Mental Fatigue After Aneurysmal Subarachnoid Hemorrhage: A Prospective 5-Year Follow-Up Study

Abstract

Objectives: Mental fatigue is a common and debilitating symptom following an aneurysmal subarachnoid hemorrhage (aSAH). However, its long-term prevalence and consequences remain unclear. In this longitudinal pilot study, the Mental Fatigue Scale (MFS) was used to evaluate the prevalence, severity, and dynamics of mental fatigue for up to 5 years and to correlate patient demographics and early complications to the development of mental fatigue.

Method: Functional outcomes were scored using the Glasgow Outcome Scale-Extended (GOSE) during telephone interviews 1, 3, and 5 years after aSAH. The MFS questionnaires (maximum score 42, ≥ 10.5 points indicating mental fatigue) were subsequently sent by mail. Patient admission data and events during the acute phase were recorded.

Results: Of 64 included patients, 31 could be assessed at all time points. Mental fatigue (MFS score ≥ 10.5) was present in 58%, 48%, and 52% of the patients at 1, 3, and 5 years, respectively. A significant decrease in the total MFS score was observed between 1 and 5 years (p = 0.025). The proportion of patients experiencing severe mental fatigue halved from 1 to 3 years. The median (range) MFS scores were significantly higher for women (14.5, 0–29.5) than for men (3, 0–17.5) at 1 year (p = 0.043). Compared with patients experiencing loss of consciousness at ictus (LOCi), those without LOCi exhibited a progressive decline in the total MFS score (p = 0.003).

Conclusions: Although total MFS scores significantly improved, mental fatigue was a common and persistent symptom affecting half of the patients up to 5 years following aSAH. Mental fatigue was more prevalent in women than men; further, patients who experienced LOCi during the acute phase improved less over time. Our results highlight the importance of evaluating mental fatigue when assessing patient recovery and long-term outcomes.

Trial Registration: Clinical Trial NCT06239142