Analysis Of Cognitive Function In Patients With Acute Minor Ischemic Stroke And Transient Ischemic Attack

Objective:To explore the characteristics of cognitive changes and related factors affecting cognitive function in patients with acute minor ischemic stroke(NIHSS score<5)and transient ischemic attack.Methods:Acute minor ischemic stroke and TIA patients were adopted from the First Affiliated Hospital of Soochow University from February 2018 to December 2018,the onset time was within 7 days.MoCA,MMSE,ADL,and HAMD Scale were used to assess first scores for patients.Patients with HAMD score of ?8 and an ADL score of<60 were to be excluded.a total of 123 patients were enrolled.The MoCA and MMSE scale were reassessed 14 days after first assessment.The first scores and post-14 days scores changes in MMSE and MoCA were evaluated.Patients were divided into cognitive impairment group and normal group according to the MoCA scores of 2 weeks after first evaluation.The clinical data of the two groups were analyzed statistically.According to the changes of MoCA scores between two weeks,the patients were divided into cognitive improvement group and non-improvement group.Compared with first scores,patients with improved MoCA score of ?2 were divided into improvement group,and the remaining patients were non-improved group.Clinical factors that influence the change of cognitive function in the acute phase of the patient were analyzed.Results:1.Compared with the first level,the MMSE and MoCA scores improved after two weeks,and the difference was statistically significant.2.The statistical analysis of the individual scores of the MoCA showed that the patient's visual space and executive function,delayed recall were the most common damaged.In the Acute phase,the patient's visual space and executive function,naming,ion,and delayed recall were the most obvious improved,and the difference was statistically significant.3.35(28.5%)patients were divided into normal group,88(71.5%)in the cognitive impairment group in the first scores.After two weeks,45(36.6%)in the cognitive normal group,and 78(63.4%)in the cognitive impairment group.Logistic analysis showed that elevated HS-CRP,silent lacunar infarction,age,and low first MMSE score were risk factors for cognitive impairment.4.Multiple linear regression showed a negative correlation between age and MoCA score(B=-0.272;P<0.001),and MMSE score was positively correlated with MoCA score(B=0.607 P<0.001).5.62 patients(50.4%)were divided into cognitive function improvement group,61 patients(49.6%)were in non-improvement group.Logistic regression analysis showed that the silent lacunar infarction was a risk factor for no improvement in cognitive function.Conclusion:1.About 71.5%of patients with acute minor ischemic stroke and TIA had cognitive impairment at first evaluation.Cognitive dysfunction still exists in 63.4%after two weeks,and 50.4%of patients had improved cognitive function in the acute phase.2.HS-CRP elevation,silent lacunar infarction,age,and low first MMSE score are risk factors for cognitive impairment in acute phase.As the age increases,the first MMSE level decreases,and the MoCA score also decreases.3.Silent lacunar infarction is a risk factor for poor prognosis in patients with acute minor stoke and TIA.