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Early MoCA-Assessed Cognitive Impairment After Aneurysmal Subarachnoid Hemorrhage and Relationship to 1-Year Functional Outcome

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Abstract

Recent clinical research into aneurysmal subarachnoid hemorrhage (aSAH) has confirmed the long-term effect of cognitive dysfunction on functional outcomes. We hypothesized that early cognitive impairment was a marker of permanent brain injury and hence predicted long-term functional outcome. Hong Kong Chinese patients with aneurysmal subarachnoid hemorrhage were evaluated prospectively by means of the Montreal Cognitive Assessment (MoCA) in the subacute phase (2–4 weeks after aSAH) and by neuropsychological evaluation of functional outcomes in the chronic phase (1 year after aSAH). This multi-center prospective observational study is registered at ClinicalTrials.gov of the US National Institutes of Health (NCT01038193). One hundred and eight patients completed both the subacute and chronic phase assessments. Cognitive dysfunction in the subacute phase independently correlated with functional outcomes at 1 year, after adjusting for age, admission clinical condition, treatment modality, motor score, and mobility in the subacute phase, but the positive predictive values remained low. MoCA-assessed cognitive impairment in the subacute phase cannot accurately predict functional outcomes at 1 year. Future study should focus on understanding the relative importance of different components of early cognitive impairment.

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Acknowledgments

This study was supported by the Neurosurgery Research and Training Fund, The Chinese University of Hong Kong.

Compliance with Ethics Requirement

The study was approved by the Joint CUHK-NTEC Clinical Research Ethics Committee and local ethics committees of participating centers. The study conformed to the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008, and written informed consent was obtained from all of the participants or their next of kin. The study is registered with ClinicalTrials.gov of the US National Institutes of Health (NCT01038193).

Conflict of Interest

All authors declare that they have no conflicts of interest.

Author information

Authors and Affiliations

  1. Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong

    George Kwok Chu Wong, Sandy Wai Lam, Karine Ngai & Wai Sang Poon

  2. Division of Neurology, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong

    Vincent Mok

  3. Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong

    Deyond Siu

  4. Department of Psychological Studies, The Hong Kong Institute of Education, 10 Lo Ping Road, Tai Po, New Territories, Hong Kong

    Adrian Wong

  5. Department of Surgery, Prince of Wales Hospital, 4/F Clinical Science Building, 30-32 Ngan Shing Street, Shatin, New Territories Hong Kong SAR, China

    George Kwok Chu Wong

Authors
  1. George Kwok Chu Wong
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  2. Sandy Wai Lam
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  3. Adrian Wong
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  4. Vincent Mok
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  5. Deyond Siu
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  6. Karine Ngai
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  7. Wai Sang Poon
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Corresponding author

Correspondence to George Kwok Chu Wong.

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Authors’ Contributions

Wong GK, Wong A, and Mok V conceived and designed the study; Cognitive Dysfunction after Aneurysmal Subarachnoid Hemorrhage Investigators were responsible for patient recruitment; Lam SW and Ngai K assessed the patients; Wong G and Poon WS supervised the study; Wong GK drafted the manuscript; all authors critically reviewed and agreed to the final version of the manuscript.

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Wong, G.K.C., Lam, S.W., Wong, A. et al. Early MoCA-Assessed Cognitive Impairment After Aneurysmal Subarachnoid Hemorrhage and Relationship to 1-Year Functional Outcome. Transl. Stroke Res. 5, 286–291 (2014). https://doi.org/10.1007/s12975-013-0284-z

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  • DOI: https://doi.org/10.1007/s12975-013-0284-z

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