The Impact of Carotid Artery Stenting on Cerebral Perfusion, Functional Connectivity, and Cognition in Severe Asymptomatic Carotid Stenosis Patients
Background and purposeAsymptomatic carotid artery stenosis can lead to not only stroke but also cognition impairment. Although it has been proven that carotid artery stenting (CAS) can reduce the risk of future strokes, the effect of CAS on cognition is conflicting. In recent years, pulsed arterial...
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| Format: | Article |
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Frontiers Media S.A.
2017-08-01
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| Series: | Frontiers in Neurology |
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| Online Access: | http://journal.frontiersin.org/article/10.3389/fneur.2017.00403/full |
| _version_ | 1811201109126021120 |
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| author | Tao Wang Dong Sun Yumin Liu Bin Mei Huagang Li Shengming Zhang Junjian Zhang |
| author_facet | Tao Wang Dong Sun Yumin Liu Bin Mei Huagang Li Shengming Zhang Junjian Zhang |
| author_sort | Tao Wang |
| collection | DOAJ |
| description | Background and purposeAsymptomatic carotid artery stenosis can lead to not only stroke but also cognition impairment. Although it has been proven that carotid artery stenting (CAS) can reduce the risk of future strokes, the effect of CAS on cognition is conflicting. In recent years, pulsed arterial spin labeling (pASL) MRI and resting-state functional MRI (R-fMRI) have been employed in cognitive impairment studies. For the present study, cognition is evaluated in severe asymptomatic carotid artery stenosis patients undergoing CAS, and the mechanisms underlying the cognitive change are explored by pASL MRI and R-fMRI.Materials and methodsWe prospectively enrolled 24 asymptomatic, severe (≥70%), unilateral internal carotid artery stenosis patients, who were expecting the intervention of CAS. Cognition assessment (including the Montreal Cognitive Assessment Beijing Version, the Minimum Mental State Examination, the Digit Symbol Test, the Rey Auditory Verbal Learning Test, and the Verbal Memory Test) and an integrated MRI program (pASL MRI, and R-fMRI) were administered 7 days before and 3 months after CAS.Results16 subjects completed the follow-up study. After stenting, significant improvement in the scores of the MMSE, the Verbal Memory test, and the delayed recall was found. No significant difference was found in the scores of the Montreal Cognitive Assessment Beijing Version, the Digit Symbol Test, and the immediate recall. After CAS treatment, asymptomatic carotid artery stenosis patients showed increased perfusion in the left frontal gyrus, increased amplitude of low-frequency fluctuation (ALFF) in the right precentral gyrus, and increased connectivity to the posterior cingulate cortex (PCC) in the right supra frontal gyrus. However, no significant correlations were found between these imaging changes and cognition assessments.ConclusionSuccessful CAS can partly improve cognition in asymptomatic carotid artery stenosis patients. The cognition improvement may be partly attributed to the increased perfusion in the left frontal gyrus, increased ALFF in the right precentral gyrus, and increased connectivity to the PCC in the right supra frontal gyrus. |
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| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-12T02:16:27Z |
| publishDate | 2017-08-01 |
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| series | Frontiers in Neurology |
| spelling | doaj.art-15ce1099dae8407698fe0b2983c735132022-12-22T03:52:15ZengFrontiers Media S.A.Frontiers in Neurology1664-22952017-08-01810.3389/fneur.2017.00403262751The Impact of Carotid Artery Stenting on Cerebral Perfusion, Functional Connectivity, and Cognition in Severe Asymptomatic Carotid Stenosis PatientsTao Wang0Dong Sun1Yumin Liu2Bin Mei3Huagang Li4Shengming Zhang5Junjian Zhang6Department of Neurology, Zhongnan Hospital, Wuhan University, Wuhan, ChinaDepartment of Neurology, Zhongnan Hospital, Wuhan University, Wuhan, ChinaDepartment of Neurology, Zhongnan Hospital, Wuhan University, Wuhan, ChinaDepartment of Neurology, Zhongnan Hospital, Wuhan University, Wuhan, ChinaDepartment of