Cutting a long story short: Reaction times in acute stroke are associated with longer term cognitive outcomes

Background: The viability and usefulness of cognitive assessment in acute stroke have been questioned, with practical challenges arising from the focal nature of neurological deficits as well as heterogeneity in arousal state. We aimed to test whether acute measures of attention correlate with attentional function at 3 months post-stroke. Methods: Patients with confirmed stroke completed 2 computerised cognitive tasks (CogState) within 2 weeks of stroke. The tasks were a simple reaction time task (Detection) and a choice reaction time task (Identification) that required a button press to visual stimuli (playing cards). Each task took approximately 4 min. The Montreal Cognitive Assessment (MoCA) and an extended neuropsychological battery were administered at 3 months post-stroke. Results: Thirty-three patients (mean age 75.5 years, SD 11.9) participated in this preliminary study. Correlations indicated that both Detection speed (r = - 0.73, p < 0.001) and Identification speed (r = - 0.61, p = 0.007) at baseline were associated with attentional function at 3 months, as measured by established neuropsychological tests (Trails-A, Digit span, Digit symbol). In addition, Detection speed at baseline was correlated with total 3-month MoCA score (r = - 0.54, p = 0.012). Conclusion: Simple and brief computerised assessment of attentional function in acute stroke is possible and is related to longer term attentional and cognitive performance.