Executive Function Declines in the First 6 Months After a Transient Ischemic Attack or Transient Neurological Attack

Area of Science:

• Neurology
• Neuroscience
• Cognitive Science

Background:

• Transient ischemic attack (TIA) and transient neurological attack (TNA) are linked to cognitive impairment, but their long-term effects remain unclear.
• Understanding the determinants and course of cognitive function after TIA and TNA is crucial for patient management.

Purpose of the Study:

• To prospectively assess cognitive performance following TIA and TNA.
• To investigate the relationship between cognitive outcomes, clinical diagnosis (TIA vs. TNA), and diffusion-weighted imaging (DWI) findings.

Main Methods:

• 121 patients (≥45 years) without prior stroke or dementia underwent cognitive assessments and MRI within 7 days of a TIA or TNA.
• Cognitive tests were repeated at 6 months.
• Domain-specific cognitive performance was analyzed over time, comparing DWI-positive and DWI-negative patients, and TIA versus TNA groups.

Main Results:

• Executive function declined significantly (-0.23; P=0.01) within 6 months post-event, while attention improved (0.11; P=0.02).
• Patients with DWI lesions showed worse baseline executive function (-0.26 vs. 0.08; P=0.048), persisting throughout the study.
• Clinical diagnosis (TIA or TNA) did not influence cognitive function trajectories.

Conclusions:

• Executive function deteriorates in the initial 6 months following TIA or TNA.
• The presence of an initial DWI lesion is associated with persistent executive function deficits.