Distinct spatiotemporal patterns of white matter hyperintensity progression.

White matter hyperintensity, a key imaging biomarker for brain health, has prognostic implications for stroke. Using a multicenter MRI dataset of 9179 stroke patients plus the UK Biobank (n = 36,210 low/high risk controls), we employ Subtype and Stage Inference modeling and identify three distinct white matter hyperintensity progression subtypes: fronto-parietal, radial, and temporo-occipital. Longitudinal validation confirms classification stability. The fronto-parietal subtype shows delayed onset and more hypertension, while the temporo-occipital subtype has more atrial fibrillation and coronary heart disease. The fronto-parietal and radial subtypes are linked to small vessel stroke, while the temporo-occipital subtype is linked to cardioembolism. The fronto-parietal subtype has higher 1-year ischemic stroke recurrence, while the temporo-occipital subtype shows a higher incidence of early neurological deterioration by symptomatic hemorrhagic transformation and worse 3-month outcomes. Beyond capturing progression, demographics, and vascular risks, and improving post-stroke outcome prediction, this subtyping-staging model also holds potential for stroke prediction.
Cardiovascular diseases
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Chung Chung, Park Park, Ryu Ryu, Schellingerhout Schellingerhout, Kim Kim, Gwak Gwak, Haddad Haddad, Jahanshad Jahanshad, Kim Kim, Hong Hong, Oh Oh, Jeong Jeong, Kim Kim, Park Park, Choi Choi, Lee Lee, Park Park, Park Park, Park Park, Kang Kang, Yu Yu, Oh Oh, Lee Lee, Kim Kim, Cha Cha, Kim Kim, Lee Lee, Han Han, Cho Cho, Lee Lee, Bath Bath, Wardlaw Wardlaw, Bae Bae, Kim Kim, Kim Kim
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