Reder Sebastian R, Hardt Jochen, Brockmann Marc A, Brockmann Carolin, Kim Suam, Kawulycz Melina, Schulz Marie, Kantelhardt Sven Rainer, Petrowski Katja, Fischbeck Sabine
Department of Neuroradiology, University Medical Center, Johannes Gutenberg-University of Mainz, Mainz, Germany.
Department of Medical Psychology and Medical Sociology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
Sci Rep. 2025 Aug 20;15(1):30562. doi: 10.1038/s41598-025-15544-1.
To explore the mental and physical health (MH, PH) on individuals living with brain aneurysms and to profile their differences in disease experience. In N = 111 patients the Short Form 36 Health Survey (SF-36) was assessed via an online survey; Supplementary data included angiography and magnetic resonance imaging (MRI) findings (including AI-based brain Lesion Volume analyses in ml, or LV). Correlation and regression analyses were conducted (including biological sex, age, overall brain LV, PH, MH). Disease profiles were determined using principal component analysis. Compared to the German normative cohort, patients exhibited overall lower SF-36 scores. In regression analyses, the DW was predictable by PH (β = 0.345) and MH (β=-0.646; R = 0.557; p < 0.001). Vasospasm severity correlated significantly with LV (r = 0.242, p = 0.043), MH (r=-0.321, p = 0.043), and PH (r=-0.372, p = 0.028). Higher LV were associated with poorer PH (r=-0.502, p = 0.001), unlike MH (p > 0.05). Main disease profiles were identified: (1) those with increased LV post-rupture (high DW); (2) older individuals with stable aneurysms (low DW); (3) revealing a sex disparity in QoL despite similar vasospasm severity; and 4), focused on chronic pain and its impact on daily tasks. Two sub-profiles highlighted trauma-induced impairments, functional disabilities from LV, and persistent anxiety. Reduced thalamic and pallidal volumes were linked to low QoL following subarachnoid hemorrhage. MH has a greater impact on life quality compared to physical disabilities, leading to prolonged DW. A singular physical impairment was rather atypical for a perceived worse outcome. Patient profiles revealed that clinical history, sex, psychological stress, and pain each contribute uniquely to QoL and work capacity. Prioritizing MH in assessing workability and rehabilitation is crucial for survivors' long-term outcome.
探索脑动脉瘤患者的身心健康状况，并剖析他们在疾病体验方面的差异。对111名患者通过在线调查评估了简短健康调查问卷（SF - 36）；补充数据包括血管造影和磁共振成像（MRI）结果（包括基于人工智能的脑病变体积分析，单位为毫升，即LV）。进行了相关性和回归分析（包括生物学性别、年龄、全脑LV、身心健康）。使用主成分分析确定疾病特征。与德国正常队列相比，患者的SF - 36总分较低。在回归分析中，DW可由身心健康状况预测（β = 0.345）和心理健康状况（β = - 0.646；R = 0.557；p < 0.001）。血管痉挛严重程度与LV显著相关（r = 0.242，p = 0.043）、心理健康状况（r = - 0.321，p = 0.043）和身体健康状况（r = - 0.372，p = 0.028）。较高的LV与较差的身体健康状况相关（r = - 0.502，p = 0.001），与心理健康状况不同（p > 0.05）。确定了主要疾病特征：（1）破裂后LV增加的患者（高DW）；（2）动脉瘤稳定的老年患者（低DW）；（3）尽管血管痉挛严重程度相似，但生活质量存在性别差异；以及（4）关注慢性疼痛及其对日常任务的影响。两个子特征突出了创伤引起的损伤、LV导致的功能残疾和持续性焦虑。丘脑和苍白球体积减小与蛛网膜下腔出血后低生活质量相关。与身体残疾相比，心理健康对生活质量的影响更大，导致DW延长。单一的身体损伤对于预后较差的情况而言相当不典型。患者特征表明，临床病史、性别、心理压力和疼痛各自对生活质量和工作能力有独特贡献。在评估工作能力和康复过程中优先考虑心理健康对于幸存者的长期预后至关重要。
