scholarly journals Functional connectivity analysis and prediction of cognitive change after carotid artery stenting

2019 ◽  
Vol 131 (6) ◽  
pp. 1709-1715 ◽  
Author(s):  
Naoki Tani ◽  
Takahide Yaegaki ◽  
Akio Nishino ◽  
Kenta Fujimoto ◽  
Hiroyuki Hashimoto ◽  
...  
Keyword(s):  
Working Memory ◽  
Cognitive Function ◽  
Functional Connectivity ◽  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Neuropsychological Tests ◽  
Cognitive Change ◽  
Cerebral Revascularization ◽  
Clinical Trial Registration ◽  
Adult Intelligence Scale

OBJECTIVEThe neurocognitive course of patients who have undergone cerebral revascularization has been the subject of many studies, and the reported effects of carotid artery stenting (CAS) on cognitive function have varied from study to study. The authors hypothesized that cognitive amelioration after CAS is associated with alteration of the default mode network (DMN) connectivity, and they investigated the correlation between functional connectivity (FC) of the DMN and post-CAS changes in cognitive function in order to find a clinical marker that can be used to predict the effect of cerebral revascularization on patients’ cognitive function in this preliminary exploratory study.METHODSThe authors examined post-CAS changes in cognitive function in relation to FC in patients treated for unilateral carotid artery stenosis. Resting-state functional MRI (rs-fMRI) was performed with a 3-T scanner before and 6 months after CAS in 8 patients. Neuropsychological tests (Wechsler Adult Intelligence Scale III and Wechsler Memory Scale–Revised) were administered to each patient before and 6 months after CAS. The DMN was mapped for each patient through independent component analysis of the rs-fMR images, and the correlation between FC of the DMN and post-CAS change in cognitive function was analyzed on a voxel level. Multivariable regression analysis was performed to identify preoperative factors associated with a post-CAS change in cognitive function.RESULTSPost-CAS cognitive function varied between patients and between categories of neuropsychological tests. Although there was no significant overall improvement in Working Memory scores after CAS, post-CAS Working Memory scores changed in negative correlation with changes in FC between the DMN and the precentral/superior frontal gyrus and between the DMN and the middle frontal gyrus. In addition, the preoperative FC between those areas correlated positively with the post-CAS improvement in working memory.CONCLUSIONSFC between the DMN and working memory–related areas is closely associated with improvement in working memory after CAS. Preoperative analysis of FC of the DMN may be useful for predicting postoperative improvement in the working memory of patients being treated for unilateral stenosis of the extracranial internal carotid artery.Clinical trial registration no.: UMIN000020045 (www.umin.ac.jp/ctr/index.htm)

Abstract WP474: Improvement of Cognitive Function and Reorganization of Brain Networks Following Carotid Endarterectomy and Carotid Artery Stenting

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Masaaki Kohta ◽  
Atsushi Fujita ◽  
Kohkichi Hosoda ◽  
Eiji Kohmura
Keyword(s):  
Cognitive Function ◽  
Functional Connectivity ◽  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Cognitive Assessment ◽  
Carotid Artery Stenting ◽  
Special Focus ◽  
Neurocognitive Performance ◽  
Resting State Functional Connectivity ◽  
Revascularization Surgery

Background: Internal carotid artery stenosis (ICS) can lead to cognitive impairment as well as ischemic stroke. Although carotid revascularization surgery, such as carotid endarterectomy (CEA) and carotid artery stenting (CAS), can prevent future strokes, the effect of revascularization on cognitive function is controversial. In this study, we examined the resting-state functional connectivity (FC) in ICS patients undergoing revascularization surgery, with a special focus on the Default Mode Network (DMN). Methods: We prospectively enrolled 24 ICS patients, who were expecting the intervention of CEA (14 cases) or CAS (10 cases). Cognitive assessment, including the Mini-Mental State Examination (MMSE), the Frontal Assessement Battery (FAB), and the Japanese version of the Montreal Cognitive Assessment (MoCA-J) and rs-fMRI were administered ≤ 1 week preoperatively and postoperatively at 1 week. For the analysis of FC, a seed was placed in the region associated with DMN. Results: After revascularization surgery, significant improvement in the score of MMSE (27.4 vs 28.4, P = 0.03) and MoCA-J (23.1 vs 25.0, P = 0.0001) was found. As for the analysis of the CAS and CEA groups, the MoCA-J score of the CEA group (24.1 vs 26.1, P = 0.001) and the MMSE score of the CAS group (26.0 vs 28.4, P = 0.01) showed statistically significant improvements. In both CAS and CEA groups, Seed-to-Voxel focusing on DMN revealed increased connectivity between medial prefrontal cortex and precuneus. Conclusion: Both CEA and CAS are associated with an improvement in neurocognitive performance and reorganization of functional connectivity, including DMN.

