Efect of Carotid Artery Stenting on Cognitive Function in Patients with Carotid Artery Stenosis: A Prospective, 3-Month-Follow-Up Study
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background and Purpose Carotid artery stenting (CAS) is emerging as an alternative to carotid endarterectomy for the treatment of carotid artery stenosis (CS), but the efect of CAS onthe cognitive function of patients with severe CS has not been fully investigated. Te aim ofthis study was to use comprehensive neuropsychological tests to determine the efect of CASon cognitive function from baseline to 3 months postprocedure in patients with severe CS. Methods Tirty-one patients due to undergo CAS due to high-grade CS (≥70%) and 11control subjects who were diagnosed with CS, but who did not undergo CAS, and who visitedthe clinic or emergency room between February 2009 and February 2012 were recruited consecutively at baseline (i.e., pre-CAS). Follow-up neuropsychological evaluations afer 3 monthswere completed by 23 of the 31 patients who underwent CAS, and by 10 of the 11 control subjects. Te primary cognitive outcome was assessed using a neuropsychological test containingsubcategories designed to test general cognitive function, attention, visuospatial function, language and related functions, memory, and frontal lobe/executive function. Results Of the 23 patients undergoing CAS who completed the 3-month follow-up tests, 12had asymptomatic CS. During the 3-month follow-up period, the patients who underwent CASand those with asymptomatic CS achieved similar results to the control group on all cognitivetests. However, symptomatic CS patients (n=11) who underwent CAS exhibited improvements in visuospatial function (p=0.046) and total Seoul Neuropsychological Screening Battery-Dementia Version scores (p=0.010) in comparison with both the asymptomatic CS patients and the control group. Conclusions Te fndings of this study suggest that CAS has a positive efect on cognitivefunction in patients with symptomatic CS over a 3-month follow-up period. A long-term, multicenter, prospective case-control study would be helpful to predict quality of life and prognoses for patients undergoing CAS.
Abstract
Background and Purpose Carotid artery stenting (CAS) is emerging as an alternative to carotid endarterectomy for the treatment of carotid artery stenosis (CS), but the efect of CAS onthe cognitive function of patients with severe CS has not been fully investigated. Te aim ofthis study was to use comprehensive neuropsychological tests to determine the efect of CASon cognitive function from baseline to 3 months postprocedure in patients with severe CS. Methods Tirty-one patients due to undergo CAS due to high-grade CS (≥70%) and 11control subjects who were diagnosed with CS, but who did not undergo CAS, and who visitedthe clinic or emergency room between February 2009 and February 2012 were recruited consecutively at baseline (i.e., pre-CAS). Follow-up neuropsychological evaluations afer 3 monthswere completed by 23 of the 31 patients who underwent CAS, and by 10 of the 11 control subjects. Te primary cognitive outcome was assessed using a neuropsychological test containingsubcategories designed to test general cognitive function, attention, visuospatial function, language and related functions, memory, and frontal lobe/executive function. Results Of the 23 patients undergoing CAS who completed the 3-month follow-up tests, 12had asymptomatic CS. During the 3-month follow-up period, the patients who underwent CASand those with asymptomatic CS achieved similar results to the control group on all cognitivetests. However, symptomatic CS patients (n=11) who underwent CAS exhibited improvements in visuospatial function (p=0.046) and total Seoul Neuropsychological Screening Battery-Dementia Version scores (p=0.010) in comparison with both the asymptomatic CS patients and the control group. Conclusions Te fndings of this study suggest that CAS has a positive efect on cognitivefunction in patients with symptomatic CS over a 3-month follow-up period. A long-term, multicenter, prospective case-control study would be helpful to predict quality of life and prognoses for patients undergoing CAS.
