ABSTRACT NUMBER: ESOC2026A1993 AUTONOMIC DYSFUNCTION AS A DETERMINANT OF POST-STROKE FATIGUE: PRELIMINARY FINDINGS OF A PROSPECTIVE LONGITUDINAL STUDY

Abstract Background and aims Post-stroke fatigue (PSF) is a common, debilitating, and poorly understood complication. Autonomic dysfunction, as reflected by altered heart rate variability (HRV), has been associated with adverse stroke outcomes. This study aimed to investigate the relationship between HRV parameters measured in acute stroke, and PSF at 3 months. Methods HRV was assessed in 35 consecutive acute ischemic stroke patients within 72 hours of admission using 10-minute ECG recordings. To reduce influence of transient environmental fluctuations, the first and last minutes were excluded, and the remaining signal was segmented into overlapping 5-minute windows, averaged to derive stable HRV estimates. After artefact correction and exclusion of atrial fibrillation patients, time- and frequency-domain HRV indices (SDNN, RMSSD, LF, HF, LF/HF) were calculated. PSF was defined as Fatigue Severity Scale (FSS) score ≥4 at 3 months post-stroke. Patients were classified according to the presence or absence of PSF. Owing to small sample size, nonparametric statistical analyses were applied. Results The median age was 65 years, median NIHSS 2, 34% were female and 31% (11/35) developed PSF. LF power (ms2) was significantly lower in patients with PSF compared with those without PSF (median [IQR] 106 [80–330] vs. 246 [142–659]; p = 0.020). HF power also tended to be lower in the PSF group (137 [50–580] vs. 479 [185–1075]; p = 0.067). Conclusions Lower LF and a trend toward lower HF in acute HRV measurements were associated with PSF at 3 months, supporting a role for autonomic imbalance in PSF. Conflict of interest Anissa Ourtani: nothing to disclose; Wout Roelandt: nothing to disclose; Ellen Boels: nothing to disclose; Fernando Esteban Ramirez Barbosa: nothing to disclose; Kurt Barbé: nothing to disclose; Andreea Motoc: nothing to disclose; Robin Gens: nothing to disclose; Marie-Dominique Gazagnes: nothing to disclose; Fenne Vandervorst: nothing to disclose; Sylvie De Raedt: nothing to disclose. Figure 1 - belongs to Results