Clinical Neurology and Neurosurgery

2016

DOI: 10.1016/j.clineuro.2016.03.027

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Atherosclerotic carotid stenosis and cognitive function

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The Psychosocial Consequences Of Cardiovascular Diseases1

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Cited by 36 publications

(44 citation statements)

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“…The development of carotid artery stenosis was associated with the decrease in neuropsychological performance due to the chronic drop of cerebral blood flow [40] and by affecting the neurovascular unit increases the likelihood for dementia [41]. It seems that both symptomatic and asymptomatic carotid stenoses are associated with cognitive impairment [42]. Withal, hypertensive individuals are more susceptible to developing cognitive impairments than those whose BP values are within normal limits [43].…”

Section: The Psychosocial Consequences Of Cardiovascular Diseasesmentioning

confidence: 99%

Psychosomatic Interrelations in Cardiovascular Diseases and Their Consequences on Patient’s Quality of Life

2017

Well-Being and Quality of Life - Medical Perspective

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At present, the cardiovascular diseases (CVD) are among the major concerns of World Health Organization (WHO), assurance health systems and researchers in the specific field, because they are the number one cause of deaths globally, and according to several perspective studies, they will become the pathology that generates the greatest economic burden worldwide, through morbidity, disability, poor quality of life, and cause of death. Nowadays, the psychic field and the vulnerability of individual mental level to stress are an important link in the development of mental illness, CVD (included in the group of psychosomatic disorders), and also of interrelationship between them. The combined effects of these factors are reflected in the behavioral and cardiovascular (CV) system's pathophysiological changes, which determine the impairment of health-related quality of life for the CV patients, on both short-term and long-term. This chapter aims to address both the interrelationship of psychosocial factors with CVD in terms of its multifactorial etiology and the mark of this bidirectional link on the quality of life of the patients. In several sections, the following issues will be described: general aspects regarding the relationship between homeostasis-stress-pathology; the role of stress as a psychosocial factor in the multifactorial etiology of CVD; the implications of mental disorders in the pathogenesis of CVD; behavioral aspects of CV patient during his illness, and strategies for improving therapeutic adherence and the quality of life of these patients.

“…The development of carotid artery stenosis was associated with the decrease in neuropsychological performance due to the chronic drop of cerebral blood flow [40] and by affecting the neurovascular unit increases the likelihood for dementia [41]. It seems that both symptomatic and asymptomatic carotid stenoses are associated with cognitive impairment [42]. Withal, hypertensive individuals are more susceptible to developing cognitive impairments than those whose BP values are within normal limits [43].…”

Section: The Psychosocial Consequences Of Cardiovascular Diseasesmentioning

confidence: 99%

Psychosomatic Interrelations in Cardiovascular Diseases and Their Consequences on Patient’s Quality of Life

2017

Well-Being and Quality of Life - Medical Perspective

View full text Add to dashboard Cite

At present, the cardiovascular diseases (CVD) are among the major concerns of World Health Organization (WHO), assurance health systems and researchers in the specific field, because they are the number one cause of deaths globally, and according to several perspective studies, they will become the pathology that generates the greatest economic burden worldwide, through morbidity, disability, poor quality of life, and cause of death. Nowadays, the psychic field and the vulnerability of individual mental level to stress are an important link in the development of mental illness, CVD (included in the group of psychosomatic disorders), and also of interrelationship between them. The combined effects of these factors are reflected in the behavioral and cardiovascular (CV) system's pathophysiological changes, which determine the impairment of health-related quality of life for the CV patients, on both short-term and long-term. This chapter aims to address both the interrelationship of psychosocial factors with CVD in terms of its multifactorial etiology and the mark of this bidirectional link on the quality of life of the patients. In several sections, the following issues will be described: general aspects regarding the relationship between homeostasis-stress-pathology; the role of stress as a psychosocial factor in the multifactorial etiology of CVD; the implications of mental disorders in the pathogenesis of CVD; behavioral aspects of CV patient during his illness, and strategies for improving therapeutic adherence and the quality of life of these patients.

