ABSTRACT NUMBER: ESOC2026A1702 IMPAIRED CUTANEOUS MICROCIRCULATION IN PARETIC LIMBS AFTER ACUTE ISCHEMIC STROKE: RESULTS FROM THE PROSPECTIVE OBSERVATIONAL LUMOS STUDY

Abstract Background and aims Cardiovascular autonomic dysfunction is a frequent complication following acute ischemic stroke (AIS), leading to microcirculatory disturbances. However, its specific impact on paretic limbs and its role in functional recovery remain poorly understood. We characterized cutaneous microcirculation after AIS and hypothesized that microcirculatory impairment is more pronounced in paretic extremities. Methods LUMOS was a prospective observational study (12/2022–12/2023) of AIS survivors at a German tertiary stroke center. Cutaneous microcirculation (mean perfusion units, PU) was assessed bilaterally at three forearm sites using Laser Doppler Imaging (LDI) at admission (t1) and on day three (t2). Functional outcome (mRS) was assessed at 90 days. Generalized linear mixed models (GLMM) were used for analysis, with model fit determined by the Akaike information criterion. Results In our cohort of 66 AIS patients (median age 74 years [IQR 64–84]), mean cutaneous blood flow was significantly lower in paretic extremities compared to non-paretic limbs (81.90 ± [SD] PU vs. 86.12 ± 26.23 PU; p=0.02). Perfusion decreased significantly over time in paretic and non-paretic extremities (t1: 88.49 ± 27.08 PU vs. t2: 79.32 ± 28.84 PU; p=0.002) (Figure). However, early microcirculatory impairment did not predict 90-day functional outcome (p > 0.05). Conclusions Cutaneous micocirculation deteriorated in both, paretic and non-paretic extremities in AIS survivors, suggesting systemic dysautonomia beyond the effect of local immobilization. LDI-based assessment of cutaneous microcirculation may be a viable bedside tool for autonomic function monitoring in these patients but its long-term prognostic value warrants further investigation. Conflict of interest Isabella Püschel: nothing to disclose. Aileen Dürr: nothing to disclose. Eyad Altarsha: nothing to disclose. Norma Diel: nothing to disclose. Erik Simon: nothing to disclose. Kristian Barlinn: nothing to disclose. Hagen B. Huttner: nothing to disclose. Timo Siepmann: nothing to disclose. Figure 1 - belongs to Results