2025
Voxel-Wise Map of Intracerebral Hemorrhage Locations Associated With Worse Outcomes
Karam G, Chen M, Zeevi D, Harms B, Berson E, Torres-Lopez V, Rivier C, Malhotra A, Qureshi A, Falcone G, Sheth K, Payabvash S. Voxel-Wise Map of Intracerebral Hemorrhage Locations Associated With Worse Outcomes. Stroke 2025, 56: 868-877. PMID: 40052269, DOI: 10.1161/strokeaha.124.048453.Peer-Reviewed Original ResearchConceptsImpact of intracerebral hemorrhageAssociated with worse outcomesClinical risk factorsVoxel-wise mapsMapping of brain regionsBaseline hematomaVoxel-wise analysisHematoma volumeICH locationBrain regionsValidation cohortWorse outcomesPresence of intraventricular hemorrhageRisk factorsBaseline hematoma volumeModified Rankin Scale scorePoor scan qualityMulticenter clinical trialRankin Scale scoreDeep white matterLow-risk categoryComprehensive stroke centerIntraventricular hemorrhageConsecutive patientsPatient ageApixaban to Prevent Covert Infarcts After Cryptogenic Stroke in Patients With Atrial Cardiopathy
Lansberg M, Wintermark M, Chen H, Howard G, Cassarly C, Pauls Q, Kemp S, Harris T, Krishnaiah B, Stanton R, Lyerly M, Miller B, Smith E, Tirschwell D, Sheth K, Kamel H, Longstreth W, Elkind M, Broderick J, Lazar R. Apixaban to Prevent Covert Infarcts After Cryptogenic Stroke in Patients With Atrial Cardiopathy. JAMA Neurology 2025, 82: 220-227. PMID: 39869342, PMCID: PMC11773411, DOI: 10.1001/jamaneurol.2024.4838.Peer-Reviewed Original ResearchConceptsCovert infarctsResearch magnetic resonance imagingCompletion of participationParticipant completionAtrial cardiopathyMain OutcomesParent studyRandomized clinical trialsPrimary outcomeFollow-up magnetic resonance imagingMagnetic resonance imagingParticipantsFollow-up periodRecurrent strokeStrokeIschemic strokeFollow-upBaseline characteristicsAncillary studiesCryptogenic strokeBaselineInsufficient qualityPreventionInfarctionIQRFever Prevention in Acute Vascular Brain Injury—Reply
Greer D, Sheth K. Fever Prevention in Acute Vascular Brain Injury—Reply. JAMA 2025, 333: 636-636. PMID: 39841455, DOI: 10.1001/jama.2024.25530.Peer-Reviewed Original ResearchSpatial Correlates of Dementia and Disability After Intracerebral Hemorrhage.
Chen Y, Rivier C, Mora S, Torres Lopez V, Payabvash S, Sheth K, Harloff A, Falcone G, Rosand J, Mayerhofer E, Anderson C. Spatial Correlates of Dementia and Disability After Intracerebral Hemorrhage. Journal Of The American Heart Association 2025, 14: e037930. PMID: 39921496, DOI: 10.1161/jaha.124.037930.Peer-Reviewed Original ResearchConceptsFollow-up telephone interviewsElectronic health recordsAssociated with disabilityAssociated with dementiaDevelopment of dementiaDevelopment of disabilityIncident dementiaAssociated with intracerebral hemorrhageIntracerebral hemorrhageHealth recordsTelephone interviewsDementia conversionCohort studyDementiaDisabilityLobar intracerebral hemorrhageIntracerebral hemorrhage locationIntracerebral hemorrhagic lesionsFunctional outcomesNoncontrast computed tomography scanCohortMedian follow-up timeRight posterior limbOutcomesLeft temporo-occipital regionOptimal Magnitude of Blood Pressure Reduction and Hematoma Growth and Functional Outcomes in Intracerebral Hemorrhage
