A two-year prospective longitudinal study of the dynamics of cognitive functions in different periods of stroke

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OBJECTIVE

To examine the dynamics of cognitive functions 3, 6, 12, and 24 months after ischemic stroke (IS).

MATERIAL AND METHODS

The study included 32 patients (women 21.4%), aged 40—71 years (mean age 58.7 years), with IS less than 3 months old and a moderately pronounced decrease in activity in everyday life. At four visits (baseline, after 12, 36, 84 weeks), a neuropsychological examination of cognitive functions was carried out using a 10-point system (1 point — maximum impairment, 10 points — no impairment), testing according to the Barthel scale, the National Institutes of Health Stroke Scale (NIHSS), the modified Rankin scale (mRs). During the study, patients received unified basic therapy and underwent multimodal rehabilitation courses.

RESULTS

When assessing cognitive functions in the period 3—6 months after IS, there was a significant (p<0.05) improvement in memory (6.5±0.62 to 8.0±0.74 points), attention (5.7±0.58 to 7.2±0.73 points), praxis (7.9±0.78 to 9.1±0.85 points), speech (6.5±0.67 to 7.5±0.87 points); a significant increase in the average Barthel score (65.8±5.4 to 89.2±8.6) was accompanied by a significant decrease in neurological deficit (7.7±0.51 to 5.3±0.33 NIHSS points and 3.9±0.28 to 2.6±0.15 mRs points). In the period 6—12 months after IS, significant disturbances were detected in the areas of memory, attention and thinking. Cognitive function continued to deteriorate 12—24 months after IS. In the period 6—24 months after IS, no significant changes in the average values on the Barthel, NIHSS, and mRs were detected.

CONCLUSION

The most favorable interval for the recovery of cognitive functions in patients after IS is the early recovery period. As the time after a stroke increases, the ability to recovery cognitive functions decreases.

Keywords:

cognitive functions

early recovery period of ischemic stroke

activity in everyday life

Authors:

Mayorova L.A.

Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology;
Institute of Higher Nervous Activity and Neurophysiology

ORCID: 0000-0001-5112-7878

Grechko A.V.

Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology;
Patrice Lumumba Peoples’ Friendship University of Russia

ORCID: 0000-0003-3318-796X

Fateeva V.V.

Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology

ORCID: 0000-0001-9935-3962

Received:

13.08.2023

Accepted:

23.08.2023

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