Abstract
Objective: This study aims to longitudinally investigate social cognition and behavior in both aSAH and anSAH patients to determine whether there is recovery of early impairments or
whether these persist in the chronic stage. We will investigate whether there is a relation between social cognition and behavioral problems in the chronic stage after SAH, and whether there is a relation with long-term societal participation. This would have large clinical relevance, since it would allow for early identification of patients at risk for diminished long-term societal participation.
Methods: This longitudinal follow-up study included SAH patients who were admitted to the University Medical Center Groningen. Neuropsychological assessments were performed in
the subacute stage (3–6 months) after SAH (T1) and again in the chronic stage (2–4 years) after SAH (T2). Emotion recognition was measured using the Ekman 60-Faces test (FEEST), and
Theory of Mind (ToM) was measured using the Cartoon Test and the Faux Pas Test. Behavioral problems were quantified using the Apathy Evaluation Scale (AES) and the Dysexecutive
Questionnaire (DEX). Of both questionnaires, both a self-rated and proxy-rated version were used. Finally, the Role Resumption List (RRL) was used to assess changes in amount and quality of work, social relations, leisure activities and mobility.
Results: A total of 59 aSAH and 22 anSAH patients were included in this study. For the Cartoon test, a significant improvement was found for aSAH patients at T2. The effect size was small to medium. For the other tests, no significant differences were found over time. Furthermore, significantly more problems on both the DEX-self and DEX-proxy were reported at T2 in anSAH patients. The effect size was large. There were no significant differences on the AES over time in either of the patient groups. A significant negative correlation between the FEEST and AES-I as well as between the Cartoons and AES-I was found in aSAH patients, but not anSAH
patients, at T2. Correlations between social cognition tests and societal participation at T2 were not significant. However, the DEX-self, DEX-proxy and AES-S were significantly
correlated with both work and societal participation in aSAH patients. For anSAH patients this was the case for the DEX-proxy only.
Conclusions: Social cognition impairments and behavioral problems after SAH seem to persist over time. Moreover, behavioral changes in the chronic stage after both aSAH and anSAH are related to long-term problems in work and societal participation. The findings of the current study emphasize the need for more attention to social cognition and behavior after SAH. This might allow for early identification of patients at risk for diminished long-term participation and may guide a more individualized rehabilitation approach.
whether these persist in the chronic stage. We will investigate whether there is a relation between social cognition and behavioral problems in the chronic stage after SAH, and whether there is a relation with long-term societal participation. This would have large clinical relevance, since it would allow for early identification of patients at risk for diminished long-term societal participation.
Methods: This longitudinal follow-up study included SAH patients who were admitted to the University Medical Center Groningen. Neuropsychological assessments were performed in
the subacute stage (3–6 months) after SAH (T1) and again in the chronic stage (2–4 years) after SAH (T2). Emotion recognition was measured using the Ekman 60-Faces test (FEEST), and
Theory of Mind (ToM) was measured using the Cartoon Test and the Faux Pas Test. Behavioral problems were quantified using the Apathy Evaluation Scale (AES) and the Dysexecutive
Questionnaire (DEX). Of both questionnaires, both a self-rated and proxy-rated version were used. Finally, the Role Resumption List (RRL) was used to assess changes in amount and quality of work, social relations, leisure activities and mobility.
Results: A total of 59 aSAH and 22 anSAH patients were included in this study. For the Cartoon test, a significant improvement was found for aSAH patients at T2. The effect size was small to medium. For the other tests, no significant differences were found over time. Furthermore, significantly more problems on both the DEX-self and DEX-proxy were reported at T2 in anSAH patients. The effect size was large. There were no significant differences on the AES over time in either of the patient groups. A significant negative correlation between the FEEST and AES-I as well as between the Cartoons and AES-I was found in aSAH patients, but not anSAH
patients, at T2. Correlations between social cognition tests and societal participation at T2 were not significant. However, the DEX-self, DEX-proxy and AES-S were significantly
correlated with both work and societal participation in aSAH patients. For anSAH patients this was the case for the DEX-proxy only.
Conclusions: Social cognition impairments and behavioral problems after SAH seem to persist over time. Moreover, behavioral changes in the chronic stage after both aSAH and anSAH are related to long-term problems in work and societal participation. The findings of the current study emphasize the need for more attention to social cognition and behavior after SAH. This might allow for early identification of patients at risk for diminished long-term participation and may guide a more individualized rehabilitation approach.
| Original language | English |
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| Publication status | Published - 2023 |