Subacute cognitive impairment after first-ever transient ischemic attack or ischemic stroke in young adults: The ODYSSEY study
European Stroke Journal, vol. 8, pp. 283–293
Abstract
Abstract Introduction: We aimed to investigate the prevalence of cognitive impairment in the subacute phase after transient ischemic attack (TIA) and ischemic stroke (IS), factors associated with a vascular cognitive disorder, and the prevalence of subjective cognitive complaints and their relation with objective cognitive performance. Patients and methods: In this multicenter prospective cohort study, we recruited patients with first-ever TIA and IS, aged 18–49 years, between 2013 and 2021 for cognitive assessment up to 6 months after index event. We calculated composite Z-scores for seven cognitive domains. We defined cognitive impairment as a composite Z-score < −1.5. We defined major vascular cognitive disorder as a Z-score < −2.0 in one or more cognitive domains. Results: Fifty three TIA and 545 IS patients completed cognitive assessment with mean time to assessment of 89.7 (SD 40.7) days. The median NIHSS at admission was 3 (interquartile range, 1–5). Cognitive impairment was common in five domains (up to 37%), with similar proportion in TIA and IS patients. Patients with major vascular cognitive disorder had a lower education level, higher NIHSS scores and more frequent lesions in the left frontotemporal lobe than without vascular cognitive disorder (p < 0.05 FDR-corrected). Subjective memory and executive cognitive complaints were present in about two-thirds of the patients, but were weakly associated with objective cognitive performance (β: −0.32 and −0.21, respectively). Discussion and conclusion: In the subacute phase after TIA or stroke in young adults, cognitive impairment and subjective cognitive complaints are prevalent, but they are weakly associated with each other.
Authors 24
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Radboud University Nijmegen · Radboud University Medical Center · Donders Institute for Brain, Cognition and Behaviour
Affiliation as printed
Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands 1
Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
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Radboud University Nijmegen · Radboud University Medical Center · Donders Institute for Brain, Cognition and Behaviour
Affiliation as printed
Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands 1
Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
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Radboud University Nijmegen · Radboud University Medical Center · Donders Institute for Brain, Cognition and Behaviour
Affiliation as printed
Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands 1
Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
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Radboud University Nijmegen · Radboud University Medical Center · Donders Institute for Brain, Cognition and Behaviour
Affiliation as printed
Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands 1
Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
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Affiliation as printed
Department of Neurology, Amphia Hospital, Breda, The Netherlands 2
Department of Neurology, Amphia Hospital, Breda, The Netherlands
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Affiliation as printed
Department of Neurology, Medisch Spectrum Twente, Enschede, The Netherlands 3
Department of Neurology, Medisch Spectrum Twente, Enschede, The Netherlands
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Affiliation as printed
Department of Neurology, Medisch Spectrum Twente, Enschede, The Netherlands 3
Department of Neurology, Medisch Spectrum Twente, Enschede, The Netherlands
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Canisius-Wilhelmina Ziekenhuis
Affiliation as printed
Department of Neurology, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands 4
Department of Neurology, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
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Affiliation as printed
Department of Neurology, Catharina Hospital, Eindhoven, The Netherlands 5
Department of Neurology, Catharina Hospital, Eindhoven, The Netherlands
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Affiliation as printed
Department of Neurology, Catharina Hospital, Eindhoven, The Netherlands 5
Department of Neurology, Catharina Hospital, Eindhoven, The Netherlands
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Affiliation as printed
Department of Neurology, Franciscus Gasthuis & Vlietland, BA Rotterdam, The Netherlands 6
Department of Neurology, Franciscus Gasthuis & Vlietland, BA Rotterdam, The Netherlands
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Elisabeth-TweeSteden Ziekenhuis
Affiliation as printed
Department of Neurology, Elisabeth-TweeSteden Hospital, Tilburg, Netherlands 7
Department of Neurology, Elisabeth-TweeSteden Hospital, Tilburg, Netherlands
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Affiliation as printed
Department of Neurology, Haga Hospital, Den Haag, Netherlands 8
Department of Neurology, Haga Hospital, Den Haag, Netherlands
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Affiliation as printed
Department of Neurology, Amphia Hospital, Breda, The Netherlands 2
Department of Neurology, Amphia Hospital, Breda, The Netherlands
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Affiliation as printed
Department of Neurology, Rijnstate Hospital, Arnhem, The Netherlands 9
Department of Neurology, Rijnstate Hospital, Arnhem, The Netherlands
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Affiliation as printed
Department of Neurology, Jeroen Bosch Hospital, ‘s-Hertogenbosch, The Netherlands 10
Department of Neurology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
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Maastricht University Medical Centre
Affiliation as printed
Department of Neurology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Centre, Maastricht, The Netherlands 11
Department of Neurology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Centre, Maastricht, The Netherlands
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Leiden University · Leiden University Medical Center
Affiliation as printed
Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands 12
Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
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Amsterdam UMC Location University of Amsterdam · Amsterdam University Medical Centers
Affiliation as printed
Department of Neurology, Amsterdam University Medical Centre, location AMC, Amsterdam, The Netherlands 13
Department of Neurology, Amsterdam University Medical Centre, location AMC, Amsterdam, The Netherlands
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Affiliation as printed
Department of Neurology, Medical Centre Leeuwarden, Leeuwarden, The Netherlands 14
Department of Neurology, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
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Medisch Centrum Haaglanden · Stichting Haaglanden Medisch Centrum
Affiliation as printed
Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands 15
Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands
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Radboud University Nijmegen · Radboud University Medical Center · Donders Institute for Brain, Cognition and Behaviour
Affiliation as printed
Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands 1
Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
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Radboud University Nijmegen · Donders Institute for Brain, Cognition and Behaviour · Donders Centre for Cognition
Affiliation as printed
Radboud University, Donders Institute for Brain, Cognition and Behaviour, Center for Cognition, Nijmegen, The Netherlands 16
Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands 17
Radboud University, Donders Institute for Brain, Cognition and Behaviour, Center for Cognition, Nijmegen, The Netherlands
Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
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Anil M. Tuladhar corresponding
Radboud University Nijmegen · Radboud University Medical Center · Donders Institute for Brain, Cognition and Behaviour
Affiliation as printed
Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands 1
Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
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