Ischemic lesion volume correlates with long-term functional outcome and quality of life of middle cerebral artery stroke survivors

Purpose: Previous studies investigating relationships between stroke lesion volume and outcome were restricted to short follow-up periods (3–6 months) and outcome measures of stroke severity and activities only, whereas functional improvement has been found to extend far beyond six months. Therefore, this study investigated relationships between infarct volume and a broad range of outcomes of stroke survivors at a long follow-up period.

Methods: Correlations between lesion volumes (determined by conventional MRI scans in the second week post-stroke) and outcomes after one year of 75 first-ever ischemic stroke survivors were investigated.

Results: Moderate Spearman Rank correlation coefficients were found between lesion volume and motor impairment (Motricity Index (MI): −0.43, p < 0.01; Fugl Meyer Motor Assessment Scale (FM): −0.43; p < 0.01). Correlation coefficients with activities of daily living were moderate but low associated with Barthel Index (r $_s$ = 0.30; p < 0.01), modified Rankin Scale (r $_s$ = 0.39; p < 0.01) and Frenchay Activities Index (r $_s$ = −0.35; p < 0.01). Lesion volume had a significant but low association (r $_s$ = 0.27; p = 0.02) with patient's health status measured with Sickness Impact Profile 68 (SIP68)) and a moderate correlation with well-being assessed with Life Satisfaction Questionnaire (LSQ; r $_s$ = −0.45; p < 0.01). Found correlation coefficients were slightly stronger after correction for mixed (cortical/subcortical) and purely subcortical lesion location.

Conclusions: It can be concluded that infarct volume moderately correlates with long-term motor impairment, functional outcome and quality of life of patients surviving stroke.