Li Q, Lv X, Morotti A, Qureshi A, Dowlatshahi D, Falcone G, Sheth K, Shoamanesh A, Murthy S, Viswanathan A, Goldstein J. Optimal Magnitude of Blood Pressure Reduction and Hematoma Growth and Functional Outcomes in Intracerebral Hemorrhage. Neurology 2025, 104: e213412. PMID: 39913881, PMCID: PMC11803522, DOI: 10.1212/wnl.0000000000213412.Peer-Reviewed Original ResearchConceptsSystolic blood pressure reductionSystolic blood pressureMagnitude of blood pressure reductionATACH-2 trialHematoma expansionMagnitude of SBP reductionAcute kidney injuryATACH-2Blood pressure reductionIntracerebral hemorrhageMm HgSBP reductionPost hoc analysisFunctional outcomesHematoma growthAntihypertensive Treatment of Acute Cerebral Hemorrhage 2Poor outcomeHoc analysisMedian hematoma volumeModified Rankin Scale scoreSevere intracerebral hemorrhagePressure reductionMultivariable logistic regression assessed associationsRisk of poor outcomesAdmission systolic blood pressureBidirectional relationship between epigenetic age and stroke, dementia, and late-life depression
Rivier C, Szejko N, Renedo D, Clocchiatti-Tuozzo S, Huo S, de Havenon A, Zhao H, Gill T, Sheth K, Falcone G. Bidirectional relationship between epigenetic age and stroke, dementia, and late-life depression. Nature Communications 2025, 16: 1261. PMID: 39893209, PMCID: PMC11787333, DOI: 10.1038/s41467-024-54721-0.Peer-Reviewed Original ResearchThis study shows a bidirectional link between accelerated epigenetic aging and brain health events like stroke, dementia, and depression, supporting new prevention strategies for aging-related conditions.Polygenic Susceptibility to Diabetes and Poor Glycemic Control in Stroke Survivors
Demarais Z, Conlon C, Rivier C, Clocchiatti-Tuozzo S, Renedo D, Torres-Lopez V, Sheth K, Meeker D, Zhao H, Ohno-Machado L, Acosta J, Huo S, Falcone G. Polygenic Susceptibility to Diabetes and Poor Glycemic Control in Stroke Survivors. Neurology 2025, 104: e210276. PMID: 39889253, DOI: 10.1212/wnl.0000000000210276.Peer-Reviewed Original ResearchConceptsStroke survivorsWorse glycemic controlPoor glycemic controlStroke patientsAssociated with worse glycemic controlGlycemic controlPolygenic risk scoresClinical management of stroke patientsAssociated with poor glycemic controlManagement of stroke patientsCross-sectional designGenetic association studiesUncontrolled diabetesSusceptibility to T2DMUK BiobankType 2 diabetes mellitusAdverse vascular outcomesRisk scoreAssociation studiesHemoglobin A1cSurvivorsVascular outcomesSusceptibility to diabetesStrokeDiabetesA failure to launch: blood pressure control after stroke in a regional health system
Forman R, Xin X, Kim C, Kernan W, Sheth K, Krumholz H, de Havenon A, Spatz E, Lu Y. A failure to launch: blood pressure control after stroke in a regional health system. Journal Of Hypertension 2025, 43: 715-718. PMID: 39995224, DOI: 10.1097/hjh.0000000000003961.Peer-Reviewed Original ResearchConceptsYale New Haven Health SystemRegional health systemHealth systemSystolic blood pressureDiastolic blood pressureMonths post strokeAverage proportion of patientsBP controlPost strokeBlood pressureProfessional visitsPrimary outcomeBlood pressure controlProportion of patientsAverage proportionVisitsSBP valuesEpic systemPressure controlStrokePatientsGlobal budgetImproving the Robustness of Deep-Learning Models in Predicting Hematoma Expansion from Admission Head CT.
