Dynamics of Cognitive Impairment in the Recovery Period of Ischemic Stroke

INTRODUTION. The widespread and insufficiently studied structure of post-stroke cognitive impairment makes it urgent to conduct studies with the use of extensive neuropsychological testing and monitoring of post-stroke cognitive impairment at different time periods from the development of ischemic stroke, which will make it possible to assess the degree of progression and phenotype of cognitive deficit in stroke patients. AIM. To assess the structure of cognitive deficit in patients in the acute and early recovery periods of ischemic stroke and the degree of post-stroke cognitive impairment progression in 6 months since the development of cerebrovascular disease. MATERIALS AND METHODS. 192 patients who underwent an ischemic stroke in period from 2020 to 2023 were examined. Neuropsychological testing was performed on the 14th day (baseline) and in 6 months (endpoint) after ischemic stroke development using tests to evaluate the general status and severity of impairments in perception functions, memory, attention, cognitive flexibility, speech and constructive praxis. RESULTS AND DISCUSSION. A positive trend was found for cognitive flexibility by reducing patients with severe impairment (by 16.7 %) and increasing the overall score at the study endpoint. A negative dynamic was demonstrated for the perception functions and attention by reducing the amount of patients with normal initial scores (by 10 % and 14 % respectively) and neuropsychological testing scores after 6 months. For episodic memory, an increase in the number of patients with severe impairments was found (by 15.7 %). During assessing changes in speech dysfunction, an increase in the total index and the number of patients with mild disorders (by 10.1 %) was revealed against the background of a decrease in the percentage of patients with severe disorders, which indicates positive dynamics. Correlation analysis at baseline revealed the most significant relationship of the cognitive flexibility score with the functions of memory (r = 0.480), perception (r = 0.440), and constructive praxis (r = 0.370). The endpoint results revealed correlations of the cognitive flexibility score with attention (r = 0, 320), perception, and memory (r = 0, 310); perceptual function with memory (r = 0, 360) and attention (r = 0, 350). CONCLUSION. The obtained data allow us to evaluate the main trends in the development and course of post-stroke cognitive impairment, as well as to determine the role of individual cognitive impairment in the formation of the phenotype of cognitive disorder at different time periods after ischemic stroke.