Cognitive Decline in Asymptomatic Middle Cerebral Artery Stenosis Patients with Moderate and Poor Collaterals: A 2-Year Follow-Up Study

Meng, Yuanyuan; Yu, K.; Zhang, Ligong; Liu, Yingchun

doi:10.12659/msm.913797

Cited by 13 publications

(13 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recently, a clinical-based study suggested that in participants with asymptomatic severe MCA stenosis, poor collateral circulation was associated with declines in multiple cognitive domains characterised by vascular cognitive impairment. 17 The association between cognitive function and aICAS in other intracranial arteries remains to be clarified.…”

Section: Introductionmentioning

confidence: 99%

Kongcun Town Asymptomatic Intracranial Artery Stenosis study in Shandong, China: cohort profile

Wang

Zhao

et al. 2020

BMJ Open

View full text Add to dashboard Cite

PurposeThe population-based Kongcun Town Asymptomatic Intracranial Artery Stenosis (KT-aICAS) study aims to investigate the prevalence of aICAS and major cardiovascular risk factors (CRFs) or biomarkers related to the development and prognosis of aICAS.ParticipantsThe KT-aICAS study included 2311 rural residents who were aged ≥40 years and living in Kongcun Town, Shandong Province, China. Baseline examination was conducted from October 2017 to October 2018, during which information on demographics, socioeconomics, personal and family medical history, and lifestyle factors was collected through face-to-face interviews, physical examination and blood tests. aICAS was initially screened using transcranial Doppler examination and then diagnosed using magnetic resonance angiography. Atherosclerosis in carotid arteries was diagnosed via carotid ultrasonography. High-resolution MRI was further used to evaluate the vessel wall of aICAS. Neuropsychological assessments were performed in the participants diagnosed with aICAS and the age-matched and sex-matched controls.Findings to dateOf the 2311 participants, 2027 (87.7%) completed the diagnostic procedure and aICAS was detected in 154 persons, resulting in an overall prevalence of 7.6%. The prevalence of aICAS increased with advancing age from 5.1% in participants aged 40–49 years to 12.7% in those aged ≥70 years (p<0.001). aICAS was detected in 305 intracranial arteries, including 221 (72.5%) in the anterior circulation and 84 (27.5%) in the posterior circulation (p<0.001). In addition, major CRFs were highly prevalent among middle-aged and elderly rural dwellers who were free of clinical stroke.Future plansFollow-up examinations will be performed every 3 years following the baseline examination. This study will increase our knowledge about the natural history of aICAS and facilitate studies of aICAS-associated disorders among rural-dwelling Chinese adults, such as ischaemic stroke and vascular cognitive impairment.Trial registration numberChiCTR1800017197.

show abstract

Section: Introductionmentioning

confidence: 99%

Kongcun Town Asymptomatic Intracranial Artery Stenosis study in Shandong, China: cohort profile

Wang

Zhao

et al. 2020

BMJ Open

View full text Add to dashboard Cite

show abstract

“…Previous study found that patients with poor and moderate collateral circulation in aMCAS had worse cognitive function than patients with good collateral circulation, 13 which suggested that cognitive impairment in patients with aMCAS may be associated with hypoperfusion. This was further confirmed in this study that perfusion decompensation was an independent risk factor for cognitive impairment in patients with aMCAS.…”

Section: Discussionmentioning

confidence: 99%

Nomogram to Predict Cognitive Impairment in Patients with Asymptomatic Middle Cerebral Artery Stenosis

