Abstract Background and aims Post-stroke cognitive impairment (PSCI) affects up to 70% of patients in the acute phase of ischemic stroke and significantly contributes to long-term disability and reduced quality of life. Despite advances in reperfusion therapies, early strategies specifically targeting cognitive recovery remain insufficiently studied. This study aimed to evaluate whether an optimized early therapeutic approach improves cognitive and psychoemotional outcomes in acute ischemic stroke patients. Methods Fifty patients with acute ischemic stroke were prospectively randomized into two groups (n=25 each). The intervention group received standard therapy plus Cytoflavin starting from day 2 of the acute phase (10 ml intravenously twice daily for 7 days, followed by 2 tablets twice daily for 14 days). The control group received standard therapy alone. Cognitive status was assessed using the MMSE and MoCA scales. Psychoemotional status was evaluated using the Spielberger–Hanin anxiety scale. Results Fifty patients with acute ischemic stroke were randomized into two groups (n=25 each). Compared with the control group, patients receiving Cytoflavin demonstrated greater improvement in global cognitive performance. MMSE scores increased by 25% from baseline, while MoCA scores improved by 40%, indicating enhanced executive and attentional functions. The control group showed only modest changes. In addition, reactive anxiety scores significantly decreased in the intervention group, reflecting improved psychoemotional status, whereas trait anxiety remained largely unchanged in both groups. Conclusions Early metabolic and neuroprotective therapy was associated with improved cognitive performance and reduced anxiety in acute ischemic stroke patients, suggesting potential benefits for functional recovery. Conflict of interest
Saidmuxtorova et al. (2026) studied this question.