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COGNITIVE AND EMOTIONAL DYSFUNCTION IN PATIENTS AFTER TRANSIENT
ISCHEMIC ATTACKS (TIA)
¹'Choʻliyev Farrux
²Norboyev Adhamjon
³Niyozov Shaxzod
¹'²'³1st-year Residents, Department of Neurology,
Samarkand State Medical University
Affiliation: Department of Neurology,
Samarkand State Medical University, Uzbekistan
https://doi.org/10.5281/zenodo.15511422
Research Objective
: To assess the cognitive and emotional outcomes in patients following
transient ischemic attacks (TIAs), and to analyze correlations with clinical, neuroimaging, and risk
factor profiles. The main objective of this thesis is to investigate the short- and medium-term
cognitive and emotional consequences that follow transient ischemic attacks (TIA) in patients aged
40–70 years. Although TIAs have historically been viewed as benign and reversible neurological
events, growing research suggests that even brief cerebral ischemia can result in lasting disruptions
in cognition and mood.
This study aims to identify the prevalence and severity of post-TIA cognitive dysfunction,
particularly in domains such as executive functioning, memory, and attention, using standardized
neuropsychological tools. Additionally, it evaluates the emotional well-being of patients post-TIA
by assessing levels of depression and anxiety, which are often underdiagnosed in clinical practice.
By analyzing the relationship between neuroimaging findings (e.g., microvascular
changes), vascular risk profiles, and post-TIA cognitive/emotional outcomes, this research seeks
to advocate for routine neuropsychological and emotional health assessments in post-TIA care
protocols. The broader goal is to propose an integrated rehabilitation model that addresses not just
motor recovery but also cognitive and emotional well-being.
Introduction
: Transient ischemic attacks, often labeled as “mini-strokes,” are critical
warning signs for future strokes. Though symptoms typically resolve within 24 hours, mounting
evidence shows that TIAs can result in persistent cognitive and emotional impairments. Early
recognition and intervention are essential to improve prognosis and quality of life.
This study investigates the prevalence and characteristics of post-TIA cognitive and
affective disturbances, providing insight into targeted therapeutic and preventive measures.
Materials and Methods
: A total of 62 patients with confirmed diagnosis of TIA were
included in this prospective observational study conducted between January 2023 and June 2024.
Inclusion Criteria
:
a.
Age 40–70 years
b.
Clinical diagnosis of TIA with symptom resolution within 24 hours
c.
Normal or reversible findings on MRI
Exclusion Criteria
:
1.
Prior history of dementia, psychiatric disorders
2.
Hemorrhagic lesions or infarcts on imaging
Data Collected
:
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1. Neuropsychological testing using MMSE and MoCA
2. Emotional status evaluation using Beck Depression and Anxiety Inventories
3. Neurological assessments
4. Brain MRI and vascular imaging
5. Vascular risk profiling (hypertension, diabetes, dyslipidemia)
Results
: Out of 62 patients, 36 (58%) were male and 26 (42%) female. Common vascular
risk factors included:
a.
Hypertension: 61%
b.
Diabetes mellitus: 29%
c.
Dyslipidemia: 44%
d.
Smoking: 33%
Cognitive Findings
:
a.
38.7% exhibited mild cognitive impairment (MoCA < 26)
b.
Most affected domains: attention, executive function, delayed recall
Emotional Findings
:
a.
Depression symptoms (Beck ≥ 14): 27%
b.
Anxiety symptoms (Beck ≥ 12): 21%
Imaging
:
a.
MRI revealed microvascular changes in 41%
b.
Carotid stenosis (>50%) in 19%
c.
Follow-up (3 months):
d.
Cognitive symptoms persisted in 24%
e.
Depression/anxiety persisted in 15%
Conclusion
: Despite the transient nature of TIA symptoms, a significant number of
patients exhibit ongoing cognitive and emotional deficits. These findings highlight the need for
post-TIA rehabilitation programs that include cognitive screening, psychological support, and
aggressive management of vascular risk factors. This study provides compelling evidence that
transient ischemic attacks—despite their brief and often subtle presentation—can leave behind
enduring cognitive and emotional sequelae. A substantial portion of patients exhibited mild
cognitive impairment, particularly affecting attention and executive function, while others
experienced symptoms of depression and anxiety. These findings challenge the conventional
understanding of TIAs as “harmless events” and point to a deeper and more insidious neurological
impact.
The persistence of such symptoms even three months post-incident underscores the
necessity of early detection and holistic management strategies. Neuroimaging data revealing
microvascular abnormalities further support the hypothesis that cerebral vulnerability exists even
in the absence of full infarction.
These results highlight the urgent need for inclusion of cognitive and psychological
screening in standard post-TIA evaluations, with follow-up care incorporating neuropsychological
support and tailored cognitive rehabilitation programs. Public health strategies should also focus
on educating patients and healthcare providers alike about the latent risks associated with TIA,
encouraging early lifestyle modifications and risk factor control to prevent progression to full-
blown stroke.
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Implementing structured follow-up protocols and multidisciplinary care involving
neurologists, psychologists, and primary care physicians can significantly improve recovery and
reduce the risk of subsequent strokes and long-term disability.
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