gms | German Medical Science

65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

11. - 14. Mai 2014, Dresden

Hippocampal damage and affective disorders after treatment of cerebral aneurysms

Meeting Abstract

  • Maria Wostrack - Neurochirurgische Klinik, Klinikum Rechts der Isar, Technische Universität München, Deutschland
  • Benjamin Friedrich - Neuroradiologische Klinik, Klinikum Rechts der Isar, Technische Universität München, Deutschland
  • Kathrin Harmening - Neurochirurgische Klinik, Klinikum Rechts der Isar, Technische Universität München, Deutschland
  • Bernhard Meyer - Neurochirurgische Klinik, Klinikum Rechts der Isar, Technische Universität München, Deutschland
  • Annette Förschler - Neuroradiologische Klinik, Klinikum Rechts der Isar, Technische Universität München, Deutschland
  • Yu-Mi Ryang - Neurochirurgische Klinik, Klinikum Rechts der Isar, Technische Universität München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocMI.18.09

doi: 10.3205/14dgnc386, urn:nbn:de:0183-14dgnc3864

Veröffentlicht: 13. Mai 2014

© 2014 Wostrack et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Despite good neurological outcome after the treatment of ruptured or incidental cerebral aneurysms, many patients complain about mood disturbances such as anxiety and depression. The present study investigated the nature of these affective disorders, their trigger factors and corresponding structural brain changes.

Method: We assessed 64 patients matched by history of previous subarachnoid hemorrhage (SAH) and treatment modality (clipping vs. coiling) by a test battery including the Hospital Anxiety and Depression Scale (HADS) and Beck Depression Inventory-II (BDI-II). MR-imaging for the evaluation of structural changes included H1-MR spectroscopy, hippocampal volumetry, and Diffusion Tensor Imaging (DTI).

Results: The applied multimodal imaging revealed no significant differences between patients with previous SAH and patients with incidental aneurysms. There were also no substantial differences between patients with and without previous SAH with respect to depression and anxiety. However, we observed significantly higher mean HADS scores in patients treated surgically versus patients treated by coiling (p<0.01). BDI-II tended to be higher in surgically treated patients, but this difference appeared statistically insignificant. Surgically treated patients displayed substantial hippocampal damage in all imaging techniques: reduction in mean concentrations of N-acetylaspartate (p=0, 04), hippocampal volume reduction (p=0,012), and diffusion disorder (p=0.02). The structural alterations correlated significantly with the increased HADS scores.

Conclusions: In contrast to the endovascular treatment, surgery of aneurysms seems to be associated with an increased incidence of mood disorders corresponding to the hippocampal neuronal loss, independent of the preceding SAH.