Objective  To investigate the effects of serum homocysteine and vitamin B₁₂ on cognitive function and the prognosis in patients with acute ischemic stroke.

  Methods  A total of 67 patients with first episode acute ischemic stroke who were treated in stroke center of our hospital were randomly selected as research objects. The prognosis, cognitive function, and neurological deficit of subjects at the time points of admission, 3 and 6 months after the onset of the disease were assessed by professional neurologists with modified Rankin Scale (MRS) and Barthel Index Scale (BI), Montreal Cognitive Assessment Scale (MoCA) and Mini Mental State Scale (MMSE), and National Institutes of Health Stroke Scale (NIHSS), respectively. The correlations between serum homocysteine (Hcy), vitamin B₁₂ and cognitive function, prognosis were further analyzed.

  Results  At the time points of admission, 3 and 6 months after the onset of the disease, Hcy level gradually decreased and vitamin B₁₂ level gradually increased, showing a significant differences (P < 0.05). After adjusting for age and baseline NIHSS, serum homocysteine levels were not associated with BI and mRS at 3 and 6 months of follow-up(P>0.05), but were negatively correlated with MoCA scores and MMSE scores (P < 0.05). Vitamin B₁₂ levels at 3 and 6 months after onset were positively correlated with BI, and negatively correlated with mRS(P < 0.05).

  Conclusion  Serum Hcy levels are associated with cognitive dysfunction in patients with ischemic stroke, the higher the Hcy level is, the lighter cognitive dysfunction will be. The study prelininarily showed that vitamin B₁₂ levels are associated with prognosis, the higher the serum vitamin B₁₂ level become, the better the neurological function of the patients will be.