{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T18:00:22Z","timestamp":1790791222508,"version":"4.1.0"},"reference-count":55,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T00:00:00Z","timestamp":1762819200000},"content-version":"vor","delay-in-days":314,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Priority Research Centre Programme","award":["2021R1A6A1A03038865"],"award-info":[{"award-number":["2021R1A6A1A03038865"]}]},{"name":"Basic Science Research Programme","award":["2020R1A2C3008295"],"award-info":[{"award-number":["2020R1A2C3008295"]}]},{"name":"Medical Device Development","award":["KMDF_PR_20200901_0098"],"award-info":[{"award-number":["KMDF_PR_20200901_0098"]}]},{"DOI":"10.13039\/501100001321","name":"National Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001321","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Korean government"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Sarcopenia, a common geriatric condition characterized by the loss of skeletal muscle mass and function, can negatively affect functional outcomes in acute ischaemic stroke; however, the underlying mechanisms remain unclear. We hypothesized that sarcopenia affects post-stroke outcomes, mediated through its impact on dysphagia, early neurological deterioration, or post-stroke recovery, particularly in patients with motor deficits. To explore this hypothesis, we included 600 consecutive elderly (\u226565 years) patients with acute (&amp;lt;1 week) ischaemic stroke and assessed: (i) the relationships sarcopenia has with dysphagia, early neurological deterioration and various phases of recovery after stroke (in-hospital, post-discharge [up to 3 months], and chronic [3 months to 1 year]) and (ii) whether either presenting symptoms or lesion locations modify the impact of sarcopenia on stroke outcomes. Temporal muscle thickness, a marker of sarcopenia, was measured by brain magnetic resonance imaging and dichotomized into low versus high temporal muscle thickness at the 25th percentile cut-off point. Logistic regression analysis, mediation analysis and statistical brain mapping were conducted. Mean age was 75.3 \u00b1 6.1 years and 303 (50.5%) were male. Low temporal muscle thickness (&amp;lt;5.1\u2005mm) was independently associated with dysphagia (adjusted odds ratio 1.89 [95% confidence interval 1.06\u20133.37], P = 0.03), early neurological deterioration (adjusted odds ratio 2.75 [95% confidence interval 1.61\u20134.71], P &amp;lt; 0.001) and post-discharge recovery (adjusted odds ratio 0.56 [95% confidence interval 0.34\u20130.94], P = 0.03) but not with in-hospital or chronic recovery. In addition, dysphagia, early neurological deterioration and post-discharge recovery were shown to mediate the association between low temporal muscle thickness and poor functional outcome (modified Rankin scale score \u2265 3) at 3 months, accounting for \u223c45% of the total effect. Low temporal muscle thickness had a greater impact on stroke outcomes in patients with motor deficit, facial palsy, dysarthria, or pontine lesions. Furthermore, brain mapping revealed that low temporal muscle thickness had a stronger impact on functional outcomes in infarctions involving brain regions responsible for motor strength, planning, execution, and control: i.e. pallidum, fronto-pontine tract, parieto-occipito-temporo-pontine tract, middle cerebellar peduncle, and corticospinal tract. Sarcopenia leads to poor functional outcomes, probably due to its association with dysphagia, early neurological deterioration, and limited post-discharge recovery in elderly acute ischaemic stroke patients, particularly those with motor deficit, bulbar symptoms, or lesions involving pons and motor pathways. Understanding and identifying the mechanisms underlying sarcopenia-related effects on post-stroke outcomes may inform comprehensive, time-specific approaches to personalised management for this patient population.<\/jats:p>","DOI":"10.1093\/braincomms\/fcaf386","type":"journal-article","created":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T13:06:09Z","timestamp":1762520769000},"source":"Crossref","is-referenced-by-count":5,"title":["Mechanisms of how sarcopenia affects functional outcomes in acute ischaemic stroke"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7850-0804","authenticated-orcid":false,"given":"Dong-Seok","family":"Gwak","sequence":"first","affiliation":[{"name":"Department of Neurology, Dongguk University Ilsan Hospital , Goyang 10326,","place":["Republic of Korea"]},{"name":"National Priority Research Centre for Stroke , Goyang 10326,","place":["Republic of 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University Ilsan Hospital , Goyang 10326,","place":["Republic of Korea"]},{"name":"National Priority Research Centre for Stroke , Goyang 10326,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8194-3462","authenticated-orcid":false,"given":"Ji Sung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Asan Medical Centre , Seoul 05505 ,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong-Eog","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurology, Dongguk University Ilsan Hospital , Goyang 10326,","place":["Republic of Korea"]},{"name":"National Priority Research Centre for Stroke , Goyang 10326,","place":["Republic of 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