The Event‐Related P300 Potential Approach to Cognitive Functions of Nondemented Patients with Cerebral and Peripheral Arteriosclerosis

Abstract

As demonstrated by P300 potentials, even nondemented arteriosclerotic patients reveal signs of subtle cognitive dysfunction affecting especially the older cAD patient. In the short-term, carotid endarterectomy presumably improves cognitive functions unspecifically in nondemented patients with a higher initial degree of P300 abnormality.

The Relationship Between Endothelin‐1, Event‐Related P300 Potentials, and Prognosis in Cerebral Arteriosclerosis

“…Furthermore, a group of healthy subjects without any known arteriosclerotic, neurologic, or medical disease served as an age‐matched control group (normal controls; mean age: 59 ± 14 years) for P300 (N = 118; 36 males and 82 females) and ET‐1 data analysis (n = 33; 5 males, 28 females). Although this group is not sex‐matched with the patient groups ( P < .001; Chi‐squared test), this gender difference did neither confound the electrophysiological results, as shown previously, 1 nor the ET‐1 data, as shown below. In this healthy control group, 95 percent of subjects were right‐handed, 5% left‐handed.…”

“…Detailed information on concurrent medication was obtained, and patients taking centrally active substances (e.g., tranquilizers) were not included. Finally, subjects with psychometric evidence for organic brain syndrome were also excluded, as described below 1 . According to these criteria, a total of 188 consecutive patients with either cerebral or peripheral arteriosclerosis, who were referred to the department of vascular surgery for carotid endarterectomy or bypass surgery, was screened, as reported previously 1 .…”

“…Finally, subjects with psychometric evidence for organic brain syndrome were also excluded, as described below 1 . According to these criteria, a total of 188 consecutive patients with either cerebral or peripheral arteriosclerosis, who were referred to the department of vascular surgery for carotid endarterectomy or bypass surgery, was screened, as reported previously 1 . From these, 52 were not included into this study: eleven because of long‐standing insulin‐dependent diabetes mellitus complicated by retinopathy, 10 because of decompensated heart failure, 3 because of Parkinson's disease, 7 because of ophthalmologic diseases, 3 because of previous malignancies, and 18 patients with pAD, who also had significant carotid artery stenosis or a history of major stroke.…”

“…Twenty‐five percent of nondemented patients with carotid stenosis (cAD) have P300 abnormalities that are not related to either the degree of the stenosis or the kind of previous cerebral symptoms 1 . In contrast to theories on multi‐infarct dementia, 2 this neurophysiological evidence for subclinical cognitive dysfunction suggests that factors other than the number or volume of cerebral infarcts may be involved at least in early cognitive dysfunction of these cAD patients.…”

Evoked Potentials in Geriatric Depression

“…The P300 latency was correlated negatively with scores for initiation and perseveration on the Mattis Dementia Rating Scale (R À0X688; p`0X01). It is conceivable that cerebrovascular disease which is associated with increased P300 latency and decreased P300 amplitude (Kugler et al, 1995) contributes to the slowing in cognitive performance and the de®cits in initiation and perseveration noted in our sample of depressed patients. Executive functions that regulate neuropsychological performance are believed to be controlled by a neural network involving fronto-parietal systems and thalamo-palliadal circuits.…”