Long-term fatigue after perimesencephalic subarachnoid haemorrhage in relation to cognitive functioning, mood and comorbidity

Abstract

Purpose: To study relationships between fatigue and objective and subjective cognitive functioning, mood and comorbidity in the long term after perimesencephalic subarachnoid haemorrhage (PM-SAH).

Methods: Cross-sectional study. Objective cognitive functioning was measured with: Trail Making Test; Symbol Substitution; D2; Verbal and Semantic Fluency; Tower Test; Digit Span; 15-Words Test; Rey Complex Figure. Subjective cognitive functioning: Cognitive Failure Questionnaire. Fatigue: Fatigue Severity Scale. Mood: Hospital Anxiety and Depression Scale.

Results: Forty-six patients, mean age 50.4 (SD = 9.4), mean time after PM-SAH 4.7 (SD = 1.6) years participated. Patients with fatigue (33%) had significantly lower scores than patients without fatigue on most objective cognitive functioning tests (p < 0.05). Fatigue score was significantly associated with subjective and objective cognitive functioning, mood and comorbidity. After adjustment for mood and comorbidity, fatigue remained associated with attention and executive functioning.

Conclusions: This study supports our previous findings that a third of patients with PM-SAH experience fatigue and problems of cognitive functioning, also in the long term. Future research should investigate whether these patients would benefit from long-term follow-up and/or cognitive rehabilitation programmes.

Implications for Rehabilitation

• Consequences for patients with PM-SAH are underestimated.

• One in every three patients suffered from fatigue in the long term after onset of PM-SAH.

• Patients with PM-SAH should be screened for problems of cognitive functioning, fatigue and mood in outpatient clinic just as patients with aneurysmal SAH.

Keywords:

• Cognitive functioning
• fatigue
• haemorrhage
• mood
• perimesencephalic
• subarachnoid

Disclosure statement

No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

None of the authors has a commercial interest or any conflict of interest regarding the submission of this manuscript.

Material in the manuscript has not been published and is not being considered for publication elsewhere in whole or in part in any language except as an oral presentation at the Dutch Congress of Rehabilitation Medicine in Rotterdam, the Netherlands, November 2015.

Funding information

Financial support for this study was provided by: Johanna Kinderfonds (grant no. 03.10.13–2003/0200) and Stichting BIO, The Netherlands.