FOSTER - Functional Outcome after STroke and Effective Reserve

TitleFunctional Outcome after STroke and Effective Reserve (FOSTER)Purpose and aims The prevalence of stroke increases globally, necessitating a deeper understanding of mechanisms of recovery and functional independence.

This study investigates spatial lesion information and the brain’s effective reserve (eR) capacity, in mitigating adverse effects of acute stroke lesions.Aims 1) To develop and validate a baseline outcome model using spatial lesion information; 2) Incorporating spatial lesion data into the eR metric.Project organisation and time plan The project period (June 2024 to January 2026) includes 12 months at Massachusetts General Hospital/Harvard Medical School and 6 months at University of Gothenburg.Scientific methods Utilizing deep learning computational imaging analysis of MRI lesion patterns, we will develop a predictive model for functional outcome (measured by modified Rankin Scale) after stroke, in three large multicenter stroke patient cohorts (DISCOVERY, GASROS, MRI-GENIE).

Using spatial lesion data we will refine a present eR metric. We will validate the model in the Sahlgrenska Carotid cohort.

Clinical importance Reportedly, higher eR correlates with better outcomes and increased ability to cope with vascular events.

The pivotal focus shift to study protective mechanisms deepens the understanding of brain resilience and holds promise for improved stroke outcome prognostication, enabling individualized treatment decisions and rehabilitation strategies.