Principal Investigator: Dr Ian Galea
Institution: University of Southampton
Mr Diederik Bulters – University Hospital Southampton NHS Foundation TrustTags: 49305, Brain, cognition, genetics, genotyping, hearing, outcomes, subarachnoid-haemorrhage
Subarachnoid haemorrhage is a common cause of stroke in young and middle-aged adults caused by a bleed on the brain. It occurs after rupture of a swelling (or aneurysm) on a major artery supplying the brain and results in release of blood over the brain surface (or the subarachnoid space), which then clots. In survivors, subarachnoid haemorrhage results in substantial loss of quality of life, and a significant cost to the UK economy due to inability to return to work. There is increasing recognition that, although people with a history of SAH look outwardly healthy, they have substantial “hidden” disability which impairs their daily functioning. These hidden deficits mostly consist of problems with memory, concentration and processing of heard information such as speech and music. There are no treatments to prevent or improve recovery from these deficits. Hence a better understanding as to what contributes to a poor outcome after brain haemorrhage is needed. There are over a thousand UK BioBank participants with a history of subarachnoid haemorrhage. First we intend to confirm that employment, physical activity, memory and concentration and hearing is reduced in people with a history of subarachnoid haemorrhage compared to people who have not had a subarachnoid haemorrhage. Then we intend to see whether any specific variation in the genetic code of individuals with a history of subarachnoid haemorrhage predisposed them to a worse or better outcome. It is possible that certain genetic variations may reflect a biological process which can be improved or inhibited with available drugs. We hope that this study will demonstrate the importance of the hidden deficits after subarachnoid haemorrhage, identify potential new treatments and ultimately help improve the management of people with subarachnoid haemorrhage. Finally this study will provide two students, working under our close supervision, with experience in research.
Project extension – January 2020
The overarching theme relates to under-recognized clinical outcomes after subarachnoid haemorrhage (SAH) and their genetic determinants. SAH cases and controls will be carefully defined using a combination of available phenotypes.
- Are cognitive deficits commoner after SAH compared to controls?
- Is auditory processing disorder more frequent after SAH compared to controls?
- Is employment rate different after SAH compared to controls?
- Is physical activity reduced after SAH compared to controls?
- Are other health and psychosocial problems commoner after SAH compared to controls
- Does genetic variation influence clinical outcomes after SAH?
- Are there genetic variations which predispose to SAH?
- To compare cognitive deficits in individuals after SAH versus controls
- To compare speech-in-noise test in individuals after SAH versus controls
- To compare employment rate in individuals after SAH versus controls
- To compare physical activity in individuals after SAH versus controls
- To compare other health and psychosocial problems in individuals after SAH versus controls
- To investigate the relationship between common genetic variants and the clinical outcomes (employment, physical activity, cognitive deficit and hearing) after SAH
- To identify whether there are genetic variations that predispose to SAH
The original scope relating to SAH risk and outcome remains unchanged. Here we extend the scope to be able to better study mechanisms affecting SAH risk and outcome, which will be investigated using clinical and MRI data.
Hence we add two aims:
- To investigate the link between medications, and SAH occurrence and outcome
- To investigate the association between brain MRI changes, and SAH occurrence and outcome
And two research questions:
- Are anti-inflammatory or other medications associated with SAH risk or outcome after SAH?
9. Are brain MRI changes linked to SAH occurrence or outcome?
Last updated Apr 20, 2020