onset ischemic stroke (EOS) and late onset ischemic stroke (LOS).
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- Gene-gene interactions are believed to play a significant role in the development of multifactorial diseases like cerebral venous thrombosis (CVT), highlighting potential causes of unexplained heritability.
- A study involving 882 CVT patients and 1,205 control participants found that specific gene variants significantly increased the likelihood of developing CVT, particularly when individuals had certain blood types.
- The research concluded that the interactions between specific genes could raise the risk of CVT by as much as 14 times, underscoring the importance of understanding these genetic factors in disease etiology.
Article Synopsis
- - A study analyzed data from the Get With The Guidelines-Stroke registry to identify methods for predicting large vessel occlusion (LVO) strokes without neuroimaging, focusing on adult patients diagnosed with ischemic stroke between 2016 and 2021.
- - Out of 416,022 patients, 30.1% had LVO, with a moderate predictive accuracy (AUC of 0.79) using clinical factors and the NIH Stroke Scale, indicating that current methods only slightly predict LVO status.
- - The findings highlight a challenge in predicting LVO accurately without vascular imaging, as the predictive models, even when including various risk factors, showed limitations and moderate success rates.
Article Synopsis
- - The study investigates how age, sex, and imaging features relate to coma in patients with cerebral venous thrombosis (CVT), using data from a large international study.
- - Among 596 adult CVT patients, 8.9% experienced coma, with a higher prevalence in men (13.1%) compared to women (7.5%), despite CVT being more common in women.
- - Findings suggest that male sex and older age are significant factors linked to coma in CVT cases, highlighting a complex interplay between gender and clinical outcomes.
Article Synopsis
- - Stroke genetic research has advanced, but recovery applications lag due to the limitations of the modified Rankin Scale (mRS), which doesn’t accurately reflect biological processes following a stroke.
- - The study involved 1,270 participants, assessing changes in cognition and motor skills over two years, which showed significant improvements in cognitive and motor deficits from 20% and 70% to 7.2% and 30%, respectively.
- - Genome-Wide Association Studies (GWAS) uncovered new gene associations linked to cognitive, motor, and global impairments, suggesting that focusing on specific stroke recovery traits can enhance our understanding of genetic influences on recovery.
Background And Objectives: Evidence of the so-called "obesity paradox," which refers to the protective effect and survival benefit of obesity in patients with spontaneous intracerebral hemorrhage (ICH), remains controversial. This study aims to determine the association between body mass index (BMI) and functional outcomes in patients with ICH and whether it is modified by race/ethnicity.
Methods: Included individuals were derived from the Ethnic/Racial Variations of Intracerebral Hemorrhage study, which prospectively recruited 1,000 non-Hispanic White, 1,000 non-Hispanic Black, and 1,000 Hispanic patients with spontaneous ICH.
Background And Objectives: Despite notable advances in genetic understanding of stroke recovery, most studies focus only on candidate genes. To date, only 2 genome-wide association studies (GWAS) have focused on stroke outcomes, but they were limited to the modified Rankin Scale (mRS). The mRS maps poorly to biological processes.
View Article and Find Full Text PDFBackground And Aims: Epilepsy is highly heritable, with numerous known genetic risk loci. However, the genetic predisposition's role in post-acute brain injury epilepsy remains understudied. This study assesses whether a higher genetic predisposition to epilepsy raises post-stroke or Transient Ischemic Attack (TIA) survivor's risk of Post-Stroke Epilepsy (PSE).
View Article and Find Full Text PDFObjective: Genome-wide association studies have identified 1q22 as a susceptibility locus for cerebral small vessel diseases, including non-lobar intracerebral hemorrhage (ICH) and lacunar stroke. In the present study, we performed targeted high-depth sequencing of 1q22 in ICH cases and controls to further characterize this locus and prioritize potential causal mechanisms, which remain unknown.
Methods: A total of 95,000 base pairs spanning 1q22, including SEMA4A, SLC25A44, and PMF1/PMF1-BGLAP were sequenced in 1,055 spontaneous ICH cases (534 lobar and 521 non-lobar) and 1,078 controls.
Article Synopsis
- The study investigates how vascular risk factors like blood pressure, diabetes, and body mass index relate to the risk and recurrence of cervical artery dissections (CeADs), a major cause of stroke in young people.
- Using genetic analysis, it found that higher systolic and diastolic blood pressure significantly increases the risk of CeAD, while higher body mass index showed unclear effects.
- The research suggests that β-blockers could lower the risk of CeAD, which could help shape prevention strategies and clinical trials related to this condition.
