Cognitive Performance in Asymptomatic Patients With Advanced Carotid Disease

Popović, Iva; Lovrenčić-Huzjan, Arijana; Šimundić, Ana-Maria; Popović, Alek; Šerić, Vesna; Demarin, Vida

doi:10.1097/wnn.0b013e3182313020

Cited by 44 publications

(39 citation statements)

References 44 publications

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“…Subtest differences could be seen even among those whose Mini Mental Status Examination (MMSE) scores were within normal limits. Second, performance on the visuospatial/executive subtest is worse among patients with occlusion/stenosis of the ICA than among patients with vascular risk factors whose ICA is normal, and worse still for ICA patients with more than 2 vascular risk factors [35,36]. In contrast, 1 study found no group differences on any subtest scores when comparing patients with mild-to-moderate vascular dementia with a group of patients with mild-to-moderate Alzheimer's disease who were carefully matched for age, gender, education and total MMSE score [44].…”

Section: Content Evidencementioning

confidence: 99%

“…A multitude of studies comparing the MoCA to the MMSE as a cognitive screening tool were unanimous in concluding the following: (1) MoCA scores are normally distributed, whereas MMSE scores show ceiling effects, (2) the prevalence of cognitive impairment among patients with cerebrovascular disease using the originally published cut-off scores is greater when assessed using the MoCA than when using the MMSE and (3) while a substantial number of those who pass the MMSE fail the MoCA, the converse is rarely true. This has been demonstrated in clinical samples composed of patients with any stroke [18,22], any stroke or TIA [12,14,15,20,21,29,34], small-vessel disease or silent cerebral infarct [25,33], SAH [39,40] and stenosis or occlusion of the ICA [35,36]. …”

Section: Consequencesmentioning

confidence: 99%

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Validity and Applications of the Montreal Cognitive Assessment for the Assessment of Vascular Cognitive Impairment

Koski¹

2013

Cerebrovasc Dis

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Cognitive impairment is common among patients with stroke or other cerebrovascular disease and influences long-term outcome, including occupational functioning. Recognition and monitoring of mild cognitive impairment is thus essential to good patient care. The Montreal Cognitive Assessment (MoCA) has been suggested as a brief screening test of vascular cognitive impairment. This paper presents a critical review of the research literature evaluating the validity and utility of this test with the aim of informing future clinical and research practice. A total of 30 papers employing the MoCA in the context of cerebrovascular disease were identified. Reporting of the methods and results of such studies tended to fall short of the established reporting guidelines. Under-specification of the exclusion criteria applied and their impact make it difficult to assess the potential impact of sampling bias and loss to follow-up. Nevertheless, content validity evidence suggests that the MoCA covers most of the domains that represent cognitive impairment in cerebrovascular disease, with mixed evidence for its preferential sensitivity to the type of cognitive impairment encountered in the context of vascular disease. Evidence clearly supports the need to establish norms and cut-offs for the MoCA that are culturally appropriate and that are matched to the range of cognitive impairment that is present in the population being assessed. Recent modifications of the MoCA have been developed for assessing patients with visual impairment or restricted mobility, which may reduce the impact of ‘untestability' on cognitive screening in the clinic or research context. The MoCA correlates well with other measures of cognitive and functional abilities in patients with cerebrovascular disease, and may also predict future response to rehabilitation and long-term occupational outcome. Further research is needed to provide evidence for the validity of the MoCA in longitudinal studies. However, it compares favourably to the Mini Mental State Examination as a screening test that is sensitive to the milder forms of cognitive impairment that often accompany cerebrovascular disease.

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Section: Content Evidencementioning

confidence: 99%

Section: Consequencesmentioning

confidence: 99%

Validity and Applications of the Montreal Cognitive Assessment for the Assessment of Vascular Cognitive Impairment

Koski¹

2013

Cerebrovasc Dis

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“…Accumulating evidence showed that patients with severe carotid artery stenosis are correlated with VCI in memory (Inzitari et al., 2000; Popovic et al., 2011; Sztriha, Nemeth, Sefcsik, & Vecsei, 2009). Patients with high‐grade carotid artery disease showed lower scores on cognitive function tests than normal controls (Sander et al., 2010; Silvestrini et al., 2011; Zhong et al., 2011, 2012).…”

