Carotid stenting enhances cognition

Carotid artery stenting does more than help prevent strokes. It could also improve thought processes in some patients, according to German researchers.

Their study is the first to combine neuropsychological testing with perfusion imaging used to monitor stroke-related events during carotid artery stenting, said principal investigator Dr. Iris Q. Grunwald, a consultant at Saarland University Clinic in Homburg.

Grunwald and colleagues sought to evaluate the cognitive performance of 26 patients undergoing the procedure. They found noticeable changes in these patients' cognitive speed and memory after the intervention. The investigators presented their results at the 2005 RSNA meeting.

"Stenting of the carotid artery may offer more than reduced stroke risk, especially to patients with impaired brain perfusion," Grunwald said.

All patients underwent diffusion- and perfusion-weighted imaging with MR before and after stenting. Patients underwent neuropsychological testing to gauge their memory function and information processing speed at least one day before and three months after the procedure. They also underwent testing for dementia and depression.

Results showed a statistically significant increase in cognitive speed after stenting regardless of the patient's age or the severity of stenosis. The researchers found the degree of vessel stenosis correlated with perfusion deficit in the affected brain area. Blood flow improvement after stenting resulted in an increase in memory function in patients with previous perfusion deficit.

None of the patients suffered from depression or dementia.

Neuropsychological tests included the Mini Mental Status Examination (MMSE), symbol digit, and subtests from the U.S. National Institute on Aging's Consortium to Establish a Registry for Alzheimer's Disease (CERAD).

Further studies including different time intervals and more refined testing are needed, the researchers said.

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