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. 2021 Jun 2;12:3289. doi: 10.1038/s41467-021-23492-3

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© The Author(s) 2021

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 5 — a Lesion atom 1. Less than 5% of samples of the difference Bayesian posterior distribution between men and women (i.e., posterior distribution of lesion atom 1 in men—posterior distribution of lesion atom 1 in women) overlapped with zero, suggesting a substantially larger lesion atom 1 effect in women. This specific lesion pattern represented right-hemispheric lesions in frontal, insular, and precentral regions (difference distribution: mean = −1.2, HPDI = −1.96 to −0.31). b–d Lesion atoms 7–9. Almost all lesion atoms of the left hemisphere, but the one representing precentral cortex and middle and inferior frontal gyrus regions, indicated more pronounced effects on stroke severity in women. Lesion atom 7 highlighted left-sided insular cortex and subcortical regions (difference distribution: mean = −1.61, HPDI = −3.12 to −0.02). Lesion atom 8 comprised brainstem lesions, as well bilateral, left-hemispherically more distinct thalamus lesions (difference distribution: mean = −4.67, HPDI = −8.55 to −1.08) and lesion atom 9 widespread left-sided cortical lesions relating to the superior, middle and inferior temporal gyri, postcentral cortex, angular and supramarginal gyrus, and latero-occipital cortex (difference distribution: mean = −3.42, HPDI = −6.15 to −0.63). e Lesion atom 10. Lesions in left-sided brain regions of the presumed posterior circulation were associated to more severe strokes specifically in women (difference distribution: mean = −1.99, HPDI = −3.90 to −0.22). The sex difference for lesion atom 10 can be considered the most pronounced and robust one, given it was reliably observable in all ancillary analyses and was replicated in an independent dataset of stroke patients. All analyses were corrected for overall sex effects, i.e., lesion atom-independent effects (e.g., due to potential female-specific delayed hospital arrival). Of note, this correction was independent of the explicit knowledge or measurement of the causes of these global sex differences. Source data are provided as a Source data file.