Cognitive deficits among patients surviving aneurysmal subarachnoid hemorrhage. A contemporary systematic review

Nussbaum, Eric S.; Mikoff, Nick; Paranjape, Geeta

doi:10.1080/02688697.2020.1859462

Cited by 27 publications

(32 citation statements)

References 98 publications

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“…Numerous studies have documented cognitive sequelae after aSAH (Al-Khindi et al, 2010 ; Rinkel and Algra, 2011 ; Nordenmark et al, 2019b ; Burke et al, 2020 ; Nussbaum et al, 2020 ). Despite increasing interest in using neuropsychological tests in fatigue research, a lack of correlation between fatigue and neuropsychological performance has been observed across a wide variety of clinical samples (DeLuca, 2005 ).…”

Section: Discussionmentioning

confidence: 99%

“…Even though the mortality rates are high, survival has improved due to early intervention and advances in management. Remarkably, most aSAH survivors recover without significant neurological deficits, however, even patients with good outcome report substantial problems with fatigue, as well as cognitive and emotional problems (Al-Khindi et al, 2010 ; Nordenmark et al, 2019a ; Nussbaum et al, 2020 ; Tang et al, 2020 ). Fatigue represents the most frequent symptom after aSAH and is found in 50–70% of patients even several years after the hemorrhage (Kutlubaev et al, 2012 ; Western et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

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Fatigue After Aneurysmal Subarachnoid Hemorrhage: Clinical Characteristics and Associated Factors in Patients With Good Outcome

Western

Nordenmark

Sorteberg

et al. 2021

Front. Behav. Neurosci.

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Fatigue after aneurysmal subarachnoid hemorrhage (post-aSAH fatigue) is a frequent, often long-lasting, but still poorly studied sequel. The aim of the present study was to characterize the nature of post-aSAH fatigue with an itemized analysis of the Fatigue Severity Scale (FSS) and Mental Fatigue Scale (MFS). We further wanted to assess the association of fatigue with other commonly observed problems after aSAH: mood disorders, cognitive problems, health-related quality of life (HRQoL), weight gain, and return to work (RTW). Ninety-six good outcome aSAH patients with fatigue completed questionnaires measuring fatigue, depression, anxiety, and HRQoL. All patients underwent a physical and neurological examination. Cognitive functioning was assessed with a neuropsychological test battery. We also registered prior history of fatigue and mood disorders as well as occupational status and RTW. The patients experienced fatigue as being among their three most disabling symptoms and when characterizing their fatigue they emphasized the questionnaire items “low motivation,” “mental fatigue,” and “sensitivity to stress.” Fatigue due to exercise was their least bothersome aspect of fatigue and weight gain was associated with depressive symptoms rather than the severity of fatigue. Although there was a strong association between fatigue and mood disorders, especially for depression, the overlap was incomplete. Post-aSAH fatigue related to reduced HRQoL. RTW was remarkably low with only 10.3% of patients returning to their previous workload. Fatigue was not related to cognitive functioning or neurological status. Although there was a strong association between fatigue and depression, the incomplete overlap supports the notion of these two being distinct constructs. Moreover, post-aSAH fatigue can exist without significant neurological or cognitive impairments, but is related to reduced HRQoL and contributes to the low rate of RTW.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Fatigue After Aneurysmal Subarachnoid Hemorrhage: Clinical Characteristics and Associated Factors in Patients With Good Outcome

Western

Nordenmark

Sorteberg

et al. 2021

Front. Behav. Neurosci.

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“…A recent systematic review including 65 studies investigated the cognitive deficits associated with SAH [ 35 ]. Nussbaum et al searched two databases (PubMed and Google Scholar) for studies published between 2010–2019, reporting patients with aneurismal SAH that experienced long-term cognitive deficits.…”

Section: Discussionmentioning

confidence: 99%

“…The authors concluded that SAH patients, including those that appear normal at the time of hospital discharge, may present cognitive impairment that, although difficult to detect, can interfere with daily functioning. However, the researchers did not assess the quality of the included diagnostic test accuracy studies [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Montreal Cognitive Assessment for Evaluating Cognitive Impairment in Subarachnoid Hemorrhage: A Systematic Review

