ABSTRACT
Objective:
To analyze the correlation between
cognitive impairment and cortical
atrophy in
elderly patients with asymptomatic
carotid artery stenosis (ACAS).
Methods:
In this
cross-sectional study, 40 consecutive
elderly patients with ACAS treated in the Department of
Neurology, Northern Jiangsu People′s
Hospital from July 1, 2020 to June 30, 2021 (ACAS group), and 40
elderly healthy controls
who accepted
physical examination during the same period (
control group) were included. Cognitive assessment was performed using the Mental
State Examination Scale (MMSE) and the Montreal Cognitive Assessment Scale (MoCA), and
brain magnetic resonance imaging scanning was performed in the ACAS group. The
artificial intelligence technique was applied for
brain lobe segmentation and cortical volume calculation. The χ2-test, independent sample t-test and Wilcoxon non-parametric test were used to analyze the difference of clinical data and cognitive scores between the two groups. In the ACAS group, the cortical volumes of the side with
carotid stenosis was compared with that of the normal side, and Spearman′s correlation
analysis was used to assess the correlation between cognitive scores and cortical
atrophy.
Results:
Compared with the
control group, the ACAS group got significantly lower scores of MMSE and MoCA, as well as lower scores of visuospatial
executive function,
attention and calculation,
language function, abstraction
ability and delayed recall [(25.60±2.49) vs (27.18±1.01), (22.05±3.59) vs (25.60±1.43), (2.73±1.04) vs (4.08±0.62), (4.53±0.93) vs (5.03±0.66), 2.00 (0.00) vs 3.00 (0.00), 1.00 (1.00) vs 2.00 (0.00), and (2.95±0.96) vs (3.35±0.62)] (all P<0.05). There was not significant differences in naming and
orientation ability between the two groups (both P>0.05). The volume of cortical,
temporal lobe,
frontal lobe,
parietal lobe and insular lobe on the side with
carotid stenosis in the ACAS group were significantly smaller than those on the normal side [186.23 (177.97, 202.53) vs 194.67 (185.65, 204.82) cm 3, 54.74 (50.66, 56.95) vs 55.61 (51.24, 58.49) cm 3, 72.98 (70.76, 78.34) vs 75.27 (72.34, 80.66) cm 3, 53.66 (51.11, 57.86) vs 56.59 (52.80, 60.09) cm 3, 6.57 (6.35, 7.07) vs 6.72 (6.46, 7.34) cm 3] (all P<0.05). The MoCA score in the ACAS group was positively related to the cortical volume ratio of the two sides ( r=0.427, P<0.01). The
attention ( r=0.353) and abstraction ( r=0.226)
ability scores were positively correlated with the
temporal lobe volume ratios of the two sides (both P<0.05). The visuospatial
executive ( r=0.187) and
language ( r=0.373)
ability scores were positively correlated with
frontal lobe volume ratios of the two sides (both P<0.05), and visuospatial
executive ( r=0.386), naming ( r=0.344),
language ( r=0.517), abstraction ( r=0.335) and delayed recall ( r=0.333)
ability scores were positively correlated with
parietal lobe volume ratios of the two sides (all P<0.05).
Conclusion:
In
elderly patients with ACAS, the
cognitive impairment and cortical
atrophy on the sides with
carotid stenosis are significant and a positive correlation is detected between them.