Abstract TMP84: Baseline Cerebral Blood Flow Association With Cognitive Functions: Prospective Cohort Study.

Abstract

Introduction: Carotid occlusive disease is reported to impact cognitive function. Reduced cerebral blood flow is considered a culprit in carotid disease-related cognitive impairment. However, the association is not consistent. Aim: To investigate the relationship between baseline cerebral blood flow (BCBF) and cognitive functions in a well-defined cohort of patients with severe occlusive extracranial carotid disease. Methods: Patients undergoing carotid intervention for occlusive diseases were prospectively recruited from two academic institutions. All patients received neurocognitive testing and MRI scanning pre-intervention. For neurocognitive testing, raw scores were normalized against age, education, and standard scores as appropriate. The cognitive domain-specific normalized scores were derived using principal component analysis. Univariate and multiple linear regression models were fitted to evaluate predictors of various cognitive domains including memory, executive function and language. Variables with P<0.1 in the univariate analysis were included in the multiple models. Results: A total of 140 patients were included in our analysis. Most patients were males (96%) with a mean age of 69.9 years. Almost half of the cohort (50.8%) were symptomatic. Most patients were smokers (78.1%) and hypertensive (86.4%). Diabetes was prevalent (39.4%). In the multiple regression model, BCBF was independently associated with Trail Making Test (TMT) [regression coefficient(B)=-0.015, Standard Error (SE):0.008, p=0.04]. Other significant predictors of TMT were prior stroke and diabetes. BCBF was also associated with scores on the Stroop test (B=0.023, SE=0.009), albeit nonsignificant, in the multiple regression model (P=0.06). Age, renal insufficiency, and prior stroke were independently associated with Stroop test, p<0.5. Conclusion: Our study showed an association between BCBF and baseline executive function measured by TMT in patients with severe carotid occlusive disease. BCBF was also associated with Stroop test in a trend that did not reach statistical significance. Inconsistency in the association between CBF and cognitive function may be due to diverse cognitive measures and patient-related comorbidities.