Riesgo de deterioro cognitivo en pacientes con ictus minor o accidente isquémico transitorio mediante la batería neuronorma. Estudio de casos y controles

Abstract

INTRODUCTION: Transient ischemic attack (TIA) is a brief episode of focal neurological dysfunction caused by cerebral ischemia that usually does not leave any consequences and when there are some they are very mild. A small volume brain injury can be associated with this neurological clinic, in this case the vascular event is called minor ictus (MI). According to the present literature, patients with MI or TIA suffer from cognitive alterations, mainly deficits in executive functions and processing speed despite having a volume of injury that may seem insignificant. However, although there many studies about the impact that these strokes have on cognitive functioning, it is still not clear which profile predominates, the etiology of cognitive impairment and its relationship with neuroimaging tests. This study aims to assess the cognitive functions in a sample of patients diagnosed with TIA/MI and compare the results with a control group. Likewise, a study of the diagnostic validity of the battery administered is carried out. MATERIAL AND METHODS: The sample consists of 50 cases (age: 57.7 ± 8.0, women 30%) with TIA/IM and 50 controls (age: 56.8 ± 8.7, women 46%) of the same population base. The Neuronorma Battery is administered to all subjects and data about subjective memory complaints is gathered. All cases are evaluated three months after the vascular event. RESULTS: Patients with TIA/MI presented significantly lower scores in several cognitive cognitive domains. 58% (corresponding to 29 subjects) presented deficits in memory, 46% (corresponding to 23 subjects) presented deficits in executive function, 32% (corresponding to 16 subjects) presented deficits in visuospatial and visuoconstructive function and a 20% (which corresponded to 10 subjects) presented attention-concentration deficits. The 38% of the subjects had a single affected cognitive domain and 62% had two or more domains. Subjective cognitive complaints were more frequent in patients with TIA/IM than in control subjects and these were present in almost half of the cases (48%). CONCLUSIONS: Patients with AIT/MI have alterations in their cognitive functioning that can be detected in a neuropsychological evaluation. Knowing these cognitive alterations would allow us to launch rehabilitation programs and improve the functioning of patients in different areas of life. In the future, It would be convenient to have longitudinal studies, with larger samples and neuroimaging tests as well as other possible biomarkers which will allow us to obtain more conclusive data on cognitive functions in TIA/MI patients.