Association between Carotid Intima-Media Thickness and Cognitive Impairment in a Chinese Stroke Population: A Cross-sectional Study

Yue, Wei; Wang, Anxin; Liang, Hui; Hu, Fengyun; Zhang, Yunshu; Deng, Meiying; Li, Tong; Hu, Xiao; Ye, Zhenxuan; Shen, Ying; Ji, Yong

doi:10.1038/srep19556

Cited by 14 publications

(21 citation statements)

References 28 publications

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“…As described above, functional MRI [40] showed pathological cerebral alterations in RA. In non-RA, stroke patients, other investigators also found associations between cognitive decline and carotid atherosclerosis [41]. Cerebral blood flow in association with cognitive function has not yet been assessed in RA before.…”

Section: Discussionmentioning

confidence: 98%

Assessment of cognitive function in female rheumatoid arthritis patients: associations with cerebrovascular pathology, depression and anxiety

Oláh¹,

Kardos²,

Andrejkovics

et al. 2019

Rheumatol Int

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We assessed cognitive function of female rheumatoid arthritis (RA) patients and analyze the determinants, with special focus on cerebrovascular morphology. Sixty methotrexate (MTX-) or biologic-treated RA patients and 39 healthy controls were included in a cross-sectional study. Smoking habits, alcohol intake and time spent in education were recorded. Standard measures were performed to assess cognitive function (Montreal Cognitive Assessment, MOCA; Trail Making Test, TMT; Victoria Stroop Test, VST; Wechsler Adult Intelligence Scale, WAIS; Benton Visual Retention test, BVRT), depression (Beck Depression Inventory, BDI), anxiety (State-Trait Anxiety Inventory, STAIT/S) and general health status (Short Form 36, SF-36). Mean disease activity (28-joint Disease Activity Score, mDAS28; erythrocyte sedimentation rate, mESR; C-reactive protein, mCRP) of the past 12 months was calculated; anti-cyclic citrullinated peptide (CCP) and rheumatoid factor (RF) were assessed. Cerebral vascular lesions and atrophy, carotid intima-media thickness (cIMT) and plaques, as well as median cerebral artery (MCA) circulatory reserve capacity (CRC) were assessed by brain magnetic resonance imaging (MRI), carotid ultrasound and transcranial Doppler, respectively. Cognitive function tests showed impairment in RA vs controls. Biologic-vs MTX-treated subgroups differed in TMT-A. Correlations were identified between cognitive function and depression/anxiety tests. WAIS, STAIS, STAIT and BDI correlated with most SF-36 domains. Numerous cognitive tests correlated with age and lower education. Some also correlated with disease duration, mESR and mDAS28. Regarding vascular pathophysiology, cerebral vascular lesions were associated with VST-A, carotid plaques with multiple cognitive parameters, while MCA and CRC with MOCA, BVRT and BDI. RA patients have significant cognitive impairment. Cognitive dysfunction may occur together with or independently of depression/anxiety. Older patients and those with lower education are at higher risk to develop cognitive impairment. Cognitive screening might be a useful tool to identify subgroups to be further investigated for cerebrovascular pathologies.

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Section: Discussionmentioning

confidence: 98%

Assessment of cognitive function in female rheumatoid arthritis patients: associations with cerebrovascular pathology, depression and anxiety

Oláh¹,

Kardos²,

Andrejkovics

et al. 2019

Rheumatol Int

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“…The design and main results of the Study of Oxidative Stress in Patients with Acute Ischemic Stroke (SOS‐Stroke) have been described in detail previously . In brief, SOS‐Stroke was a prospective, multicenter registry that consisted of consecutively selected patients ( n = 4164) with acute ischemic stroke.…”

Section: Methodsmentioning

confidence: 99%

Association between oxidized low‐density lipoprotein and cognitive impairment in patients with ischemic stroke

