Cognitive performance following carotid endarterectomy or stenting in asymptomatic patients with severe ICA stenosis

Livio Picchetto, Gianfranco Spalletta, Barbara Casolla, Claudia Cacciari, Michele Cavallari, Cristiano Fantozzi, Alessandro Ciuffoli, Maurizia Rasura, Francesca Imperiale, Giuliano Sette, Carlo Caltagirone, Maurizio Taurino, Francesco Orzi

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Article number342571
JournalCardiovascular Psychiatry and Neurology
Volume2013
DOIs
Publication statusPublished - 2013

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Psychiatry and Mental health
  • Clinical Neurology
  • Neurology

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    Picchetto, L., Spalletta, G., Casolla, B., Cacciari, C., Cavallari, M., Fantozzi, C., Ciuffoli, A., Rasura, M., Imperiale, F., Sette, G., Caltagirone, C., Taurino, M., & Orzi, F. (2013). Cognitive performance following carotid endarterectomy or stenting in asymptomatic patients with severe ICA stenosis. Cardiovascular Psychiatry and Neurology, 2013, [342571]. https://doi.org/10.1155/2013/342571