Cognitive improvement in patients with carotid stenosis is independent of treatment type

Wapp, Manuela; Everts, Regula; Burren, Yuliya; Kellner-Weldon, Frauke; El-Koussy, Marwan; Wiest, Roland; Federspiel, Andrea; Michel, Patrik; Schroth, Gerhard (2015). Cognitive improvement in patients with carotid stenosis is independent of treatment type. Swiss medical weekly, 145, w14226. EMH Schweizerischer Ärzteverlag 10.4414/smw.2015.14226

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Treatment of carotid artery stenosis decreases the long-term risk of stroke and may enhance cerebral blood flow. It is therefore expected to have the potential to prevent cognitive decline or even improve cognition over the long-term. However, intervention itself can cause peri-interventional cerebral infarcts, possibly resulting in a decline of cognitive performance, at least for a short time. We investigated the long-term effects of three treatment methods on cognition and the emotional state one year after intervention. In this prospective observational cohort study, 58 patients with extracranial carotid artery stenosis (≥70%) underwent magnetic resonance imaging and assessment of cognition, mood and motor speed before carotid endarterectomy (n = 20), carotid stenting (n = 10) or best medical treatment (n = 28) (i.e., time-point 1 [TP1]), and at one-year follow-up (TP2). Gain scores, reflecting cognitive change after treatment, were built according to performance as (TP2 -TP1)/TP1. Independent of the treatment type, significant improvement in frontal lobe functions, visual memory and motor speed was found. Performance level, motor speed and mood at TP1 were negatively correlated with gain scores, with greater improvement in patients with low performance before treatment. Active therapy, whether conservative or interventional, produces significant improvement of frontal lobe functions and memory in patients with carotid artery disease, independent of treatment type. This effect was particularly pronounced in patients with low cognitive performance prior to treatment.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology
04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy > Psychiatric Neurophysiology (discontinued)
04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy
04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy > UPD Murtenstrasse

UniBE Contributor:

Wapp, Manuela; Everts, Regula; Burren, Yuliya; Kellner-Weldon, Frauke; El-Koussy, Marwan; Wiest, Roland; Federspiel, Andrea and Schroth, Gerhard

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1424-7860

Publisher:

EMH Schweizerischer Ärzteverlag

Language:

English

Submitter:

Andrea Federspiel

Date Deposited:

28 Jan 2016 10:40

Last Modified:

28 Jan 2016 10:40

Publisher DOI:

10.4414/smw.2015.14226

PubMed ID:

26700596

BORIS DOI:

10.7892/boris.74512

URI:

https://boris.unibe.ch/id/eprint/74512

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