Changes in cognitive function during the 1-year period following endarterectomy and stenting of patients with high-grade carotid artery stenosis.
BACKGROUND
In patients with severe carotid artery stenosis, cognitive decline and changes in cognitive function before to after treatment have been noted, though the true effects of treatment in such patients remain unclear. A convenient and repeatable neuropsychological test battery is needed for such patients.


METHODS
In 26 patients with severe carotid artery stenosis treated by carotid endarterectomy (CEA) and stenting (CAS), cognitive function was examined before and 1 week, 3 months, 6 months, and 1 year after treatment. RBANS and MMSE were selected as a test battery, and changes in test scores and long-term results of revascularization were evaluated.


RESULTS
RBANS was useful and suitable for neuropsychological testing in such patients, and yielded the following results: (1) Patients before treatment had, on average, RBANS scores rated low average, with mild but relatively diffuse cognitive impairment; (2) RBANS scores were increased significantly at 3 months after CEA and CAS, and cognitive improvement was maintained over 1 year; and (3) scores were decreased temporarily at 1 week after CEA, but not after CAS.


CONCLUSIONS
Patients with severe carotid artery stenosis exhibited mild decline in cognitive function, which was improved after CEA and CAS. RBANS is a suitable test battery for this type of patient.
Takaiwa
Akiko
A
Department of Neurosugery, University of Toyama, Japan.
Hayashi
Nakamasa
N
Kuwayama
Naoya
N
Akioka
Naoki
N
Kubo
Michiya
M
Endo
Shunro
S
D000368:Aged; D000369:Aged, 80 and over; D016893:Carotid Stenosis / Q000150:complications* / Q000473:pathology / Q000601:surgery*; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D016894:Endarterectomy, Carotid / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D017063:Outcome Assessment, Health Care / Q000379:methods; D011446:Prospective Studies; D015607:Stents / Q000706:statistics & numerical data*; D016896:Treatment Outcome