Carotid Revascularization Improves Cognition in Patients With Asymptomatic Carotid Artery Stenosis and Cognitive Decline. Greater Improvement in Younger Patients With More Disordered Neuropsychological Performance

Turowicz, Agnieszka; Czapiga, Alina; Malinowski, Maciej; Majcherek, Jarosław; Litarski, Andrzej; Janczak, Dariusz

doi:10.1016/j.jstrokecerebrovasdis.2021.105608

Cited by 20 publications

(21 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our research we observed that asymptomatic patients following CEA showed significant improvement of the cognitive performances measured by MMSE. The statistically significant improvement in MMSE scores in the midterm analysis (12 months) supports the hypothesis that the improvements in cerebral perfusion following the CEA procedure led to better cognitive performances and are in line with the findings from literature [7][8][9][10]. Regarding the rs-fMRI analysis, it is noteworthy that our findings are concordant to those found by Wang T et al [14].…”

Section: Discussionsupporting

confidence: 92%

The mid-term effects of carotid endarterectomy on cognition and regional neural activity analyzed with the amplitude of low frequency fluctuations technique

et al. 2021

View full text Add to dashboard Cite

Purpose The study aims to evaluate the mid-term effects of carotid endarterectomy (CEA) on cognition and resting-state functional magnetic resonance imaging (rs-fMRI) using the Amplitude of Low Frequency Fluctuations (ALFF) technique. Methods In this observational study, patients eligible for CEA were prospectively included. On the same day, within 1 week of the CEA procedure performed and 12 months after the CEA procedure, all patients underwent (i) an MRI examination for rs-fMRI analysis and (ii) a cognitive evaluation using the Italian version of the Mini-Mental State Examination (MMSE) corrected for age and schooling. Pre-CEA and post-CEA MMSE scores were evaluated using paired sample t-tests, adopting a p-value < 0.05 as statistical threshold. The ALFF technique was used for analyzing the differences between pre-CEA and post-CEA rs-fMRI scans in terms of regional neural activation. This was accomplished by applying non-parametric statistics based on randomization/permutation for cluster-level inferences, adopting a cluster-mass p-value corrected for false discovery < 0.05 for cluster threshold, and a p-uncorrected < 0.01 for the voxel threshold. Results Twenty asymptomatic patients were enrolled. The mean MMSE score resulted improved following CEA procedure (p-value = 0.001). The ALFF analysis identified a single cluster of 6260 voxels of increased regional neural activity following CEA, and no cluster of reduced activity. The majority of voxels covered the right precentral gyrus, the right middle frontal gyrus, and the anterior division of the cingulate gyrus. Conclusion Mid-term cognitive improvements observed after CEA are associated to increased regional neural activity of several cerebral regions.

show abstract

Section: Discussionsupporting

confidence: 92%

The mid-term effects of carotid endarterectomy on cognition and regional neural activity analyzed with the amplitude of low frequency fluctuations technique

et al. 2021

View full text Add to dashboard Cite

show abstract

“…In the most recent study from 2021, a group of Polish researchers found greater improvement in cognitive function in younger people with poorer baseline cognitive parameters. The only strong predictors of improvement 6 months after surgery were young age and a low MoCA score [47]. Improvement 1 year after the procedure affected visual memory, motor functions, and frontal lobe-related functions and was independent of treatment method.…”

Section: Comparison Of Cas and Ceamentioning

confidence: 91%

“…Some researchers point out the relationship between age and persistence of cognitive deterioration. CAS and age greater than 80 years have been associated with significant long-term cognitive impairment [47]. A slightly different opinion is held by Wasser K., who observed cognitive deterioration in individuals aged 68 years and older and found that it persisted longer in patients after CEA than in patients after CAS [48].…”

Section: Comparison Of Cas and Ceamentioning

confidence: 99%

“…However, the researchers recorded changes in cerebral blood flow in the hemisphere on the side of the stenosis and found that these changes normalized after reperfusion. The authors themselves state that the result of their study should be considered a success that does not contribute to a clear explanation of the effects of revascularization methods on cognitive performance [47].…”

Section: Comparison Of Cas and Ceamentioning

confidence: 99%

See 1 more Smart Citation

Cognitive Functions in Patients after Carotid Artery Revascularization—A Narrative Review

et al. 2021

View full text Add to dashboard Cite

Carotid revascularization may lead to improved cognitive function beyond stroke prevention. This article summarizes the conclusions from available studies on the effects of carotid reperfusion procedures on cognitive function. The papers cited used different neuropsychological tests for cognitive assessment, resulting in different methodologies and the results obtained were not always convergent. However, most studies reported an improvement in neurocognitive abilities after both vascular interventions, but a more precise assessment of the specific benefits is still awaited. Clinical determinants to predict the effects of these treatments on cognitive function are still being sought, but results are not yet satisfactory. In view of these studies, carotid stenosis seems to be an independent risk factor for cognitive deterioration, and the main mechanisms responsible are embolism and cerebral hypoperfusion. The aim of this study is to order the knowledge about the effects of carotid artery stenting (CAS) and endarterectomy (CEA) on neurocognitive functions and to verify the usefulness of using these treatments.

show abstract

“…29e34 Three reported no differences between CEA and CAS. 29,30,33 The remainder reported no significant differences across most domains, but that CEA was associated with improvement in one to two domains including working memory index, 32 while CAS was associated with improvements in one to two domains including executive and motor function, 34 psychomotor speed, 32 and visuospatial and constructional abilities. 31…”

Section: Carotid Endarterectomy Vs Carotid Artery Stentingmentioning

confidence: 97%

Editor's Choice – Effect of Carotid Interventions on Cognitive Function in Patients With Asymptomatic Carotid Stenosis: A Systematic Review

Ancetti

Paraskevas²,

Faggioli

et al. 2021

European Journal of Vascular and Endovascular Surgery

View full text Add to dashboard Cite

Carotid Revascularization Improves Cognition in Patients With Asymptomatic Carotid Artery Stenosis and Cognitive Decline. Greater Improvement in Younger Patients With More Disordered Neuropsychological Performance

Cited by 20 publications

References 33 publications

The mid-term effects of carotid endarterectomy on cognition and regional neural activity analyzed with the amplitude of low frequency fluctuations technique

The mid-term effects of carotid endarterectomy on cognition and regional neural activity analyzed with the amplitude of low frequency fluctuations technique

Cognitive Functions in Patients after Carotid Artery Revascularization—A Narrative Review

Editor's Choice – Effect of Carotid Interventions on Cognitive Function in Patients With Asymptomatic Carotid Stenosis: A Systematic Review

Contact Info

Product

Resources

About