scholarly journals Cognitive Performance following Carotid Endarterectomy or Stenting in Asymptomatic Patients with Severe ICA Stenosis

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Livio Picchetto ◽  
Gianfranco Spalletta ◽  
Barbara Casolla ◽  
Claudia Cacciari ◽  
Michele Cavallari ◽  
...  
Keyword(s):  
Carotid Stenosis ◽  
Cognitive Functions ◽  
Verbal Fluency ◽  
Stroke Risk ◽  
Brain Functions ◽  
Immediate Recall ◽  
Asymptomatic Patients ◽  
Before And After ◽  
Overall Performance ◽  
Ica Stenosis

Background. Endarterectomy (CEA) or stenting (CAS) of a stenotic carotid artery is currently undertaken to reduce stroke risk. In addition removal of the arterial narrowing has been hypothesized to improve cerebral hemodynamics and provide benefits in cognitive functions, by supposedly resolving a “hypoperfusion” condition. Methods. In this study we sought to test whether resolution of a carotid stenosis is followed by measurable changes in cognitive functions in 22 subjects with “asymptomatic” stenosis. Results. A main finding of the study was the statistically significant pre-post difference observed in the performance of phonological verbal fluency and Rey’s 15-word immediate recall. Remarkably, there was a significant interaction between phonological verbal fluency performance and side of the carotid intervention, as the improvement in the verbal performance, a typical “lateralized” skill, was associated with resolution of the left carotid stenosis. Conclusion. The results reflect a substantial equivalence of the overall performance at the before- and after- CEA or CAS tests. In two domains, however, the postintervention performance resulted improved. The findings support the hypothesis that recanalization of a stenotic carotid could improve brain functions by resolving hypothetical “hypoperfusion” states, associated with the narrowing of the vessels.

NCCTG N0574 (Alliance): A phase III randomized trial of whole brain radiation therapy (WBRT) in addition to radiosurgery (SRS) in patients with 1 to 3 brain metastases.

2015 ◽  
Vol 33 (18_suppl) ◽  
pp. LBA4-LBA4 ◽  
Author(s):  
Paul D. Brown ◽  
Anthony L. Asher ◽  
Karla V. Ballman ◽  
Elana Farace ◽  
Jane H Cerhan ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Brain Metastases ◽  
Verbal Fluency ◽  
Cognitive Testing ◽  
Phase Iii ◽  
Tumor Control ◽  
Close Monitoring ◽  
Immediate Recall ◽  
Whole Brain Radiation ◽  
Before And After

LBA4 Background: WBRT significantly improves tumor control in the brain after SRS, yet the role of adjuvant WBRT remains undefined due to concerns regarding neurocognitive risks. Methods: Patients with 1-3 brain metastases, each < 3 cm by contrast MRI, were randomized to SRS alone or SRS + WBRT and underwent cognitive testing before and after treatment. The primary endpoint was cognitive progression (CP) defined as decline > 1 SD from baseline in any of the 6 cognitive tests at 3 months. Time to CP was estimated using cumulative incidence adjusting for survival as a competing risk. Results: 213 patients were enrolled with 2 ineligible and 3 cancels prior to receiving treatment. Baseline characteristics were well-balanced between study arms. The median age was 60 and lung primary the most common (68%). CP at 3 months was more frequent after WBRT + SRS vs. SRS alone (88.0% vs. 61.9% respectively, p = 0.002). There was more deterioration in the WBRT + SRS arm in immediate recall (31% vs. 8%, p = 0.007), delayed recall (51% vs. 20%, p = 0.002), and verbal fluency (19% vs. 2%, p = 0.02). Intracranial tumor control at 6 and 12 months were 66.1% and 50.5% with SRS alone vs. 88.3% and 84.9% with SRS+WBRT (p < 0.001). Median OS was 10.7 for SRS alone vs. 7.5 months for SRS+WBRT respectively (HR = 1.02, p = 0.93). Conclusions: Decline in cognitive function, specifically immediate recall, memory and verbal fluency, was more frequent with the addition of WBRT to SRS. Adjuvant WBRT did not improve OS despite better brain control. Initial treatment with SRS and close monitoring is recommended to better preserve cognitive function in patients with newly diagnosed brain metastases that are amenable to SRS. Clinical trial information: NCT00377156.

