Key result
Severe asymptomatic carotid stenosis is linked to poorer cognition alongside decreased cerebral blood flow.
Why the study?
Asymptomatic carotid artery stenosis patients may have cognitive impairment despite absence of TIA or stroke, challenging the notion of true asymptomatic status.
Does severe asymptomatic carotid stenosis affect cognitive function and brain perfusion/connectivity compared to healthy controls?
Case-Control (n=43)
Does severe asymptomatic carotid stenosis affect cognitive function and brain perfusion/connectivity compared to healthy controls?
Severe asymptomatic carotid stenosis is associated with measurable cognitive impairment and corresponding brain perfusion and connectivity deficits, challenging the notion that it is truly 'asymptomatic'.
May warrant cognitive screening in severe asymptomatic carotid stenosis; leaves open whether revascularization alters outcomes.
Carotid artery stenosis without transient ischemic attack (TIA) or stroke is considered as "asymptomatic." However, recent studies have demonstrated that these asymptomatic carotid artery stenosis (aCAS) patients had cognitive impairment in tests of executive function, psychomotor speed, and memory, indicating that "asymptomatic" carotid stenosis may not be truly asymptomatic. In this study, when 19 aCAS patients compared with 24 healthy controls, aCAS patients showed significantly poorer performance on global cognition, memory, and executive function. By utilizing an integrated MRI including pulsed arterial spin labeling (pASL) MRI, Proton MR Spectroscopy (MRS), and resting-state functional MRI (R-fMRI), we also found that aCAS patients suffered decreased cerebral blood flow (CBF) mainly in the Left Frontal Gyrus and had decreased NAA/Cr ratio in the left hippocampus and decreased connectivity to the posterior cingulate cortex (PCC) in the anterior part of default mode network (DMN).
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Wang et al. (2017) conducted a case-control in Severe Asymptomatic Carotid Stenosis (n=43). Severe asymptomatic carotid stenosis vs. Healthy controls was evaluated on Cognitive performance and brain MRI metrics (perfusion, metabolites, functional connectivity). Severe asymptomatic carotid stenosis was associated with significantly poorer global cognition, memory, and executive function, alongside decreased cerebral blood flow and altered brain connectivity.
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