Social cognition impairments after aneurysmal subarachnoid hemorrhage

Objective: Impaired social cognition (SC) is a possible underlying cause of behavioral and interpersonal changes after aneurysmal subarachnoid hemorrhage (aSAH). To date, SC has not been investigated after aSAH. Therefore, we aimed to investigate SC after aSAH and its relationship with frontal lesions. Participants and Methods; 89 aSAH patients (mean age 53.2 years) conducted a neuropsychological test battery in the subacute phase (mean = 4.8 months) post-SAH. A broad range of SC tests was administered; Emotion recognition (Facial Expressions of Emotion - Stimuli and Test; FEEST), Theory of Mind (Cartoon Test, Faux Pas Test; FP), and emotional empathy (FP Empathy Score, Balanced Emotional Empathy Scale; BEES) were investigated. Frontal infarctions on post-SAH MRI were registered. Between-group comparisons and correlations were used. Results: ASAH patients scored significantly worse on the FEEST (M = 45.64), Cartoons (M = 18.30) and Faux Pas (M FP correct = 4.17, M FP Empathy = 1.84) than controls (M = 48.76, M = 23.50, M = 4.63, M = 2.52 resp.), all ps < 0.05. BEES scores did not differ significantly between patients and controls. No significant correlations were found between the presence of frontal infarctions and SC tests. Conclusions: In the subacute phase after aSAH, several aspects of social cognition were clearly impaired (i.e. emotion recognition, Theory of Mind, empathy). These impairments were not related to frontal lesions. Considering the adverse consequences for daily functioning of social cognitive deficits, neuropsychological assessment after aSAH should include social cognition tests for all patients regardless of their lesion locations