Quality of Life and cognitive functioning in recently diagnosed TIA patients

Sixty to eighty patients are referred yearly to our hospital because of a
temporary neurological dysfunction lasting less than 24 hours caused by
transient cerebral ischemia. These *transient ischemic attacks*(TIA) can be
distinguished from small strokes when the neurological symptoms persist for a
couple of days. Because of the short-lived neurological symptoms medical
follow up and care are often limited. Nevertheless, research has shown that a
considerable proportion of TIA patients experience complaints that do not
disappear or even increase after their attack. The Dutch stroke guidelines
therefore advice that besides the control of somatic risk factors attention
needs to be given to possible emotional, behavioral and cognitive consequences
of a TIA.
This study aims on the detection of possible causes of complaints after a
TIA. The focus will be on detection of memory complaints and possible
underlying factors such a vascular condition, anxiety, depression, and sleep
problems. The goals of this study fit within our ongoing research towards
explanations for discrepancies between cognitive complaints and actual
cognitive test performance
A possible explanation for such discrepancies is that standardly used clinical
memory tests measure memory consolidation over a relatively short period
(20-30min) instead over a prolonged period (days to weeks). Long term
*overnight* consolidation processes might especially be prone for relatively
*slow* functional changes due to stress, depression, diminished vascular
condition or sleeping apnea. Aforementioned factors have also been described
as possible risk and comorbid conditions of TIA or *small strokes*. The
prevalence of sleep apnea among stroke victims for example is high and ranges
between 30-80%. A TIA history has also been associated with a heightened
risk for depression. Despite apparent neurological recovery, TIA patients have
also been found to report more memory problems and fatigue compared to healthy
controls.

Our research goals are as follows:

1) identification of sleep and/or memory problems among 100 recently diagnosed
TIA or small stroke patient,
2) testing the relation between memory complaints and long term memory
consolidation
3) assessing the influence of comorbid anxiety, depression and sleep problems
upon quality of life, memory complaints and long term forgetting rates.

Cross sectional observational study

Recently diagnosed TIA and small stroke patients will be asked to rate their
Quality of Life, psychological well being, sleep and cognitive functioning. In
addition these patients will undergo a concise cognitive screening. A second
follow up memory testing procedure will be carried out two weeks later to
assess the long term memory consolidation of the previously, at baseline,
learned material.

Multivariate analyses (regressions) will be used to test the relations between
ratings of quality of life on one hand, and ratings concerning psychological
well being, sleep and memory on the other hand.

Multivariate analyses (regressions) will be used to test the relations between
sleep complaints, depression an anxiety on one hand, and memory complaints
and memory testscores on the other hand.

associations between cognitive complaints and memory tests outcome measures
(e.e. initial learning, short term recall & recognition, and percentage decline
of information over a prolonged period of time) will be assessed with
correlations.

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