2024
Brain Health Outcomes in Sexual and Gender Minority Groups: Results From the All of Us Research Program.
Huo S, Rivier C, Clocchiatti-Tuozzo S, Renedo D, Sunmonu N, de Havenon A, Sarpong D, Rosendale N, Sheth K, Falcone G. Brain Health Outcomes in Sexual and Gender Minority Groups: Results From the All of Us Research Program. Neurology 2024, 103: e209863. PMID: 39321407, DOI: 10.1212/wnl.0000000000209863.Peer-Reviewed Original ResearchConceptsBrain health outcomesSexual minoritiesGender minoritiesSGM groupHealth outcomesSGM personsLate-life depressionGender identitySexual orientationHigher odds of dementiaUS population-based studyElectronic health record dataOdds of dementiaHealth record dataGender minority groupsPopulation-based studyOdds of strokeCross-sectional studyMultivariate logistic regressionHealth disparitiesBaseline questionnaireNon-SGMSubgroups of genderTransgender womenUS adultsAutomated detection of early signs of irreversible ischemic change on CTA source images in patients with large vessel occlusion
Mak A, Matouk C, Avery E, Behland J, Haider S, Frey D, Madai V, Vajkoczy P, Griessenauer C, Zand R, Hendrix P, Abedi V, Sanelli P, Falcone G, Petersen N, Sansing L, Sheth K, Payabvash S, Malhotra A. Automated detection of early signs of irreversible ischemic change on CTA source images in patients with large vessel occlusion. PLOS ONE 2024, 19: e0304962. PMID: 38870240, PMCID: PMC11175522, DOI: 10.1371/journal.pone.0304962.Peer-Reviewed Original ResearchConceptsDiffusion-weighted imagingLarge vessel occlusionIrreversible ischemic changesPoor functional outcomeFunctional outcomesIschemic changesInfarct volumeAlberta Stroke Program Early CT ScorePredicting poor functional outcomeVessel occlusionFollow-up diffusion-weighted imagingAnterior circulation LVO strokeCTA source imagesReceiver operating characteristic curveExpert human readersPredicting final infarctionASPECTS regionsAdmission CTANon-inferior performanceBaseline CTACT scoreFinal infarctEndovascular therapyHU attenuationValidation cohortSecondary Prevention in Patients With Stroke Versus Myocardial Infarction: Analysis of 2 National Cohorts
Rivier C, Acosta J, Leasure A, Forman R, Sharma R, de Havenon A, Spatz E, Inzucchi S, Kernan W, Falcone G, Sheth K. Secondary Prevention in Patients With Stroke Versus Myocardial Infarction: Analysis of 2 National Cohorts. Journal Of The American Heart Association 2024, 13: e033322. PMID: 38639369, PMCID: PMC11179946, DOI: 10.1161/jaha.123.033322.Peer-Reviewed Original ResearchMeSH KeywordsAgedAntihypertensive AgentsBlood PressureCross-Sectional StudiesFemaleHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMiddle AgedMyocardial InfarctionPlatelet Aggregation InhibitorsPractice Guidelines as TopicRisk AssessmentRisk FactorsSecondary PreventionStrokeUnited KingdomUnited StatesConceptsMyocardial infarctionPrevention scoreSecondary preventionImplementation of preventive therapyNational cohortUK BiobankAntiplatelet therapy useGuideline-directed therapyPrevention profilesBlood pressure controlAdherence to guideline-directed therapyLow-density lipoprotein controlNeighborhood deprivation levelHistory of strokeVascular risk profileStatin useAntiplatelet useTherapy usePreventive therapyComparison to participantsPrevention criteriaCross-sectional analysisBlood pressurePatientsPressure controlAssociation Between Hematoma Volume and Risk of Subsequent Ischemic Stroke: A MISTIE III and ATACH-2 Analysis
