Table of Contents
Cardiovascular Psychiatry and Neurology
Volume 2013, Article ID 342571, 6 pages
http://dx.doi.org/10.1155/2013/342571
Clinical Study

Cognitive Performance following Carotid Endarterectomy or Stenting in Asymptomatic Patients with Severe ICA Stenosis

1Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), University of Rome “La Sapienza”, Sant’Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy
2Fondazione Santa Lucia, Instituto di Ricovero e Cura a Carattere Scientifico (IRCCS) and Memory Clinic, V. Ardeatina 306, 00179 Rome, Italy
3Department of Vascular Surgery, Sant’Andrea Hospital, University of Rome “La Sapienza”, Via di Grottarossa 1035-1039, 00189 Rome, Italy
4Department of Neurology and Psychiatry (Parkinson’s Centre) and Research Centre of Social Diseases (CIMS), University “La Sapienza”, Viale dell’Università 20, 00185 Rome, Italy

Received 30 April 2013; Revised 30 September 2013; Accepted 8 November 2013

Academic Editor: Janusz K. Rybakowski

Copyright © 2013 Livio Picchetto et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Endarterectomy (CEA) or stenting (CAS) of a stenotic carotid artery is currently undertaken to reduce stroke risk. In addition removal of the arterial narrowing has been hypothesized to improve cerebral hemodynamics and provide benefits in cognitive functions, by supposedly resolving a “hypoperfusion” condition. Methods. In this study we sought to test whether resolution of a carotid stenosis is followed by measurable changes in cognitive functions in 22 subjects with “asymptomatic” stenosis. Results. A main finding of the study was the statistically significant pre-post difference observed in the performance of phonological verbal fluency and Rey’s 15-word immediate recall. Remarkably, there was a significant interaction between phonological verbal fluency performance and side of the carotid intervention, as the improvement in the verbal performance, a typical “lateralized” skill, was associated with resolution of the left carotid stenosis. Conclusion. The results reflect a substantial equivalence of the overall performance at the before- and after- CEA or CAS tests. In two domains, however, the postintervention performance resulted improved. The findings support the hypothesis that recanalization of a stenotic carotid could improve brain functions by resolving hypothetical “hypoperfusion” states, associated with the narrowing of the vessels.