• Stroke · Aug 2014

    Persistent cognitive impairment after transient ischemic attack.

    • Frank G van Rooij, Pauline Schaapsmeerders, Noortje A M Maaijwee, Dirk A H J van Duijnhoven, Frank-Erik de Leeuw, Roy P C Kessels, and Ewoud J van Dijk.
    • Departments of Neurology (F.G.v.R., P.S., N.A.M.M., F.-E.d.L., E.J.v.D.) and Medical Psychology (D.A.H.J.v.D., R.P.C.K.), Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Nijmegen, The Netherlands.
    • Stroke. 2014 Aug 1; 45 (8): 2270-4.

    Background And PurposeBy definition, the symptoms of a transient ischemic attack (TIA) subside completely within 24 hours. Imaging studies show signs of persistent ischemic tissue damage in a substantial amount of patients with TIA. Cerebral infarction can cause permanent cognitive impairment. Whether permanent cognitive impairment occurs after TIA is unclear, as is its profile.MethodsPatients with TIA aged 45 to 65 years without prior stroke or dementia underwent comprehensive neuropsychological testing within 3 months. Z scores per cognitive domain were obtained, based on the mean of a control group within the same age range. Cognitive impairment was defined as a domain z score <-1.65. Patients underwent either computed tomography or MRI brain imaging.ResultsOne hundred seven patients with TIA (63% women, mean age, 56.6 years) were included and compared with 81 controls (56% women, mean age, 52.9 years). Patients performed worse on all cognitive domains except episodic memory. Working memory (25%), attention (22%), and information processing speed (16%) were most frequently impaired and more often than in the control group (age- and sex-adjusted odds ratios, respectively, 22.5 [95% confidence interval, 2.9-174.3], 6.8 [1.9-24.3], 7.1 [1.5-32.5]). More than 35% of patients with TIA had impairment of ≥1 cognitive domain. Presence of silent brain infarcts was related to worse executive functioning but did not explain the whole relationship between TIA and cognitive impairment.ConclusionsMore than a third of patients with TIA have impairment of ≥1 cognitive domain within 3 months after their TIA. The affected domains fit in the vascular cognitive impairment profile.© 2014 American Heart Association, Inc.

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