Effects of carotid endarterectomy on cognitive function in patients with carotid stenosis

Abstract

To investigate the theraputic effects of carotid endarterectomy (CEA) on cognitive function in patients with carotid stenosis (CAS) and congnitive impairment. CEA was performed on 38 patients with CAS from December 2011 to July 2013. There were 26 male and 12 female patients, with an average age of (70 ± 7) years. Patients was underwent neuropsychological examinations (NPEs) including Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) at 1 week before and 6 weeks after treatment. Cerebral perfusion was assessed with MR perfusion-weighted imaging and diffusion-weighted inmaging at 1 week before and 6 weeks after treatment. All of the 38 patients completed NPEs and MRI at baseline and 6 weeks after CEA. After therapy, the parameters and the extents of abnormal perfusion was improved, including the decrease of time to peak (29 ± 9 vs. 23 ± 4), relative mean transit time (22 ± 8 vs. 14 ± 6), arrive time (21 ± 8 vs. 15 ± 4) and relative cerebral blood volume (11.6 ± 3.5 vs. 7.5 ± 3.2) (t = 1.31 to 5.24, all P < 0.05). Significant improvement in MoCA (20.4 ± 1.5 vs. 22.0 ± 1.6, t = -4.25, P = 0.000) but MMSE (26.16 ± 1.35 vs. 26.47 ± 1.52, t = -0.96, P = 0.341) was observed. CEA significantly improved the assessment of visuospacial/constructive abilities (2.4 ± 0.9 vs. 2.8 ± 0.7), naming (2.0 ± 0.7 vs. 2.3 ± 0.6), abstraction (1.2 ± 0.7 vs. 1.6 ± 0.6) and attention (2.3 ± 0.6 vs. 2.6 ± 0.5) (t = 0.015 to 0.029, P = 0.015). CEA can improve the cognitive function of patients with carotid stenosis as well as the cerebral perfusion of patients and has therapeutic effects on vascular mild cognitive impairment.