Intracerebral haemorrhage laterality and associations with mood and pain: a MISTIE III substudy
Background The prognostic significance of the affected hemisphere in haemorrhagic stroke remains uncertain. We aimed to determine the relationship between the affected hemisphere (right or left) and differences in non-motor outcomes, including mood and pain, in patients with acute, supratentorial in...
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| Series: | Stroke and Vascular Neurology |
| Online Access: | https://svn.bmj.com/content/early/2025/04/18/svn-2024-003755.full |
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| author | Issam Awad Daniel Hanley Wendy C Ziai Matthew L Flaherty Mario Zuccarello Radhika Avadhani Noeleen Ostapkovich Dawson C Cooper Efrat Abramson Vishank A Shah Lourdes Carhuapoma Lauren H Sansing |
| author_facet | Issam Awad Daniel Hanley Wendy C Ziai Matthew L Flaherty Mario Zuccarello Radhika Avadhani Noeleen Ostapkovich Dawson C Cooper Efrat Abramson Vishank A Shah Lourdes Carhuapoma Lauren H Sansing |
| author_sort | Issam Awad |
| collection | DOAJ |
| description | Background The prognostic significance of the affected hemisphere in haemorrhagic stroke remains uncertain. We aimed to determine the relationship between the affected hemisphere (right or left) and differences in non-motor outcomes, including mood and pain, in patients with acute, supratentorial intracerebral haemorrhage (ICH). These non-motor outcomes are often overlooked in studies following ICH but impact patient recovery and well-being.Methods A secondary prespecified analysis of the Minimally Invasive Surgery with Thrombolysis in Intracerebral Hemorrhage Evacuation (MISTIE) III study—a randomised, international, multicentre, placebo-controlled trial of participants with spontaneous, non-traumatic, supratentorial ICH of 30 mL or more that evaluated minimally invasive surgery with thrombolysis compared with standard medical care. Outcomes included EQ-5D three-level version (EQ-5D-3L, composite and individual non-motor components) and modified Rankin scale (mRS) scores at days 30, 180 and 365 post-ICH.Results A total of 493 participants were eligible for analysis at day 30 following ICH. In multivariable analyses, patients with right hemispheric ICH were more likely to report problems with pain and discomfort at days 30 (β=0.257 (95% CI 0.131, 0.383)), 180 (β=0.213 (95% CI 0.090, 0.336)) and 365 (β=0.209 (95% CI 0.090, 0.328)) post-ICH. Patients with right hemispheric ICH were also more likely to report problems with anxiety and depression at days 30 (β=0.160 (95% CI 0.030, 0.291)) and 180 (β=0.171 (95% CI 0.049, 0.293)) following ICH. There were no differences in mRS scores between patients with left or right-sided haemorrhages.Conclusions Right hemispheric lesions were associated with increased reports of mood-related symptoms (depression, anxiety) and pain in patients with acute ICH over time.Trial registration number NCT01827046. |
| format | Article |
| id | doaj-art-4987a3a6c9fb4c7fa49f3ba40e2a34dc |
| institution | OA Journals |
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| series | Stroke and Vascular Neurology |
| spelling | doaj-art-4987a3a6c9fb4c7fa49f3ba40e2a34dc2025-08-20T02:12:49ZengBMJ Publishing GroupStroke and Vascular Neurology2059-869610.1136/svn-2024-003755Intracerebral haemorrhage laterality and associations with mood and pain: a MISTIE III substudyIssam Awad0Daniel Hanley1Wendy C Ziai2Matthew L Flaherty3Mario Zuccarello4Radhika Avadhani5Noeleen Ostapkovich6Dawson C Cooper7Efrat Abramson8Vishank A Shah9Lourdes Carhuapoma10Lauren H Sansing11Neurosurgery, University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA2 Division of Brain Injury Outcomes, Department of Neurology and Neurosurgery, Johns Hopkins University, Baltimore, Maryland, USA7 Departments of Neurology, Neurosurgery, and Anesthesiology Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA5 Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA1Department of Neurosurgery, University of Cincinnati (UC) College of Medicine, Cerebrovascular Center at UC Neuroscience Institute, Cincinnati, Ohio, USADepartment of Neurology, Division of Brain Injury Outcomes, Johns Hopkins University, Baltimore, Maryland, USA2 Division of Brain Injury Outcomes, Department of Neurology and Neurosurgery, Johns Hopkins University, Baltimore, Maryland, USAUniversity of Minnesota Medical School, Minneapolis, Minnesota, USAInterdepartmental Neuroscience Program, Yale School of Medicine, New Haven, Connecticut, USADepartment of Neurology, Johns Hopkins School of Medicine, Baltimore, Maryland, USADepartment of Neurology, Johns Hopkins School of Medicine, Baltimore, Maryland, USADepartment of Neurology and Immunobiology, Yale University School of Medicine, New Haven, Connecticut, USABackground The prognostic significance of the affected hemisphere in haemorrhagic stroke remains uncertain. We aimed to determine the relationship between the affected hemisphere (right or left) and differences in non-motor outcomes, including mood and pain, in patients with acute, supratentorial intracerebral haemorrhage (ICH). These non-motor outcomes are often overlooked in studies following ICH but impact patient recovery and well-being.Methods A secondary prespecified analysis of the Minimally Invasive Surgery with Thrombolysis in Intracerebral Hemorrhage Evacuation (MISTIE) III study—a randomised, international, multicentre, placebo-controlled trial of participants with spontaneous, non-traumatic, supratentorial ICH of 30 mL or more that evaluated minimally invasive surgery with thrombolysis compared with standard medical care. Outcomes included EQ-5D three-level version (EQ-5D-3L, composite and individual non-motor components) and modified Rankin scale (mRS) scores at days 30, 180 and 365 post-ICH.Results A total of 493 participants were eligible for analysis at day 30 following ICH. In multivariable analyses, patients with right hemispheric ICH were more likely to report problems with pain and discomfort at days 30 (β=0.257 (95% CI 0.131, 0.383)), 180 (β=0.213 (95% CI 0.090, 0.336)) and 365 (β=0.209 (95% CI 0.090, 0.328)) post-ICH. Patients with right hemispheric ICH were also more likely to report problems with anxiety and depression at days 30 (β=0.160 (95% CI 0.030, 0.291)) and 180 (β=0.171 (95% CI 0.049, 0.293)) following ICH. There were no differences in mRS scores between patients with left or right-sided haemorrhages.Conclusions Right hemispheric lesions were associated with increased reports of mood-related symptoms (depression, anxiety) and pain in patients with acute ICH over time.Trial registration number NCT01827046.https://svn.bmj.com/content/early/2025/04/18/svn-2024-003755.full |
| spellingShingle | Issam Awad Daniel Hanley Wendy C Ziai Matthew L Flaherty Mario Zuccarello Radhika Avadhani Noeleen Ostapkovich Dawson C Cooper Efrat Abramson Vishank A Shah Lourdes Carhuapoma Lauren H Sansing Intracerebral haemorrhage laterality and associations with mood and pain: a MISTIE III substudy Stroke and Vascular Neurology |
| title | Intracerebral haemorrhage laterality and associations with mood and pain: a MISTIE III substudy |
| title_full | Intracerebral haemorrhage laterality and associations with mood and pain: a MISTIE III substudy |
| title_fullStr | Intracerebral haemorrhage laterality and associations with mood and pain: a MISTIE III substudy |
| title_full_unstemmed | Intracerebral haemorrhage laterality and associations with mood and pain: a MISTIE III substudy |
| title_short | Intracerebral haemorrhage laterality and associations with mood and pain: a MISTIE III substudy |
| title_sort | intracerebral haemorrhage laterality and associations with mood and pain a mistie iii substudy |
| url | https://svn.bmj.com/content/early/2025/04/18/svn-2024-003755.full |
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