title: Effect of Carotid Artery Stenting on Cognitive Function in Patients with Internal Carotid Artery Stenosis and Cerebral Lacunar Infarction: A 3-Year Follow-Up Study in China.
abstract: OBJECTIVE
  Carotid artery stenting (CAS) is an important therapeutic strategy for patients with carotid artery stenosis. However, the potential influence of CAS on cognitive function in patients with carotid artery stenosis and cerebral lacunar infarction has not been determined. This study investigated changes in cognitive function associated with CAS and the factors related to these changes.
  
  
  METHODS
  This prospective cohort study comprised 579 Chinese patients with cerebral lacunar infarction and carotid artery stenosis for whom CAS was indicated, and a matched control group of 552 healthy individuals. Cognitive function before CAS and at scheduled intervals from 6 months to 3 years was assessed with instruments that included the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scale. Potential factors that might affect cognitive function were analyzed via logistic regression.
  
  
  RESULTS
  The MMSE and MoCA scores of the patients before CAS were significantly lower than that of the control subjects. These scores were significantly higher 6 months after CAS and sustained or increased throughout the 3-year follow-up. Also significantly improved after CAS from baseline were scores for an alternating trail test, cube copying, clock-drawing, attention, and delayed recall in an auditory-verbal learning test. Logistic regression analyses showed that age greater than 65 y, little education, diabetes, and hypertension were independent risk factors for deteriorated MoCA scores 3 years after CAS.
  
  
  CONCLUSIONS
  CAS was associated with significantly improved cognitive function in cerebral lacunar infarction patients with severe stenosis.
authors.affiliation: Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, 250021, PR China; Department of Neurology, Liaocheng People's Hospital and Liaocheng Clinical School of Taishan Medical University, Liaocheng, Shandong, 252000, PR China.
authors.forename: Zhang Yong
authors.initials: ZY
authors.lastname: Xia
authors.affiliation: Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, 250021, PR China.
authors.forename: Qin Jian
authors.initials: QJ
authors.lastname: Sun
authors.affiliation: Department of Neurology, the Third People's Hospital of Liaocheng, Liaocheng, Shandong, 252000, PR China.
authors.forename: Hua
authors.initials: H
authors.lastname: Yang
authors.affiliation: Department of Neurology, Liaocheng People's Hospital and Liaocheng Clinical School of Taishan Medical University, Liaocheng, Shandong, 252000, PR China.
authors.forename: Ming Xia
authors.initials: MX
authors.lastname: Zhang
authors.affiliation: Department of Neurology, Liaocheng People's Hospital and Liaocheng Clinical School of Taishan Medical University, Liaocheng, Shandong, 252000, PR China.
authors.forename: Ru
authors.initials: R
authors.lastname: Ban
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, 210002, PR China.
authors.forename: Ge Lin
authors.initials: GL
authors.lastname: Xu
authors.affiliation: Department of Neurology, Liaocheng People's Hospital and Liaocheng Clinical School of Taishan Medical University, Liaocheng, Shandong, 252000, PR China.
authors.forename: Ya Ping
authors.initials: YP
authors.lastname: Wu
authors.affiliation: School of Biomedical Sciences, Charles Sturt University, Wagga Wagga, NSW 2678, Australia.
authors.forename: Le Xin
authors.initials: le X
authors.lastname: Wang
authors.affiliation: Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, 250021, PR China.
authors.forename: Yi Feng
authors.initials: YF
authors.lastname: Du
mesh_terms: D002339:Carotid Arteries / Q000503:physiopathology*; D016893:Carotid Stenosis / Q000150:complications*; D016022:Case-Control Studies; D002681:China; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011379:Prognosis; D011446:Prospective Studies; D011597:Psychomotor Performance; D015607:Stents / Q000009:adverse effects*; D059409:Stroke, Lacunar / Q000150:complications*; D013997:Time Factors