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Cognitive function dynamics in patients with comorbidity after carotid revascularization

https://doi.org/10.14412/2074-2711-0-0-

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Abstract

The preventive effect of carotid revascularization in cerebrovascular pathology (CVP) is widely known. Nevertheless, certain aspects of post-surgery prognosis in such patients with comorbidity (especially, diabetes mellitus) are insufficiently addressed.

Aim: to study the effect of diabetes mellitus type 2 (DM2) on cognitive function after carotid revascularization.

Materials and methods: 99 patients with chronic CVP underwent carotid angioplasty with stenting (CAS): group 1 (n=51, median age 64,5 years) without DM2, group 2 (n=48, median age 64 years) with DM2. All patients had a follow-up clinical, neurological and neuropsychological assessment, blood analyses, carotid ultrasound, brain MRI. During CAS the transcranial monitoring of the blood flow in the middle cerebral artery was performed.

Results: The baseline prevalence of cognitive dysfunction were roughly the same in both groups (75%), but they were more marked in patients with DM2. Follow-up assessment identified a small positive trend in group 1 patients, while in patients with DM2 a decline in cognitive function was observed. In patients with DM2 an increase in abstract reasoning was observed only 2 months after CAS.

After CAS ipsilateral acute cerebral ischemic lesions have been identified (via MRI) in 11 (22%) patients of group 1 and in 24 (50%) patients with DM2. The analysis found a correlation between cognitive dysfunction and new cerebral ischemic lesions (MRI data).

Conclusion: The association of CVP with DM2 leads to a decrease in cognitive function. Carotid revascularization (CAS) may lead to acute cerebral ischemic lesions (including “silent”), which may cause to transient cognitive dysfunction.

Carotid angioreconstruction in patients with DM2 needs to make optimal prognoses and assess possible neuroprotective treatment arises.

About the Authors

M. M. Tanashyan
Research Centre of Neurology, Moscow
Russian Federation

Corresponding Member of RAS, Professor, Deputy Director for Science, Head of 1st Neurological Department,

Moscow



K. V. Antonova
Research Centre of Neurology
Russian Federation

PhD, Senior Researcher, Scientific Advisory Department,

Moscow



O. V. Lagoda
Research Centre of Neurology
Russian Federation

PhD, Senior Researcher, 1st Neurological Department,

Moscow



E. S. Berdnikovitch
Research Centre of Neurology
Russian Federation

PhD, head of psyhology and logopedia group, 

Moscow



R. B. Medvedev
Research Centre of Neurology
Russian Federation

MD, PhD; Researcher, 1st Neurological Department,

Moscow



I. I. Titkova
Research Centre of Neurology
Russian Federation

psyhologist,

Moscow



A. V. Naminov
Research Centre of Neurology
Russian Federation

post-graduate RCN,

Moscow



A. V. Annushkin
Research Centre of Neurology
Russian Federation

post-graduate RCN,

Moscow



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For citation:


Tanashyan M.M., Antonova K.V., Lagoda O.V., Berdnikovitch E.S., Medvedev R.B., Titkova I.I., Naminov A.V., Annushkin A.V. Cognitive function dynamics in patients with comorbidity after carotid revascularization. Neurology, Neuropsychiatry, Psychosomatics. 0;. (In Russ.) https://doi.org/10.14412/2074-2711-0-0-

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ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)