Tran A, Karam G, Zeevi D, Qureshi A, Malhotra A, Majidi S, Murthy S, Park S, Kontos D, Falcone G, Sheth K, Payabvash S. Improving the Robustness of Deep-Learning Models in Predicting Hematoma Expansion from Admission Head CT. American Journal Of Neuroradiology 2025, ajnr.a8650. PMID: 39794133, DOI: 10.3174/ajnr.a8650.Peer-Reviewed Original ResearchFast Gradient Sign MethodDeep learning modelsRobustness of deep learning modelsAdversarial attacksAdversarial imagesAdversarial trainingSign MethodModel robustnessDeploying deep learning modelsDeep learning model performanceConvolutional neural networkImprove model robustnessAcute intracerebral hemorrhageHematoma expansionMulti-threshold segmentationReceiver operating characteristicIntracerebral hemorrhageGradient descentType attacksData perturbationNeural networkProjected GradientTraining setAntihypertensive Treatment of Acute Cerebral HemorrhageThreshold-based segmentation
2024
Optimizing Automated Hematoma Expansion Classification from Baseline and Follow-Up Head Computed Tomography
Tran A, Desser D, Zeevi T, Karam G, Zietz J, Dell’Orco A, Chen M, Malhotra A, Qureshi A, Murthy S, Majidi S, Falcone G, Sheth K, Nawabi J, Payabvash S. Optimizing Automated Hematoma Expansion Classification from Baseline and Follow-Up Head Computed Tomography. Applied Sciences 2024, 15: 111. PMID: 40046237, PMCID: PMC11882137, DOI: 10.3390/app15010111.Peer-Reviewed Original ResearchIntracerebral hemorrhageHematoma expansionFollow-up CT scansFollow-up head computed tomographyPredictors of poor outcomeDeep learning classification modelFollow-up scansHead computed tomographyFalse-negative resultsHematoma segmentationAutomated segmentationMulticentre cohortCT scanValidation cohortPoor outcomeComputed tomographyFollow-upClassification modelOptimizational methodHematomaAnnotationGenal: a Python toolkit for genetic risk scoring and Mendelian randomization
Rivier C, Clocchiatti-Tuozzo S, Huo S, Torres-Lopez V, Renedo D, Sheth K, Falcone G, Acosta J. Genal: a Python toolkit for genetic risk scoring and Mendelian randomization. Bioinformatics Advances 2024, 5: vbae207. PMID: 39776894, PMCID: PMC11706532, DOI: 10.1093/bioadv/vbae207.Peer-Reviewed Original ResearchPolygenic risk scoresMendelian randomizationMR analysisGenome-wide association studiesPRS computationRisk scoreGenetic association dataGenetic risk scoreGenetic epidemiological studiesMR-PRESSOAssociation studiesGenetic epidemiologyMultiple R packagesMR methodsAssociation dataR packageEpidemiological studiesComputational experimentsGenalePython toolkitPython packageScoresPLINKComputation timeEpidemiologyLipid-Lowering Therapy Use When Indicated and Subsequent Ischemic Stroke Severity.
Gordon-Kundu B, Peyravi R, Garg A, Baker A, Salas S, Levien M, Faridi K, de Havenon A, Krumholz H, Sheth K, Forman R, Sharma R. Lipid-Lowering Therapy Use When Indicated and Subsequent Ischemic Stroke Severity. Journal Of The American Heart Association 2024, 14: e033365. PMID: 39699007, DOI: 10.1161/jaha.123.033365.Peer-Reviewed Original ResearchConceptsPrescribed lipid-lowering therapyNational Institutes of Health Stroke Scale scoreAcute ischemic strokeLipid-lowering therapyStroke Scale scoreStroke severityGuidelines-Stroke registryAtherosclerotic cardiovascular disease eventsCardiovascular disease eventsScale scoreGuideline-recommended criteriaSevere stroke symptomsStudy assessed usePropensity score subclassificationLipid-lowering therapy useNational InstituteLogistic regression modelsCholesterol management guidelinesPoststroke disabilityElevated low-density lipoprotein cholesterolInstitutional GetSmall vessel diseaseTime of acute ischemic strokeLarge-artery atherosclerosisLow-density lipoprotein cholesterolMachine Learning Models for 3-Month Outcome Prediction Using Radiomics of Intracerebral Hemorrhage and Perihematomal Edema from Admission Head Computed Tomography (CT)
