A Two-Year Prospective Longitudinal Study of the Dynamics of Cognitive Functions at Different Poststroke Time Points

Objective. To assess the dynamics of cognitive functions 3, 6, 12, and 24 months after ischemic stroke (IS). Materials and methods. The study include 32 patients aged 40–71 (mean 58.7) years, 21.4% women, with IS of duration less than three months and moderate reductions in the activities of daily living. Patients visited four times (baseline, and at 12, 36, and 84 weeks) for neuropsychological examination of cognitive functions using a 10-point system (1 point corresponding to maximum impairment and 10 points to no impairment) and testing on the Barthel scale, National Institutes of Health Stroke Scale (NIHSS), and modified Rankin scale (mRs). During the study, patients received unified basal therapy and multimodal courses of rehabilitation. Results. Assessment of cognitive functions in the period 3–6 months after IS demonstrated improvements in the memory (from 6.5 ± 0.62 to 8.0 ± 0.74 points; p < 0.05), attention (from 5.7 ± 0.58 to 7.2 ± 0.73 points; p < 0.05), praxis (from 7.9 ± 0.78 to 9.1 ± 0.85 points; p < 0.05), and speech (from 6.5 ± 0.67 to 7.5 ± 0.87 points; p < 0.05), with an increase in the mean score on the Barthel scale from 65.8 ± 5.4 to 89.2 ± 8.6 (p < 0.05) points, a reduction in neurological deficit on the NIHSS from 7.7 ± 0.51 to 5.3 ± 0.33 points (p < 0.05), and a reduction in disability on the mRs from 3.9 ± 0.28 to 2.6 ± 0.15 points (p < 0.05). In the period 6–12 months after IS, impairments were detected in memory (p < 0.05), attention (p < 0.05), and thinking (p < 0.05) domains; deterioration of cognitive functions continued in the period 12–24 months after IS. No significant changes in mean Barthel, NIHSS, or mRs scores were detected in the period 6–24 months after IS. Conclusions. The early recovery period is a favorable interval for restoration of cognitive functions in post- IS patients. The ability to recover cognitive functions decreases with increases time after stroke. © The Author(s), under exclusive licence to Springer Nature Switzerland AG 2024.