Background Non-Hispanic Black adults have a higher proportion of vascular cognitive impairment and Alzheimer's disease and related dementias compared with non-Hispanic White adults that may be due to differences in the burden of cerebral small vessel disease and risk alleles for Alzheimer's disease and related dementias. We describe here the methods of an ancillary study to the REGARDS (Reason for Geographic and and Racial Difference in Stroke) study, which will examine the role of magnetic resonance imaging markers of cerebral small vessel disease and vascular as well as genetic risk factors for Alzheimer's disease and related dementias in racial disparity in the prevalence and trajectory of vascular cognitive impairment and dementia in non-Hispanic White and non-Hispanic Black participants. Methods In participants with no prior history of stroke who had an incident stroke or transient ischemic attack after enrollment in the study, magnetic resonance imaging scans will be evaluated using the Standards for Reporting Vascular Changes on Neuroimaging international consensus criteria and automated analysis pipelines for quantification of cerebral small vessel disease.
View Article and Find Full Text PDFLacunar infarcts and vascular dementia are important phenotypic characteristics of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy, the most common inherited cerebral small vessel disease. Individuals with the disease show variability in the nature and onset of symptoms and rates of progression, which are only partially explained by differences in pathogenic mutations in the gene. Recognizing the disease early in its course and securing a molecular diagnosis are important clinical goals, despite the lack of proven disease-modifying treatments.
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- CADASIL is a genetic condition affecting blood vessels in the brain, leading to varying symptoms, and this study aims to validate a new grading system for it across multiple medical centers in the U.S.
- Researchers analyzed medical records from patients with confirmed CADASIL, categorizing them into five severity grades based on symptoms like migraines, stroke, and dementia.
- The study found a good agreement in grading among different raters and noted that patients with less severe grades were generally younger and had fewer vascular risk factors compared to those with higher severity grades.
Objective: Genome-wide association studies have identified as a susceptibility locus for cerebral small vessel diseases (CSVDs), including non-lobar intracerebral hemorrhage (ICH) and lacunar stroke. In the present study we performed targeted high-depth sequencing of in ICH cases and controls to further characterize this locus and prioritize potential causal mechanisms, which remain unknown.
Methods: 95,000 base pairs spanning , including and / were sequenced in 1,055 spontaneous ICH cases (534 lobar and 521 non-lobar) and 1,078 controls.
GE Healthcare announced on April 19, 2022, that their main factory and distributor of iodinated contrast had experienced a temporary shutdown because of COVID-19 outbreak in Shanghai, China. This, along with other supply chain issues, led to a worldwide shortage of iodinated contrast agents, Omnipaque and Visipaque. Our Comprehensive Stroke Center was confronted with the cascading effect of this iodinated contrast material shortage.
View Article and Find Full Text PDFBackground: In this genome wide association study (GWAS) we aimed to discover single nucleotide polymorphisms (SNPs) associated with motor recovery post-stroke.
Methods: We used the Vitamin Intervention for Stroke Prevention (VISP) dataset of 2,100 genotyped patients with non-disabling stroke. Of these, 488 patients had motor impairment at enrollment.
Background: Studies from early in the COVID-19 pandemic showed that patients with ischemic stroke and concurrent SARS-CoV-2 infection had increased stroke severity. We aimed to test the hypothesis that this association persisted throughout the first year of the pandemic and that a similar increase in stroke severity was present in patients with hemorrhagic stroke.
Methods: Using the National Institute of Health National COVID Cohort Collaborative (N3C) database, we identified a cohort of patients with stroke hospitalized in the United States between March 1, 2020 and February 28, 2021.
Article Synopsis
- The study examines the relationship between neuroimaging-derived brain age estimates and post-stroke outcomes, hypothesizing that older brain age correlates with cardiovascular risk factors and poorer recovery.
- T2-FLAIR images from over 4,000 stroke patients were analyzed to derive a Relative Brain Age (RBA), which indicates how aged a patient's brain appears compared to their chronological age.
- The findings showed that higher RBA was linked to a history of conditions like hypertension and diabetes, and significantly affected functional outcomes after stroke, especially in patients with minor strokes.
This study aimed to investigate the influence of stroke lesions in predefined highly interconnected (rich-club) brain regions on functional outcome post-stroke, determine their spatial specificity and explore the effects of biological sex on their relevance. We analyzed MRI data recorded at index stroke and ~3-months modified Rankin Scale (mRS) data from patients with acute ischemic stroke enrolled in the multisite MRI-GENIE study. Spatially normalized structural stroke lesions were parcellated into 108 atlas-defined bilateral (sub)cortical brain regions.
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