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Published on: November 19, 2020
Cognitive Impairment after Aneurysmal Subarachnoid Hemorrhage: Temporal Patterns and Electrophysiological Risk
Kun Yang1,2, Peng Liu3, Oxana Semyachkina-Glushkovskaya4
1Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China.
Aging and Disease
|July 27, 2026
Summary
Cognitive impairment is common after aneurysmal subarachnoid hemorrhage (aSAH), leading to significant loss of cognitive function over time. Event-related potentials (ERPs) show promise in predicting this impairment, especially in older patients.
Area of Science:
- Neurology
- Neuroscience
- Medical Research
Background:
- Cognitive impairment (CI) is a frequent complication following aneurysmal subarachnoid hemorrhage (aSAH), impacting patient outcomes.
- The temporal progression and reliable prediction of CI after aSAH using multimodal data remain incompletely understood.
Purpose of the Study:
- To assess the time course of first-detected CI in aSAH survivors.
- To compare CI-free survival between aSAH and unruptured intracranial aneurysm (UIA) patients.
- To evaluate multimodal prediction schemes for CI after aSAH.
Main Methods:
- Prospective cohort study including aSAH and UIA survivors.
- CI defined by education-adjusted Montreal Cognitive Assessment (MoCA) scores (<26 or <23).
- Six prediction models tested: clinical variables, baseline cognition, plasma biomarkers, event-related potentials (ERPs), MRI, and CSF markers.
Main Results:
- aSAH patients had significantly lower 24-month CI-free survival (43.7%) compared to UIA patients (71.4%).
- The ERP CP2 pair model demonstrated superior predictive performance (AUROC 0.928, Brier score 0.103) in internal validation.
- The ERP model showed greatest incremental value in patients aged ≥60 years and those with Fisher grade 3-4.
Conclusions:
- aSAH is associated with earlier CI and a substantial reduction in CI-free survival compared to UIAs.
- An ERP-based prediction model offers stable, internally validated performance for identifying patients at risk of CI post-aSAH.
- Further external multicenter validation is recommended prior to clinical implementation.
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