This preprint is under consideration at Brain Imaging and Behavior. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
Research Article
Craig Weinkauf
University of Arizona
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
A growing body data indicates that extracranial carotid artery disease can contribute to cognitive impairment. However, there have been mixed reports regarding the benefit of carotid endarterectomy (CEA) as it relates to preserving cognitive function. In this work, diffusion magnetic resonance imaging (dMRI) is used to provide insight into structural brain changes that occur because of significant carotid artery stenosis, as well as changes that occur in response to CEA. The study design was a prospective, non-randomized, controlled study that enrolled patients with asymptomatic carotid stenosis. Fourteen subjects had severe ECAD ≥70% stenosis in at least one carotid artery and were scheduled to undergo surgery). Thirteen had ECAD with <70% stenosis or occluded, therefore not requiring surgery. All subjects underwent neurocognitive testing using the Montreal Cognitive Assessment test and high angular resolution, multi-shell diffusion magnetic resonance imaging (dMRI) of the brain at baseline and at four-six months follow-up. Changes in MoCA scores as well as in Fractional anisotropy along the hippocampus were compared at baseline and follow-up. At baseline, fractional anisotropy (FA) was significantly lower along the ipsilateral hippocampus in subjects with severe ECAD compared to subjects without severe ECAD. MoCA scores were lower in these individuals but this did not reach statistical significance. At follow-up, MoCA scores increased significantly in subjects who underwent CEA and remained statistically equal in control subjects that did not have CEA. FA remained unchanged in the CEA group, and decreased in the control group. This study suggests that CEA improves cognition and preserves hippocampal white matter structure compared to control subjects not undergoing CEA.
Keywords
Carotid Artery Atherosclerosis, Diffusion Magnetic Resonance Imaging, Fractional Anisotropy, Neurocognitive Assessment
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
This is a list of supplementary files associated with this preprint. Click to download.
Loading...
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 11 Feb, 2021
No community comments so far
Editorial decision: Major Revisions Needed
On 18 Oct, 2021
Reviews received
Received 24 Mar, 2021
Reviewers invited
Invitations sent on 07 Feb, 2021
Editor assigned
On 30 Jan, 2021
First submitted
On 29 Jan, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Surgery
Learn more about our company.
A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
This preprint is under consideration at Brain Imaging and Behavior. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Craig Weinkauf
University of Arizona
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 11 Feb, 2021
No community comments so far
Editorial decision: Major Revisions Needed
On 18 Oct, 2021
Reviews received
Received 24 Mar, 2021
Reviewers invited
Invitations sent on 07 Feb, 2021
Editor assigned
On 30 Jan, 2021
First submitted
On 29 Jan, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Surgery
License:
This work is licensed under a CC BY 4.0 License. Read Full License
A growing body data indicates that extracranial carotid artery disease can contribute to cognitive impairment. However, there have been mixed reports regarding the benefit of carotid endarterectomy (CEA) as it relates to preserving cognitive function. In this work, diffusion magnetic resonance imaging (dMRI) is used to provide insight into structural brain changes that occur because of significant carotid artery stenosis, as well as changes that occur in response to CEA. The study design was a prospective, non-randomized, controlled study that enrolled patients with asymptomatic carotid stenosis. Fourteen subjects had severe ECAD ≥70% stenosis in at least one carotid artery and were scheduled to undergo surgery). Thirteen had ECAD with <70% stenosis or occluded, therefore not requiring surgery. All subjects underwent neurocognitive testing using the Montreal Cognitive Assessment test and high angular resolution, multi-shell diffusion magnetic resonance imaging (dMRI) of the brain at baseline and at four-six months follow-up. Changes in MoCA scores as well as in Fractional anisotropy along the hippocampus were compared at baseline and follow-up. At baseline, fractional anisotropy (FA) was significantly lower along the ipsilateral hippocampus in subjects with severe ECAD compared to subjects without severe ECAD. MoCA scores were lower in these individuals but this did not reach statistical significance. At follow-up, MoCA scores increased significantly in subjects who underwent CEA and remained statistically equal in control subjects that did not have CEA. FA remained unchanged in the CEA group, and decreased in the control group. This study suggests that CEA improves cognition and preserves hippocampal white matter structure compared to control subjects not undergoing CEA.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
This is a list of supplementary files associated with this preprint. Click to download.
Loading...