A comparative study of the effect of stress on the cognitive parameters in women with increased body mass index before and after menopause

2018 ◽  
Vol 29 (5) ◽  
pp. 469-471 ◽  
Author(s):  
M.B. Ramesh ◽  
S. Ammu ◽  
A.K. Nayanatara ◽  
N.A. Vinodini ◽  
K.C. Pratik ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Cognitive Functions ◽  
Overweight And Obesity ◽  
The Body ◽  
Relaxation Techniques ◽  
Stress Scale ◽  
Brain Functions ◽  
Wide Range ◽  
Before And After

Abstract Background The increasing prevalence of overweight and obesity is a critical public health problem for women. The negative effect of stress on memory and cognitive functions has been widely explored for decades in numerous research projects using a wide range of methodology. Deterioration of memory and other brain functions is a hallmark of Alzheimer’s disease. Estrogen fluctuations and withdrawal have myriad direct effects on the central nervous system that have the potential to influence cognitive functions. The present study aims to compare the effect of stress on the cognitive functions in overweight/obese women before and after menopause. Methods A total of 142 female subjects constituting women before menopause between the ages of 18 and 44 years and women after menopause between the ages of 45 and 60 years were included in the sample. Participants were categorized into overweight/obese groups based on the body mass index. The major tool perceived stress scale was used for measuring the perception of stress. On the basis of the stress scale measurement, each group was classified into with stress and without stress. Addenbrooke’s Cognitive Examination-III was used for measuring the cognitive functions. Results Premenopausal women with stress showed a significant (p<0.05) decrease in the cognitive parameters such as attention and orientation, fluency, language and visuospatial ability. Memory did not show any significant changes in this group. Whereas, in the postmenopausal stressed women, all the cognitive functions except fluency showed a significant (p<0.05) decrease. Conclusions Stress is a significant factor on the cognitive functions of obese and overweight women before and after menopause. Practice of yoga and encouragement in activities like gardening, embroidery, games and relaxation techniques should be recommended to prevent stress. Insights into the neurobiology before and after menopause can be gained from future studies examining the effect on the hypothalamic-pituitary-adrenal axis in relation to cognition and stress.

Effect of Image Normalization on Carotid Plaque Classification and the Risk of Ipsilateral Hemispheric Ischemic Events: Results from the Asymptomatic Carotid Stenosis and Risk of Stroke Study

Vascular ◽  
2005 ◽  
Vol 13 (4) ◽  
pp. 211-221 ◽  
Author(s):  
Andrew N. Nicolaides ◽  
Stavros K. Kakkos ◽  
Maura Griffin ◽  
Michael Sabetai ◽  
Surinder Dhanjil ◽  
...  
Keyword(s):  
Carotid Stenosis ◽  
Internal Carotid Artery Stenosis ◽  
Stroke Rate ◽  
Asymptomatic Carotid Stenosis ◽  
Asymptomatic Carotid ◽  
Image Normalization ◽  
Symptomatic Carotid ◽  
Asymptomatic Patients ◽  
Before And After ◽  
Plaque Classification

The aim of this study was to determine the effect of image normalization on plaque classification and the risk of ipsilateral ischemic neurologic events in patients with asymptomatic carotid stenosis. The first 1,115 patients recruited to the Asymptomatic Carotid Stenosis and Risk of Stroke (ACSRS) study with a follow-up of 6 to 84 months (mean 37.1 months) were included in this study. Duplex ultrasonography was used for grading the degree of internal carotid artery stenosis and for plaque characterization (types 1–5), which was performed before and after image normalization. One hundred sixteen ipsilateral ischemic hemispheric events occurred. Image normalization resulted in 60% of plaques being reclassified. Before image normalization, a high event rate was associated with all types of plaque. After image normalization, 109 (94%) of the events occurred in patients with plaque types 1 to 3. For patients with European Carotid Stenosis Trial (ECST) 70 to 99% diameter stenosis (equivalent to North American Symptomatic Carotid Endarterectomy Trial [NASCET] 50–99%) with plaque types 1 to 3, the cumulative stroke rate was 14% at 7 years (2% per year), and for patients with plaque types 4 and 5, the cumulative stroke rate was 0.9% at 7 years (0.14% per year). The results suggest that asymptomatic patients with plaque types 4 and 5 classified as such after image normalization are at low risk irrespective of the degree of stenosis.

