Key result
Severe asymptomatic carotid artery stenosis was associated with significantly worse performance on the Stroop color-word test (median score 26.5 vs 28.0, p=0.002) compared to controls without stenosis.
Why the study?
Carotid stenosis can lead to cognitive impairment, but cognitive function has mostly been assessed by paper and pencil tests rather than computerized neuropsychological assessment devices.
Does severe asymptomatic carotid artery stenosis impair cognitive function as assessed by a computerized neuropsychological assessment device?
Case-Control (n=100)
No
Does severe asymptomatic carotid artery stenosis impair cognitive function as assessed by a computerized neuropsychological assessment device?
Absolute Event Rate: 26.5% vs 28%
p-value: p=0.002
Severe asymptomatic carotid artery stenosis is associated with worse cognitive function, particularly in attention, working memory, and executive ability, which can be effectively screened using a computerized neuropsychological assessment device.
SACAS linked to worse attention/executive scores on CNAD; hypothesis-generating for screening, needs larger validation before any clinical use.
Background Carotid stenosis can lead to stroke and cognitive impairment. Moreover, the cognitive function was assessed mostly by paper and pencil cognitive tests. This study aimed to evaluate the impact of severe asymptomatic carotid artery stenosis (SACAS) on cognitive function by a computerized neuropsychological assessment device (CNAD). The diagnostic value of screening SACAS of the CNAD was analyzed. Methods There were 48 patients with ≥70% asymptomatic carotid stenosis and 52 controls without carotid stenosis. Duplex ultrasound defined the degree of stenosis. The differences of cognitive function were analyzed between patients and controls. The relationship of scores of cognitive tests and age were analyzed in the linear regression equation. The diagnostic value of CNAD was evaluated by the receiver operating characteristic (ROC) curve. Results Stenosis and control subjects had no statistically significant differences in baseline characteristics. Stenosis patients had worse scores for Stroop color-word test ( p = 0.002), one back test ( p = 0.013), and identification test ( p = 0.006) corresponding to attention and executive ability. The analysis of linear regression equation indicated that cognitive scores of stenosis patients declined faster with age, especially for digit span test, Stroop color-word test, one back test and identification test. In analysis of ROC curve, the Stroop color-word test ( p = 0.002), one back test ( p = 0.013), and identification test ( p = 0.006), and comprehensive index of the three tests ( p = 0.001) had the diagnostic value. Conclusion The CNAD has evaluation value and screening value for patients with cognitive impairment and SACAS. But it is necessary to update the CNAD and conduct a study with a bigger sample.
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Hu et al. (2023) conducted a case-control in Severe asymptomatic carotid artery stenosis (n=100). Severe asymptomatic carotid artery stenosis vs. No carotid stenosis was evaluated on Stroop color-word test score (median) (p=0.002). Severe asymptomatic carotid artery stenosis was associated with significantly worse performance on the Stroop color-word test (median score 26.5 vs 28.0, p=0.002) compared to controls without stenosis.
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