BackgroundThe aim of this study was to investigate the influence of carotid artery stenting (CAS) on the cognition and quality of life of elderly patients with severe stenosis of the internal carotid artery.Material/Methods65 elderly patients with symptomatic severe stenosis of internal carotid artery were recruited into 2 groups: the pharmacotherapy group (n=29) and the CAS group (n=36). Before surgery and 1, 3, 6, and 12 months after surgery, Montreal cognitive assessment (MoCA) was used for the evaluation of cognition and WHOQOL-BREF was used for the assessment of quality of life.ResultsAt 12 months after surgery, total MoCA score and WHOQOL-BREF score in the pharmacotherapy group was significantly reduced when compared with those before surgery (P<0.05). In the CAS group, the total MoCA score, scores of attention and delayed recall, and WHOQOL-BREF score increased significantly at different time points after surgery when compared with those before surgery (P<0.05). Moreover, in CAS group, the MoCA score and WHOQOL-BREF markedly increased gradually over time (P<0.05). Compared with the pharmacotherapy group, cognition and quality of life in the CAS group were improved dramatically during the follow-up period (P<0.05).ConclusionsSevere stenosis of the internal carotid artery is a cause of cognition impairment, and CAS may improve cognition and quality of life.
BackgroundWe aimed to investigate cognitive function and affective disorder in elderly patients with symptomatic vertebrobasilar artery stenosis (SVAS) after stent-assisted angioplasty (SAA) and to explore the potential mechanism.Material/MethodsThe study subjects were 26 elderly SVAS patients who were non-responsive to pharmacotherapy and received SAA (study group) and 30 patients receiving intracoronary stent implantation (control group). Montreal cognitive assessment (MoCA), Hamilton depression rating scale (HAMD), and Hamilton anxiety rating scale (HAMA) were used.ResultsThe total MoCA score, scores of line connection, copying cube, drawing clock, and delayed recall increased significantly in the study group after surgery (P<0.05, P<0.01). In addition, the MoCA score increased over time and the total MoCA score at 12 months was markedly higher than that at 1 month (P<0.05). The scores of HAMD and HAMA decreased dramatically after surgery compared with before surgery in these patients (P<0.01). A comparison at the corresponding period was performed between study group and control group, and it was found that the differences in total MoCA scores and scores of line connection, copying cube, drawing clock, and delayed recall before surgery and at 1 month after surgery were significant (P<0.05, P<0.01).ConclusionsSAA may improve the visuospatial/executive abilities and delayed recall, as well as the depression and anxiety in patients with SVAS. Larger and controlled trails are needed to investigate the effect of SAA on cognition and affection in these patients.
The work was supported by grants from the Key Projects of Hangzhou Health Science and Technology Plan (ZD20210010), Guidance Project of Hangzhou Science Plan (agriculture and social development) (20211231Y034), and Construction Fund of Medical Key Disciplines of Hangzhou (2020-2024) Conflict of interest:None declared Background:Meningitis has been found to be associated with dementia. Different pathogens of meningitis lead to different cognitive impairments. However, the change of cognitive function and cellular metabolism in the hippocampus in varicella zoster virus (VZV) meningitis has received little attention. We aimed to explore the cognitive function and changes of cellular metabolism in bilateral hippocampal regions in VZV meningitis. Material/Methods:We used magnetic resonance spectroscopy to check the cellular metabolism in the bilateral hippocampal region in 23 VZV meningitis patients and 19 controls in our hospital from June 2020 to November 2022. Also, cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) scale, and the correlation between MoCA scores and cellular metabolism in the bilateral hippocampal region was analyzed. Results:Six (26.1%) of the 23 patients with VZV meningitis had cognitive decline. Compared with that of the control group, the MoCA scores of VZV meningitis patients was much impaired (25.88±2.31 vs 27.74±1.94, P<0.05), visual-spatial executive function and delayed recall were significantly decreased (P<0.05), and N-acetylaspartate (NAA)/creatine (Cr) ratios in the bilateral hippocampus of patients with VZV meningitis were significantly lower (P<0.05). NAA/Cr ratios in the left and right hippocampus were positively correlated with MoCA scores (r=0.4158, P=0.0385; r=0.5274, P=0.0010, respectively), and negatively correlated with white blood cell count (P<0.01) and protein content in cerebrospinal fluid (P<0.05). Conclusions:Patients with VZV meningitis had cognitive dysfunction and altered cellular metabolism of bilateral hippocampal regions. The main cognitive abnormalities were visual-spatial executive function and delayed recall.
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