참고문헌 (28)
- Goldstein LB, "Primary prevention of ischemic stroke: a guideline from the American Heart Association", American Stroke Association Stroke Council: cosponsored by the Atherosclerotic Peripheral Vascular Disease Interdisciplinary Working Group; Cardiovascular Nursing Council; Clinical Cardiology Council; Nutrition, Physical Activity, and Metabolism Council; and the Quality of Care and Outcomes Research Interdisciplinary Working Group: the American Academy of Neurology affirms the value of this guideline, 2006, pp.37, 1583~1633
- Kitagawa K, "Relationship between cerebral blood flow and later cognitive decline in hypertensive patients with cerebral small vessel disease", Hypertens Res, 32, pp.816~820 (2009)
- Hamster W, "Neuropsychological changes associated with stenoses or occlusions of the carotid arteries. A comparative psychometric study", Eur Arch Psychiatry Neurol Sci, 234, pp.69~73 (1984)
- Mathiesen EB, "Prevalence of and risk factors associated with carotid artery stenosis: the Tromsø Study", Cerebrovasc Dis, 12, pp.44~51 (2001)
- O’Brien JT, "Vascular cognitive impairment", Lancet Neurol, 2, pp.89~98 (2003)
- Rao R, "The role of carotid stenosis in vascular cognitive impairment", Eur Neurol, 46, pp.63~69 (2001)
- Grunwald IQ, "Cognitive changes after carotid artery stenting", Neuroradiology, 48, pp.319~323 (2006)
- Turk AS, "Effect of carotid artery stenting on cognitive function in patients with carotid artery stenosis: preliminary results", AJNR Am J Neuroradiol, 29, pp.265~268 (2008)
- De Rango P, "The role of carotid artery stenting and carotid endarterectomy in cognitive performance:a systematic review", Stroke, 39, pp.3116~3127 (2008)
- Ghogawala Z, "Cognitive outcomes after carotid revascularization: the role of cerebral emboli and hypoperfusion", Neurosurgery, 62, pp.385~395 (2008)
- Folstein MF, "“Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician", J Psychiatr Res, 12, pp.189~198 (1975)
- Kang Y, "A validity study on the Korean Mini-Mental State Examination (K-MMSE) in dementia patients", J Korean Neurol Assoc, 15, pp.300~308 (1997)
- 안현정, "Seoul Neuropsychological Screening Battery-Dementia Version (SNSB-D): A Useful Tool for Assessing and Monitoring Cognitive Impairments in Dementia Patients", Journal of Korean Medical Science, 25(7), pp.1071~1076 (2010), 대한의학회
- Kim H, "Normative data on the Korean version of the Boston Naming Test", J Clin Exp Neuropsychol, 21, pp.127~133 (1999)
- Inzitari D, "The causes and risk of stroke in patients with asymptomatic internal-carotid-artery stenosis. North American Symptomatic Carotid Endarterectomy Trial Collaborators", N Engl J Med, 342, pp.1693~1700 (2000)
- Yamauchi H, "Long-term changes of hemodynamics and metabolism after carotid artery occlusion", Neurology, 54, pp.2095~2102 (2000)
- Grunwald IQ, "Influence of carotid artery stenting on cognitive function", Neuroradiology, 52, pp.61~66 (2010)
- Xu G, "Cognitive performance after carotid angioplasty and stenting with brain protection devices", Neurol Res, 29, pp.251~255 (2007)
- Aleksic M, "Cognitive function remains unchanged after endarterectomy of unilateral internal carotid artery stenosis under local anaesthesia", Eur J Vasc Endovasc Surg, 31, pp.616~621 (2006)
- Gossetti B, "Embolism to the brain during carotid stenting and surgery", Acta Chir Belg, 107, pp.151~154 (2007)
- Lal BK, "Cognitive changes after surgery vs stenting for carotid artery stenosis", J Vasc Surg, 54, pp.691~698 (2011)
- 김정은, "Cognitive Dysfunction in 16 Patients with Carotid Stenosis: Detailed Neuropsychological Findings", Journal of Clinical Neurology, 3(1), pp.9~17 (2007), 대한신경과학회
- Lal BK, "Cognitive function after carotid artery revascularization", Vasc Endovascular Surg, 41, pp.5~13 (2007)
- Mathiesen EB, "Reduced neuropsychological test performance in asymptomatic carotid stenosis: The Tromsø Study", Neurology, 62, pp.695~701 (2004)
- Capoccia L, "Silent stroke and cognitive decline in asymptomatic carotid stenosis revasculariza-tion", Vascular, 20, pp.181~187 (2012)
- Capoccia L, "Comparative study on carotid revascularization (endarterectomy vs stenting) using markers of cellular brain injury, neuropsychometric tests, and diffusion-weighted magnetic resonance imaging", J Vasc Surg, 51, pp.584~591 (2010)
- Cheng Y, "Effects of carotid artery stenting on cognitive function in patients with mild cognitive impairment and carotid stenosis", Exp Ther Med, 5, pp.1019~1024 (2013)
- Ishihara H, "Cognitive outcome differences on the side of carotid artery stenting", J Vasc Surg, 57, pp.125~130 (2013)