Psychometric and EEG changes after carotid endarterectomy

Area of Science:

• Neurology
• Neurosurgery
• Cognitive Science

Background:

• Carotid stenosis significantly impacts brain function, but the effects of surgical intervention remain unclear.
• Pre-operative cognitive deficits are present in a notable portion of patients with severe carotid stenosis.

Purpose of the Study:

• To evaluate the impact of carotid endarterectomy (CEA) on cognitive performance and electroencephalogram (EEG) patterns.
• To compare outcomes between patients with unilateral and bilateral severe carotid stenosis.

Main Methods:

• Sixty-nine non-demented patients with severe carotid stenosis (≥70%) underwent CEA.
• Psychometric tests (Trail Making Test A, Symbol Digit Test) and spectral EEG analysis were performed pre- and post-surgery (5 months).
• Patients were categorized into unilateral (Group A) and bilateral (Group B) stenosis groups.

Main Results:

• Baseline, Group B patients exhibited slower performance on the Trail Making Test A compared to Group A.
• Post-CEA, significant improvements in psychometric test scores were observed across all patients.
• EEG mean dominant frequency improved in Group B patients, correlating with cognitive improvements (r=0.43, p=0.05).

Conclusions:

• Carotid endarterectomy enhances cognitive performance in patients with severe carotid stenosis.
• Patients with bilateral stenosis may experience accelerated EEG frequency post-CEA, linked to cognitive benefits.
• Approximately one-third of non-demented patients with severe carotid stenosis exhibit detectable cognitive impairments.