Harris W, Kaiser J, Liao V, Avadhani R, Iadecola C, Falcone G, Sheth K, Qureshi A, Goldstein J, Awad I, Hanley D, Kamel H, Ziai W, Murthy S. Association Between Hematoma Volume and Risk of Subsequent Ischemic Stroke: A MISTIE III and ATACH-2 Analysis. Stroke 2024, 55: 541-547. PMID: 38299346, PMCID: PMC10932908, DOI: 10.1161/strokeaha.123.045859.Peer-Reviewed Original ResearchConceptsIntracerebral hemorrhage volumeMedian ICH volumeRisk of ischemic strokeHematoma volumeIntracerebral hemorrhageIncreased risk of ischemic strokeATACH-2ICH volumeIschemic strokeCumulative incidenceMISTIE IIIIncreased riskLong-term increased riskIntracerebral hemorrhage characteristicsMedian hematoma volumeHeterogeneous cohort of patientsMedian follow-upPrimary analysisIntracerebral hemorrhage locationCohort of patientsNontraumatic intracerebral hemorrhageCox regression analysisShort-term risk of ischemic strokeCox regression modelsIndividual patient dataCOVID‐19 Infection Is Associated With Poor Outcomes in Patients With Intracerebral Hemorrhage
Renedo D, Leasure A, Young R, Rivier C, Alhanti B, Mac Grory B, Messe S, Reeves M, Hassan A, Schwamm L, de Havenon A, Matouk C, Sheth K, Falcone G. COVID‐19 Infection Is Associated With Poor Outcomes in Patients With Intracerebral Hemorrhage. Journal Of The American Heart Association 2024, 13: e030999. PMID: 38293940, PMCID: PMC11056169, DOI: 10.1161/jaha.123.030999.Peer-Reviewed Original ResearchConceptsOdds of poor outcomeIntracerebral hemorrhageCOVID-19 infectionPoor outcomeHealth care deliverySkilled nursing facilityMultivariate analysisOdds of mortalityConcomitant COVID-19 infectionAssociated with poor outcomesCare deliveryNursing facilitiesPoor functional outcomeCOVID-19OddsICH outcomeImpact of COVID-19No significant differenceObservational studyHemorrhagic strokeWorsen outcomesPatient populationFunctional outcomesStroke dataPatients
2023
Suboptimal Sleep Duration Is Associated With Poorer Neuroimaging Brain Health Profiles in Middle‐Aged Individuals Without Stroke or Dementia
Clocchiatti‐Tuozzo S, Rivier C, Renedo D, Lopez V, Geer J, Miner B, Yaggi H, de Havenon A, Payabvash S, Sheth K, Gill T, Falcone G. Suboptimal Sleep Duration Is Associated With Poorer Neuroimaging Brain Health Profiles in Middle‐Aged Individuals Without Stroke or Dementia. Journal Of The American Heart Association 2023, 13: e031514. PMID: 38156552, PMCID: PMC10863828, DOI: 10.1161/jaha.123.031514.Peer-Reviewed Original ResearchConceptsSuboptimal sleep durationWhite matter hyperintensitiesMiddle-aged individualsLong sleep durationLarger WMH volumeSleep durationMiddle-aged adultsHealth profileWMH volumeAmerican Heart Association's LifeAsymptomatic middle-aged adultsWMH presenceVolume of WMHOptimal sleepSelf-reported sleep durationModifiable risk factorsWhite matter tractsProspective magnetic resonanceSimple 7Cardiovascular healthRisk factorsShort sleepMatter hyperintensitiesHigh riskEarly interventionAssociation of Poor Oral Health With Neuroimaging Markers of White Matter Injury in Middle-Aged Participants in the UK Biobank.