“…Our study showed that the majority of ICAS patients treated with the CAS procedure experienced a significant increase in some aspects of cognitive function regardless of the laterality of the procedure or whether they were symptomatic. Many studies have evaluated and compared the effects of the CAS procedure on cognitive function in ICAS patients 3,[13][14][15][16][17][18] ; however, conclusions have varied among studies, possibly because different studies used different neuropsychological batteries. Studies that used WAIS scores 13,14,16) evaluated their results using paired t-tests and rarely focused on whether each patient showed a significant change.…”

Section: Discussionmentioning

confidence: 99%

“…1,2) In Japan, CAS has been covered by insurance since April 2008. ICAS increases the risk of cognitive dysfunction 3) as well as ischemic stroke, and low cognitive performance is a risk factor for death, even in asymptomatic ICAS patients. 4) However, whether CAS benefits patients with ICAS in terms of cerebral hemodynamic impairment and cognitive function remains controversial.…”

Section: Introductionmentioning

confidence: 99%

Beneficial Effect of Carotid Artery Stenting on Cerebral Hemodynamic Impairment and Cognitive Function

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et al. 2020

Neurol. Med. Chir.(Tokyo)

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The aim of this study was to evaluate the effects of the carotid artery stenting (CAS) procedure on cerebral hemodynamics and cognitive performance in patients with internal carotid artery stenosis. In this prospective observational study, 16 consecutive patients in a single institute were treated with CAS from 2010 to 2011 (71.7 ± 7.3 years old, 12 males, and six left-sided procedures). Before and after the CAS procedure, all patients were evaluated with single photon emission computed tomography using 123 I-iodoamphetamine and acetazolamide as well as the Weschler Adult Intelligent Scale (WAIS) to assess three intelligent quotients and four indexes. Patients with decreased preprocedural cerebral blood flow (CBF) and cerebrovascular reserve (CVR) experienced significant increases in CBF and CVR (P = 0.01 and 0.03). Twelve (75%) patients experienced a significant increase in one or more WAIS scores, while two (13%) showed a significant decrease. The most frequently improved scores were the Working Memory Index and Processing Speed Index (seven patients/44%). Preprocedural CBF was significantly correlated with the Full-scale and Performance Intelligent Quotients (r = 0.51-0.56, P = 0.02-0.04), and patients who experienced a significant increase in these scores had larger increases in CVR than patients with unchanged scores (P = 0.0097-0.019). These results indicate that the CAS procedure improved impaired cerebral hemodynamics and might benefit the cognitive function of patients with internal carotid artery stenosis related to impaired cerebral hemodynamics.

“…This parameter is also associated with metabolic syndrome, insulin sensitivity, and other age-related functional impairments [22, 23]. Moreover, intima-media thickness was shown to reliably predict the progression of Alzheimer's disease in general [24] and Alzheimer-associated cognitive decline in particular [25]. Moreover, revascularization improves cognitive function, thus, indicating that association between carotid artery stenosis and cognitive decline may be causative [26, 27].…”

Section: Discussionmentioning

confidence: 99%

Markers of arterial health could serve as accurate non-invasive predictors of human biological and chronological age

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Ткачева³

et al. 2017

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The decline in functional capacity is unavoidable consequence of the process of aging. While many anti-aging interventions have been proposed, clinical investigations into anti-aging medicine are limited by lack of reliable techniques for evaluating the rate of ageing. Here we present simple, accurate and cost-efficient techniques for estimation of human biological age, Male and Female Arterial Indices. We started with developing a model which accurately predicts chronological age. Using machine learning, we arrived on a set of four predictors, all of which reflect the functioning of the cardiovascular system. In Arterial Indices models, results of carotid artery duplex scan that show the thickness of the intima media complex and quantitatively describe the degree of stenosis are combined with pulse wave velocity and augmentation index measurements performed by applanation tonometry. In our cohort, the age of men was determined with MAE = 6.91 years (adjusted R-squared = 0.55), and the age of women with MAE = 5.87 years (adjusted R2 = 0.69). The Epsilon-accuracies of age-predicting models were at 86.5% and 80% for women and men, respectively. Substantially higher differences between the predicted age and the calendar age were noted for patients with Type 2 Diabetes Mellitus (T2D) as compared to non-T2D controls, indicating that the model could serve as a good approximation for an elusive biological age. Notably, in females with chronological and biological ages mismatching by 5 or more years, significant increases in in Framingham CVD scores and lower levels of IGF-1 were observed.Proposed Male and Female Arterial Indices derive biological age from the results of functional tests which do not require specialized laboratory equipment and, therefore, could be performed in hospitals and community health clinics.

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