The effect of time on cognitive impairments after non-traumatic subarachnoid haemorrhage and after traumatic brain injury

Tölli, Anna; Höybye, Charlotte; Bellander, Bo‐Michael; Johansson, Fredrik; Borg, Jörgen

doi:10.1080/02699052.2018.1497203

Cited by 12 publications

(9 citation statements)

References 66 publications

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“…The most common hypofunction in the current study group was for gonadal hormones, observed in 38%, and most common hyperfunction for high cortisol levels in 52% (Table II). As recently reported (19), although both cognitive and global function improves significantly until 12 months after both TBI and aSAH, impairments remain at 12 months. In the current study group, cognitive impairment according to BNIS was present in 54% of cases and impaired global outcome according to GOSE in 37%.…”

Section: Discussionsupporting

confidence: 80%

“…Most PiDs were transient, with no need for replacement therapy, but a small subgroup (7%) needed such therapy. In this cohort of patients, who were recruited from the neurointensive care unit at one university hospital and who went through the same structured neurorehabilitation and follow-up programme, we also assessed cognitive and global function until one year after the event (19). Cognitive and global function improved significantly over time in both diagnostic groups and was not significantly different between groups at 12 months.…”

mentioning

confidence: 99%

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Impact of pituitary dysfunction on cognitive and global outcome after traumatic brain injury and aneurysmal subarachnoid haemorrhage

Tölli¹,

Höybye²,

Bellander³

et al. 2019

J Rehabil Med

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Traumatic brain injury and aneurysmal subarachnoid haemorrhage are leading causes of physical, cognitive and behavioural disabilities. Traumatic brain injury and aneurysmal subarachnoid haemorrhage may affect the hypothalamus and pituitary gland, which are of major importance for our hormone balance. The purpose of the study was to investigate the relationship between the pituitary dysfunction after traumatic brain injury and aneurysmal aneurysmal subarachnoid haemorrhage, and cognitive and global outcomes at 12 months after the injury. In total, we included 127 patients during neurointensive care. Follow-up was at a rehabilitation medicine department. The study showed negative associations between high level of growth hormone and prolactin and behavioural and cognitive function; and between low gonadotropins and high prolactin and global outcome. We conclude that some pituitary dysfunctions during the first year after traumatic brain injury and aneurysmal subarachnoid haemorrhage may have clinically relevant, independent effects on clinical outcome at 12 months. Objective: To explore associations between pituitary dysfunction and clinical outcome at 12 months after traumatic brain injury and aneurysmal subarachnoid haemorrhage. Methods: Prospective cohort study of 82 patients with traumatic brain injury and 45 with aneurysmal subarachnoid haemorrhage, included at one neurointensive care unit. Baseline data comprised age, sex, Glasgow Coma Scale (GCS) score, S100B and pupil light reactions. Hormone data were collected in the neurointensive care unit and after 3, 6 and 12 months. Outcome was assessed with Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS), Rancho Los Amigos Cognitive Scale-Revised (RLAS-R) and Glasgow Outcome Scale Extended (GOSE). Results: The most frequent hormonal deviations were hypogonadotropic hypogonadism (38%) and hypercortisolism (52%). At 12 months, performance on BNIS was impaired in 54% and GOSE in 37%. Controlling for baseline variables, low levels of gonadal hormones were associated with lower GOSE score (b =-0.80, p = 0.033), high levels of prolactin with lower RLAS (b =-1.42, p = 0.034) and high levels of serum insulin-like growth factor I (S-IGF-I) with lower RLAS level (b =-1.78, p = 0.002) and lower GOSE score (b =-1.49, p = 0.006). Conclusion: These data suggest that pituitary dysfunctions during the first year after traumatic brain injury and aneurysmal subarachnoid haemorrhage may have clinically relevant, independent effects on clinical outcome at 12 months.