Rivier C, Renedo D, de Havenon A, Sunmonu N, Gill T, Payabvash S, Sheth K, Falcone G. Association of Poor Oral Health With Neuroimaging Markers of White Matter Injury in Middle-Aged Participants in the UK Biobank. Neurology 2023, 102: e208010. PMID: 38165331, PMCID: PMC10870735, DOI: 10.1212/wnl.0000000000208010.Peer-Reviewed Original ResearchConceptsPoor oral healthOral healthBrain healthRisk factorsNeuroimaging markerWMH volumeHealth profileMD scoreSelf-reported poor oral healthCross-sectional neuroimaging studiesFractional anisotropyWhite matter hyperintensity volumeModifiable risk factorsWhite matter injuryPresence of denturesMendelian randomizationMiddle-aged personsFA scoreMiddle-aged participantsLoose teethCardiovascular diseaseHyperintensity volumeBrain MRIModifiable processEarly interventionImprovement in the Prediction of Cerebrovascular Events With White Matter Hyperintensity
de Havenon A, Smith E, Sharma R, Falcone G, Bangad A, Prabhakaran S, Sheth K. Improvement in the Prediction of Cerebrovascular Events With White Matter Hyperintensity. Journal Of The American Heart Association 2023, 12: e029374. PMID: 37345754, PMCID: PMC10356061, DOI: 10.1161/jaha.123.029374.Peer-Reviewed Original ResearchConceptsWhite matter hyperintensitiesIncident strokePrimary outcomeHypertensive individualsMatter hyperintensitiesAtherosclerotic cardiovascular disease risk scoreCognitive impairmentCardiovascular disease risk scoreVascular risk factorsCurrent cigarette smokingDisease risk scoreMagnetic resonance imagingLogistic regression modelsRandomization armCerebrovascular eventsVascular riskCigarette smokingPrognostic informationRisk factorsPrognostic abilityRisk scoreCognitive declineResonance imagingDeLong testStrokePolygenic Susceptibility to Hypertension and Cognitive Performance in Middle-aged Persons Without Stroke or Dementia
Rivier C, Szejko N, Renedo D, Noche R, Acosta J, Both C, Sharma R, Torres-Lopez V, Payabvash S, de Havenon A, Sheth K, Gill T, Falcone G. Polygenic Susceptibility to Hypertension and Cognitive Performance in Middle-aged Persons Without Stroke or Dementia. Neurology 2023, 101: e512-e521. PMID: 37295956, PMCID: PMC10401683, DOI: 10.1212/wnl.0000000000207427.Peer-Reviewed Original ResearchHigher Hospital Frailty Risk Score Is Associated With Increased Risk of Stroke: Observational and Genetic Analyses
Renedo D, Acosta J, Koo A, Rivier C, Sujijantarat N, de Havenon A, Sharma R, Gill T, Sheth K, Falcone G, Matouk C. Higher Hospital Frailty Risk Score Is Associated With Increased Risk of Stroke: Observational and Genetic Analyses. Stroke 2023, 54: 1538-1547. PMID: 37216451, PMCID: PMC10212531, DOI: 10.1161/strokeaha.122.041891.Peer-Reviewed Original ResearchConceptsHospital Frailty Risk ScoreRisk of strokeHighest Hospital Frailty Risk ScoresDate of consentFrailty Risk ScoreMendelian randomization analysisStroke riskRisk scoreRandomization analysisTime of enrollmentAvailable electronic health recordsMendelian randomizationElectronic health recordsLook-back periodIncident strokeDose-response wayFrailty statusHemorrhagic strokeMultivariable analysisStroke eventsObservational studyHigh riskFrailtySignificant associationSimilar associationImpact of genetic polymorphisms on the risk of epilepsy amongst patients with acute brain injury: A systematic review
Misra S, Quinn T, Falcone G, Sharma V, de Havenon A, Zhao Y, Eldem E, French J, Yasuda C, Dawson J, Liebeskind D, Kwan P, Mishra N. Impact of genetic polymorphisms on the risk of epilepsy amongst patients with acute brain injury: A systematic review. European Journal Of Neurology 2023, 30: 1791-1800. PMID: 36912749, DOI: 10.1111/ene.15777.Peer-Reviewed Original ResearchConceptsPost-traumatic epilepsyPost-stroke epilepsyTraumatic brain injuryRisk of epilepsySystematic reviewSingle nucleotide polymorphismsBrain injuryOdds ratioRisk of PSERisk of PTEAcute brain injuryGenetic polymorphismsConfidence intervalsAssociation of SNPsQ-Genie toolPSE patientsLate seizuresHazard ratioStroke patientsTBI patientsPrespecified protocolStudy qualityCurrent evidenceEpilepsyPatientsPolygenic Susceptibility to Hypertension and Blood Pressure Control in Stroke Survivors