scholarly journals Effect of Carotid Artery Stenting on Cognitive Function in Patients With Carotid Artery Stenosis: Preliminary Results

2008 ◽  
Vol 29 (2) ◽  
pp. 265-268 ◽  
Author(s):  
A.S. Turk ◽  
I. Chaudry ◽  
V.M. Haughton ◽  
B.P. Hermann ◽  
H.A. Rowley ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Carotid Artery Stenting ◽  
Artery Stenosis ◽  
Preliminary Results

scholarly journals Association of AKAP6 and MIR2113 with cognitive performance in a population based sample of older adults

2016 ◽  
Author(s):  
Shea J. Andrews ◽  
Debjani Das ◽  
Kaarin J. Anstey ◽  
Simon Easteal
Keyword(s):  
Older Adults ◽  
Working Memory ◽  
Cognitive Function ◽  
Episodic Memory ◽  
Cognitive Performance ◽  
Cognitive Change ◽  
European Ancestry ◽  
Substantial Contribution ◽  
Perceptual Speed ◽  
Cognitive Domains

AbstractGenetic factors make a substantial contribution to inter-individual variability in cognitive function. A recent meta-analysis of genome-wide association studies identified two loci, AKAP6 and MIR2113 that are associated with general cognitive function. Here, we extend this previous research by investigating the association of MIR2113 and AKAP6 with baseline and longitudinal nonlinear change across a broad spectrum of cognitive domains in community-based cohort of 1,570 older adults without dementia. Two SNPs, MIR211-rs10457441 and AKAP6-rs17522122 were genotyped in 1,570 non-demented older Australians of European ancestry, who were examined up to 4 times over 12 years. Linear mixed effects models were used to examine the association between AKAP6 and MIR2113 with cognitive performance in episodic memory, working memory, vocabulary, perceptual speed and reaction time at baseline and with linear and quadratic rates of change. AKAP6-rs17522122*T was associated with worse baseline performance in episodic memory, working memory, vocabulary and perceptual speed, but it was not associated with cognitive change in any domain. MIR2113-rs10457441*T was associated with accelerated decline in episodic memory. No other associations with baseline cognitive performance or with linear or quadratic rate or cognitive changes was observed for this SNP. These results confirm the previous finding that, AKAP6 is associated with performance across multiple cognitive domains at baseline but not with cognitive decline, while MIR2113 primarily affects the rate at which memory declines over time.

scholarly journals Cognitive Functions in Patients after Carotid Artery Revascularization—A Narrative Review

2021 ◽  
Vol 11 (10) ◽  
pp. 1307
Author(s):  
Magdalena Piegza ◽  
Gniewko Więckiewicz ◽  
Dawid Wierzba ◽  
Jacek Piegza
Keyword(s):  
Cognitive Function ◽  
Carotid Artery ◽  
Cognitive Assessment ◽  
Neuropsychological Tests ◽  
Independent Risk Factor ◽  
Cerebral Hypoperfusion ◽  
Cognitive Deterioration ◽  
Carotid Revascularization ◽  
Neurocognitive Functions ◽  
Precise Assessment

Carotid revascularization may lead to improved cognitive function beyond stroke prevention. This article summarizes the conclusions from available studies on the effects of carotid reperfusion procedures on cognitive function. The papers cited used different neuropsychological tests for cognitive assessment, resulting in different methodologies and the results obtained were not always convergent. However, most studies reported an improvement in neurocognitive abilities after both vascular interventions, but a more precise assessment of the specific benefits is still awaited. Clinical determinants to predict the effects of these treatments on cognitive function are still being sought, but results are not yet satisfactory. In view of these studies, carotid stenosis seems to be an independent risk factor for cognitive deterioration, and the main mechanisms responsible are embolism and cerebral hypoperfusion. The aim of this study is to order the knowledge about the effects of carotid artery stenting (CAS) and endarterectomy (CEA) on neurocognitive functions and to verify the usefulness of using these treatments.

