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Improvement of working memory after stenting for cervicocerebral artery stenosis
Zi-Jun He1, Bin Qin, Zhuang Cui
1Department of Neurosurgery, Beijing Hospital, Beijing, China.
Insights
Patients with cervicocerebral artery stenosis show impaired working memory, particularly with carotid stenosis. Endovascular stenting improved memory function by enhancing cerebral blood flow.
Area of Science:
- Neurology
- Vascular Medicine
- Cognitive Science
Background:
- Cervicocerebral artery stenosis is linked to cerebral ischemia.
- Working memory deficits may be associated with reduced cerebral blood flow in these patients.
Purpose of the Study:
- To assess working memory in patients with cervicocerebral artery stenosis.
- To evaluate the impact of endovascular stenting on working memory and cerebral perfusion.
Main Methods:
- 35 patients with cervicocerebral artery stenosis underwent endovascular stenting.
- Working memory was assessed using memory quotient (MQ) scores pre- and post-stenting.
- Regional cerebral blood flow (rCBF) changes were evaluated using SPECT in a subset of patients.
Main Results:
- Patients exhibited lower mean MQ scores, especially with carotid stenosis.
- Stenting significantly increased MQ scores, particularly in those with carotid stenosis.
- Improved rCBF post-stenting correlated with greater MQ score increments.
Conclusions:
- Working memory impairment is prevalent in cervicocerebral artery stenosis, notably with carotid involvement.
- Endovascular stenting may ameliorate working memory deficits by improving cerebral perfusion.
Objective:
To investigate the working memory of patients with cervicocerebral artery stenosis and its change after stenting.
Methods:
35 patients with cervicocerebral artery stenosis (≥50% with related symptoms of cerebral ischemia, or ≥70% with or without related symptoms of cerebral ischemia) underwent endovascular stenting. Working memory of all 35 patients before and within 3 weeks of stenting was evaluated by memory quotient (MQ) scores. Change in regional cerebral blood flow (rCBF) was assessed by single photon emission CT (SPECT) for 13 of the patients. MQ scores were compared according to location and degree of stenosis for all patients, as well as changes in rCBF for the 13 patients.
Results:
Mean MQ scores were significantly lower than normal for patients with carotid artery stenosis alone and for patients with carotid stenosis in addition to vertebrobasilar and/or subclavical stenosis, but not for patients with vertebrobasilar and/or subclavical stenosis. MQ scores were significantly increased after stenting for all patients, especially those with carotid stenosis. There was no significant difference between patients with moderate stenosis and those with severe (>70%) stenosis in MQ increments pre- and post-stenting (p=0.085). Nine of the 13 patients who received SPECT showed an improvement in rCBF after stenting, and their MQ increments were significantly higher than those without an improvement in rCBF (p=0.020).
Conclusions:
Working memory impairment can be observed in patients with cervicocerebral artery stenosis, especially those with carotid stenosis. Endovascular stenting of stenosis might improve the impairment by alleviating cerebral perfusion deficit.
