Abstract

BackgroundThis study aimed to investigate the cerebral blood flow (CBF) and frontal lobe cognitive function in severe internal carotid artery (ICA) stenosis patients with different types of collateral circulation.MethodsOne hundred twenty-six patients with severe unilateral ICA stenosis were enrolled. Digital subtraction angiography (DSA) was performed to recruit patients with one of three common types of collateral circulation: anterior communicating artery (AcoA), posterior communicating artery (PcoA) and ophthalmic artery (OA). The hemodynamic parameters of the middle cerebral artery (MCA) were measured using transcranial Doppler (TCD), and the individual frontal lobe cognitive attention functions were evaluated using Word Fluency Test, Trail-Making Test (TMT), Digit Span, and Stroop Color Word Test (SCWT). The correlation between hemodynamic changes and the scores of all tasks was analyzed.ResultsOn the side of arterial stenosis, the CBF velocities were highest in AcoA group and lowest in the OA group. All patients performed worse in TMT and Digit Span than the matched normal controls. The AcoA group exhibited a lower pulsatility index (PI) and a longer response time in the Stroop task, but had a higher accuracy rate in the Stroop task and higher scores in Word Fluency Test than the PcoA and OA groups. In all the three groups, PI was positively correlated with the accuracy rate for Stroop interference effects.ConclusionsOur findings suggested that the frontal lobe cognitive function of patients with ICA was impaired, and AcoA collaterals may be beneficial for selective attention functions, whereas OA collaterals may be associated with impairment of selective attention functions. Additionally, a high PI may be an indicator for identifying impaired selective attention in patients with severe ICA stenosis.

Highlights

  • This study aimed to investigate the cerebral blood flow (CBF) and frontal lobe cognitive function in severe internal carotid artery (ICA) stenosis patients with different types of collateral circulation

  • In the present study, we investigated whether cerebral Blood flow velocity (BFV) and frontal lobe cognitive function would be influenced by the different type of collateral circulation in patients with ICA stenosis

  • We found the BFV of ipsilateral middle cerebral artery (MCA) was significantly reduced in patients with ICA stenosis

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Summary

Introduction

This study aimed to investigate the cerebral blood flow (CBF) and frontal lobe cognitive function in severe internal carotid artery (ICA) stenosis patients with different types of collateral circulation. Severe internal carotid artery (ICA) stenosis is characterized by chronic cerebral hypoperfusion due to the decreased cerebral blood flow (CBF). Stroop Color Word Test (SCWT) is a classic, widely-used psychological evaluation tool that ignores irrelevant information and enhances the ability of suppressing interference which delays the response [9]. It demands resolution of a conflict reading and naming, which require selective attention [10]. The aforementioned tests call for the function of frontal lobe, which could be influenced by the blood supply of ICA

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