This is a prospective study aimed to explore the changes of cognitive function after surgery for CAS and the correlation with brain connectivity, in order to look for the clinical biomarkers to predict the carotid stent implantation for patients which can effect the cognition
Carotid artery stenting (CAS) can significantly decrease the incidence of ischemic stroke in patients with severe carotid artery stenosis has been confirmed in large randomized controlled studies (1, 2).Previous studies showed carotid artery stenosis is closely related to cognitive dysfunction, including asymptomatic carotid artery stenosis(≥70%).Cognitive impairment is one of the most serious problem facing the elderly. The impact on cognitive function in patients with CAS has been discussed by many researchers, however the effect still remained conflicting. In past few years, several imaging techniques, such as resting-state functional MRI (R-fMRI), had been increasingly used to study cognitive impairment in humans. In this study, we evaluated the cognition performance in severe carotid artery stenosis patients undergoing CAS and explored the mechanisms underlying the cognition changes by the Rs-fMRI. Inclusion criteria: * age between 55 years and 80 years * unilateral internal carotid artery stenotic degree ≥ 70% * right-hand-dominant * free of dementia, and depression * modified Rankin Scale: 0 or 1 * education ≥6 years * obtained written informed consent. Exclusion criteria: * contralateral internal carotid artery stenosis ≥ 50% * posterior circulation diseases * MMSE \< 26, which is a cut-off value for mild cognitive impairment * severe systemic diseases and neuropsychiatric diseases (such as congestive heart failure) * any contraindications for MRI scan (e.g., metal implants) * Non atherosclerotic stenosis, such as dissection, vasculitis.
Study Type
OBSERVATIONAL
Enrollment
30
the first affiliated hospital of Zhejiang university
Hangzhou, Zhejiang, China
RECRUITINGMontreal Cognitive Assessment, MOCA
use MOCA to assess the cognition before CAS
Time frame: before CAS(within 1 week)
Mini-mental State Examination,MMSE
use MMSE to assess the cognition before CAS
Time frame: before CAS(within 1 week)
Montreal Cognitive Assessment, MOCA
use MOCA to assess the cognition after CAS
Time frame: 3 months after CAS
Mini-mental State Examination,MMSE
use MMSE to assess the cognition after CAS
Time frame: 3 months after CAS
Digit Symbol Test
use to assess the cognition before CAS
Time frame: before CAS(within 1 week)
Digit Symbol Test
use to assess the cognition after CAS
Time frame: 3 months after CAS
Trail Making Test A/B
use to assess the cognition before CAS
Time frame: before CAS(within 1 week)
Trail Making Test A/B
use to assess the cognition after CAS
Time frame: 3 months after CAS
digital span test
use to assess the cognition before CAS
Time frame: before CAS(within 1 week)
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digital span test
use to assess the cognition after CAS
Time frame: 3 months after CAS