Neurosurgical Artificial Intelligence Laboratory Aachen (NAILA), RWTH Aachen University Hospital, Aachen, Germany.
Department of Neurosurgery, Faculty of Medicine, RWTH Aachen University, Aachen, Germany.
Commun Biol. 2023 Mar 31;6(1):354. doi: 10.1038/s42003-023-04733-1.
Ischemic cerebrovascular events often lead to aphasia. Previous work provided hints that such strokes may affect women and men in distinct ways. Women tend to suffer strokes with more disabling language impairment, even if the lesion size is comparable to men. In 1401 patients, we isolate data-led representations of anatomical lesion patterns and hand-tailor a Bayesian analytical solution to carefully model the degree of sex divergence in predicting language outcomes ~3 months after stroke. We locate lesion-outcome effects in the left-dominant language network that highlight the ventral pathway as a core lesion focus across different tests of language performance. We provide detailed evidence for sex-specific brain-behavior associations in the domain-general networks associated with cortico-subcortical pathways, with unique contributions of the fornix in women and cingular fiber bundles in men. Our collective findings suggest diverging white matter substrates in how stroke causes language deficits in women and men. Clinically acknowledging such sex disparities has the potential to improve personalized treatment for stroke patients worldwide.
缺血性脑血管事件常导致失语症。之前的研究提示，此类中风可能以不同的方式影响女性和男性。即使病变大小与男性相当，女性中风后语言障碍往往更严重。在 1401 名患者中，我们提取了基于数据的解剖病变模式，并精心设计了贝叶斯分析解决方案，以仔细模拟性别差异对中风后 3 个月语言预后的预测程度。我们定位到左优势语言网络中的病变-预后效应，该网络突出了腹侧通路，作为不同语言表现测试的核心病变焦点。我们提供了详细的证据，证明与皮质下通路相关的大脑-行为之间存在特定于性别的关联，穹窿在女性中，扣带纤维束在男性中具有独特的贡献。我们的综合研究结果表明，中风导致女性和男性语言缺陷的白质基础存在差异。临床上承认这些性别差异有可能改善全球中风患者的个体化治疗。
