{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:08:47Z","timestamp":1777943327598,"version":"3.51.4"},"reference-count":32,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T00:00:00Z","timestamp":1715904000000},"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":["International Journal of Stroke"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Lacunar stroke represents around a quarter of all ischemic strokes; however, their identification with computed tomography in the hyperacute setting is challenging. We aimed to validate a clinical score to identify lacunar stroke in the acute setting, independently, with data from the WAKE-UP trial using magnetic resonance imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We analyzed data from the WAKE-UP trial and extracted Oxfordshire Community Stroke Project (OCSP) classification. Lacunar score was defined by National Institutes of Health Stroke Scale (NIHSS)\u2009&lt;\u20097 and OCSP lacunar syndrome. Assessment of lacunar infarct by two independent investigators was blinded to clinical data. We calculated sensitivity, specificity, negative and positive predictive value (NPV and PPV, respectively) of lacunar score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We included 503 patients in the analysis, mean (\u00b1SD) age 65.2 (\u00b111.6)\u2009years, 325 (65%) males, median (IQR) NIHSS\u2009=\u20096 (4\u20139); 108 (22%) lacunar infarcts were identified on magnetic resonance (MR), patients fulfilling lacunar score criteria were 120 (24%), of which 47 (44%) had a lacunar infarct. Lacunar score was negative in 322 (82%) of patients without lacunar infarct. Patients with lacunar score had lower NIHSS (4 vs 7, p\u2009&lt;\u20090.001), higher systolic (157 vs 151\u2009mmHg, p\u2009=\u20090.001) and diastolic (86 vs 83\u2009mmHg, p\u2009=\u20090.013) blood pressure and smaller infarct volume (2.4 vs 9.5\u2009mL, p\u2009&lt;\u20090.001). Performance of lacunar score was as follows: sensitivity 0.44; specificity 0.82; PPV 0.39; NPV 0.84; and accuracy 0.73. Assuming a prevalence of lacunar stroke of 13%, PPV lowered to 0.30 but NPV was 0.90. Lacunar score performed better for supratentorial lacunar infarcts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Lacunar score had a very good specificity and NPV for screening of lacunar stroke. Implementation of this simple tool into clinical practice may help hyperacute management and guide patient selection in clinical trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data access statement:<\/jats:title>\n                    <jats:p>Data supporting the results of this paper are available upon reasonable request to the corresponding author.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17474930241253987","type":"journal-article","created":{"date-parts":[[2024,4,27]],"date-time":"2024-04-27T07:02:27Z","timestamp":1714201347000},"page":"935-941","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Validation of a simple clinical tool for screening of acute lacunar stroke\u2014A substudy of the WAKE-UP trial"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3941-7383","authenticated-orcid":false,"given":"Francesco","family":"Arba","sequence":"first","affiliation":[{"name":"Stroke Unit, Careggi University Hospital, Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Rinaldi","sequence":"additional","affiliation":[{"name":"NEUROFARBA Department, University of Florence, Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7793-0941","authenticated-orcid":false,"given":"M\u00e4rit","family":"Jensen","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Neurologie, Kopf- und Neurozentrum, Universit\u00e4tsklinikum Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Endres","sequence":"additional","affiliation":[{"name":"Klinik und Hochschulambulanz f\u00fcr Neurologie, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Berlin, Germany"},{"name":"Centrum f\u00fcr Schlaganfallforschung Berlin (CSB), Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Berlin, Germany"},{"name":"German Center for Neurodegenerative Diseases (DZNE), Partner Site Berlin, Berlin, Germany"},{"name":"German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany"},{"name":"German Center for Mental Health (DZPG), Partner Site Berlin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jochen B","family":"Fiebach","sequence":"additional","affiliation":[{"name":"Centrum f\u00fcr Schlaganfallforschung Berlin (CSB), Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robin","family":"Lemmens","sequence":"additional","affiliation":[{"name":"VIB Center for Brain & Disease Research, Department of Neurosciences, Experimental Neurology, KU Leuven\u2014University of Leuven, Leuven, Belgium"},{"name":"Department of Neurology, University Hospitals Leuven, Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9535-022X","authenticated-orcid":false,"given":"Keith W","family":"Muir","sequence":"additional","affiliation":[{"name":"Institute of Neuroscience & Psychology, University of Glasgow, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norbert","family":"Nighoghossian","sequence":"additional","affiliation":[{"name":"Department of Stroke Medicine, Universit\u00e9 Claude Bernard Lyon, Lyon, France"},{"name":"Hospices Civils de Lyon, Lyon, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salvador","family":"Pedraza","sequence":"additional","affiliation":[{"name":"Department of Radiology, Institut de Diagn\u00f2stic per la Imatge (IDI), Hospital Universitari Dr. Josep Trueta, Institut d\u2019Investigaci\u00f3 Biom\u00e8dica de Girona (IDIBGI), Girona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claus Z","family":"Simonsen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6614-8417","authenticated-orcid":false,"given":"Vincent","family":"Thijs","sequence":"additional","affiliation":[{"name":"Florey Institute of Neuroscience and Mental Health, Heidelberg, VIC, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Gerloff","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Neurologie, Kopf- und Neurozentrum, Universit\u00e4tsklinikum Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9812-6642","authenticated-orcid":false,"given":"Joanna 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