Abstract
Quality of life (QoL) disturbances are common after aneurysmal subarachnoid hemorrhage (aSAH) both in physical and mental health domains and their causes are not clearly understood. Corticotropin-releasing hormone receptor 1 (CRHR1) is involved in stress reactivity and development of mental health disturbances after negative life-events. We performed a retrospective cohort study of long-term QoL outcomes among 125 surgically treated aSAH patients (2001–2013). QoL was assessed with Short Form Health Survey (SF-36) and compared to an age and gender matched general population. Genotyping of CRHR1 single nucleotide polymorphisms was performed (Rs7209436, Rs110402, Rs242924) and their effect on QoL scores was explored. aSAH patients experienced a reduced quality of life in all domains. CRHR1 minor genotype was associated with higher SF-36 mental health (OR = 1.31–1.6, p < 0.05), role-emotional (OR = 1.57, p = 0.04) and vitality scores (OR = 1.31–1.38, p < 0.05). Association of all studied SNP’s with vitality and Rs242924 with mental health scores remained statistically significant after Bonferroni correction. Mental quality of life scores were associated with physical state of patients, antidepressant history and CRHR1 genotype. Predisposition to mental health disturbances after stressful life-events might be associated with reduced mental QoL after aSAH and selected patients could be provided advanced counselling in the recovery phase.
Highlights
Quality of life (QoL) disturbances are common after aneurysmal subarachnoid hemorrhage both in physical and mental health domains and their causes are not clearly understood
Effect of Corticotropinreleasing hormone receptor 1 (CRHR1) in major depression is moderated by a history of negative life events[16] and CRHR1 genotype is associated with cortisol reactivity to stress[17,18,19]
In beta-binomial regression analysis we explored the association of CRHR1 genotype with SF-36 quality of life scores (Table 4)
Summary
Quality of life (QoL) disturbances are common after aneurysmal subarachnoid hemorrhage (aSAH) both in physical and mental health domains and their causes are not clearly understood. Corticotropinreleasing hormone receptor 1 (CRHR1) is involved in stress reactivity and development of mental health disturbances after negative life-events. CRHR1 minor genotype was associated with higher SF-36 mental health (OR = 1.31–1.6, p < 0.05), role-emotional (OR = 1.57, p = 0.04) and vitality scores (OR = 1.31–1.38, p < 0.05). Mental quality of life scores were associated with physical state of patients, antidepressant history and CRHR1 genotype. Despite survival rates improving up to 65% and physical disability decreasing among survivors, psychosocial outcomes after aSAH remain to be notably poor since up to 55% of patients report reduced quality of life years after the haemorrhage[5]. Genes that regulate the function of the stress response system are probable moderators of the effect that adverse life events have on development of long-term mental health disturbances[9,10]. We hypothesize that CRHR1 genotype will influence the mental component of quality of life after aSAH
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