Effect of Unilateral Carotid Artery Stenting on Cognitive Function in Patients with Severe Bilateral Stenosis

2020 ◽  
Vol 135 ◽  
pp. 188-191 ◽  
Author(s):  
Mitsutaka Nakahara ◽  
Kouichi Misaki ◽  
Taishi Tsutsui ◽  
Riho Nakajima ◽  
Akifumi Yoshikawa ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Carotid Artery ◽  
Carotid Artery Stenting

scholarly journals The cognitive impact of chronic low back pain: Positive effect of multidisciplinary pain therapy

2017 ◽  
Vol 17 (1) ◽  
pp. 273-278 ◽  
Author(s):  
Marcus Schiltenwolf ◽  
Michael Akbar ◽  
Eva Neubauer ◽  
Simone Gantz ◽  
Herta Flor ◽  
...  
Keyword(s):  
Working Memory ◽  
Low Back Pain ◽  
Back Pain ◽  
Reaction Time ◽  
Cognitive Function ◽  
Recognition Memory ◽  
Chronic Low Back Pain ◽  
Visual Memory ◽  
Low Back ◽  
Adult Intelligence Scale

AbstractObjectivesLittle is known about the affected cognitive problems in chronic low back pain patients. For this patient cohort research mostly focused on memory of pain, rather than cognitive difficulties related to pain. Chronic pain may be associated with specific (yet undefined) cognitive deficits that affect everyday behaviour. We set out to compare the cognitive function of patients with chronic low back pain (cLBP) in the course of multidisciplinary pain treatments before and after therapy.MethodsThirty-three patients with cLBP and 25 healthy controls between 20 and 70 years were recruited into the study. The inclusion criteria for patients were: (1) a history of at least 12 weeks of chronic myofascial low back pain without radicular pain sensation before enrolment; (2) grade II and higher chronicity according to von Korff; (3) no opioid medication. The patients recruited had a mean pain duration of 7.13 ± 7.16 years and reported a mean pain intensity of 6.62 ± 2.04 (visual analogue score, VAS). Their mean back function according to the Funktionsfragebogen Hannover (FFbH, a questionnaire comparable with the Health Assessment Questionnaire) was 52.39 ± 20.23%.At three time points (before therapy, 3 weeks and 6 months after therapy) the study subjects were assessed prospectively with a battery of visual memory tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB). These included choice reaction time (CRT), pattern recognition memory (PRM) and spatial span (SSP). In parallel, the Trail-Making Test (TMT-A, TMT-B) and the Wechsler Adult Intelligence Scale (WAIS-III) were used to evaluate intelligence and cognitive flexibility.ResultsAt the beginning of MDPT (T1), it took patients with cLBP significantly longer than HC to complete TMT-A (38.29 ± 19.99 s vs 30.25 ± 14.19 s, p = 0.047) and TMT-B (72.10 ± 26.98 s vs 55.99 ± 22.14 s, p = 0.034). There were no significant differences between patients and HC in CRT, PRM and SSP. Three weeks (T2) and 6 months (T3) after MDPT, TMT-A reaction time of patients significantly improved by 6.5 s and 8.1 ms (38.3 ±19.9 s vs 31.8 ±12.3 s, p = 0.02 and 31.8 ± 12.3 s vs 30.2 ± 8.9 s, p = 0.021, respectively). The patients’ working memory was also better 6 months after MDPT (48.8 ± 11.1% at T1, 51.2 ±11.9% at T2, 57.1 ±10.9% at T3, p = 0.008). Significant correlations among pain, depression/anxiety, medication and neuropsychological tests were found.ConclusionsThese findings show that patients with cLBP have slowed speeds of information processing and working memory, but no alteration in attention and recognition memory. There are clearly interactions of cognitive function with pain, depression, anxiety, and medication. MDPT may improve the impaired cognitive function of patients with cLBP.ImplicationHealth professionals should contemplate the results from this study when planning therapy strategies especially when prescribing pain medications such opioids to patients with chronic low back pain.

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