Bruendl, Elisabeth and Proescholdt, Martin and Schoedel, Petra and Bele, Sylvia and Hoehne, Julius and Zeman, Florian and Stoerr, Eva-Maria and Brawanski, Alexander and Schebesch, Karl-Michael (2018) Excessive release of endogenous neuropeptide Y into cerebrospinal fluid after treatment of spontaneous subarachnoid haemorrhage and its possible impact on self-reported neuropsychological performance - results of a prospective clinical pilot study on good-grade patients. NEUROLOGICAL RESEARCH, 40 (12). pp. 1001-1013. ISSN 0161-6412, 1743-1328
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Objectives: Neuropsychological dysfunction after treatment of spontaneous subarachnoid haemorrhage (sSAH) is common but underreported. The vasoconstrictor neuropeptide Y (NPY) is excessively released after sSAH and in psychiatric disorders. We prospectively analysed the treatment-specific differences in the secretion of endogenous cerebrospinal fluid (CSF) NPY during the acute stage after sSAH and its impact on cognitive processing. Methods: A total of 26 consecutive patients (f:m = 13:8; mean age 50.6 years) with good-grade sSAH were enrolled (drop out n = 5): n = 9 underwent endovascular aneurysm occlusion, n = 6 microsurgery, and n = 6 patients with perimesencephalic SAH received standardized intensive medical care. Ventricular CSF was drawn daily from day 1-10. CSF NPY levels were determined with competitive enzyme immunoassay. All patients underwent neuropsychological self-report assessment [36-Item Short Form Health Survey (SF-36) and ICD-10-Symptom-Rating questionnaire (ISR)] after the onset of sSAH (day 11-35; t(1)) and at the 6-month follow-up (t(2)). Results: At t(1), increased mean levels of NPY in CSF significantly correlated with impaired performance in most ISR scores (ISR total p = .018, depression p = .035, anxiety p = .008, nutrition disorder p = .047, supplementary items p = .038) and in several psychological SF-36 items (vitality p = .019, general mental health p = .001, mental component summary p = .025). Discussion: To the best of our knowledge, this study is the first to correlate the levels of endogenous NPY in supratentorial CSF with cognitive outcome in good-grade sSAH patients. Excessive NPY release into CSF may have a short-term influence on the pathogenesis of neuropsychological deficits. The impact of cerebrovascular manipulation on NPY release has to be further elucidated.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | POSTTRAUMATIC-STRESS-DISORDER; EXTERNAL JUGULAR-VEIN; INTRACRANIAL ANEURYSMS; CEREBRAL-CIRCULATION; VASOSPASM; OUTCOMES; BRAIN; INNERVATION; RECOVERY; ANXIETY; Cognitive impairment; health-related quality of life; ICD-10-symptom-rating questionnaire; neuropeptide Y; NPY; neuropsychological outcome; 36-item short form health survey; spontaneous subarachnoid haemorrhage |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Neurochirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 04 Oct 2019 08:06 |
| Last Modified: | 04 Oct 2019 08:06 |
| URI: | https://pred.uni-regensburg.de/id/eprint/13380 |
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