An Integrated Analysis of Risk Factors of Cognitive Impairment in Patients with Severe Carotid Artery Stenosis.

Ru Tao Luo; Pei Jiong Wang; Xiao Feng Deng; Shu Jie Zhou; Meng Zhao; Jing Qian; Dong Zhang; Rong Wang; Yan Zhang

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An Integrated Analysis of Risk Factors of Cognitive Impairment in Patients with Severe Carotid Artery Stenosis.

Author: Ru Tao LUO ^{1
,

2
,

3
,

4
,

5} ; Pei Jiong WANG ^{3
,

4
,

5
,

6} ; Xiao Feng DENG ^{3
,

4
,

5
,

6} ; Shu Jie ZHOU ⁷ ; Meng ZHAO ^{3
,

4
,

5
,

6} ; Jing QIAN ^{3
,

4
,

5
,

6} ; Dong ZHANG ^{3
,

4
,

5
,

6} ; Rong WANG ^{3
,

4
,

5
,

6} ; Yan ZHANG ^{3
,

4
,

5
,

6}
Author Information

1. Department of Neurosurgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
2. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
3. China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing 100050, China
4. Center of Stroke, Beijing Institute for Brain Disorders, Beijing 100050, China
5. Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing 100050, China.
6. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
7. Department of Neuropsychology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China.
Publication Type:Journal Article
Keywords: Carotid artery stenosis; Cognitive impairment; Memory
MeSH: Adult; Aged; Carotid Stenosis; complications; China; epidemiology; Cognition; Cognitive Dysfunction; epidemiology; etiology; psychology; Cohort Studies; Cross-Sectional Studies; Female; Humans; Male; Memory; Middle Aged; Neuropsychological Tests; Risk Factors
From: Biomedical and Environmental Sciences 2018;31(11):797-804
CountryChina
Language:English
Abstract: OBJECTIVE:To investigate cognitive dysfunction in patients with carotid artery stenosis (CAS) and potential risk factors related to cognitive-especially memory-dysfunction.
METHODS:Forty-seven patients with carotid artery stenosis were recruited into our study cohort. The Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) were adopted to assess cognitive function, the Wechsler Memory Scale (WMS) to assess memory function, high-resolution MRI and enhanced ultrasound to evaluate carotid plaques, and computed tomography perfusion (CTP) imaging to evaluate intracranial blood perfusion. Single-factor analysis and multiple-factor regression analysis were used to analyze potential risk factors of cognitive impairment.
RESULTS:Mini-Mental State Examination test results showed that 22 patients had cognitive impairment, and MoCA test results showed that 10 patients had cognitive impairment. Analysis of various risk factors indicated that the average memory quotient of female patients was higher than that of males (P = 0.024). The cognitive and memory performance of those with an educational background above high school were significantly better than those of participants with high school or lower (P = 0.045). Patients with abnormal intracranial perfusion performed worse on the MMSE test (P = 0.024), and their WMS scores were significantly lower (P = 0.007). The MMSE scores and the memory quotients were significantly lower in patients with a history of cerebral infarction (MMSE, P = 0.047, memory quotient score, P = 0.018).
CONCLUSION:A history of cerebral infarction and abnormal cerebral perfusion are associated with decline in overall cognitive function and memory in patients with carotid stenosis. Being female and having an educational background above high school may be protective factors in the development of cognitive dysfunction.