Neuropsychological Outcome One Year after Carotid Revascularization: A before-and-after Study
10.5758/vsi.2017.33.4.146
- Author:
Laura CASAS-HERNANZ
1
;
Maite GAROLERA
;
Dolors BADENES
;
Salvador QUINTANA
;
Susana MILLÁN
;
Noemi CALZADO
;
Jorge DE FRANCISCO
;
Josep ROYO
;
Miquel AGUILAR
Author Information
1. Servei de Neurologia, Hospital Universitari Mútua Terrassa, Barcelona, Spain. lauracasass@gmail.com
- Publication Type:Original Article
- Keywords:
Endarterectomy;
Carotid stenosis;
Angioplasty;
Cognition;
Neuropsychological tests
- MeSH:
Angioplasty;
Atrophy;
Carotid Stenosis;
Cognition;
Endarterectomy;
Humans;
Neuropsychological Tests;
Semantics;
White Matter
- From:Vascular Specialist International
2017;33(4):146-155
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The aim of our study was to determine the clinical profile of patients considered cognitive ‘responders’ to surgery in order to establish clinical variables associated with a favorable cognitive performance. MATERIALS AND METHODS: A total of 70 patients were included in the study. A well-validated, comprehensive standardized neurocognitive battery of tests of about 2 hours was administered. Patients were examined twice, 1-week before surgery and 1-year postoperatively. The criterion to be included in the ‘responder’ group was the following: to obtain a positive difference between post-revascularization and pre-revascularization neuropsychological assessment ≥1 standard deviation in ≥2 tests. RESULTS: Twenty-seven patients (38.6%) were cognitive responders to treatment. In bivariate analysis between responders and non-responders, presence of atrophy (P=0.003), small vessels (P=0.577), symptoms (P=0.046), and age (P=0.030) were the factors statistically significant. When comparing cognitive performance before and after carotid revascularization, significant differences were observed in semantic fluency with a lower performance after 12 months (P=0.004, d=0.29), and in the Language index (Repeatable Battery for the Assessment of Neuropsychological Status) (P=0.005, d=0.34). CONCLUSION: Patients without neurological symptoms, of a younger age and without atrophy and white matter small vessel lesions are better cognitive responders 1-year after carotid revascularization.