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Section: Discussionsupporting

confidence: 80%

mentioning

confidence: 99%

Impact of pituitary dysfunction on cognitive and global outcome after traumatic brain injury and aneurysmal subarachnoid haemorrhage

Tölli¹,

Höybye²,

Bellander³

et al. 2019

J Rehabil Med

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“…64 On the contrary, five studies (n=261) found no change in depressive symptoms between the first assessment at 3, 6, or 9 months and subsequent follow-up(s) at 6, 9 months, 1, 1.5, 2, or 4 years after SAH. 18,19,23,25,29 In a cross-sectional study, the proportion of patients with depression was not statistically different from patients 2 to 5, 5 to 10, and even more than 10 years after SAH, with 8.3%, 10.7%, and 8.6%, respectively. 37 The weighted frequency of depression was 33% up to a year after SAH and 28% a year or more after.…”

Section: Time Course Of Depression After Sahmentioning

confidence: 84%

“…Fifty-one of 55 studies (93%) used one of the following screening or rating scales to ascertain the presence of depression: Hospital Anxiety Depression Scale (HADS), 18,19,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40] Beck Depression Inventory (BDI), [12][13][14][15][16][17][18][19][20][21][40][41][42][43][44][45][46][47][48][49][50][51] Center for Epidemiologic Studies Depression (CESD), [22][23][24]52,53 Montgomery Åsberg Depression Rating Scale (MADRS), 54,55 Geriatric Depression Scale (GDS), 56,57 International Classification of Diseases...…”

Section: Resultsmentioning

confidence: 99%

“…Eight studies (n=539) assessed depression at more than one time point ( Supplementary Table 3). 18,19,23,25,29,41,44,64 In one study (n=113), the proportion of patients with depression increased from 24.8% at discharge to 61.7% at the 12-month follow-up. 44 In another study, 72% of patients with depressive symptoms at 3 months still had symptoms at 2 to 5 years.…”

Section: Time Course Of Depression After Sahmentioning

confidence: 99%

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Depression after Subarachnoid Hemorrhage: A Systematic Review

et al. 2020

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Background and Purpose Depression is common and debilitating illness accompanying many neurological disorders including non-traumatic subarachnoid hemorrhage (SAH). The aim of this systematic review was to identify and critically appraise all published studies that have reported the frequency, severity and time course of depression after SAH, the factors associated with its development and the impact of depression on patients’ quality of life after SAH.Methods The PubMed database was searched for studies published in English that recruited at least 40 patients (>18 years old) after SAH who were also diagnosed with depression.Results Altogether 55 studies covering 6,327 patients met study entry criteria. The frequency of depression ranged from 0% to 61.7%, with a weighted proportion of 28.1%. Depression remained common even several years after the index SAH. Depression after SAH was associated with female sex, premorbid depression, anxiety, substance use disorders or any psychiatric disorders, and coping styles. Comorbid cognitive impairment, fatigue, and physical disability also increased the risk of depression. Aneurysmal SAH and infarction may be related to depression as well. Depression reduces the quality of life and life satisfaction in patients after SAH.Conclusions Depression is common after SAH and seems to persist. Further research is needed to clarify its time course and identify the neuroendocrine and neurochemical factors and brain circuits associated with the development of post-SAH depression. Randomized controlled treatment trials targeting SAH-related depression are warranted.

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Depression screening in patients with aneurysmal subarachnoid haemorrhage and their caregivers: A systematic review

Leung

Cartoon²,

Hammond³

2023

Australian Critical Care

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The effect of time on cognitive impairments after non-traumatic subarachnoid haemorrhage and after traumatic brain injury

Abstract: Cognitive improvements after SAH and TBI exhibit similarities and correlate with global function. GCS scores are associated with outcome after TBI but not after SAH.

Cited by 12 publications

References 66 publications

Impact of pituitary dysfunction on cognitive and global outcome after traumatic brain injury and aneurysmal subarachnoid haemorrhage

Impact of pituitary dysfunction on cognitive and global outcome after traumatic brain injury and aneurysmal subarachnoid haemorrhage

Depression after Subarachnoid Hemorrhage: A Systematic Review

Depression screening in patients with aneurysmal subarachnoid haemorrhage and their caregivers: A systematic review

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