The Effects of Glibenclamide on Cognitive Performance, Quality of Life, and Emotional Aspects Among Patients With Aneurysmal Subarachnoid Hemorrhage: A Randomized Controlled Trial

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY World neurosurgery Pub Date : 2025-01-01 DOI:10.1016/j.wneu.2024.09.048

Isabela Costola Windlin , Bruno Braga Sisnando da Costa , João Paulo Mota Telles , Leonardo B. Oliveira , Edwin Koterba , Vitor Nagai Yamaki , Nicollas Nunes Rabelo , Davi Jorge Fontoura Solla , Manoel Jacobsen Teixeira , Eberval Gadelha Figueiredo

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Abstract

Background

Aneurysmal subarachnoid hemorrhage (aSAH) is associated with a high incidence of long-term cognitive impairment, decreased quality of life (QoL), and psychiatric disorders. The effects of glibenclamide on such outcomes in the setting of aSAH are unknown.

Objective

To assess the impact of glibenclamide in patients with aSAH on cognitive performance, QoL, and emotional aspects.

Methods

Patients identified with aSAH were randomly allocated to receive 5 mg of glibenclamide for 21 days or placebo, starting within 96 hours of the ictus. After 6 months, patients were evaluated with Montreal Cognitive Assessment test (cognitive performance), Medical Outcomes Short-form Health Survey (QoL), and Hospital Anxiety and Depression Scale and Screen for Post-traumatic Stress Symptoms (emotional aspects).

Results

The mean Montreal Cognitive Assessment score was 22.5 ± 6.2. No statistically significant difference was found between groups, with a mean score of 21.7 ± 6.4 in the Glibenclamide group and 23.4 ± 6.2 in the placebo group (P = 0.392). A score <23 was observed in 16 patients (35.6%) and its frequency was similar between groups (P = 0.900). The most frequently impaired domains were Attention (N = 21/45; 46.7%) and Visuospatial (18/45; 40.0%). Impairment of each domain was similar between groups (P > 0.05). In each domain, the mean score was similar between groups (P > 0.05). The Hospital Anxiety and Depression Scale scores did not differ between groups (P > 0.05). The mean Screen for Post-traumatic Stress Symptoms score as well as the mean scores of its domains were similar between groups (P > 0.05).

Conclusions

Glibenclamide did not improve cognitive performance, QoL, and emotional aspects after 6 months of follow-up of aSAH survivors.

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格列本脲对动脉瘤性蛛网膜下腔出血患者认知能力、生活质量和情绪方面的影响：随机对照试验。

简介：动脉瘤性蛛网膜下腔出血（aSAH动脉瘤性蛛网膜下腔出血（aSAH）与长期认知障碍、生活质量（QoL）下降和精神障碍的高发病率有关。格列本脲对发生蛛网膜下腔出血时上述结果的影响尚不清楚：评估格列本脲对 aSAH 患者认知能力、生活质量和情绪方面的影响：方法：被确诊为 ASAH 的患者被随机分配到接受 5 毫克格列本脲治疗 21 天或安慰剂治疗 21 天，治疗从发作后 96 小时内开始。6个月后，对患者进行MoCA测试（认知能力）、SF-36（QoL）以及HADS和SPTSS（情绪方面）评估：平均 MoCA 得分为 22.5 ± 6.2。格列吡嗪组的平均得分为（21.7 ± 6.4），安慰剂组为（23.4 ± 6.2）（P=0.392）。A 得分 0.05）。在每个领域，各组的平均得分相似（p>0.05）。组间的 HADS 评分没有差异（P>0.05）。各组的 SPTSS 平均得分及其各领域的平均得分相似（P>0.05）：结论：格列本脲并没有改善急性脑梗死幸存者随访六个月后的认知能力、生活质量和情绪。

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来源期刊

World neurosurgery CLINICAL NEUROLOGY-SURGERY

CiteScore

3.90

自引率

15.00%

发文量

1765

审稿时长

47 days

期刊介绍： World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal''s mission is to: -To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care. -To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide. -To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients. Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS