Key result
Carotid endarterectomy or stenting in 22 subjects with asymptomatic severe ICA stenosis yielded statistically significant improvements in phonological verbal fluency and immediate recall.
Why the study?
Does carotid endarterectomy or stenting improve cognitive performance in asymptomatic patients with severe ICA stenosis?
Observational (n=22)
Does carotid endarterectomy or stenting improve cognitive performance in asymptomatic patients with severe ICA stenosis?
Carotid revascularization in asymptomatic severe ICA stenosis may improve specific cognitive domains, particularly verbal fluency following left-sided interventions, supporting the hypothesis of resolving hypoperfusion.
Hypothesis-generating only in small cohort; leaves open whether revascularization improves cognition in asymptomatic severe ICA stenosis.
Background. Endarterectomy (CEA) or stenting (CAS) of a stenotic carotid artery is currently undertaken to reduce stroke risk. In addition removal of the arterial narrowing has been hypothesized to improve cerebral hemodynamics and provide benefits in cognitive functions, by supposedly resolving a "hypoperfusion" condition. Methods. In this study we sought to test whether resolution of a carotid stenosis is followed by measurable changes in cognitive functions in 22 subjects with "asymptomatic" stenosis. Results. A main finding of the study was the statistically significant pre-post difference observed in the performance of phonological verbal fluency and Rey's 15-word immediate recall. Remarkably, there was a significant interaction between phonological verbal fluency performance and side of the carotid intervention, as the improvement in the verbal performance, a typical "lateralized" skill, was associated with resolution of the left carotid stenosis. Conclusion. The results reflect a substantial equivalence of the overall performance at the before- and after- CEA or CAS tests. In two domains, however, the postintervention performance resulted improved. The findings support the hypothesis that recanalization of a stenotic carotid could improve brain functions by resolving hypothetical "hypoperfusion" states, associated with the narrowing of the vessels.
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Picchetto et al. (2013) conducted an observational in Asymptomatic severe internal carotid artery (ICA) stenosis (n=22). Carotid endarterectomy (CEA) or stenting (CAS) was evaluated on Measurable changes in cognitive functions. Carotid endarterectomy or stenting in 22 subjects with asymptomatic severe ICA stenosis yielded statistically significant improvements in phonological verbal fluency and immediate recall.
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