Carotid and Vertebral Arterial Variations in Alzheimer's Disease

Abstract

The effects of carotid and vertebral arterial morphological variations on cognitive function impairment remain unclear. We investigated the association between extracranial carotid and vertebral arterial variations and the risk of Alzheimer's disease (AD). A prospective study with a 5-year followup was conducted from July 2008 to June 2013. A total of 1741 subjects (50 years of age and older) were examined for carotid and vertebral arterial variations using computed tomography angiography (CTA) and completed the study follow-up. Variations of the carotid and vertebral arteries were classified as tortuosity, kinking and coiling, according to the Weibel and Fields criteria. Cognitive function was assessed using the Mini-Mental State Examination and the Activities of Daily Living scale. We analyzed the association between arterial variations and the risk of AD by using multivariate Cox proportional-hazards models. The prevalence of carotid arterial variations was 38.4%, and the prevalence of vertebral arterial variations was 86.6%. Among the 1741 subjects who completed the study follow-up, 134 AD cases were detected. The subjects diagnosed with AD displayed greater kinking and coiling in the carotid artery (P<0.01) and vertebral artery (P<0.05) than the subjects without AD. After adjusting for potential confounders, kinking and coiling (hazard ratio [HR]=1.93, 95% confidence interval [CI], 1.37 to 2.86, P<0.01) in the carotid artery were significantly associated with AD. Additionally, after adjusting for potential confounders, kinking and coiling (HR=1.73, 95% CI, 1.25 to 2.31, P<0.01) in the vertebral artery were significantly associated with the risk of AD. We determined that age, hypertension and smoking status were significant predictors of AD in the multivariable models with carotid and vertebral arterial variation. The results of the current study indicate that severe carotid and vertebral arterial variations are associated with a significantly increased risk of AD. Further investigation into the association between these variations and AD would be useful for preventing AD.

<p>Identification of Predictors for Hemorrhagic Transformation in Patients with Acute Ischemic Stroke After Endovascular Therapy Using the Decision Tree Model</p>

“…There are three different types of the aortic arch, which are delineated based on the vertical distance from the innominate artery and the top of the aortic arch. 18 The arterial tortuosity (tortuosity, kinking, and coiling) 19 and atherosclerotic stenosis (> 50%) of the proximal path vessels and contralateral or/and posterior main artery stenosis >50% (contralateral internal carotid artery/M1 artery, basilar artery, and dominant VA) were evaluated by head and neck CTA. The Alberta Stroke Program Early CT Score (ASPECTS) was assessed prospectively for each patient by a neuroradiologist, who was blind to the procedure, using the CT scan.…”

Effect of Carotid Artery Morphological Variations on Cognitive Function

“…There have been few reports on the effects of carotid morphological variations on cognitive function. Zhou et al [ 16 ] conducted follow-up of 1741 patients (over 50 years of age) who had completed CTA examination and diagnosed carotid and vertebral artery morphological changes. Severe carotid and vertebral artery morphological variations increased the incidence of Alzheimer's disease (AD).…”

Variations of transverse foramina in cervical vertebrae: what happens to the vertebral artery?

“…Variations of the vertebral artery are also common findings and they may be asymptomatic or have various clinical manifestations. Vertigo, cervical myelopathy, and ischemic events caused by occlusion and dissection of the artery have been attributed to variations of its course and even Alzheimer's disease seems to be associated with such variations according to recent studies [7][8][9][10][11][12]. The course and the variations of vertebral arteries are also of great importance for spine surgeons.…”