Acosta J, Both C, Demarais Z, Conlon C, Leasure A, Torres-Lopez V, de Havenon A, Petersen N, Gill T, Sansing L, Sheth K, Falcone G. Polygenic Susceptibility to Hypertension and Blood Pressure Control in Stroke Survivors. Neurology 2023, 100: e1587-e1597. PMID: 36690452, PMCID: PMC10103110, DOI: 10.1212/wnl.0000000000206763.Peer-Reviewed Original ResearchConceptsWorse BP controlUncontrolled blood pressureDiastolic blood pressureBlood pressureStroke survivorsPolygenic risk scoresBP controlPolygenic susceptibilityMean diastolic blood pressureMean systolic blood pressureStroke Prevention TrialBlood pressure controlSystolic blood pressureResistant hypertensionVascular eventsHemorrhagic strokePrevention trialsVitamin InterventionMultivariable modelRisk scoreGenetic predispositionPressure controlLogistic regressionSurvivorsHypertension
2022
Deep Learning Applications for Acute Stroke Management
Chavva IR, Crawford AL, Mazurek MH, Yuen MM, Prabhat AM, Payabvash S, Sze G, Falcone GJ, Matouk CC, de Havenon A, Kim JA, Sharma R, Schiff SJ, Rosen MS, Kalpathy‐Cramer J, Gonzalez J, Kimberly WT, Sheth KN. Deep Learning Applications for Acute Stroke Management. Annals Of Neurology 2022, 92: 574-587. PMID: 35689531, DOI: 10.1002/ana.26435.Peer-Reviewed Original ResearchConceptsDeep machine learningDeep learning applicationsMedical image analysisDeep neural networksPixel-wise labelingAcute stroke managementReal-world examplesDL applicationsDL approachMachine learningLearning applicationsDL modelsNeural networkStroke managementLesion segmentationMaximal utilityImage analysisElectronic medical record dataInter-rater variabilityCause of disabilityMedical record dataRelevant clinical featuresStroke detectionAdvanced neuroimaging techniquesDecision makingRacial/Ethnic Variation in White Matter Hyperintensity Progression in the ACCORDION MIND Study
Herman AL, de Havenon A, Falcone GJ, Prabhakaran S, Sheth KN. Racial/Ethnic Variation in White Matter Hyperintensity Progression in the ACCORDION MIND Study. The Neurologist 2022, 28: 157-159. PMID: 35834785, DOI: 10.1097/nrl.0000000000000454.Peer-Reviewed Original ResearchConceptsWMH progressionWhite matter hyperintensitiesLow-density lipoproteinCardiovascular riskWhite patientsBlack patientsWMH volumeSystolic blood pressure levelsWhite matter hyperintensity progressionBlack diabetic patientsBlood pressure levelsExclusion of patientsMagnetic resonance imagingDiabetes (ACCORD) trialDiabetic patientsMean SBPPrimary outcomePatient raceMultivariate regression modelMatter hyperintensitiesA1c measurementHigh riskPatientsNormal rangeCognitive declineCT angiographic radiomics signature for risk stratification in anterior large vessel occlusion stroke
Avery EW, Behland J, Mak A, Haider SP, Zeevi T, Sanelli PC, Filippi CG, Malhotra A, Matouk CC, Griessenauer CJ, Zand R, Hendrix P, Abedi V, Falcone GJ, Petersen N, Sansing LH, Sheth KN, Payabvash S. CT angiographic radiomics signature for risk stratification in anterior large vessel occlusion stroke. NeuroImage Clinical 2022, 34: 103034. PMID: 35550243, PMCID: PMC9108990, DOI: 10.1016/j.nicl.2022.103034.Peer-Reviewed Original ResearchConceptsLarge vessel occlusion strokeIndependent cohortPrognostication toolsMechanical thrombectomyRisk stratificationOcclusion strokeExternal cohortAnterior circulation large vessel occlusion strokeOutcome predictionAcute stroke triageAnterior circulation territoryRadiomic featuresTime of admissionGeisinger Medical CenterLVO stroke patientsReliable clinical informationSignificant differencesAdmission CTAStroke patientsPrognostic informationFavorable outcomeStroke triageTreatment decisionsMedical CenterRadiomics signatureEffect of Intensive Blood Pressure Control on Incident Stroke Risk in Patients With Mild Cognitive Impairment
