Abstract TP37: The Relationship Between Long-Term Neuropsychiatric Symptoms and Cognitive Performances in Intracerebral Hemorrhage Survivors

Abstract

Introduction: Neuropsychiatric (NP) symptoms have substantial influence on patients surviving with intracerebral hemorrhage (ICH), but their impact to cognitive impairment and life quality are poorly understood. We aim to investigate the subtypes of long-term NP symptoms, and their correlation to neurocognitive profiles and quality of life (QoL) in ICH survivors. Methods: Fifty-six patients survived with spontaneous ICH for at least 12 months were prospectively recruited to participate in this study. Each patient received comprehensive neurocognitive and NP assessment as well as a questionnaire for their QoL. We reported the prevalence and types of NP symptoms, and compared the demographic and neuroimaging findings between patients with and without NP symptoms. Multivariable linear regression models were applied to investigate the association between NP symptoms and cognitive domains after adjustment for age, sex, educational years, hematoma location and small vessel disease (SVD) scores. Results: NP symptoms were present in 24 (42.9%) of the recruited patients, in which affective symptoms were most common (35.7%), followed by apathy/vegetative symptoms (26.8%), hyperactivity (17.9%), and psychosis (1.8%). Patients with NP symptoms showed more cerebral SVD changes and they were associated with worse general cognitive abilities (p<0.05). In our analysis regarding each NP subtype, the presence of apathy/vegetative symptoms was associated with slower processing speed (p=0.015) and worse category fluency (p=0.042) while the affective or hyperactivity symptoms were neither associated any domain-specific neurocognitive functions. Additionally, the presence of these NP symptoms except for psychosis independently predicts worse QoL. Conclusions: Long-term NP symptoms are frequent in ICH survivors and is independently related to cognitive dysfunction and worse life quality. The NP subtype, especially apathy/vegetative symptoms, should be well-characterized for their contribution to neurocognitive domains.