Background Cognitive impairment is common following cerebrovascular disease. Recently it has been associated with hippocampal ultra-structural damage in stroke survivors. We aim to study the long-term cognitive profile of patients after ischaemic stroke and characterise the cognitive behaviours associated with any dynamic changes in the structure, function and metabolism of the hippocampi, using multimodal MRI at 3Tesla.

Methods We are conducting a dual-centre study to investigate the predictive value of diagnostic MRI and resting-state fMRI based on observing natural history of cognitive function following stroke (at baseline and 1 year). We aim to recruit stroke patients with a cognitive impairment (MoCA<26) and age-matched healthy controls. All participants will undergo an MRI scan, the Birmingham Cognition Screen (BCoS: Humphreys et al. 2012) and Montreal Cognitive Assessment (MoCA). These measures have all been validated for screening the stroke population (BCoS: Bickerton et al. 2013).

Ethics Sandwell and West Birmingham Hospitals (SWBH) NHS Trust sponsor this study. The protocol has favourable opinion from the Black Country NRES Committee, approved by SWBH Research & Development, and in process of approval by the University Hospital Birmingham Foundation Trust. The study is ongoing and recruiting eligible participants from SWBH NHS Trust.

Outcomes To understand the predictive value of neuroimaging biomarkers of hippocampi in stroke survivors to determine their cognitive performance at one year.