de Havenon A, Sharma R, Falcone GJ, Prabhakaran S, Sheth KN. Effect of Intensive Blood Pressure Control on Incident Stroke Risk in Patients With Mild Cognitive Impairment. Stroke 2022, 53: e242-e245. PMID: 35502662, PMCID: PMC9246875, DOI: 10.1161/strokeaha.122.038818.Peer-Reviewed Original ResearchConceptsIntensive BP controlIntensive blood pressure controlMild cognitive impairmentMontreal Cognitive Assessment scoreBlood pressure controlBP controlIncident strokePrimary outcomeCognitive Assessment scoreCognitive impairmentCox modelPressure controlAssessment scoresAnalysis of SPRINTIncident stroke riskStandard BP controlIncident stroke eventsRace/ethnicityBaseline BPRandomization armHazard ratioStroke riskPatient ageStroke eventsAtrial fibrillationAnalysis of Clinical Traits Associated With Cardiovascular Health, Genomic Profiles, and Neuroimaging Markers of Brain Health in Adults Without Stroke or Dementia
Acosta JN, Both CP, Rivier C, Szejko N, Leasure AC, Gill TM, Payabvash S, Sheth KN, Falcone GJ. Analysis of Clinical Traits Associated With Cardiovascular Health, Genomic Profiles, and Neuroimaging Markers of Brain Health in Adults Without Stroke or Dementia. JAMA Network Open 2022, 5: e2215328. PMID: 35622359, PMCID: PMC9142873, DOI: 10.1001/jamanetworkopen.2022.15328.Peer-Reviewed Original ResearchConceptsBrain healthBrain volumeMagnetic resonance imagingLower mean volumeLifestyle factorsCardiovascular healthLarge population-based cohort studyLife's Simple 7 (LS7) scoresPopulation-based cohort studyBrain magnetic resonance imagingMean volumeWhite matter hyperintensity volumeBrain health benefitsCommunity-dwelling personsImproved brain healthOutcomes of interestUK BiobankFinal analytical sampleAsymptomatic personsCohort studyLS7 scoreNeuroimaging markerHyperintensity volumeMAIN OUTCOMEGenetic predispositionBedside detection of intracranial midline shift using portable magnetic resonance imaging
Sheth KN, Yuen MM, Mazurek MH, Cahn BA, Prabhat AM, Salehi S, Shah JT, By S, Welch EB, Sofka M, Sacolick LI, Kim JA, Payabvash S, Falcone GJ, Gilmore EJ, Hwang DY, Matouk C, Gordon-Kundu B, RN AW, Petersen N, Schindler J, Gobeske KT, Sansing LH, Sze G, Rosen MS, Kimberly WT, Kundu P. Bedside detection of intracranial midline shift using portable magnetic resonance imaging. Scientific Reports 2022, 12: 67. PMID: 34996970, PMCID: PMC8742125, DOI: 10.1038/s41598-021-03892-7.Peer-Reviewed Original ResearchConceptsMidline shiftNeuroscience intensive care unitCare measurementYale-New Haven HospitalValuable bedside toolIntensive care unitPoor clinical outcomeBrain-injured patientsMass effectNew Haven HospitalMagnetic resonance imagingClinical outcomesIll patientsCare unitStroke patientsFunctional outcomeBedside toolObservational studyBedside detectionImaging examsPatientsResonance imagingPortable MRIImaging suiteSignificant concordance
2021
The coronal plane maximum diameter of deep intracerebral hemorrhage predicts functional outcome more accurately than hematoma volume
Haider SP, Qureshi AI, Jain A, Tharmaseelan H, Berson ER, Majidi S, Filippi CG, Mak A, Werring DJ, Acosta JN, Malhotra A, Kim JA, Sansing LH, Falcone G, Sheth K, Payabvash S. The coronal plane maximum diameter of deep intracerebral hemorrhage predicts functional outcome more accurately than hematoma volume. International Journal Of Stroke 2021, 17: 777-784. PMID: 34569877, PMCID: PMC9005571, DOI: 10.1177/17474930211050749.Peer-Reviewed Original ResearchSimilar admission NIHSS may represent larger tissue-at-risk in patients with right-sided versus left-sided large vessel occlusion
Mak A, Matouk C, Avery EW, Behland J, Frey D, Madai VI, Vajkoczy P, Malhotra A, Karam A, Sanelli P, Falcone GJ, Petersen NH, Sansing L, Sheth KN, Payabvash S. Similar admission NIHSS may represent larger tissue-at-risk in patients with right-sided versus left-sided large vessel occlusion. Journal Of NeuroInterventional Surgery 2021, 14: 985-991. PMID: 34645705, DOI: 10.1136/neurintsurg-2021-017785.Peer-Reviewed Original ResearchConceptsLarge vessel occlusionFinal infarct volumeLarger final infarct volumeWorse discharge outcomesInfarct volumeAdmission NIHSSDischarge outcomesVessel occlusionScale scoreMultivariate analysisAnterior large vessel occlusionLower admission NIHSS scoreHealth Stroke Scale scoreAdmission National InstitutesAdmission stroke severityPoor discharge outcomeStroke Scale scoreLarger infarct volumesAdmission NIHSS scoreRankin Scale scoreVoxel-wise analysisIncomplete reperfusionInfarct distributionOcclusion sideNIHSS score