Dierksen F, Sommer J, Tran A, Lin H, Haider S, Maier I, Aneja S, Sanelli P, Malhotra A, Qureshi A, Claassen J, Park S, Murthy S, Falcone G, Sheth K, Payabvash S. Machine Learning Models for 3-Month Outcome Prediction Using Radiomics of Intracerebral Hemorrhage and Perihematomal Edema from Admission Head Computed Tomography (CT). Diagnostics 2024, 14: 2827. PMID: 39767188, PMCID: PMC11674633, DOI: 10.3390/diagnostics14242827.Peer-Reviewed Original ResearchIntegrated discrimination indexNet reclassification indexPerihematomal edemaHead computed tomographyIntracerebral hemorrhageComputed tomographyClinical variablesClinical predictors of poor outcomeOutcome predictionAcute supratentorial intracerebral hemorrhageAdmission head computed tomographyRadiomic featuresNon-contrast head computed tomographyPredictors of poor outcomeModified Rankin Scale scoreIntracerebral hemorrhage scoreSupratentorial intracerebral hemorrhageIntracerebral hemorrhage patientsClinical risk factorsRankin Scale scoreReceiver operating characteristic areaOperating characteristics areaSecondary brain injuryHematoma evacuationPatient selectionA Hybrid Transformer-Convolutional Neural Network for Segmentation of Intracerebral Hemorrhage and Perihematomal Edema on Non-Contrast Head Computed Tomography (CT) with Uncertainty Quantification to Improve Confidence
Tran A, Desser D, Zeevi T, Abou Karam G, Dierksen F, Dell'Orco A, Kniep H, Hanning U, Fiehler J, Zietz J, Sanelli P, Malhotra A, Duncan J, Aneja S, Falcone G, Qureshi A, Sheth K, Nawabi J, Payabvash S. A Hybrid Transformer-Convolutional Neural Network for Segmentation of Intracerebral Hemorrhage and Perihematomal Edema on Non-Contrast Head Computed Tomography (CT) with Uncertainty Quantification to Improve Confidence. Bioengineering 2024, 11: 1274. PMID: 39768092, PMCID: PMC11672977, DOI: 10.3390/bioengineering11121274.Peer-Reviewed Original ResearchNon-contrast head computed tomographyPerihematomal edemaHead computed tomographyIntracerebral hemorrhageComputed tomographyVolume similarityUniversity Medical Center Hamburg-EppendorfSecondary brain injuryYale cohortInfratentorial locationMulticentre trialCT scanTreatment planningNon-contrastHamburg-EppendorfImaging markersHemorrhagic strokeHemorrhageEdemaCohortBrain injuryDice coefficientPortable, low-field magnetic resonance imaging for evaluation of Alzheimer’s disease
Sorby-Adams A, Guo J, Laso P, Kirsch J, Zabinska J, Garcia Guarniz A, Schaefer P, Payabvash S, de Havenon A, Rosen M, Sheth K, Gomez-Isla T, Iglesias J, Kimberly W. Portable, low-field magnetic resonance imaging for evaluation of Alzheimer’s disease. Nature Communications 2024, 15: 10488. PMID: 39622805, PMCID: PMC11612292, DOI: 10.1038/s41467-024-54972-x.Peer-Reviewed Original ResearchConceptsWhite matter hyperintensitiesMachine learning pipelineMild cognitive impairmentAlzheimer's diseaseWhite matter hyperintensities volumeLearning pipelineAssessment of patientsIncrease accessCognitive impairmentEvaluation of Alzheimer's diseaseDementiaLF-MRIPoint-of-care assessmentMagnetic resonance imagingHippocampal volumeResonance imagingImage qualityDiseaseReduce costsAnisotropic counterpartIncreasing availabilityManual segmentationMobile Stroke Unit Management in Patients With Acute Ischemic Stroke Eligible for Intravenous Thrombolysis
Mac Grory B, Sun J, Alhanti B, Lusk J, Li F, Adeoye O, Furie K, Hasan D, Messe S, Sheth K, Schwamm L, Smith E, Bhatt D, Fonarow G, Saver J, Xian Y, Grotta J. Mobile Stroke Unit Management in Patients With Acute Ischemic Stroke Eligible for Intravenous Thrombolysis. JAMA Neurology 2024, 81: 1250-1262. PMID: 39466286, PMCID: PMC11581552, DOI: 10.1001/jamaneurol.2024.3659.Peer-Reviewed Original ResearchEmergency medical servicesEmergency medical service managementMobile stroke unitPrehospital managementSymptomatic intracranial hemorrhageHospital dischargeGlobal disabilityIn-hospital mortalityEfficacy end pointUtility-weighted modified Rankin scaleStroke unit managementAcute ischemic strokeIschemic strokePrimary analytic cohortDiagnosis of ischemic strokeIntravenous thrombolysisAmerican Heart AssociationEnd pointsGuidelines-StrokeUW-mRSSecondary efficacy end pointsMain OutcomesMedical servicesStroke unitAmbulation statusFever Prevention in Patients With Acute Vascular Brain Injury
