Publication
Intracranial aneurysm rupture is predicted by measures of solar activity
Journal Paper/Review - Dec 17, 2014
Stienen Martin N., Bijlenga Philippe, Schaller Karl, Hildebrandt Gerhard, Fandino Javier, Fathi Ali-Reza, Daniel Roy Thomas, Röthlisberger Michel, Fung Christian, Woernle Christoph M, Schatlo Bawarjan, Battaglia Marina, Smoll Nicolas Roydon, SWISS SOS Investigators
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Brief description/objective
Objective: The cause precipitating intracranial aneurysm rupture remains unknown in many cases. It has been observed that aneurysm ruptures are clustered in time but the trigger mechanism remains obscure. As solar activity has been associated with cardiovascular mortality and morbidity we decided to study its association to aneurysm rupture in the Swiss population.
Methods: Patient data was extracted from the Swiss SOS database, at time of analysis covering 918 consecutive patients with angiography-proven aSAH treated at seven Swiss neurovascular centers between 01/01/2009-12/31/2011. The daily rupture frequency (RF) was correlated to the absolute amount and the change in various parameters of interest representing continuous measurements of solar activity (radioflux (F10.7 index), solar proton flux, solar flare occurrence, planetary K-index/planetary A-index, Space Environment Services Center (SESC) sunspot number and sunspot area) using Poisson regression analysis.
Results: During the period of interest there were 517 days without recorded aneurysm rupture. There were 398, 139, 27, 12, 1 and 1 days with 1, 2, 3, 4, 5 and 6 ruptures per day. Poisson regression analysis demonstrated a significant correlation of F10.7 index and RF (incidence rate ratio (IRR)=1.006303; standard error (SE) 0.0013201; 95% confidence interval (CI) 1.003719-1.008894; p<0.001), according to which every 1-unit increase of the F10.7 index increased the count for an aneurysm to rupture by 0.63%. A likewise statistically significant relationship of both the SESC sunspot number (IRR 1.003413; SE 0.0007913; 95%CI 1.001864-1.004965; p<0.001) and the sunspot area (IRR 1.000419; SE 0.0000866; 95%CI 1.000249-1.000589; p<0.001) emerged. All other variables analyzed showed no significant correlation with RF.
Conclusion: We found higher radioflux, SESC sunspot number and sunspot area to be associated with an increased count of aneurysm rupture. The clinical meaningfulness of this statistical association must be interpreted carefully and future studies are warranted to rule out a type-1 error.