Working Memory Impairment in Transient Ischaemic Attack: N-back as a Sensitive Measure for Detection

Laura J. Smith, Polly Gregory, Philip Clatworthy, Lucy Gallop, George Stothart

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Background: Transient ischaemic attack (TIA) can lead to lasting changes in brain structure and function resulting in cognitive impairment. Cognitive screening tools may lack sensitivity for detecting cognitive impairments, particularly executive function, which tends to be the earliest affected domain in vascular cognitive impairment. Aim: In this preliminary study, we examine a working memory (WMem) task as a sensitive measure of cognitive impairment in TIA. Method: Patients referred to a TIA clinic for transient neurological symptoms completed a general cognitive screening tool (Montreal Cognitive Assessment; MoCA), and a WMem task (2-N-back) in a cross-sectional design. Results: TIA patients (n = 12) showed significantly reduced WMem performance on the N-back compared to patients diagnosed with mimic clinical conditions with overlapping symptoms (n = 16). No group differences were observed on the MoCA. Conclusions: Assessing WMem may provide a sensitive measure of cognitive impairment after TIA, with implications for cognitive screening in TIA services to triage patients for further neuropsychological support, or for interventions to prevent vascular dementia.

Original languageEnglish
Pages (from-to)124-131
Number of pages8
JournalBrain Impairment
Issue number1
Early online date15 Dec 2021
Publication statusPublished - 15 Mar 2023

Bibliographical note

Funding Information:
This research received no specific grant from any funding agency, commercial or not-for-profit sector. PC is funded by a Stroke Association (UK) Thompson Family Senior Clinical Lectureship.


  • N-back
  • sensitivity (d′)
  • transient ischaemic attack
  • Working memory

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Neurology
  • Clinical Neurology
  • Cognitive Neuroscience
  • Behavioral Neuroscience
  • Speech and Hearing


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