Neurology, Zhongnan Hospital, Wuhan University, Wuhan, ChinaDepartment of Neurology, Zhongnan Hospital, Wuhan University, Wuhan, ChinaDepartment of Neurology, Zhongnan Hospital, Wuhan University, Wuhan, ChinaBackground and purposeAsymptomatic carotid artery stenosis can lead to not only stroke but also cognition impairment. Although it has been proven that carotid artery stenting (CAS) can reduce the risk of future strokes, the effect of CAS on cognition is conflicting. In recent years, pulsed arterial spin labeling (pASL) MRI and resting-state functional MRI (R-fMRI) have been employed in cognitive impairment studies. For the present study, cognition is evaluated in severe asymptomatic carotid artery stenosis patients undergoing CAS, and the mechanisms underlying the cognitive change are explored by pASL MRI and R-fMRI.Materials and methodsWe prospectively enrolled 24 asymptomatic, severe (≥70%), unilateral internal carotid artery stenosis patients, who were expecting the intervention of CAS. Cognition assessment (including the Montreal Cognitive Assessment Beijing Version, the Minimum Mental State Examination, the Digit Symbol Test, the Rey Auditory Verbal Learning Test, and the Verbal Memory Test) and an integrated MRI program (pASL MRI, and R-fMRI) were administered 7 days before and 3 months after CAS.Results16 subjects completed the follow-up study. After stenting, significant improvement in the scores of the MMSE, the Verbal Memory test, and the delayed recall was found. No significant difference was found in the scores of the Montreal Cognitive Assessment Beijing Version, the Digit Symbol Test, and the immediate recall. After CAS treatment, asymptomatic carotid artery stenosis patients showed increased perfusion in the left frontal gyrus, increased amplitude of low-frequency fluctuation (ALFF) in the right precentral gyrus, and increased connectivity to the posterior cingulate cortex (PCC) in the right supra frontal gyrus. However, no significant correlations were found between these imaging changes and cognition assessments.ConclusionSuccessful CAS can partly improve cognition in asymptomatic carotid artery stenosis patients. The cognition improvement may be partly attributed to the increased perfusion in the left frontal gyrus, increased ALFF in the right precentral gyrus, and increased connectivity to the PCC in the right supra frontal gyrus.http://journal.frontiersin.org/article/10.3389/fneur.2017.00403/fullcarotid artery stentingasymptomatic carotid artery stenosiscognitionpulsed arterial spin labelingresting-state functional MRIdefault mode network |
| spellingShingle | Tao Wang Dong Sun Yumin Liu Bin Mei Huagang Li Shengming Zhang Junjian Zhang The Impact of Carotid Artery Stenting on Cerebral Perfusion, Functional Connectivity, and Cognition in Severe Asymptomatic Carotid Stenosis Patients Frontiers in Neurology carotid artery stenting asymptomatic carotid artery stenosis cognition pulsed arterial spin labeling resting-state functional MRI default mode network |
| title | The Impact of Carotid Artery Stenting on Cerebral Perfusion, Functional Connectivity, and Cognition in Severe Asymptomatic Carotid Stenosis Patients |
| title_full | The Impact of Carotid Artery Stenting on Cerebral Perfusion, Functional Connectivity, and Cognition in Severe Asymptomatic Carotid Stenosis Patients |
| title_fullStr | The Impact of Carotid Artery Stenting on Cerebral Perfusion, Functional Connectivity, and Cognition in Severe Asymptomatic Carotid Stenosis Patients |
| title_full_unstemmed | The Impact of Carotid Artery Stenting on Cerebral Perfusion, Functional Connectivity, and Cognition in Severe Asymptomatic Carotid Stenosis Patients |
| title_short | The Impact of Carotid Artery Stenting on Cerebral Perfusion, Functional Connectivity, and Cognition in Severe Asymptomatic Carotid Stenosis Patients |
| title_sort | impact of carotid artery stenting on cerebral perfusion functional connectivity and cognition in severe asymptomatic carotid stenosis patients |
| topic | carotid artery stenting asymptomatic carotid artery stenosis cognition pulsed arterial spin labeling resting-state functional MRI default mode network |
| url | http://journal.frontiersin.org/article/10.3389/fneur.2017.00403/full |
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