Connectometry evaluation in patients undergoing carotid endarterectomy: an exploratory study

Area of Science:

• Neuroscience
• Neurosurgery
• Medical Imaging

Background:

• Carotid Endarterectomy (CEA) is a surgical procedure to remove plaque from carotid arteries.
• Understanding the neurological effects of CEA, particularly on brain connectivity and cognitive function, is crucial.

Purpose of the Study:

• To investigate changes in local brain connectivity following CEA using connectometry.
• To evaluate the impact of CEA on cognitive performance as measured by the Mini Mental State Examination (MMSE).

Main Methods:

• Prospective study of 17 patients (mean age 74.1 years) eligible for CEA.
• Magnetic Resonance Imaging (MRI) with Diffusion Tensor Imaging (DTI) for connectometry analysis before and 3-6 months after CEA.
• Cognitive evaluation using MMSE before and after CEA, analyzed with T-Student tests.

Main Results:

• MMSE scores significantly improved after CEA.
• Connectometry revealed statistically significant increases in connectivity in the cerebellar hemispheres and corpus callosum for a T-score threshold of 3 (p-FDR = 0.0106667).
• Network analysis showed improved small worldness, clustering coefficient, local and global efficiency, and reduced characteristic path length post-CEA.

Conclusions:

• CEA is associated with improved cognitive performance.
• CEA leads to significant changes in interhemispheric local connectivity within the corpus callosum and cerebellum.
• Connectometry is a valuable tool for assessing brain connectivity changes after surgical interventions like CEA.