ABSTRACT NUMBER: ESOC2026A1363 MICROBIOTA IN ACUTE ISCHEMIC STROKE: PRELIMINARY CLINICAL AND NEUROPSYCHOLOGICAL FINDINGS FROM A PROSPECTIVE COHORT

Abstract Background and aims Experimental and clinical evidence suggests that gut, oral and systemic microbiota may influence inflammation, vascular dysfunction and post-stroke recovery. However, microbial patterns across different biological compartments and their association with clinical outcomes remain underexplored, particularly in patients undergoing reperfusion therapies. We conducted a prospective, multimodal cohort that integrated clinical, neuroimaging, neuropsychological and, biological data. We present feasibility results and preliminary descriptive findings from the initial patients enrolled. Methods Adults with acute ischemic stroke treated with mechanical thrombectomy (MT) were prospectively included. Clinical, imaging, laboratory, therapeutic and functional variables were recorded. Clinical follow-up included NIHSS (baseline and visits 1-3) and mRS (discharge and 3 months). Lifestyle assessments included Mediterranean diet adherence, physical activity and quality of life (EQ-5D-5L). At 3 months, neuropsychological evaluation included the T@M test, anxiety/depression scale and Pittsburgh Sleep Quality index. Biological sampling was restricted to the baseline visit and included blood, saliva, stool and thrombus retrieval during MT. Results Nineteen patients were analysed (median age 68; 47% female). Median baseline NIHSS was 15 and ASPECTS was 9. Successful reperfusion (TICI ≥ 2b) was achieved in 84%. Baseline Mediterranean diet adherence was moderate, and physical activity showed wide variability. At 3 months, median mRS was 2. Neuropsychological assessments revealed heterogeneous performance in memory, mood symptoms and sleep quality. Conclusions This study demonstrates the feasibility and robustness of intensive multimodal phenotyping in thrombectomy patients. Future integration with microbiome sequencing will enable mechanistic insights into host-microbiome interactions shaping inflammation and functional recovery after stroke. Conflict of interest All authors: nothing to disclose.