Medial temporal lobe atrophy in poststroke cognitive impairment: 2 years follow-up study

Introduction: There are few longitudinal studies with controversial results examining delayed changes in cognition after ischemic stroke and predictive values of neuropsychological and neuroimaging markers. Aim: The objectives of this study were to evaluate the delayed change in cognition in poststroke patients and relationship to the medial temporal lobe (MTL) atrophy. Material and Methods: Eighty-five first-ever stroke inpatients (mean age 65.6 +/- 5.6) without previous cognitive complaints were prospectively evaluated with a comprehensive neuropsychological battery on the 5-th day, 1-st, 6-th, 12-th, and 24-th month. A wide range of clinical, radiological and neuropsychological variables were examined. Results: Our results showed that among all neuropsychological measures, only the IST test at the 2-year follow-up showed significant decline reaching the baseline level impairments in comparison with the results at 12-th month. On the other hand, MTL atrophy showed its high impact on the performance on all neuropsychological tests, even after 2 years post stroke. In addition, the MTL atrophy increased significantly two years after stroke compared with the baseline. Conclusion: These results enriched our previous neuropsychological and neuroimaging longitudinal findings after stroke. Moreover, the data strengthened the important role of the initial assessment of MTL atrophy, and the follow-up IST examinations as a neuropsychological quick, easy and reliable tool for delayed poststroke cognitive impairment.