Impact of @entity10334 Burden on Hemispheric Lateralization of the National Institutes of Health XXXX Scale Deficit in Acute Ischemic Stroke.

@entity10334 @entity1 @entity64 @entity1188
BACKGROUND AND PURPOSE: The National Institutes of Health @entity64 Scale (NIHSS) awards higher deficit scores for @entity1188 in the dominant hemisphere when compared with otherwise similar @entity1188 in the nondominant hemisphere. This has been shown to adversely affect @entity64 recognition, therapeutic decisions, and outcome. However, factors modifying the association between @entity1188 side and deficit severity are incompletely understood. Thus, we sought to determine whether age and age-related @entity10334 alter the relation between NIHSS deficit score and the side and volume of @entity1188 . METHODS: We studied 238 @entity1 with supratentorial, nonlacunar @entity1188 prospectively included in our @entity64 registry between January 2013 and January 2014. NIHSS deficit severity was assessed at the time of presentation. @entity1188 volumes were assessed by manual planimetry on diffusion-weighted imaging. @entity10334 burden was graded on fluid-attenuated inversion recovery images according to the Fazekas scale and dichotomized to none-to-mild (0-2) versus severe (3-6). Multivariable linear regression with backward elimination was used to identify independent predictors of the admission NIHSS. RESULTS: Left-hemispheric @entity1188 (P<0.001), severe @entity10334 (P=0.001), their interaction term (P=0.005), @entity1188 volume (P<0.001), and sex (P=0.013) were independently associated with the NIHSS deficit. Analysis of the individual NIHSS components showed that severe @entity10334 was associated with an increase of the lateralizing components of the NIHSS in @entity1 with right-hemispheric @entity1188 (P<0.05). CONCLUSIONS: Severe @entity10334 substantially attenuates the classic hemispheric lateralization of the NIHSS deficit by relating to greater NIHSS scores of components that are typically assigned to left hemisphere function.
