Cerebral hemodynamics and cognitive performance in bilateral asymptomatic carotid stenosis
Citation Manager Formats
Make Comment
See Comments
This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Abstract
Objectives: To evaluate cognitive performance in subjects with bilateral asymptomatic carotid stenosis (B-ACS) compared to subjects with unilateral ACS and to subjects with no carotid stenosis (CS) and to explore the relationship between cognitive performance and cerebral hemodynamics status in B-ACS.
Methods: The neuropsychological investigation included phonemic (ph) and categorical (ca) Verbal Fluency (VF) tests for exploring the left brain functions and Colored Progressive Matrices (CPM) and Complex Figure Copy Test (CFCT) for the right brain. Cerebral hemodynamics status was assessed using the transcranial Doppler–based breath-holding index test.
Results: A total of 333 subjects were included: 127 B-ACS, 73/77 left/right unilateral ACS, 56 no CS, mean age 70 ± 3.78 years, 65 male. Subjects with B-ACS and subjects with unilateral ACS showed significantly lower scores in all cognitive tests compared to subjects with no CS (p < 0.05). Subjects with B-ACS with left impaired hemodynamics status showed a significantly reduced ph-VF score, from 13.4 (95% confidence interval [CI] 11.2–15.8) to 7.5 (95% CI 5.4–9.7), and a reduced ca-VF score, from 19.7 (95% CI 18.1–24.1) to 10.8 (95% CI 9.5–15.1), compared to subjects with no CS. Similarly, impaired cerebral hemodynamics in the right side was associated with a significantly reduced CPM score, from an estimated mean of 34.2 (95% CI 29.8–35.4) to 24.6 (95% CI 20.2–25.8), and CFCT score from 37.0 (95% CI 32.0–37.4) to 27.1 (95% CI 23.3–28.7). All comparisons were p < 0.05.
Conclusion: Subjects with B-ACS and subjects with unilateral ACS are more likely to have cognitive dysfunction compared to subjects with no CS. There appears to be a link between cognitive dysfunction and hemodynamics impairment due to carotid stenosis.
GLOSSARY
- ACS=
- asymptomatic carotid stenosis;
- B-ACS=
- bilateral asymptomatic carotid stenosis;
- BHI=
- breath-holding index;
- CAD=
- coronary artery disease;
- CFCT=
- Complex Figure Copy Test;
- CPM=
- Colored Progressive Matrices;
- CS=
- carotid stenosis;
- CVR=
- cerebral vasomotor reactivity;
- ICA=
- internal carotid artery;
- L-ACS=
- left asymptomatic carotid stenosis;
- MCA=
- middle cerebral artery;
- MFV=
- mean cerebral flow velocity;
- MMSE=
- Mini-Mental State Examination;
- PAD=
- peripheral arterial disease;
- R-ACS=
- right asymptomatic carotid stenosis;
- TCD=
- transcranial Doppler;
- VF=
- Verbal Fluency
- Received March 2, 2012.
- Accepted June 13, 2012.
- Copyright © 2012 by AAN Enterprises, Inc.
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
For assistance, please contact:
AAN Members (800) 879-1960 or (612) 928-6000 (International)
Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international)
Sign Up
Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here
Purchase
Individual access to articles is available through the Add to Cart option on the article page. Access for 1 day (from the computer you are currently using) is US$ 39.00. Pay-per-view content is for the use of the payee only, and content may not be further distributed by print or electronic means. The payee may view, download, and/or print the article for his/her personal, scholarly, research, and educational use. Distributing copies (electronic or otherwise) of the article is not allowed.
Letters: Rapid online correspondence
- Reply to Dr. Shang
- Mauro Silvestrini, Director, Stroke Unit, Marche Polytechnic University, Ancona, Italym.silvestrini@univpm.it
- Giovanna Viticchi, Ancona, Italy; Lorenzo Falsetti, Ancona Italy, Clotilde Balucani, New York, NY USA
Submitted November 09, 2012 - Cerebral hemodynamics and cognitive performance in bilateral asymptomatic carotid stenosis
- Ty Shang, Assistant Professor, UT Southwesternty.shang@utsouthwestern.edu
Submitted November 05, 2012
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Dr. Farwa Ali and Dr. Lauren Jackson
► Watch
Related Articles
- No related articles found.
Topics Discussed
Alert Me
Recommended articles
-
Articles
Cerebral hemodynamics and cognitive performance in patients with asymptomatic carotid stenosisM. Silvestrini, I. Paolino, F. Vernieri et al.Neurology, March 23, 2009 -
Article
Neurocognitive functioning and cerebrovascular reactivity after carotid endarterectomySimona Lattanzi, Luciano Carbonari, Gabriele Pagliariccio et al.Neurology, December 27, 2017 -
Article
Severe carotid stenosis and impaired cerebral hemodynamics can influence cognitive deteriorationSimona Balestrini, Cecilia Perozzi, Claudia Altamura et al.Neurology, April 26, 2013 -
Article
Cerebrovascular reactivity predicts stroke in high-grade carotid artery diseaseMatthias Reinhard, Guido Schwarzer, Matthias Briel et al.Neurology, September 12, 2014