P4‐145: Hyperhomocysteinemia impairs spatial memory and inhibits long‐term potentiation (LTP) by modulation synapse‐associated proteins in rat brain

Background: Whereas functional recovery and survival after ischemic stroke seem to improve in patients with prior Transient Ischemic Attack (TIA), little is known about the effect of prior TIA on post-stroke cognition. Our aimwas to evaluate, in a population-based study, the impact of prior TIA on early dementia in patients who survived the first month after first-ever ischemic stroke.Methods:A total of 1697 non-aphasic patients who survived the first month after first-ever ischemic stroke were identified from the population-based registry of Dijon, France, from 1985 to 2007 and divided into three groups according to the time interval between prior TIA and stroke (< 4 weeks, 1⁄4 4 weeks, no TIA) or the duration of TIA (1⁄4 30 minutes, > 30 minutes, no TIA). Outcome was dementia diagnosed by neurologists using DSM-III or IV criteria over the first month after stroke. The Chi-squared test was used to compare the prevalence of dementia in each group. Multivariate analyses were performed using logistic regression models. Results: The prevalence of early dementia was 20.6% (95% CI: 18.5-22.7), 26.8% (95% CI: 13.3-40.4; p < 0.0001) and 33.1% (95% CI: 27.3-38.9) among the patients without TIA, with a prestroke TIA 1⁄4 4 weeks and with a prestroke TIA< 4 weeks, respectively. Patients with prestroke TIA < 4 weeks (adjusted OR: 1.83; 95% CI: 1.32-2.52; p 1⁄4 0.0003) and 1⁄4 30 minutes (adjusted OR: 1.97; 95% CI: 1.39-2.78; p 1⁄4 0.0001) had a higher risk of early dementia than those without TIA. Interaction terms between age and TIA and between period of admission and TIA were significant (p 1⁄4 0.024 and p 1⁄4 0.007 respectively). Conclusions: An ischemic stroke is harmful for cognition especially in patients who have had a recent short TIA.