Scopelliti Giuseppe, Casolla Barbara, Boulouis Grégoire, Kuchcinski Gregory, Moulin Solène, Leys Didier, Henon Hilde, Cordonnier Charlotte, Pasi Marco
Department of Neurology, Univ. Lille, Inserm U1172 - LilNCog - Lille Neuroscience & Cognition, CHU Lille, Lille, France.
Department of Neuroradiology, Univ. Lille, Inserm U1172 - LilNCog - Lille Neuroscience & Cognition, CHU Lille, Lille, France.
J Neurol Neurosurg Psychiatry. 2022 Mar;93(3):232-237. doi: 10.1136/jnnp-2021-327557. Epub 2021 Nov 2.
Neuropsychiatric (NP) symptoms are prominent features of cognitive decline, but they have been understudied in patients with spontaneous intracerebral haemorrhage (ICH). In ICH survivors, we aimed at assessing NP symptoms prevalence and profiles, and their influence on long-term outcomes.
We analysed data from consecutive 6-month ICH survivors enrolled in the Prognosis of Intracerebral Haemorrhage study. We performed NP evaluation using the Neuropsychiatric Inventory Questionnaire. Patients underwent long-term clinical follow-up after ICH (median follow-up time 7.2 years, IQR 4.8-8.2).
Out of 560 patients with ICH, 265 survived at 6 months. NP evaluation 6 months after ICH was feasible in 202 patients. NP symptoms were present in 112 patients (55%), and in 36 out of 48 patients (75%) with post-ICH dementia. Affective symptoms were present in 77 patients (38%), followed by vegetative symptoms (52 patients, 26%) and hyperactivity (47 patients, 23%). Apathy and hyperactivity were associated with post-ICH dementia and cerebral amyloid angiopathy MRI profile (all p<0.05). Apathy and hyperactivity prevailing over affective symptoms at 6-month follow-up were associated with higher risks of developing new-onset dementia (HR 5.40; 95% CI 2.27 to 12.84), while presence or severity of NP symptoms were not.
NP symptoms were present in more than half of 6-month ICH survivors, with higher prevalence and severity in patients with post-ICH dementia. Distinctive NP profile might be associated to cognitive status and inform on long-term dementia risk.
神经精神（NP）症状是认知功能下降的突出特征，但在自发性脑出血（ICH）患者中对其研究较少。在ICH幸存者中，我们旨在评估NP症状的患病率和特征，以及它们对长期预后的影响。
我们分析了连续纳入脑出血预后研究的6个月ICH幸存者的数据。我们使用神经精神问卷进行NP评估。ICH患者接受了长期临床随访（中位随访时间7.2年，四分位间距4.8 - 8.2年）。
在560例ICH患者中，265例在6个月时存活。对202例患者在ICH后6个月进行NP评估是可行的。112例患者（55%）存在NP症状，在48例ICH后痴呆患者中有36例（75%）存在NP症状。情感症状出现在77例患者（38%）中，其次是植物神经症状（52例患者，26%）和多动（47例患者，23%）。淡漠和多动与ICH后痴呆及脑淀粉样血管病MRI表现相关（所有p<0.05）。在6个月随访时淡漠和多动超过情感症状与新发痴呆的较高风险相关（HR 5.40；95%CI 2.27至12.84），而NP症状的存在或严重程度则不然。
超过一半的6个月ICH幸存者存在NP症状，在ICH后痴呆患者中患病率和严重程度更高。独特的NP特征可能与认知状态相关，并可为长期痴呆风险提供信息。
