Evidence map›Paper›PMID 34673291›Full record

ArticleCortex; a journal devoted to the study of the nervous system and behavior2021

Reclassifying stroke lesion anatomy.

Anna K Bonkhoff, Tianbo Xu, Amy Nelson, Robert Gray, Ashwani Jha, Jorge Cardoso, Sebastien Ourselin, Geraint Rees, Hans Rolf Jäger, Parashkev Nachev

Abstract read
In one paragraph

Article in Cortex; a journal devoted to the study of the nervous system and behavior, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. The Influence of Contralesional Brain Age Gradients on Chronic Stroke Aphasia Severity and Treatment Response.The Journal of neuroscience : the official journal of the Society for Neuroscience · 2026
    Article
  4. Article
  5. Article
  6. Article
  7. Review
  8. Article
  9. Cognitive control & the anterior cingulate cortex: Necessity & coherence.Cortex; a journal devoted to the study of the nervous system and behavior · 2025
    Article
  10. Prediction of stroke severity: systematic evaluation of lesion representations.Annals of clinical and translational neurology · 2024
    Article
  11. Article
  12. Article
  13. Article
  14. Review
  15. Article
  16. Article
  17. The elusive metric of lesion load.Brain structure & function · 2023
    Review
  18. Article
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Anna K BonkhoffJ. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, USA; UCL Queen Square Institute of Neurology, University College London, London, UK.
Tianbo XuUCL Queen Square Institute of Neurology, University College London, London, UK.
Amy NelsonUCL Queen Square Institute of Neurology, University College London, London, UK.
Robert GrayUCL Queen Square Institute of Neurology, University College London, London, UK.
Ashwani JhaUCL Queen Square Institute of Neurology, University College London, London, UK.
Jorge CardosoSchool of Biomedical Engineering & Imaging Sciences, King's College London, London, UK.
Sebastien OurselinSchool of Biomedical Engineering & Imaging Sciences, King's College London, London, UK.
Geraint ReesFaculty of Life Sciences, University College London, London, UK.
Hans Rolf JägerUCL Queen Square Institute of Neurology, University College London, London, UK.
Parashkev NachevUCL Queen Square Institute of Neurology, University College London, London, UK. Electronic address: p.nachev@ucl.ac.uk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Cognitive and behavioural outcomes in stroke reflect the interaction between two complex anatomically-distributed patterns: the functional organization of the brain and the structural distribution of ischaemic injury. Conventional outcome models-for individual prediction or population-level inference-commonly ignore this complexity, discarding anatomical variation beyond simple characteristics such as lesion volume. This sets a hard limit on the maximum fidelity such models can achieve. High-dimensional methods can overcome this problem, but only at prohibitively large data scales. Drawing on one of the largest published collections of anatomically-registered imaging of acute stroke-N = 1333-here we use non-linear dimensionality reduction to derive a succinct latent representation of the anatomical patterns of ischaemic injury, agglomerated into 21 distinct intuitive categories. We compare the maximal predictive performance it enables against both simpler low-dimensional and more complex high-dimensional representations, employing multiple empirically-informed ground truth models of distributed structure-outcome relationships. We show our representation sets a substantially higher ceiling on predictive fidelity than conventional low-dimensional approaches, but lower than that achievable within a high-dimensional framework. Where descriptive simplicity is a necessity, such as within clinical care or research trials of modest size, the representation we propose arguably offers a favourable compromise of compactness and fidelity.

Indexed as

StrokeBrainBrain MappingHumansBrain imagingDimensionality reductionLesion anatomyLesion–deficit predictionStroke

Identifiers

PMID34673291
PMCPMC8650827

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.