Functional MR Imaging in Patients with Carotid Artery Stenosis before and after Revascularization

Schaaf, M.; Mommertz, G.; Ludolph, A.; Geibprasert, Sasikhan; Mühlenbruch, Georg; Das, Manas; Krings, Timo

doi:10.3174/ajnr.a2219

Cited by 21 publications

(16 citation statements)

References 32 publications

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“…38,39 The cellular components of the observed FA or Fc increases are still unknown. They can be attributed to increased vasodilation and blood flow, improved neurovascular reactivity, 40 neural plasticity, 41 and/or remyelination 42 as suggested by MR spectroscopic studies.…”

Section: Discussionmentioning

confidence: 99%

Intervention versus Aggressive Medical Therapy for Cognition in Severe Asymptomatic Carotid Stenosis

Lin

Chang²,

Chou

et al. 2016

AJNR Am J Neuroradiol

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Section: Discussionmentioning

confidence: 99%

Intervention versus Aggressive Medical Therapy for Cognition in Severe Asymptomatic Carotid Stenosis

Lin

Chang²,

Chou

et al. 2016

AJNR Am J Neuroradiol

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“…Nevertheless, the neuropsychological measures and most disrupted FC did not change obviously after statistical adjustments. The strengthened FC neighbor to some disrupted areas at 3 months after CAS may be attributable to restored perfusion and vasomotor reactivity, 20 enhanced axonal transport, and/or functional plasticity of already existing pathways. A study with a larger population and longer observation is needed to determine whether cognitive impairment can be enhanced after CAS and whether the increased brain connectivity may correlate with cognitive improvement.…”

Section: Discussionmentioning

confidence: 99%

“…19 Nevertheless, it has not been studied whether complementary DTI and fcMRI may detect microstructural and functional alteration of neural networks in severe asymptomatic carotid stenosis and after carotid revascularization. 20 In this work, we investigated neuropsychological performance, DTI, and fcMRI in 17 consecutive patients with severe asymptomatic carotid stenosis and compared them with 26 healthy subjects. To our knowledge, this is the first study to demonstrate the disconnections of structural and functional connectivity in correlation with cognitive impairments in patients with severe asymptomatic carotid stenosis.…”

mentioning

confidence: 99%

Impairments in Cognitive Function and Brain Connectivity in Severe Asymptomatic Carotid Stenosis

Cheng

Lin

Soong

et al. 2012

Stroke

106

118

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Background and Purpose-Severe asymptomatic carotid stenosis has been associated with cognitive impairment, but it is unknown whether this association is attributable to effects on brain connectivity. We present cognitive network abnormalities in a group of patients at a presymptomatic stage. Methods-Seventeen patients with Ն70% asymptomatic stenosis of unilateral internal carotid artery were compared with 26 healthy controls utilizing a comprehensive neuropsychological battery, the dizziness handicap inventory, and multimodality neuroimaging including diffusion tensor imaging and resting-state functional connectivity magnetic resonance imaging. Longitudinally, assessments were completed in a subgroup of 10 patients at 3 months after carotid artery stenting. Results-Compared with the healthy controls, the patients had worse dizziness scores, poorer memory, complex visuo-spatial performances, and lower whole-brain mean fractional anisotropy. The Scheltens scores of leukoaraiosis/ infarction were not different between groups. Their seed-based functional connectivity magnetic resonance imaging showed marked decrements of interhemispheric and intrahemispheric, ipsilaterally to carotid stenosis, functional connectivity in the frontoparietal network. In the default mode network, the intrahemispheric functional connectivity was bilaterally impaired. Importantly, the disrupted mean fractional anisotropy in the patients significantly correlated with the attention and verbal memory functions. After successful carotid artery stenting, small but measurable increments of the mean fractional anisotropy and little functional connectivity in the default mode network ipsilateral-to-carotid artery stenting were noted. Conclusions-We identified for the first time distinct patterns of network disruption that correlate with cognitive fragility in patients with asymptomatic carotid stenosis. Brain connectivity may provide early and useful biomarkers for brain ischemia and reperfusion. (Stroke. 2012;43:2567-2573.)Key Words: asymptomatic carotid stenosis Ⅲ cognitive impairment Ⅲ diffusion tensor imaging Ⅲ endovascular treatment Ⅲ functional connectivity magnetic resonance imaging Ⅲ resting state Ⅲ stent A symptomatic stenosis of the internal carotid artery (ICA) is described as significant atherosclerosis without stroke or transient ischemic attack in the brain or eyes. 1 Retrospective studies comparing asymptomatic subjects with and without ultrasound-assessed carotid stenosis have shown that subjects with carotid stenosis had significantly poorer performance in tests of attention, psychomotor speed, and memory. [2][3][4] Moreover, severe ICA stenosis (Ն50%) has been associated with a higher prevalence of silent cerebral infarcts and white matter hyperintensities, 3 indicating that "asymptomatic" carotid stenosis may not be truly asymptomatic. To understand the pathological changes after chronic cerebral hypoperfusion, experimental models of vascular cognitive impairment have been induced by bilateral 5 or unilateral 6 common carotid a...

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“…Previous studies suggested that the delayed and reduced magnitude of the BOLD response might indicate the severity of compromised hemodynamics in patients with cerebral ischemic diseases. [18,19] A most recent report observed BOLD responses to specific stimulation in patients with MMD before and after revascularization, and found a predicator for postoperative outcomes, suggesting the feasibility of using BOLD-fMRI for individualized assessment of cerebral hemodynamic impairment and hemodynamic improvement after revascularization in patients with MMD. [20] ASL is another promising technology for cerebral hemodynamics assessment in perioperative management of MMD.…”

Section: Discussionmentioning

confidence: 99%

Cerebral ischemia at early postoperative period of direct revascularization for moyamoya disease: a case report and literature review

Chen¹,

Ma²,

Chen³

et al. 2017

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Hypoperfusion and hyperperfusion could be causes of early postoperative complications that lead to neurological deterioration in patients with moyamoya diseases (MMD) after superficial temporal artery (STA) and middle cerebral artery (MCA) anastomosis. Here, the authors described a case of child-onset bilateral MMD that manifested transient cerebral ischemia in the contralateral hemisphere after left STA-MCA bypass in young adulthood. A new onset of cerebral ischemia in the contralateral hemisphere and transient neurological deterioration suggested the fragile hemodynamics of MMD during early perioperative period. Serial evaluation of postoperative cerebral hemodynamics and perfusion might facilitate targeted management in patients with unstable or advanced MMD. Topic: StrokeThis is an open access article distributed under the terms of the Creative Commons AttributionNonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

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Functional MR Imaging in Patients with Carotid Artery Stenosis before and after Revascularization

Cited by 21 publications

References 32 publications

Intervention versus Aggressive Medical Therapy for Cognition in Severe Asymptomatic Carotid Stenosis

Intervention versus Aggressive Medical Therapy for Cognition in Severe Asymptomatic Carotid Stenosis

Impairments in Cognitive Function and Brain Connectivity in Severe Asymptomatic Carotid Stenosis

Cerebral ischemia at early postoperative period of direct revascularization for moyamoya disease: a case report and literature review

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