Cognitive impairment and neurovascular function in patients with severe steno-occlusive disease of a main cerebral artery

Ishikawa, Mami; Saito, Haruna; Yamaguro, Tomotaka; Ikoda, M.; Ebihara, Akira; Kusaka, Gen; Tanaka, Yuichi

doi:10.1016/j.jns.2015.12.019

Cited by 11 publications

(7 citation statements)

References 24 publications

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“…In future examinations, we plan to compare the clinical profiles of patients who experienced ICAO with CI and previous TIA versus those without previous TIA. Furthermore, mild cognitive impairment is a frequent finding in patients with lacunar stroke with associated MRI subcortical hyperintensities [24] , and we have also reported the association between cognitive function and white matter disease in patients with severe steno-occlusive disease of a main cerebral artery [21] . In future research, we would like to compare cognitive function between patients with severe steno-occlusive disease of a main cerebral artery versus patients with small vessel cerebrovascular disease and its relationship to white matter disease in the setting of each function.…”

Section: Discussionsupporting

confidence: 60%

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Collateral Flow and White Matter Disease in Patients with Internal Carotid Artery Occlusion

Ishikawa

Sugawara²,

Nagai³

et al. 2016

Eur Neurol

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Background: When an internal carotid artery (ICA) occludes, a patient may develop cerebral infarction (CI). We investigated whether CI caused by ICA occlusion (ICAO) is associated with collateral flow through the anterior and posterior communicating arteries (ACoA and PCoA). Methods: In 100 patients with ICAO, we investigated CI and white matter disease by performing an MRI and the anatomy of the ACoA and PCoA were investigated by performing magnetic resonance angiography. All patients were divided into the symptomatic CI group or the no-CI group. The collateral flow pathway was estimated by the anterior cerebral artery (ACA)-PCoA score and the collateral flow volume after ICAO was estimated by the middle cerebral artery (MCA) flow score, based on how well the MCA was visualized. Results: Of 100 patients with ICAO, the symptomatic CI group included 36 patients. ACA-PCoA score and white matter disease grades were significantly higher in the CI group (indicating poor collateral flow). More than 80% of patients with an ACA-PCoA score of 4 (poor collateral) experienced symptomatic CI. Thirty-one symptomatic CI patients (86%) had an MCA flow score of 1 or 2 (decreased MCA flow). Conclusion: The ACA-PCoA score and white matter disease grade may suggest an increased risk of CI following ICAO.

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Section: Discussionsupporting

confidence: 60%

“…Recent publications have reported the relationship between severity of white matter disease and leptomeningeal collaterals in ischemic stroke patients [18][19][20] . We reported that white matter disease correlated with cognitive impairment [21] , which we should further examine as one of neurological deficits in patients with ICAO.…”

Section: Discussionmentioning

confidence: 81%

Collateral Flow and White Matter Disease in Patients with Internal Carotid Artery Occlusion

Ishikawa

Sugawara²,

Nagai³

et al. 2016

Eur Neurol

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“…SPECT was performed using an E-CAM (two-head SPECT system; Toshiba, Tochigi, Japan) for measurement of CBF and CVR, as described in a previous report. 3 All the patients underwent IMP-SPECT at rest and after administration of acetazolamide using the 1-day method. 15 CVR was defined as (CBF after acetazolamideresting CBF)/resting CBF Â 100 (%).…”

Section: Cbf and Cvr Obtained From Imp-spectmentioning

confidence: 99%

“…Patients with severe steno-occlusive disease of a main cerebral artery often demonstrate cognitive impairment in the absence of focal neurologic deficits or causative lesions identified on magnetic resonance imaging (MRI). [1][2][3][4][5] In cerebral ischemic diseases, clinical examination of the cerebrovascular reserve (CVR) is important to estimate neurovascular function, the reduction of which contributes to brain dysfunction, cognitive impairment, and reduced cerebral blood flow (CBF). 6 In our previous study of 15 patients with severe steno-occlusive disease of a main cerebral artery using the Japanese version of the neurobehavioral cognitive status examination (COGNISTAT) and 123 I-N-isopropyl-piodoamphetamine single photon emission computed tomography ( 123 I-IMP-SPECT), we reported that cognitive impairment was associated with decreased CVR.…”

Section: Introductionmentioning

confidence: 99%

“…6 In our previous study of 15 patients with severe steno-occlusive disease of a main cerebral artery using the Japanese version of the neurobehavioral cognitive status examination (COGNISTAT) and 123 I-N-isopropyl-piodoamphetamine single photon emission computed tomography ( 123 I-IMP-SPECT), we reported that cognitive impairment was associated with decreased CVR. 3 The effects of superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis on cognitive impairment have been discussed in patients with steno-occlusive disease of a main cerebral artery 5,[7][8][9] ; however, the effectiveness of this type of surgery remains unclear. 10 In our previous report, we performed logistic regression analyses and showed that CVR correlated with COGNISTAT scores.…”

Section: Introductionmentioning

confidence: 99%

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The Early Postoperative Course of Cognitive Function and Preoperative Cerebrovascular Reserve

Ikota

Ishikawa

Kusaka

2023

J Neurol Surg A Cent Eur Neurosurg

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Background Patients with severe steno-occlusive disease of a main cerebral artery without causative lesions on magnetic resonance imaging (MRI) often develop cognitive impairment. However, the effects of revascularization surgery and the source of the cognitive impairment remain unclear. Therefore, we investigated the early postoperative course of cognitive function and its association with cerebral blood flow (CBF), cerebrovascular reserve (CVR), white matter disease (WMD), lacunar infarction, and cerebrovascular risk factors. Methods Cognitive function was examined using neurobehavioral cognitive status examination (COGNISTAT) in 52 patients with steno-occlusive disease of a main cerebral artery before and at 6 months after superficial temporal artery–middle cerebral artery (STA–MCA) anastomosis. We examined how cognition changed before and at 1, 3, and 6 months after STA–MCA anastomosis in 27 of 52 patients. CVR and CBF were calculated from 123I-N-isopropyl-p-iodoamphetamine single photon emission computed tomography, in addition to other cerebrovascular risk factors in 34 of 52 patients. Cerebral infarction and WMD (periventricular hyperintensity [PVH] and deep subcortical white matter hyperintensity) were also evaluated preoperatively by MRI. Results COGNISTAT scores improved at 1 month after STA–MCA anastomosis in patients with severe steno-occlusive disease of a main cerebral artery. Multiple stepwise regression analysis revealed that CVR (regression coefficient = –2.237, p = 0.0020) and PVH (regression coefficient = 2.364, p = 0.0029) were the best predictors of postoperative improvement in COGNISTAT scores (R 2 = 0.415; p = 0.0017). Conclusion Cognitive function improves in relation to preoperative CVR and PVH early after STA–MCA anastomosis in patients with steno-occlusive disease of a main cerebral artery.

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The independent influences of heat strain and dehydration upon cognition

et al. 2017

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Cognitive impairment and neurovascular function in patients with severe steno-occlusive disease of a main cerebral artery

Cited by 11 publications

References 24 publications

Collateral Flow and White Matter Disease in Patients with Internal Carotid Artery Occlusion

Collateral Flow and White Matter Disease in Patients with Internal Carotid Artery Occlusion

The Early Postoperative Course of Cognitive Function and Preoperative Cerebrovascular Reserve

The independent influences of heat strain and dehydration upon cognition

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