Wang¹,

Liu

Meng³

et al. 2017

Euro J of Neurology

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Background and purpose: The association between oxidized low-density lipoprotein (oxLDL) and cognitive impairment is unclear. This study aimed to investigate the potential association between oxLDL and cognitive impairment among patients with acute ischemic stroke. Methods: We measured the levels of oxLDL and recorded the Mini-Mental State Examination (MMSE) score in patients with acute ischemic stroke who were recruited from the Study of Oxidative Stress in Patients with Acute Ischemic Stroke. Cognitive impairment was defined as an MMSE score of <24. The association between oxLDL and cognitive impairment was assessed by multivariate logistic or linear regression analysis. Other clinical variables of interest were also studied. Results: A total of 3726 patients [1287 (34.54%) female] were included in this study, with a mean age of 63.62 AE 11.96 years. After adjusting for potential confounders in our logistic regression model, each SD increase in oxLDL was associated with a 26% increase in the prevalence of cognitive impairment (odds radio, 1.26; 95% confidence interval, 1.13-1.39; P < 0.0001). Similarly, higher oxLDL was associated with lower MMSE scores, with a 0.56-point decrease in MMSE score for every SD increase in oxLDL in a linear regression analysis (b = À0.56; 95% confidence interval, À0.81 to À0.32; P < 0.0001). There were no significant interactions between oxLDL and age, sex or education levels for cognitive impairment (all interactions, P > 0.05). Conclusions: Elevated levels of oxLDL were associated with a higher prevalence of cognitive impairment in patients with ischemic stroke.

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“…Recent large-scale studies have shown that an increased cIMT value is generally associated with future cerebrovascular events, independent of age and sex [23, 45, 48]. However, a few reports have questioned the role of cIMT as a predictor of cardiovascular events [49]; the most recent meta-analysis of 14 population-based studies reported a hazard ratio of 1.09 for the first myocardial infarction/stroke per every 0.1 mm increase in the cIMT [48]. One plausible explanation for this controversy may lie in the location of the cIMT measurement [50], as carotid bulb cIMT values were positively associated with future cardiac events; however, cIMT values measured in the distal wall of the common carotid artery failed to predict coronary events [43].…”

Section: Discussionmentioning

confidence: 99%

The Relationship between Carotid and Femoral Artery Intima-Media Thickness and Histopathologic Grade of Atherosclerosis in Patients with Chronic Kidney Disease

Nezami

Ghabili

Shokouhi-Gogani

et al. 2018

Nephron

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Background/Aims: Variability in the grade of atherosclerosis among patients with chronic kidney disease (CKD) could affect the ultrasound measurements of intima media thickness (IMT). We sought to investigate IMTs of carotid (cIMT) and femoral (fIMT) arteries in CKD patients and assess the degree of their correlation with histopathological atherosclerosis. Methods: Eighty-nine out of 99 enrolled subjects completed this study. The subjects were divided into 3 groups: 34 patients with CKD (Case group), 31 with coronary artery disease undergoing coronary artery bypass graft (CABG, positive control group), and 24 healthy kidney donors (negative control group). For histopathological assessment of atherosclerosis, arterial tissue samples were obtained from the patients in each study group. The cIMT and fIMTs were measured by ultrasonography. Results: Histopathological atherosclerosis was present in 82.3, 100, and 20.8% of CKD, CABG, and donor groups respectively (p < 0.001). CKD patients had higher values of cIMT and fIMT than the donor group (p = 0.01 and 0.004, respectively). cIMT was positively correlated with the grade of atherosclerosis in the CKD group only (p < 0.001), while fIMT was correlated with the grade of atherosclerosis in both CKD and donor groups (p < 0.001 and p = 0.009 respectively). In CKD patients, cIMT >0.65 mm and femoral values >0.57 mm predicted the presence of histopathological atherosclerosis with sensitivities of 96 and 92% respectively. Conclusion: Higher values of cIMT and fIMT in CKD patients are associated with higher rates and degrees of histopathological atherosclerosis. Additionally, when compared to fIMT, cIMT has a higher sensitivity for detecting atherosclerosis in CKD patients.

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Association between Carotid Intima-Media Thickness and Cognitive Impairment in a Chinese Stroke Population: A Cross-sectional Study

Cited by 14 publications

References 28 publications

Assessment of cognitive function in female rheumatoid arthritis patients: associations with cerebrovascular pathology, depression and anxiety

Assessment of cognitive function in female rheumatoid arthritis patients: associations with cerebrovascular pathology, depression and anxiety

Association between oxidized low‐density lipoprotein and cognitive impairment in patients with ischemic stroke

The Relationship between Carotid and Femoral Artery Intima-Media Thickness and Histopathologic Grade of Atherosclerosis in Patients with Chronic Kidney Disease

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