Gender-Specific Neuroimaging Signs to Predict Poor Recovery in Men vs Women after Stroke

Stroke is the leading cause of long-term adult disability in the US with the annual cost of stroke care estimated at $70 billion [1]. However, stroke patients do not recover equally. In patients with severe strokes, 30% will have minimal to no recovery [2]. Women are known to have worse post-stroke functional outcomes than men [3]. The current standard of care for stroke rehabilitation is unclear regarding dose and type of therapies prescribed [4]. There is a critical need to understand mechanisms of recovery within the brain and, notably, the poor functional outcomes in women with severe deficits from stroke. By understanding stroke mechanisms within the brain, we can better develop treatment approaches, advancing personalized stroke rehabilitation plans tailored to everyone’s needs and accurately predicting outcomes. Magnetic resonance imaging (MRI) of the brain can measure nerve tract damage by using diffusion tensor imaging (DTI). Measurements using this technique have been associated with long-term function after stroke [5-7]. In this proposal, we will conduct a pilot study to evaluate the reliability of DTI as a neuroimaging indicator to explain why women are more disabled than men after stroke.