Influence of stent-assisted angioplasty on cognitive function and affective disorder in elderly patients with symptomatic vertebrobasilar artery stenosis

Abstract

BackgroundWe aimed to investigate cognitive function and affective disorder in elderly patients with symptomatic vertebrobasilar artery stenosis (SVAS) after stent-assisted angioplasty (SAA) and to explore the potential mechanism.Material/MethodsThe study subjects were 26 elderly SVAS patients who were non-responsive to pharmacotherapy and received SAA (study group) and 30 patients receiving intracoronary stent implantation (control group). Montreal cognitive assessment (MoCA), Hamilton depression rating scale (HAMD), and Hamilton anxiety rating scale (HAMA) were used.ResultsThe total MoCA score, scores of line connection, copying cube, drawing clock, and delayed recall increased significantly in the study group after surgery (P<0.05, P<0.01). In addition, the MoCA score increased over time and the total MoCA score at 12 months was markedly higher than that at 1 month (P<0.05). The scores of HAMD and HAMA decreased dramatically after surgery compared with before surgery in these patients (P<0.01). A comparison at the corresponding period was performed between study group and control group, and it was found that the differences in total MoCA scores and scores of line connection, copying cube, drawing clock, and delayed recall before surgery and at 1 month after surgery were significant (P<0.05, P<0.01).ConclusionsSAA may improve the visuospatial/executive abilities and delayed recall, as well as the depression and anxiety in patients with SVAS. Larger and controlled trails are needed to investigate the effect of SAA on cognition and affection in these patients.

The association between vertebrobasilar insufficiency and the risk of dementia: a nationwide register-based retrospective cohort study in Taiwan

“… 26 Cervicocerebral stenosis has also been shown to be associated with cognitive dysfunction, and revascularisation of the anterior and posterior circulation using stents has been reported to improve cognition. 27–29 Collectively, these studies, along with our own, reinforce the association between decreased regional cerebral blood flow, especially in the posterior circulation, and cognitive decline. Our study further considers the potential medical and psychological confounding factors and comorbidities, using a large nationwide sample size and a longitudinal design, providing results that are more generalisable to the general population.…”

Morphological Characteristics of the Vertebrobasilar Arterial System Are Associated with Vertebrobasilar Dolichoectasia

“…The VA confluence angle is also an important factor affecting the hemodynamic characteristics of the BA [ 14 , 15 ], including the direction of the confluenced blood flow. However, it remains unknown whether a DVA simply accompanies VBD or acts to promote the occurrence of VBD, and there is little information on eventual treatments for symptoms of abnormal DVA [ 17 , 18 ].…”