OBJECTIVE: Effective decision-making is critical for resuming day-to-day activities after aneurysmal subarachnoid hemorrhage (aSAH). Little is known, however, about how decision-making is affected after aSAH, particularly under ambiguous conditions in which neither the outcome nor the outcome probabilities are known. METHOD: Here we examined the integrity of decision-making under ambiguity in a cohort of aSAH patients classified as having made a "good outcome" according to the Glasgow Outcome Scale. Thirty aSAH survivors and 33 healthy controls completed the Iowa Gambling Task (IGT) and the Balloon Analogue Risk Task (BART). Mean time of assessment poststroke was 30 months. RESULTS: Although patients and controls had similar decision-making strategies on the IGT, patients made significantly fewer switches between decks, suggesting perseveration and cognitive inflexibility. On the BART, aSAH patients demonstrated significantly enhanced risk-taking behavior relative to controls. Examination of effect sizes revealed cognitive inflexibility in 33% to 35% of aSAH patients and enhanced risk-taking behavior in 35% to 40% of aSAH patients. CONCLUSION: Approximately one third of "good outcome" aSAH patients experience cognitive inflexibility and enhanced risk-taking behavior over 2 years poststroke, illustrating the persistence of aSAH-associated cognitive impairment.
OBJECTIVE: Effective decision-making is critical for resuming day-to-day activities after aneurysmal subarachnoid hemorrhage (aSAH). Little is known, however, about how decision-making is affected after aSAH, particularly under ambiguous conditions in which neither the outcome nor the outcome probabilities are known. METHOD: Here we examined the integrity of decision-making under ambiguity in a cohort of aSAH patients classified as having made a "good outcome" according to the Glasgow Outcome Scale. Thirty aSAH survivors and 33 healthy controls completed the Iowa Gambling Task (IGT) and the Balloon Analogue Risk Task (BART). Mean time of assessment poststroke was 30 months. RESULTS: Although patients and controls had similar decision-making strategies on the IGT, patients made significantly fewer switches between decks, suggesting perseveration and cognitive inflexibility. On the BART, aSAH patients demonstrated significantly enhanced risk-taking behavior relative to controls. Examination of effect sizes revealed cognitive inflexibility in 33% to 35% of aSAH patients and enhanced risk-taking behavior in 35% to 40% of aSAH patients. CONCLUSION: Approximately one third of "good outcome" aSAH patients experience cognitive inflexibility and enhanced risk-taking behavior over 2 years poststroke, illustrating the persistence of aSAH-associated cognitive impairment.
Authors: Toshihiro Sasaki; Ulrike Hoffmann; Motomu Kobayashi; Huaxin Sheng; Abdelkader Ennaceur; Frederick W Lombard; David S Warner Journal: Neurocrit Care Date: 2016-10 Impact factor: 3.210
Authors: Elizabeth A Crago; Thomas J Price; Catherine M Bender; Dianxu Ren; Samuel M Poloyac; Paula R Sherwood Journal: J Neurosci Nurs Date: 2016-10 Impact factor: 1.230
Authors: Alba Gomez-Andres; Anna Suades; David Cucurell; Maria Angels de Miquel; Montserrat Juncadella; Antoni Rodríguez-Fornells Journal: Neuroimage Clin Date: 2019-11-05 Impact factor: 4.881