# REpeated ASseSsmEnt of SurvivorS in ICH (REASSESS ICH)

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2024 · $579,933

## Abstract

Project Summary / Abstract
Descriptive Title: REpeated ASSEssment of SurvivorS in ICH-MRI, an ancillary neuroimaging study of the
REASSESS ICH longitudinal study.
Purpose: The REpeated ASSEssment of SurvivorS MRI study will conduct a single MRI with SWI/GRE along
with blinded central measurement of cerebral small vessel disease (CSVD) parameters to determine if
evacuation of spontaneous intracerebral hemorrhage (ICH) reduces risk of later progression of CSVD. This
study builds on the funded REASSESS ICH parent study which is conducting serial long-term cognitive and
functional assessments on the same population to determine if ICH evacuation reduces risk of cognitive
decline in the ageing brain. This study will compare CSVD burden after minimally invasive surgery (MIS) as
performed in the MISTIE III and ENRICH trials, and standard of care, supplemented by comparative data from
The ROSE-Longitudinal Assessment With Neuroimaging (ROSE-LAWN) study (R-01-NS120493) which is
conducting MRI on 250 cases recruited into the ROSE study of ICH at 12-24 months with cognitive exams.
Rationale: ICH survivors are at high risk for progressive cognitive impairment which is strongly associated with
greater hematoma volume, but also with cerebral amyloid angiopathy, and with multiple markers for CSVD, the
most common cause of vascular dementia. MIS with effective hematoma volume reduction may improve long-
term functional outcomes while also reducing mortality. As such, reducing hematoma volume after ICH may
reduce the progression of CSVD as a mechanism for reducing the risk of post ICH cognitive decline.
Design: REASSESS MRI is an MRI study ancillary to the ongoing REASSESS study. MRI will be performed
during a one-time in-person visit of an anticipated 150-200 ICH survivors enrolled in MISTIE III or ENRICH.
Aim 1: To determine the effects of surgical clot reduction on MRI markers of cerebral small vessel
disease (CSVD) after ICH. We hypothesize that reducing end of treatment (EOT) ICH volume will be
associated with decrease in total burden of CSVD (including WMHs, microbleeds or siderosis, perivascular
spaces, lacunar infarcts and atrophy) in survivors of MISTIE III and ENRICH.
Exploratory Aim 1: To determine the effects of burden of CSVD on MRI on cognitive function after
surgical clot reduction for ICH. We hypothesize that the burden of total CSVD, and other MRI features of
CSVD will correlate with cognitive decline measured by the Folstein Mini-Mental Status Exam (MMSE) and will
be modified by EOT ICH volume in operated and non-operated survivors of MISTIE III and ENRICH.
Exploratory Aim 2: To determine the effects of inflammatory gene pathway expression on CSVD MRI
markers. We will evaluate whether inflammatory pathways, in particular, differ between those with and without
burden of CSVD on MRI independent of gene risk scores for dementia and surgery.

## Key facts

- **NIH application ID:** 10803650
- **Project number:** 3R01NS120557-03S1
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Matthew Flaherty
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $579,933
- **Award type:** 3
- **Project period:** 2022-01-01 → 2026-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10803650

## Citation

> US National Institutes of Health, RePORTER application 10803650, REpeated ASseSsmEnt of SurvivorS in ICH (REASSESS ICH) (3R01NS120557-03S1). Retrieved via AI Analytics 2026-06-01 from https://api.ai-analytics.org/grant/nih/10803650. Licensed CC0.

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