Cognitive Changes After Symptomatic Carotid Stenting:a Functional Imaging Study

Purpose:To further validate the impact of symptomatic carotid stenting on cognitive function and to investigate the relationship between cerebral perfusion status and the cognitive changes before and after carotid stenting.Methods:21symptomatic internal carotid atherosclerotic stenosis patients were prospectively enrolled in this study. A battery of neuropsychological tests including Mini-Mental State Examination, Finger Tapping Test, Trail Making Test and Wechsler adult memory scale, and computed tomography cerebral perfusion were done within3days before and6months after carotid stenting. Results:Successful carotid stenting was achieved in all21patients.Of all the patients, Finger Tapping Test, Trail Making Test and Wechsler adult memory scale performance showed significantly improved while Mini-Mental State Examination remaining unchanged. Based on the baseline CT perfusion finding, patients were divided into two groups:group I (n=13) as ipsilateral cerebral ischemia and group II (n=8) as non-ipsilateral cerebral ischemia. Mini-Mental State Examination and Finger Tapping Test performance of Group I were significantly worse than group II at baseline. After carotid stenting, Group I patients showed significant improvement in Finger Tapping Test, Trail Making Test and Wechsler adult memory scale. In group II, however, no significant difference was observed in any of the cognitive tests.Conclusions:Symptomatic internal carotid atherosclerotic stenosis with chronic cerebral ischemia can lead to severe cognitive impairment. Carotid stenting improves cognitive function in symptomatic internal carotid atherosclerotic stenosis with ipsilateral ischemia.