Greer D, Helbok R, Badjatia N, Ko S, Guanci M, Sheth K, Diringer M, Mehta Y, Cava L, Hinduja A, Lele A, Sarwal A, Kulik T, Keller E, Smith G, Dennesen P, Dimitriadis K, Schonenberger S, Gunther A, Meisel A, Wolf S, Kollmar R, Barlinn K, Jeon S, Han M, Hong J, Lee R, Falcone G, Dashti S, Busl K, Ermak D, Berkeley J, Amory C, Swor R, DeGeorgia M, Green-LaRoche D, Thompson B, Hatton K, Sung G, Mehta C, Zurasky J, Da Silva I, James M, Aysenne A, Cervantes A, Devlin T, Chang I, Morris N, Venkatasubramanian C, Mushlschlegel S, Zachariah J, Chaudry F, Claassen J, Dangayach N, Choi H, Sadaka F, Miller C. Fever Prevention in Patients With Acute Vascular Brain Injury. JAMA 2024, 332: 1525-1534. PMID: 39320879, PMCID: PMC11425189, DOI: 10.1001/jama.2024.14745.Peer-Reviewed Original ResearchVascular brain injuryStandard care groupCare groupMajor adverse eventsPrimary outcomeStandard care patientsBlinded outcome assessmentIntensive care unit dischargeFunctional outcomesAdverse eventsBrain injuryFever preventionFever burdenPrincipal secondary end pointBetween-group differencesOpen-label randomized clinical trialPrevention groupFunctional recoveryPrincipal secondary outcomeCare patientsAssociated with worse outcomesMain OutcomesImpact functional outcomesSecondary end pointsTemperature management devicePolygenic Risk of Epilepsy and Poststroke Epilepsy
Clocchiatti-Tuozzo S, Rivier C, Misra S, Zelano J, Mazumder R, Sansing L, de Havenon A, Hirsch L, Liebeskind D, Gilmore E, Sheth K, Kim J, Worrall B, Falcone G, Mishra N. Polygenic Risk of Epilepsy and Poststroke Epilepsy. Stroke 2024, 55: 2835-2843. PMID: 39502073, PMCID: PMC11653790, DOI: 10.1161/strokeaha.124.047459.Peer-Reviewed Original ResearchParticipants of European ancestryRisk of poststroke epilepsyPolygenic riskPoststroke epilepsyEuropean ancestryGenome-wide association study meta-analysisPRS decileCase-control genetic association studyGenetic risk lociLowest decilePolygenic risk scoresGenetic association studiesMultivariate logistic regression modelStudy meta-analysisMultivariate logistic regression resultsHistory of strokeLogistic regression modelsRisk lociAssociation studiesStroke survivorsUK BiobankGenetic informationGenetic ancestryLogistic regression resultsGenetic variantsSex Modifies the Severity and Outcome of Spontaneous Intracerebral Hemorrhage
Rivier C, Renedo D, Marini S, Magid‐Bernstein J, de Havenon A, Rosand J, Hanley D, Ziai W, Mayer S, Woo D, Sansing L, Sheth K, Anderson C, Falcone G. Sex Modifies the Severity and Outcome of Spontaneous Intracerebral Hemorrhage. Annals Of Neurology 2024, 97: 232-241. PMID: 39499118, DOI: 10.1002/ana.27123.Peer-Reviewed Original ResearchRisk of hematoma expansionHighest risk of hematoma expansionRisk of poor outcomesIntracerebral hemorrhageHematoma expansionHigh riskMale sexPoor outcomeOutcome of spontaneous intracerebral hemorrhageClinical characteristics of patientsStudies of intracerebral hemorrhageNon-traumatic intracerebral hemorrhageIndividual patient data meta-analysisPatient data meta-analysisSpontaneous intracerebral hemorrhageSingle-center studyIntracerebral hemorrhage patientsHigh risk of expansionCharacteristics of patientsIntracerebral hemorrhage severityPoor functional outcomeRandomized clinical trialsData meta-analysisHemorrhage volumeClinical characteristicsLife's Essential 8 and Poor Brain Health Outcomes in Middle-Aged Adults
Clocchiatti-Tuozzo S, Rivier C, Renedo D, Huo S, Hawkes M, de Havenon A, Schwamm L, Sheth K, Gill T, Falcone G. Life's Essential 8 and Poor Brain Health Outcomes in Middle-Aged Adults. Neurology 2024, 103: e209990. PMID: 39442069, PMCID: PMC11498939, DOI: 10.1212/wnl.0000000000209990.Peer-Reviewed Original ResearchConceptsLife's Essential 8Poor cardiovascular healthCardiovascular healthBrain healthLife's Essential 8 scoreUnadjusted riskEssential 8Determinants of cardiovascular healthUK Biobank (UKBCardiovascular health profileModifiable cardiovascular risk factorsBrain health outcomesRisk factorsComposite outcomePublic health constructsPopulation studiesMiddle-aged adultsCox modelLate-life depressionCox proportional hazards modelsBrain health benefitsMultivariate Cox modelCardiovascular risk factorsFollow-up timeAoU participants
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