ABSTRACT NUMBER: ESOC2026A2271 BRAIN IMAGING CHARACTERISTICS ASSOCIATED WITH NON-MOTOR OUTCOMES AFTER INTRACEREBRAL HAEMORRHAGE

Abstract Background and aims Adverse non-motor outcomes are common after acute intracerebral haemorrhage (ICH), but the underlying mechanisms are uncertain. We investigated associations between brain imaging characteristics and non-motor outcomes at 6 months after stroke due to ICH. Methods We included consecutive patients with spontaneous ICH from a large observational registry with baseline MRI and six-month follow-up. ICH arteriopathy was classified as arteriolosclerosis, probable cerebral amyloid angiopathy (CAA; Boston criteria v2.0), mixed-location cerebral small vessel disease (cSVD), or cryptogenic. Haematoma volume was calculated using ABC/2 (large defined as ≥30 mL). cSVD features were rated using STRIVE v2.0, including total burden (score 0–4). Thirteen non-motor outcome domains were assessed using validated patient-reported measures. We used multivariable logistic regression to investigate associations between imaging characteristics and individual non-motor outcomes. Results Of 356 patients (mean age 68 years; 42.4% female), 319 (89.6%) completed six-month follow-up. Large haematoma volume (≥30 mL), lobar ICH location, probable CAA, white matter hyperintensities (WMHs), cerebral microbleeds (CMBs), and a total cSVD burden >3 were each independently associated with 6–10 adverse non-motor outcomes. The strongest associations were observed between large ICH volume and sleep disturbance (OR 2.21, p=0.005); WMH and lobar ICH with memory problems (OR 2.95, p<0.001 and OR 2.10, p=0.017, respectively); CAA and anxiety (OR 3.76, p<0.001); CMBs and depression (OR 1.93, p=0.016); and total cSVD burden >3 and mood problems (OR 2.62, p<0.001). Conclusions Brain imaging features of ICH and cSVD are independently associated with multiple adverse non-motor outcomes at six months. Conflict of interest Authors have nothing to disclose