Section: Introductionmentioning

confidence: 99%

Severe carotid artery stenosis evaluated by ultrasound is associated with post stroke vascular cognitive impairment

Lin

et al. 2016

Brain and Behavior

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BackgroundAcute ischemic stroke has been recognized as one key cause of vascular cognitive impairment (VCI). The purpose of this study was to evaluate the correlation between carotid artery stenosis and post VCI in acute ischemic stroke patients.MethodsIn this study, B‐mode ultrasound was applied to measure the degree of carotid artery stenosis. After 1 year, the stroke patients’ cognitive function was assessed by the mini‐mental state examination (MMSE) score. The relationship between the VCI and degree of carotid artery stenosis was evaluated by multivariate regression analysis.Results VCI was observed in 136 (37.2%) of the 365 participants. High degree of carotid artery stenosis was significantly correlated with VCI (p < .01), and this correlation remained unchanged even adjustment for age, gender, education level, stroke features, and vascular risk factors.ConclusionsThese findings indicate that high‐grade stenosis of carotid artery is positively correlated with post stroke VCI in patients with acute ischemic stroke. The evaluation of 1 year post stroke cognitive function may be a potential tool for screening stroke patients at risk of VCI.

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“…However, it is now well recognized that progressive decline in cognitive functioning may result from cerebrovascular disease, even in the absence of a clinically detectable precipitating event (Jokinen et al, 2009). In 2006, the National Institute of Neurological Disorders and the Stroke-Canadian Stroke Network recommended the Montreal Cognitive Assessment (MoCA) test, or some of its subtests, as an optimal brief protocol for the assessment of vascular cognitive impairment (Hachinski et al, 2006, Popovic, Lovrencic-Huzjan, & Demarin, 2009Popovic et al, 2011). The MoCA compares equally or favorably to the mini-mental state examination (MMSE) in terms of sensitivity to cognitive impairment and sensitivity to change, over time (Koski, 2013).…”

Section: Introductionmentioning

confidence: 99%

Impact of Carotid Endarterectomy on Cognitive Performance and Depressive Symptoms

Pūcīte

Slisers

Miglāne

et al. 2016

CBUP

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OBJECTIVES:This study aims to evaluate the impact of carotid endarterectomy (CEA) on cognitive performance in patients with severe carotid disease and depressive symptoms, and to explore the possible associations between certain demographics, clinical characteristics, and cognitive function and depression. MATERIALS AND METHODS:The study included 48 patients, who were referred for endarterectomy. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) scale, while depressive symptoms were assessed using the patient health questionnaire(PHQ-9) scale. An assessment of cognitive and depressive symptoms was performed 1-3 days before surgery, and then six months after. RESULTS:A paired sample t-test found that the difference in the mean MoCA score between the before ( =23.37; SD ± 3.27) and the after ( =24.69; SD ± 3.68) surgery results was 1.32 (95% CI = 0.48 -2.16; p= 0.003; Cohen's d value = 0.95). A paired sample t-test showed that a decrease in mean PHQ-9 score of > 10 for patients six months after CEA (7.5±4.6) was statistically significant (p= 0.019; Cohen's d value = 1.32) compared with the PHQ-9 scores at baseline (12.6 ± 2.8). CONCLUSION:Carotid artery endarterectomy seems to have beneficial effects on the course of cognitive impairment and depressive symptoms in patients with severe carotid artery stenosis. Demographic, clinical characteristics (age, gender, comorbidities, previous stroke) did not have impact on course of cognitive and depressive symptoms. A limitation in our study was that the number of patients was relatively small, therefore we intend to perform further study with larger case volume to estimate the impact of carotid artery endarterectomy on cognitive functions and depressive symptoms.

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Cognitive Performance in Asymptomatic Patients With Advanced Carotid Disease

Cited by 44 publications

References 44 publications

Validity and Applications of the Montreal Cognitive Assessment for the Assessment of Vascular Cognitive Impairment

Validity and Applications of the Montreal Cognitive Assessment for the Assessment of Vascular Cognitive Impairment

Severe carotid artery stenosis evaluated by ultrasound is associated with post stroke vascular cognitive impairment

Impact of Carotid Endarterectomy on Cognitive Performance and Depressive Symptoms

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