Cornea

Simu

Roşca

2022

JCM

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Subarachnoid hemorrhage (SAH) is a severe condition with high mortality and extensive long-term morbidity. Although research has focused mainly on physical signs and disability for decades, in recent years, it has been increasingly recognized that cognitive and psychological impairments may be present in many patients with SAH, negatively impacting their quality of life. We performed a systematic review aiming to provide a comprehensive report on the diagnostic accuracy of the Montreal Cognitive Assessment (MoCA) test for evaluating the presence of cognitive impairment in patients with SAH. Using appropriate search terms, we searched five databases (PubMed, Scopus, PsychINFO, Web of Sciences, and Latin American and Caribbean Health Sciences Literature) up to January 2022. Two cross-sectional studies investigated the accuracy of MoCA in SAH patients in the subacute and chronic phase. We appraised the quality of the included studies using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) criteria. The MoCA test provides information about general cognitive functioning disturbances. However, a lower threshold than the original cutoff might be needed as it improves diagnostic accuracy, lowering the false positive rates. Further research is necessary for an evidence-based decision to use the MoCA in SAH patients.

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“…Subarachnoid hemorrhage (SAH) is a fatal type of hemorrhagic stroke with high mortality and morbidity, aneurysmal subarachnoid hemorrhage (aSAH) is the cause of 85% of cases of spontaneous SAH ( 1 ). Meanwhile, survivors may suffer from different functional deficits that may affect the quality of life and make it difficult to return to work ( 2 , 3 ). Therefore, investigating prognostic factors for functional outcomes after aSAH is an aspirational destination.…”

Section: Introductionmentioning

confidence: 99%

Prognostic significance of combined score of fibrinogen and neutrophil-lymphocyte ratio for functional outcome in patients with aneurysmal subarachnoid hemorrhage

Hou

Yang

et al. 2022

Front. Neurol.

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ObjectiveTo explore the relationship between fibrinogen and neutrophil to lymphocyte ratio (F-NLR) score and functional outcomes after aneurysmal subarachnoid hemorrhage (aSAH).MethodA retrospective study was conducted that involved all consecutive patients with aSAH admitted to our institution from March 2018 to October 2021. Factors, such as demographics, comorbidities, clinical characteristics, neuroradiological data, and laboratory parameters, were collected from institutional databases. All patients achieved neurological assessment using the modified Rankin Scale (mRS) score 3 months after discharge to clarify the functional outcomes. The results were classified as favorable (mRS score 0–2) and unfavorable (mRS score 3–6). Univariate and multivariable analyses were performed to identify the relevant factors between inflammatory markers and functional outcomes after aSAH. Subsequently, a receiver operating characteristic (ROC) curve analysis was conducted to evaluate the predicting performance of variables. A propensity score match (PSM) was performed to correct imbalances in patients' baseline characteristics.ResultsFinally, 256 patients with aSAH were included in the study cohort. A total of 94 (36.7%) patients had an unfavorable outcome. F-NLR scores were 0 [interquartile range (IQR) 0–1] and 1 (IQR 1–2) in patients with favorable and unfavorable outcomes, respectively (p < 0.001). After adjustment, the F-NLR score on admission remained significantly associated with unfavorable outcomes in patients with aSAH. In the multivariable analysis, the F-NLR score was regarded as an independent risk factor of unfavorable outcomes [odds ratio (OR) 3.113, 95% CI 1.755–5.523, p < 0.001]. In ROC analysis, the optimal cutoff value of the F-NLR score was 0.5 points. Two cohorts (n = 86 in each group) obtained from PSM with low F-NLR scores (0 points) and high F-NLR scores (1–2 points) were used for analysis. A significantly higher unfavorable functional outcome rate was observed in patients with high F-NLR scores (33.7 vs. 9.3%, p < 0.001). The area under the curve (AUC) values of F-NLR scores before and after PSM were 0.767 and 0.712, respectively.ConclusionFibrinogen and neutrophil to lymphocyte ratio score was an independent risk parameter associated with unfavorable functional outcomes at 3 months after aSAH. A higher F-NLR score predicts the occurrence of poor functional outcomes.

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Cognitive deficits among patients surviving aneurysmal subarachnoid hemorrhage. A contemporary systematic review

Cited by 27 publications

References 98 publications

Fatigue After Aneurysmal Subarachnoid Hemorrhage: Clinical Characteristics and Associated Factors in Patients With Good Outcome

Fatigue After Aneurysmal Subarachnoid Hemorrhage: Clinical Characteristics and Associated Factors in Patients With Good Outcome

Montreal Cognitive Assessment for Evaluating Cognitive Impairment in Subarachnoid Hemorrhage: A Systematic Review

Prognostic significance of combined score of fibrinogen and neutrophil-lymphocyte ratio for functional outcome in patients with aneurysmal subarachnoid hemorrhage

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