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Multimodal assessment predicts cognitive impairment after aneurysmal subarachnoid hemorrhage: a prospective cohort study

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WOS体系：
Pubmed体系：

收录情况： ◇ SCIE

作者：
Liu Peng[1,2] * ; Li Ruili[3,4] * ; Zhang Tongyu[1] * ; Xu Yueqiao[1] ; Yang Kun[5] ; Li Yuxia[6] ; Han Chuanliang[7] ; Yang Yang[8] ; Wang Changming[1,9] ; Lu Jie[3,4] ; Zhang Hongqi[1] ;
机构： [1]Department of neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China. [2]Department of neurosurgery, Peking University Third Hospital, Peking University, Beijing, China. [3]Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China. [4]Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China. [5]Department of Epidemiology and Biostatistics, Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University School of Public Health, Beijing, China. [6]Department of neurology, Tangshan central hospital, Tangshan, China. [7]The Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China. [8]Beijing United Imaging Research Institute of Intelligent Imaging, Beijing, China. [9]Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, College of Biomedical Engineering, Capital Medical University, Beijing, China.
出处：
DOI： 10.1097/JS9.0000000000002239
ISSN：

关键词： cerebrospinal fluid cognitive impairment event-related potentials magnetic resonance imaging plasma subarachnoid hemorrhage

摘要：
Risk factors and mechanisms of cognitive impairment (CI) after aneurysmal subarachnoid hemorrhage (aSAH) are unclear. This study used a neuropsychological battery, MRI, ERP and CSF and plasma biomarkers to predict long-term cognitive impairment after aSAH.214 patients hospitalized with aSAH (n = 125) or unruptured intracranial aneurysms (UIA) (n = 89) were included in this prospective cohort study. Neuropsychological tests were administered 7 to 24 months post-discharge. MRI, ERP, and CSF and plasma biomarkers were used to predict long-term CI, and area under ROC curves were calculated.Patients with aSAH CI showed significant impairment across composite scores and cognitive domains on the neuropsychological battery vs. patients with aSAH No CI. On ALFF (MRI), the right medial orbitofrontal cortex (AUC = 0.78), right inferior frontal gyrus (AUC = 0.848), and right inferior parietal lobule (AUC = 0.868) distinguished aSAH CI from aSAH No CI. For ERP, consistent changes were found across specific EEG electrodes (FP1, F3, CP1, FP2, F4, CP2), including increased PA, prolonged PL and decreased ITPC. ITPC showed the highest sensitivity for distinguishing aSAH CI from aSAH No CI, followed by PA. Channel F4 (ITPC, AUC = 0.912, PA, AUC = 0.846), corresponding to the right inferior frontal gyrus, was the most sensitive for detecting CI, followed by channel CP2 (ITPC, AUC = 0.903, PA, AUC = 0.806), corresponding to the right inferior parietal lobule. CSF (Aβ42, Aβ40, p-tau181/Aβ42, p-tau181/total-tau, total-tau) and plasma biomarkers (Aβ-40, p-tau181) were significantly associated with long-term CI.ALFF, ERP, and CSF and plasma Aβ and tau levels and ratios have clinical utility for evaluating and predicting long-term cognitive impairment following aSAH. MRI may reveal the pathogenesis of cognitive impairment following aSAH. ERP can be administered at the bedside offering sensitive, non-invasive, repeatable, and sustainable monitoring, which is particularly suitable for immobile coma patients. ERP may represent a promising method to monitor neural function and its outcomes.Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc.

基金：
This work was supported by the National Natural Science Foundation of China (Grant No. 82171374, 82001773, 81870945, 82202118, 82001324), Capital Medical University Medical Innovation Ability Improvement Project (Grant No. 12300122), and “Talent Development Program” of Xuanwu Hospital, Capital Medical University to Dr. TY Zhang (Grant No. YC20220123).
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外文
WOS：
PubmedID：
中科院(CAS)分区：
出版当年[2025]版：
大类 | 2 区 医学
小类 | 2 区 外科
最新[2025]版：
大类 | 2 区 医学
小类 | 2 区 外科
JCR分区：
出版当年[2023]版：
Q1 SURGERY
最新[2023]版：
Q1 SURGERY

影响因子： 最新[2023版] 最新五年平均 出版当年[2023版] 出版当年五年平均 出版前一年[2022版]

第一作者：
第一作者机构： [1]Department of neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China. [2]Department of neurosurgery, Peking University Third Hospital, Peking University, Beijing, China.
共同第一作者：
通讯作者：
通讯机构： [1]Department of neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China. [3]Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China. [4]Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China. [9]Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, College of Biomedical Engineering, Capital Medical University, Beijing, China.
推荐引用方式(GB/T 7714)：
Liu Peng,Li Ruili,Zhang Tongyu,et al.Multimodal assessment predicts cognitive impairment after aneurysmal subarachnoid hemorrhage: a prospective cohort study[J].International Journal Of Surgery (London, England).2025,111(2):1977-1987.doi:10.1097/JS9.0000000000002239.
APA：
Liu Peng,Li Ruili,Zhang Tongyu,Xu Yueqiao,Yang Kun...&Zhang Hongqi.(2025).Multimodal assessment predicts cognitive impairment after aneurysmal subarachnoid hemorrhage: a prospective cohort study.International Journal Of Surgery (London, England),111,(2)
MLA：
Liu Peng,et al."Multimodal assessment predicts cognitive impairment after aneurysmal subarachnoid hemorrhage: a prospective cohort study".International Journal Of Surgery (London, England) 111..2(2025):1977-1987

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