scholarly journals Meta-Analysis of the Relationship between Deep Brain Stimulation in Patients with Parkinson’s Disease and Performance in Evaluation Tests for Executive Brain Functions

2017 ◽  
Vol 2017 ◽  
pp. 1-16 ◽  
Author(s):  
A. M. Martínez-Martínez ◽  
O. M. Aguilar ◽  
C. A. Acevedo-Triana
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Verbal Fluency ◽  
Meta Analysis ◽  
Brain Functions ◽  
Before And After ◽  
And Performance ◽  
Deep Brain

Parkinson’s disease (PD) is a neurodegenerative condition, which compromises the motor functions and causes the alteration of some executive brain functions. The presence of changes in cognitive symptoms in PD could be due to the procedure of deep brain stimulation (DBS). We searched in several databases for studies that compared performance in executive function tests before and after the DBS procedure in PE and then performed a meta-analysis. After the initial search, there were 15 articles that specifically evaluated the functions of verbal fluency, working memory, cognitive flexibility, abstract thinking, and inhibition. It was found that there were differences in the evaluation of the cognitive functions in terms of the protocols, which generated heterogeneity in the results of the meta-analysis. Likewise, a tendency to diminish functions like verbal fluency and inhibition was found, being this consistent with similar studies. In the other functions evaluated, no difference was found between pre- and postsurgery scores. Monitoring of this type of function is recommended after the procedure.

Carotid Stenosis Boosts Poststent Stroke Risk

2005 ◽  
Vol 38 (16) ◽  
pp. 23
Author(s):  
MITCHEL L. ZOLER
Keyword(s):  
Carotid Stenosis ◽  
Stroke Risk

scholarly journals Electroconvulsive Therapy and Age: Effectiveness, Safety and Tolerability in the Treatment of Major Depression among Patients under and over 65 Years of Age

2021 ◽  
Vol 14 (6) ◽  
pp. 582
Author(s):  
Monika Dominiak ◽  
Anna Z. Antosik-Wójcińska ◽  
Marcin Wojnar ◽  
Paweł Mierzejewski
Keyword(s):  
Major Depression ◽  
Autobiographical Memory ◽  
Electroconvulsive Therapy ◽  
Cognitive Functions ◽  
Rating Scale ◽  
Short Form ◽  
Serious Adverse Events ◽  
Before And After ◽  
Trail Making ◽  
Resistant Depression

Electroconvulsive therapy (ECT) remains the most effective therapy in treatment-resistant depression. However, the safety of ECT has been consistently questioned, particularly among elderly patients. We assessed the efficacy and safety of ECT in patients before and after 65 years old. The study was conducted between 2015 and 2018 and included 91 patients (61 under and 29 over 65 years old) with major depression undergoing ECT. The Hamilton Depression Rating Scale was used to evaluate efficacy. Cognitive functions were assessed using: MMSE, RAVLT, Trail Making Test, Stroop Test and Autobiographical Memory Interview-Short Form. ECT was more effective in older patients as compared to younger (p < 0.001). No serious adverse events were observed in either group. Increased blood pressure and arrhythmias were more common in the older compared to the younger group (p = 0.044 and p = 0.047, respectively), while disturbances of consciousness did not differ between groups (p = 0.820). Most of the cognitive functions remained unchanged compared to baseline, whereas the outcomes of MMSE, RAVLT and Stroop tests showed greater improvements in the older compared to the younger group (all p < 0.05). The decline in the retrieval consistency of autobiographical memory was more pronounced in the younger group (p = 0.024). ECT is a highly effective, safe and well-tolerated method of treating depression regardless of age.

Sign in / Sign up

Export Citation Format

Share Document