Executive Dysfunction in Patients With Cerebral Hypoperfusion After Cerebral Angiostenosis/Occlusion

Abstract

Impairment of executive functions (EFs) was investigated in patients with cerebral hypoperfusion after cerebral angiostenosis/occlusion. Several EFs were measured in patients with cerebral angiostenosis/occlusion and healthy subjects. The vascular conditions, regional cerebral blood flow (rCBF), regional cerebral blood volume (rCBV), mean transit time (MTT), time to peak (TTP), and delay time were assessed. The scores of the vascular stenosis/occlusion group were significantly lower than those of the control group. rCBV and rCBF were negatively correlated with the error response times in the Stroop test, and the persistent error responses in the Wisconsin Card Sorting Test (WCST) were positively correlated with the Montreal Cognitive Assessment (MoCA) scores. TTP was positively correlated with the reaction and error reaction times, and the persistent error response in WCST was negatively correlated with the times of sorting in WCST and MoCA scores. MTT was positively correlated with the persistent error response in WCST. In the Stroop test, delay time was positively correlated with response time, and negatively correlated with error response times, and the persistent error response in WCST and MoCA scores. Patients with cerebral hypoperfusion after cerebral angiostenosis/occlusion had executive dysfunctions in working memory, sustained attention, response inhibition, cognitive flexibility, thought organization, planning, and implementation. Moreover, their executive dysfunctions were related with the decline in rCBF and rCBV. The prolonged TTP, MTT, and delay time suggested a slow blood flow and the poor compensation of collateral circulation, resulting in impairment of the EFs.

Influence of collateral circulation on cerebral blood flow and frontal lobe cognitive function in patients with severe internal carotid artery stenosis

“…Severe internal carotid artery (ICA) stenosis is characterized by chronic cerebral hypoperfusion due to the decreased cerebral blood flow (CBF). It has been proven that long-lasting cerebral hypoperfusion may impair energy metabolism in neurons and lead to cognitive impairment [1, 2]. Although cerebral hypoperfusion is common in patients with ICA stenosis, collateral circulation provides new paths to maintain sufficient blood supply even though it may only represent a poor compensation [2].…”

“…It has been proven that long-lasting cerebral hypoperfusion may impair energy metabolism in neurons and lead to cognitive impairment [1, 2]. Although cerebral hypoperfusion is common in patients with ICA stenosis, collateral circulation provides new paths to maintain sufficient blood supply even though it may only represent a poor compensation [2]. Some studies have investigated the association between collateral circulation and cognitive dysfunction in recent years; however, the findings on this topic have been inconsistent [3, 4].…”

Cognitive impairment in two subtypes of a single subcortical infarction

“…[ 21 ] The SCWT can be used to evaluate the behavior control functions using the conflict between perception and speech. [ 22 ] Poor performances on difficult tasks such as the Stroop-B and Stroop-C are more likely to reflect genuine impairment. [ 23 ] When exploring the different cognitive status between patients with BAD and CSVD-related SSI at baseline, only Stroop-C (correct) demonstrated a statistically significant difference, indicating that the correct numbers are more sensitive than the time in this test.…”

“…Kramer reported slower information processing in patients with subcortical ischemic vascular disease [21] . The SCWT can be used to evaluate the behavior control functions using the conflict between perception and speech [22] . Poor performances on difficult tasks such as the Stroop-B and Stroop-C are more likely to reflect genuine impairment [23] .…”

Aberrant pattern of regional cerebral blood flow in mild cognitive impairment: A meta-analysis of arterial spin labeling magnetic resonance imaging

“…Once progressed into dementia, it not only causes irreversible cognitive impairment, but also brings serious social and economic burden (Müller et al, 2020 ). Multiple studies have investigated that subjects with reduced cognitive ability often have low cerebral blood flow [CBF; (de la Torre, 2012 ; Zhao et al, 2013 ; Leardini-Tristão et al, 2020 ; Weijs et al, 2022 )]. The decreased CBF is a key process in the development of cognitive decline (Hanyu et al, 2010 ).…”