Understanding mental fatigue after subarachnoid hemorrhage: A focus on processing speed, attentional control, and...

To investigate potential contributors to mental fatigue after aneurysmal subarachnoid hemorrhage (aSAH) and angiographically negative subarachnoid hemorrhage (anSAH), with a focus on information processing speed, attentional control, and psychological distress.

This observational study included 101 patients (70 aSAH, 31 anSAH) and 86 controls. Neuropsychological assessments and questionnaires were conducted five months post-SAH. Mental and physical fatigue were assessed with the Dutch Multifactor Fatigue Scale, information processing speed and attentional control with the Trail Making Test and Vienna Test System Reaction Time and Determination Test, and psychological distress with the Hospital Anxiety and Depression Scale.

Patients reported significantly higher mental and physical fatigue than controls (p < .001) and information processing speed and attentional control were significantly lower (p < .05), with no differences between aSAH and anSAH groups. Severe mental fatigue was present in 55.7% of patients with aSAH and 61.3% of patients with anSAH, significantly exceeding the prevalence of severe physical fatigue (p < .05). Higher mental fatigue correlated with worse attentional control in aSAH and with lower information processing speed in anSAH. Both mental and physical fatigue correlated with psychological distress, particularly after anSAH.

The factors related to mental fatigue appear to differ based on the type of SAH, potentially involving problems in information processing speed and attentional control, psychological distress, or both. This study emphasizes the need for individualized rehabilitation strategies addressing both cognitive and psychological factors in managing mental fatigue after SAH.