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Agnieszka Slowik
Alumni
Publications
Sex-specific lesion pattern of functional outcomes after stroke
Anna K. Martin Sungmin Markus D. Alexander Robert W. Kathleen L. Marco J. Adrian V. Anne-Katrin Mark R. Brandon L. Steven J. T. Elissa C. John Oscar R. Stephen John W. Amanda Christoph J. Laura Lukas Katarina Jordi Steven J. Robin Christopher R. Caitrin W. James F. Chia-Ling Arndt Stefan Jonathan Jaume Tatjana Ralph L. Reinhold Pankaj Agnieszka Martin Alessandro Tara M. Daniel Turgut Vincent Achala Johan Daniel Ramin Patrick F. Bradford B. Christina Arne G. Jane Michael D. Danilo Ona Natalia S. Bonkhoff
Stroke represents a considerable burden of disease for both men and women. However, a growing body of literature suggests clinically relevan… (voir plus)t sex differences in the underlying causes, presentations and outcomes of acute ischaemic stroke. In a recent study, we reported sex divergences in lesion topographies: specific to women, acute stroke severity was linked to lesions in the left-hemispheric posterior circulation. We here determined whether these sex-specific brain manifestations also affect long-term outcomes. We relied on 822 acute ischaemic patients [age: 64.7 (15.0) years, 39% women] originating from the multi-centre MRI-GENIE study to model unfavourable outcomes (modified Rankin Scale >2) based on acute neuroimaging data in a Bayesian hierarchical framework. Lesions encompassing bilateral subcortical nuclei and left-lateralized regions in proximity to the insula explained outcomes across men and women (area under the curve = 0.81). A pattern of left-hemispheric posterior circulation brain regions, combining left hippocampus, precuneus, fusiform and lingual gyrus, occipital pole and latero-occipital cortex, showed a substantially higher relevance in explaining functional outcomes in women compared to men [mean difference of Bayesian posterior distributions (men – women) = −0.295 (90% highest posterior density interval = −0.556 to −0.068)]. Once validated in prospective studies, our findings may motivate a sex-specific approach to clinical stroke management and hold the promise of enhancing outcomes on a population level.
To examine whether high white matter hyperintensity (WMH) burden is associated with greater stroke severity and worse functional outcomes in… (voir plus) lesion pattern–specific ways.
MR neuroimaging and NIH Stroke Scale data at index stroke and the modified Rankin Scale (mRS) score at 3–6 months after stroke were obtained from the MRI–Genetics Interface Exploration study of patients with acute ischemic stroke (AIS). Individual WMH volume was automatically derived from fluid-attenuated inversion recovery images. Stroke lesions were automatically segmented from diffusion-weighted imaging (DWI) images, parcellated into atlas-defined brain regions and further condensed to 10 lesion patterns via machine learning–based dimensionality reduction. Stroke lesion effects on AIS severity and unfavorable outcomes (mRS score >2) were modeled within purpose-built Bayesian linear and logistic regression frameworks. Interaction effects between stroke lesions and a high vs low WMH burden were integrated via hierarchical model structures. Models were adjusted for age, age2, sex, total DWI lesion and WMH volumes, and comorbidities. Data were split into derivation and validation cohorts.
A total of 928 patients with AIS contributed to acute stroke severity analyses (age: 64.8 [14.5] years, 40% women) and 698 patients to long-term functional outcome analyses (age: 65.9 [14.7] years, 41% women). Stroke severity was mainly explained by lesions focused on bilateral subcortical and left hemispherically pronounced cortical regions across patients with both a high and low WMH burden. Lesions centered on left-hemispheric insular, opercular, and inferior frontal regions and lesions affecting right-hemispheric temporoparietal regions had more pronounced effects on stroke severity in case of high compared with low WMH burden. Unfavorable outcomes were predominantly explained by lesions in bilateral subcortical regions. In difference to the lesion location–specific WMH effects on stroke severity, higher WMH burden increased the odds of unfavorable outcomes independent of lesion location.
Higher WMH burden may be associated with an increased stroke severity in case of stroke lesions involving left-hemispheric insular, opercular, and inferior frontal regions (potentially linked to language functions) and right-hemispheric temporoparietal regions (potentially linked to attention). Our findings suggest that patients with specific constellations of WMH burden and lesion locations may have greater benefits from acute recanalization treatments. Future clinical studies are warranted to systematically assess this assumption and guide more tailored treatment decisions.
2021-11-08
medRxiv (Cold Spring Harbor Laboratory) (prépublication)
Feed-forward neural networks consist of a sequence of layers, in which each layer performs some processing on the information from the previ… (voir plus)ous layer. A downside to this approach is that each layer (or module, as multiple modules can operate in parallel) is tasked with processing the entire hidden state, rather than a particular part of the state which is most relevant for that module. Methods which only operate on a small number of input variables are an essential part of most programming languages, and they allow for improved modularity and code re-usability. Our proposed method, Neural Function Modules (NFM), aims to introduce the same structural capability into deep learning. Most of the work in the context of feed-forward networks combining top-down and bottom-up feedback is limited to classification problems. The key contribution of our work is to combine attention, sparsity, top-down and bottom-up feedback, in a flexible algorithm which, as we show, improves the results in standard classification, out-of-domain generalization, generative modeling, and learning representations in the context of reinforcement learning.
2021-03-17
Proceedings of The 24th International Conference on Artificial Intelligence and Statistics (publié)
In order to communicate, humans flatten a complex representation of ideas and their attributes into a single word or a sentence. We investig… (voir plus)ate the impact of representation learning in artificial agents by developing graph referential games. We empirically show that agents parametrized by graph neural networks develop a more compositional language compared to bag-of-words and sequence models, which allows them to systematically generalize to new combinations of familiar features.