Key result
Worse MoCA delayed recall is linked to decreased cerebral blood flow in right asymptomatic CASO.
Why the study?
Cerebral hemodynamic impairment in carotid artery stenosis or occlusion does not always correlate with stenosis severity, and established noninvasive indicators are lacking.
Do neurocognitive assessments correlate with cerebral hemodynamic impairment measured by PET in patients with asymptomatic carotid artery stenosis or occlusion?
Observational (n=142)
Do neurocognitive assessments correlate with cerebral hemodynamic impairment measured by PET in patients with asymptomatic carotid artery stenosis or occlusion?
Effect estimate: adjusted β 1.70 (95% CI 0.21-3.28)
p-value: p=0.027
Neuropsychological examinations, specifically specific domains of MoCA and ADAS-Cog, may serve as noninvasive markers for estimating cerebral hemodynamic impairment in asymptomatic carotid artery stenosis or occlusion.
May indicate noninvasive neurocognitive markers of hemodynamic impairment in asymptomatic CASO; leaves open prospective validation before clinical use.
Background The severity of cerebral hemodynamic impairment in patients with carotid artery stenosis or occlusion (CASO) is not always correlated with the severity of stenosis or occlusion. There are no established noninvasive indicators of cerebral hemodynamic impairment in CASO. Objective The study aimed to identify impaired neurocognitive domains as promising noninvasive severity markers. Methods In a retrospective study of 142 patients with asymptomatic CASO, we assessed associations of Montreal Cognitive Assessment (MoCA) and Alzheimer's Disease Assessment Scale-Cognitive Subscale 14 (ADAS-Cog) with 15 O-gas positron emission tomography. Results In patients with right CASO (n = 45), worse delayed recall on MoCA was significantly associated with decreased CBF (adjusted β for cerebral blood flow [CBF] 1.70, 95% confidence interval [CI] 0.21–3.28, p = 0.027), with the cutoff value of 1/2 for CBF of <35.0 mL/100 g/min (sensitivity 100%). In patients with left CASO (n = 60), language comprehension on ADAS-Cog was significantly associated with increased OEF (adjusted β for oxygen extraction fraction 5.48, 95% CI 2.29–8.67, p = 0.001), with the cutoff value of 0/1 for OEF of >52.9% (specificity 96.4%). In patients with bilateral CASO (n = 37), worse executive function on MoCA score was significantly associated with decreased CBF (adjusted β for CBF 2.70, 95% CI 0.29–5.13, p = 0.030), with the cutoff value of 2/3 for CBF of <35.0 mL/100 g/min (sensitivity 83.3%). Conclusions Neuropsychological examinations could be useful for noninvasively estimating the severity of cerebral hemodynamic impairment in patients with CASO.
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Hattori et al. (2025) conducted an observational in Asymptomatic carotid artery stenosis or occlusion (CASO) (n=142). Neurocognitive assessment (MoCA and ADAS-Cog) was evaluated on Association of MoCA and ADAS-Cog with cerebral blood flow (CBF) and oxygen extraction fraction (OEF) (adjusted β 1.70, 95% CI 0.21-3.28, p=0.027). Worse delayed recall on MoCA was significantly associated with decreased cerebral blood flow in right asymptomatic CASO (adjusted β 1.70; 95% CI 0.21–3.28; p=0.027).
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