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Executive dysfunction in patients with transient ischemic attack and minor stroke.

Peter Sörös¹, Michael Harnadek², Treena Blake²

¹Department of Clinical Neurological Sciences, London Health Sciences Centre, University Hospital, 339 Windermere Road, London, Ontario, N6A 5A5, Canada.

Journal of the Neurological Sciences

|May 17, 2015

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Transient ischemic attack (TIA) and minor stroke patients frequently experience cognitive impairment, particularly in executive functions. Standard screening tools like the MMSE may miss these deficits, necessitating more sensitive tests.

Area of Science:

Neuroscience
Neurology
Cognitive Psychology

Background:

Transient ischemic attack (TIA) and minor stroke often lead to persistent cognitive impairment.
Executive functions, including working memory and cognitive flexibility, are particularly affected.

Purpose of the Study:

To investigate the prevalence and nature of cognitive impairment in patients with TIA and minor stroke.
To evaluate the effectiveness of standard neuropsychological tests in detecting these deficits.

Main Methods:

140 patients with focal cerebral ischemic events were assessed.
A neuropsychological test battery included MMSE, Neurobehavioral Cognitive Status Examination-Judgment Subtest, Clock Drawing Test, and Trail Making Test.

Main Results:

Keywords:

Cognitive impairment Executive function Mini Mental State Examination Stroke Trail Making Test Transient ischemic attack

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57% of patients showed impairment on at least one test; 33% on two or more.
The Trail Making Test revealed high impairment rates (31% on Part A, 40% on Part B).
The Mini Mental State Examination (MMSE) showed impairment in only 5% of patients.

Conclusions:

The MMSE is limited for screening cognitive deficits in TIA and minor stroke patients.
Executive dysfunction is highly prevalent in this patient group.
More sensitive tests are needed to identify cognitive impairment after TIA and minor stroke.