{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T19:28:22Z","timestamp":1789241302602,"version":"build-2803163510"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,1,20]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Spontaneous intracerebral hemorrhage (ICH) is strongly associated with the development of long\u2010term cognitive impairment and neuropsychiatric symptoms (NPS), particularly affective disturbances including depression and anxiety. Although small vessel disease (SVD) underlies most cases of ICH, the contribution of SVD to persistent affective symptoms and the effects of cognitive dysfunction on NPS remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We prospectively recruited 95 survivors of spontaneous ICH (median, 5.7\u2009years post\u2010ICH) between 2021 and 2025 from stroke clinics using standardized clinical protocols. NPS were assessed using the Neuropsychiatric Inventory Questionnaire. Cognitive status was evaluated; brain magnetic resonance imaging was performed to quantify SVD markers. Logistic regression and mediation analyses were used to examine the associations between SVD burden, affective symptoms, and cognition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Affective symptoms were the most prevalent\n                      <jats:styled-content style=\"fixed-case\" toggle=\"no\">NPS<\/jats:styled-content>\n                      subsyndrome (37.9%), followed by apathy\/vegetative symptoms (32.6%). Patients with affective symptoms showed greater cognitive impairment and higher hypertensive\n                      <jats:styled-content style=\"fixed-case\" toggle=\"no\">SVD<\/jats:styled-content>\n                      burden, including higher numbers of deep cerebral microbleeds (4.0\u00b15.9 versus 1.2\u00b11.9,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.010) and lacunes (47.2% versus 23.7%,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.024) than those without affective symptoms. In the multivariable model, deep cerebral microbleeds (adjusted odds ratio, 1.215 [95%\n                      <jats:styled-content style=\"fixed-case\" toggle=\"no\">CI<\/jats:styled-content>\n                      , 1.03\u20131.43],\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.021), but not lacunes, were independently associated with affective symptoms. Mediation analysis revealed that cognitive impairment partially mediated this relationship (indirect effect\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.012; 35.9% of total effect).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Affective symptoms are common long\u2010term outcomes after ICH; deep perforator arteriopathy, especially with the form of deep cerebral microbleeds, contribute to these symptoms; cognitive dysfunction only partly mediates this association. There is a need to screen NPS and evaluate microvascular pathology to assess emotional health post ICH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.044666","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T11:43:38Z","timestamp":1768391018000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Cerebral Microbleeds and Long\u2010Term Affective Symptoms in Survivors of Spontaneous Intracerebral Hemorrhage"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2122-2565","authenticated-orcid":false,"given":"Sheng\u2010Sian","family":"Lin","sequence":"first","affiliation":[{"name":"National Taiwan University Hospital Bei\u2010Hu Branch","place":["Taipei, 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Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1443-928X","authenticated-orcid":false,"given":"Bo\u2010Ching","family":"Lee","sequence":"additional","affiliation":[{"name":"National Taiwan University Hospital","place":["Taipei, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li\u2010Kai","family":"Tsai","sequence":"additional","affiliation":[{"name":"National Taiwan University Hospital","place":["Taipei, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1456-3686","authenticated-orcid":false,"given":"Jiann\u2010Shing","family":"Jeng","sequence":"additional","affiliation":[{"name":"National Taiwan University Hospital Bei\u2010Hu Branch","place":["Taipei, Taiwan"]},{"name":"National Taiwan University Hospital","place":["Taipei, 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