Neuropsychological and neuroimaging evidences of cerebral dysfunction in stroke-free patients with atrial fibrillation: A review

Atrial fibrillation (AF) is the most common heart arrhythmia, with the highest prevalence in the elderly. AF has been correlated with silent lesions and cognitive impairment, even in the absence of stroke. The cognitive impairment in AF represents a risk of functional decline, morbidity, mortality and high costs, constituting a public health problem due to the increasing prevalence of this arrhythmia. Cognitive analysis of patients with AF without stroke has shown poor performance in executive, memory and learning functions. The greater loss occurs in speed processing and performance of instrumental tasks leading to functional dependence. Neuroimaging studies have shown both structural and functional abnormalities in individuals with AF even in the absence of cognitive impairment. The mechanisms related to cognitive impairment and cerebral abnormalities in the AF are still a matter of discussion in the literature and, therefore, how to stop its progression is unknown. We reviewed the recent evidence about AF and dementia in patients without stroke, with special emphasis to the reported profile of cognitive dysfunction and the neuroimaging evidence of brain abnormalities.