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Original research
Long-term neuropsychiatric symptoms in spontaneous intracerebral haemorrhage survivors
  1. Giuseppe Scopelliti1,
  2. Barbara Casolla1,
  3. Grégoire Boulouis2,
  4. Gregory Kuchcinski2,
  5. Solène Moulin1,
  6. Didier Leys1,
  7. Hilde Henon1,
  8. Charlotte Cordonnier1,
  9. Marco Pasi1
  1. 1Department of Neurology, Univ. Lille, Inserm U1172 - LilNCog - Lille Neuroscience & Cognition, CHU Lille, Lille, France
  2. 2Department of Neuroradiology, Univ. Lille, Inserm U1172 - LilNCog - Lille Neuroscience & Cognition, CHU Lille, Lille, France
  1. Correspondence to Prof Charlotte Cordonnier, Neurology, Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, Hauts-de-France, France; charlotte.cordonnier{at}univ-lille.fr

Abstract

Objective Neuropsychiatric (NP) symptoms are prominent features of cognitive decline, but they have been understudied in patients with spontaneous intracerebral haemorrhage (ICH). In ICH survivors, we aimed at assessing NP symptoms prevalence and profiles, and their influence on long-term outcomes.

Methods We analysed data from consecutive 6-month ICH survivors enrolled in the Prognosis of Intracerebral Haemorrhage study. We performed NP evaluation using the Neuropsychiatric Inventory Questionnaire. Patients underwent long-term clinical follow-up after ICH (median follow-up time 7.2 years, IQR 4.8–8.2).

Results Out of 560 patients with ICH, 265 survived at 6 months. NP evaluation 6 months after ICH was feasible in 202 patients. NP symptoms were present in 112 patients (55%), and in 36 out of 48 patients (75%) with post-ICH dementia. Affective symptoms were present in 77 patients (38%), followed by vegetative symptoms (52 patients, 26%) and hyperactivity (47 patients, 23%). Apathy and hyperactivity were associated with post-ICH dementia and cerebral amyloid angiopathy MRI profile (all p<0.05). Apathy and hyperactivity prevailing over affective symptoms at 6-month follow-up were associated with higher risks of developing new-onset dementia (HR 5.40; 95% CI 2.27 to 12.84), while presence or severity of NP symptoms were not.

Conclusion NP symptoms were present in more than half of 6-month ICH survivors, with higher prevalence and severity in patients with post-ICH dementia. Distinctive NP profile might be associated to cognitive status and inform on long-term dementia risk.

  • dementia
  • amyloid
  • cerebrovascular
  • MRI
  • stroke

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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Footnotes

  • Twitter @skopelliti, @gboulouis, @leysdidier1, @prccordonnier, @marco_pasi85

  • Contributors GS designed and conceptualised the study, analysed, and interpreted all data, and drafted the manuscript. MP designed and conceptualised the study, analysed, and interpreted all data, drafted and reviewed the manuscript. HH, DL and CC designed and conceptualised the study, interpreted data and reviewed the manuscript. BC and SM contributed to data collection and revised the manuscript. GB and GK contributed to data collection, analysed imaging data and revised the manuscript. MP was the guarantor for this study.

  • Funding Inserm U1172 and Adrinord. No award/grant number.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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