Trends in cognitive function assessed by a battery of neuropsychological tests after mild acute ischemic stroke

J Stroke Cerebrovasc Dis. 2020 Jul;29(7):104887. doi: 10.1016/j.jstrokecerebrovasdis.2020.104887. Epub 2020 May 10.

Abstract

Objective: The aim of this study is to investigate the domain-specific trends of cognitive function up to 12 months after mild acute ischemic stroke.

Methods: Enrolment of consecutive cohort of patients with mild acute ischemic stroke with recorded clinical characteristics and extensive neuropsychological assessments, including five cognitive domains. The Montreal cognitive assessment of the Beijing version (MoCA-Bj) was used to assess overall cognition. All patients completed all domain-specific examinations were categorised into three groups according to the time between the stroke onset and neuropsychological profiling, the time duration including less than one month (n = 174), one month to six months (n = 65) and over six months (n = 39).

Results: The final cohort consisted of 278 patients. The executive (χ2 = 6.95, P<0.05) and memory dysfunctions (χ2 = 9.6, P<0.01) showed strong improvement, especially in executive function, which prevalence was 48.85% at <1- month group and 25.64% at >6 months group. The prevalence of attention and information processing also had a declining trend, the differences, however, were not statistically significant (χ2 = 0.23 and 2.25, respectively, P>0.05). There was no significant change in language function (χ2 = 0.46, P>0.05) and the MoCA (χ2 = 0.59, P>0.05) at 3-time point groups. In 195 first-ever stroke patients, the results of memory (χ2 = 6.94 P<0.05) and executive dysfunctions (χ2 = 6.25 P<0.05) also showed significant improvement.

Conclusion: There is varying degree of improvement tendency in executive and memory dysfunctions after mild acute ischemic stroke. Early cognitive assessments after mild acute ischemic stroke do not reflect the cognitive level of stable period.

Keywords: Cognitive impairment; Domain-specific; Mild acute ischemic stroke; Trends.

MeSH terms

  • Adult
  • Aged
  • Attention
  • Brain Ischemia / diagnosis*
  • Brain Ischemia / epidemiology
  • Brain Ischemia / psychology
  • China / epidemiology
  • Cognition Disorders / diagnosis*
  • Cognition Disorders / epidemiology
  • Cognition Disorders / psychology*
  • Cognition*
  • Executive Function
  • Female
  • Humans
  • Male
  • Memory
  • Mental Status and Dementia Tests
  • Middle Aged
  • Neuropsychological Tests*
  • Predictive Value of Tests
  • Prevalence
  • Prognosis
  • Prospective Studies
  • Severity of Illness Index
  • Stroke / complications*
  • Stroke / diagnosis
  • Stroke / psychology
  • Stroop Test
  • Time Factors
  • Trail Making Test
  • Verbal Behavior
  • Wechsler Scales