Common carotid flow velocity is associated with cognitive function after carotid endarterectomy. (June 2020)

• Record Type: Journal Article
• Authors: Nakamizo, Akira; Amano, Toshiyuki; Matsuo, Satoshi; Kuwashiro, Takahiro; Yasaka, Masahiro; Okada, Yasushi
• Is Part Of: Journal of clinical neuroscience. Volume 76(2020)
• Page Start: 53
• Page End: 57
• Publication Date: 2020-06
• Subjects: Carotid endarterectomy -- Carotid stenosis -- Cognistat -- Cognitive decline -- Flow velocity -- Frontal assessment battery; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2020.04.050
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Ultrasonography is useful to predict cognition long after carotid endarterectomy. Common carotid artery end-diastolic flow velocity correlates with cognitive function. Pulsatility index of left common carotid artery correlates with cognitive function. Flow velocity and pulsatility index are useful markers of cognitive function. Abstract: The relationship between ultrasonographic flow parameters and cognitive function has not been well studied. This study aimed to clarify associations between carotid flow velocity (FV) and cognitive function in patients with a history of carotid endarterectomy (CEA). Ninety-four patients who previously underwent CEA participated in this study. The Neurobehavioral Cognitive Status Examination (Cognistat) and Frontal Assessment Battery (FAB) were adopted to assess cognitive functions at a mean of 6.5 ± 3.2 years after CEA. End-diastolic flow velocity (EDV) of the left and right common carotid artery (CCA) was significantly associated with total Cognistat score (p < 0.001) and total FAB score (p < 0.05). Pulsatility index (PI) of the left CCA was significantly associated with total Cognistat score and total FAB score (p < 0.01). A cut-off right CCA EDV of 14.5 cm/s offered the most reliable predictor of the bottom 25th percentile of total Cognistat score (sensitivity 83.3%, specificity 61.0%, area under the curve (AUC) 0.731, p = 0.0060), while a cut-off left CCA PI of 1.83 was the most reliable predictor of the bottom 25th percentile of total FAB score (sensitivity 73.3%, specificity 60.0%, AUC 0.679, p = 0.0179). Left and right CCA EDV correlated with sub-components of comprehension, construction, judgment, programming (p < 0.01), and conceptualization (p < 0.05). Right CCA EDV correlated with similarity (p < 0.01), repetition, naming, and memory (p < 0.05). Left CCA PI correlated with attention, conceptualization (p < 0.01), repetition, construction, similarity, and mental flexibility (p < 0.05), while right CCA PI correlated with construction (p < 0.05). CCA FV may offer useful markers of cognitive functions in patients with a history of CEA.