Document Detail

Prediction of cardioembolic, arterial, and lacunar causes of cryptogenic stroke by gene expression and infarct location.
MedLine Citation:
PMID:  22627989     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: The cause of ischemic stroke remains unclear, or cryptogenic, in as many as 35% of patients with stroke. Not knowing the cause of stroke restricts optimal implementation of prevention therapy and limits stroke research. We demonstrate how gene expression profiles in blood can be used in conjunction with a measure of infarct location on neuroimaging to predict a probable cause in cryptogenic stroke.
METHODS: The cause of cryptogenic stroke was predicted using previously described profiles of differentially expressed genes characteristic of patients with cardioembolic, arterial, and lacunar stroke. RNA was isolated from peripheral blood of 131 cryptogenic strokes and compared with profiles derived from 149 strokes of known cause. Each sample was run on Affymetrix U133 Plus 2.0 microarrays. Cause of cryptogenic stroke was predicted using gene expression in blood and infarct location.
RESULTS: Cryptogenic strokes were predicted to be 58% cardioembolic, 18% arterial, 12% lacunar, and 12% unclear etiology. Cryptogenic stroke of predicted cardioembolic etiology had more prior myocardial infarction and higher CHA(2)DS(2)-VASc scores compared with stroke of predicted arterial etiology. Predicted lacunar strokes had higher systolic and diastolic blood pressures and lower National Institutes of Health Stroke Scale compared with predicted arterial and cardioembolic strokes. Cryptogenic strokes of unclear predicted etiology were less likely to have a prior transient ischemic attack or ischemic stroke.
CONCLUSIONS: Gene expression in conjunction with a measure of infarct location can predict a probable cause in cryptogenic strokes. Predicted groups require further evaluation to determine whether relevant clinical, imaging, or therapeutic differences exist for each group.
Glen C Jickling; Boryana Stamova; Bradley P Ander; Xinhua Zhan; Dazhi Liu; Shara-Mae Sison; Piero Verro; Frank R Sharp
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-05-24
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  43     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-07-24     Completed Date:  2012-10-04     Revised Date:  2013-08-14    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2036-41     Citation Subset:  IM    
Department of Neurology and MIND Institute, University of California at Davis, Sacramento, CA 95817, USA.
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MeSH Terms
Cerebral Angiography
Cerebral Arterial Diseases / complications*,  pathology
Gene Expression / genetics
Gene Expression Profiling
Heart Diseases / complications*,  pathology,  ultrasonography
Heart Failure / complications
Hemodynamics / physiology
Inflammation / pathology
Ischemic Attack, Transient / complications
Middle Aged
Risk Factors
Stroke / diagnosis*,  genetics*
Stroke, Lacunar / diagnosis*,  genetics*
Thromboembolism / complications*,  pathology,  ultrasonography
Grant Support
NS056302/NS/NINDS NIH HHS; R01 NS056302/NS/NINDS NIH HHS; R01 NS075035/NS/NINDS NIH HHS; R01 NS079153/NS/NINDS NIH HHS; //Canadian Institutes of Health Research
Comment In:
Nat Rev Neurol. 2012 Jul;8(7):358   [PMID:  22763707 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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