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Review
. 2022 May 7;11(9):2637.
doi: 10.3390/jcm11092637.

The Cognitive Sequelae of Transient Ischemic Attacks-Recent Insights and Future Directions

Aravind Ganesh  1   2   3 , Philip A Barber  1   2   3   4
Affiliations
Review

The Cognitive Sequelae of Transient Ischemic Attacks-Recent Insights and Future Directions

Aravind Ganesh et al. J Clin Med. .

Abstract

There is now considerable evidence that Transient Ischemic Attack (TIA) carries important sequelae beyond the risk of recurrent stroke, particularly with respect to peri-event and post-event cognitive dysfunction and subsequent cognitive decline. The occurrence of a TIA could provide an important window in understanding the relationship of early mixed vascular-neurodegenerative cognitive decline, and by virtue of their clinical relevance as a "warning" event, TIAs could also furnish the opportunity to act preventatively not only for stroke prevention but also for dementia prevention. In this review, we discuss the current state of the literature regarding the cognitive sequelae associated with TIA, reviewing important challenges in the field. In particular, we discuss definitional and methodological challenges in the study of TIA-related cognitive impairment, confounding factors in the cognitive evaluation of these patients, and provide an overview of the evidence on both transient and long-term cognitive impairment after TIA. We compile recent insights from clinical studies regarding the predictors and mediators of cognitive decline in these patients and highlight important future directions for work in this area.

Keywords: cognition; cognitive impairment; dementia; transient ischemic attack.

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Conflict of interest statement

Dr. Ganesh reports membership in the editorial boards of Neurology, Stroke, Neurology Clinical Practice, and Frontiers in Neurology; consulting fees and honoraria from Atheneum, MD Analytics, Figure 1, MyMedicalPanel, Creative Research Designs, CTC Communications Corp, Alexion, and Biogen; research support from Alberta Innovates, Campus Alberta Neuroscience, the Canadian Cardiovascular Society, the University of Calgary (Hotchkiss Brain Institute), the Sunnybrook Research Institute INOVAIT program, and the Canadian Institutes of Health Research; stock/stock options from SnapDx and TheRounds.com; and has a patent application for a system for patient monitoring/assessment and delivery of remote ischemic conditioning or other cuff-based therapies. Dr. Barber is a cofounder of Andromeda Medical Imaging Inc., and reports consulting fees for Ablynx Pharmaceutical, and research support from the Canadian Institutes of Health Research and the Heart and Stroke Foundation of Canada.

Figures

Figure 1
Figure 1
The complex interplay of potential mediators of cognitive decline after a transient ischemic attack (TIA) as well as some potential confounders.
See this image and copyright information in PMC

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