{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T08:46:11Z","timestamp":1792140371604,"version":"4.4.0"},"reference-count":0,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Cereb Blood Flow Metab"],"abstract":"<jats:p>Background: Diaschisis reflects remote functional suppression following focal ischemia and large-scale network disruption. We investigate the prevalence, overlap, and determinants of multiple diaschisis subtypes using acute CTP. Methods: We retrospectively analyzed 659 patients with hyperacute large-vessel occlusion stroke. Diaschisis was primarily assessed on CBV maps and classified into Crossed Cerebellar (CCD), Ipsilateral Thalamic (ITD), Ipsilateral Hippocampal (IHD), and CCD+ITD. Tmax-based assessment was exploratory. Multivariable logistic regression evaluated severe hypoperfusion extent (Tmax&gt;6s), hypoperfusion intensity ratio (HIR), and ischemic core volume (CBF&lt;30%). Results: CCD was the most common subtype, followed by ITD and CCD+ITD, whereas IHD was rare. Greater severe hypoperfusion extent was independently associated with CCD, ITD, and CCD+ITD, while higher HIR was additionally associated with ITD, and CCD+ITD. Ischemic core volume was not independently associated with diaschisis. CCD was independently associated with left hemispheric stroke, while combined CCD+ITD was associated with female sex. Exploratory Tmax-based analyses showed broadly similar associations. Subtype overlap suggested involvement of multiple interconnected network nodes. Conclusion: Hyperacute diaschisis reflects ischemia-driven network dysfunction primarily related to severe hypoperfusion extent, with hypoperfusion severity contributing to specific subtypes. These findings support CBV-based CTP assessment for investigating large-scale network vulnerability, while Tmax-based may provide complementary information for future diaschisis research.<\/jats:p>","DOI":"10.1177\/0271678x261499044","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T06:19:12Z","timestamp":1792045152000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["EXPRESS: Perfusion Extent and Hypoperfusion Severity Determine Diaschisis Patterns in Acute Ischemic Stroke: A CT Perfusion Study"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-8794-2427","authenticated-orcid":false,"given":"QI","family":"JIA","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan Nan","family":"Sheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noemie","family":"Ligot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anissa","family":"Abderrakib","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"niloufar","family":"sadeghi.maybodi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilles","family":"Naeije","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,14]]},"container-title":["Journal of Cerebral Blood Flow &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0271678X261499044","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0271678X261499044","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T08:16:15Z","timestamp":1792138575000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0271678X261499044"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,14]]},"references-count":0,"alternative-id":["10.1177\/0271678X261499044"],"URL":"https:\/\/doi.org\/10.1177\/0271678x261499044","relation":{},"ISSN":["0271-678X","1559-7016"],"issn-type":[{"value":"0271-678X","type":"print"},{"value":"1559-7016","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,14]]},"article-number":"0271678X261499044"}}