Li¹,

Wang²,

Li³

et al. 2023

IJGM

View full text Add to dashboard Cite

Purpose This study aims to investigate the characteristics and influencing factors of cognitive impairment in patients with asymptomatic middle cerebral artery stenosis (aMCAS) and to construct a nomogram to predict the risk of cognitive impairment in patients with aMCAS. Patients and Methods We collected 54 patients with aMCAS and 35 healthy controls to investigate the impaired cognitive domains and pathogenesis in patients with aMCAS. All patients underwent a cranial MRI, CT perfusion, transcranial Doppler ultrasound, blood tests, and a comprehensive neuropsychological evaluation. According to the MoCA score, patients were divided into cognitively normal and cognitively impaired groups. To construct the nomogram, we conducted univariate and multivariate logistic regression analyses to identify factors that affect cognitive function. And the performance of nomogram was evaluated by ROC curves, calibration curves, decision curve analysis (DCA), and clinical impact curve (CIC). Results In 54 patients with aMCAS, 24 patients presented with cognitive normal, and 30 patients presented with cognitive impairment. The results of multivariate logistic regression suggested that perfusion decompensation, middle cerebral artery mean flow velocity, and LDL-cholesterol levels were independent influencing factors of cognitive impairment. In the following step, a nomogram was constructed. The AUC of the nomogram is 0.862. Calibrating curves show good agreement between nomogram predictions and actual observations, while DCA and CIC show great clinical usefulness. Conclusion Patients with aMCAS have cognitive impairment in multiple cognitive domains, and impaired executive function was observed during the perfusion compensation period. Furthermore, a nomogram was constructed and validated to predict the risk of cognitive impairment in patients with aMCAS, which can help clinicians to identify at an early stage and improve the management of patients.

show abstract

“…Our study showed that ICS was a significant risk factor for cognitive decline, independent of the effects of other vascular risk factors and markers of cerebrovascular disease, and may be implicated in the pathophysiology of vascular cognitive impairment. A prospective study investigating the role of cerebral collaterals in patients with middle cerebral artery stenosis showed that patients with ICS but good collaterals did not show an association with cognitive impairment, whereas those with poor collaterals had worse executive function, attention, and information‐processing speed [18]. Previous studies have also shown that patients with ICS and reduced breath‐holding index measured using transcranial Doppler ultrasound had lower cognitive scores [12,32].…”

Section: Discussionmentioning

confidence: 99%

“…Only one prospective study showed that asymptomatic patients with severe middle cerebral artery stenosis and moderate to poor leptomeningeal collaterals had cognitive decline after 2 years [18]. However, this study had a limited sample size ( n = 173), did not use analyses that accounted for repeated measures, and did not take into account other vascular risk factors and markers of cerebrovascular disease.…”

Section: Introductionmentioning

confidence: 99%

The effect of intracranial stenosis on cognitive decline in a memory clinic cohort

Lim

Tan

Gyanwali

et al. 2021

Euro J of Neurology

View full text Add to dashboard Cite

Background and purpose Intracranial stenosis (ICS) is a risk factor for cognitive impairment and dementia in cross‐sectional studies. However, data examining the effect of ICS on cognitive decline are limited. We investigated the effect of ICS on cognition over a period of 3 years in a memory clinic cohort. Methods Patients were recruited from the National University Hospital in Singapore. Data were collected using a standardised questionnaire, physical examination, and 3‐T magnetic resonance imaging (MRI) at baseline. ICS was defined as arterial narrowing that exceeded 50% of the luminal diameter in any intracranial vessel. Cognition was measured at baseline and annually for 3 years using the Mini‐Mental State Examination, the Montreal Cognitive Assessment, and a detailed neuropsychological test battery. The association between ICS and cognitive decline was analysed using generalised estimating equations. Results A total of 364 patients were included in the analysis. The mean (±SD) age was 71.9 (±8.0) years, and 164 (45.1%) patients were male. A total of 66 (18.1%) patients had ICS. ICS was associated with worse executive function (β = −0.37, 95% confidence interval = −0.68 to −0.05, p = 0.022) and modified the effect of follow‐up time on memory (p = 0.005) and visuomotor speed (p = 0.047). These results remained significant after controlling for demographics, overall diagnosis, cardiovascular risk factors, and MRI markers of cerebrovascular disease. Conclusions Intracranial stenosis was independently associated with worse executive function across all time points, and cognitive decline in memory and visuomotor speed over 3 years of follow‐up. This suggests that ICS may be a useful indicator of vascular brain damage leading to cognitive decline and may warrant consideration of antiatherosclerotic treatment in clinical trials.

show abstract

Cognitive Decline in Asymptomatic Middle Cerebral Artery Stenosis Patients with Moderate and Poor Collaterals: A 2-Year Follow-Up Study

Cited by 13 publications

References 39 publications

Kongcun Town Asymptomatic Intracranial Artery Stenosis study in Shandong, China: cohort profile

Kongcun Town Asymptomatic Intracranial Artery Stenosis study in Shandong, China: cohort profile

Nomogram to Predict Cognitive Impairment in Patients with Asymptomatic Middle Cerebral Artery Stenosis

The effect of intracranial stenosis on cognitive decline in a memory clinic cohort

Contact Info

Product

Resources

About