Age-dependent effects of carotid endarterectomy or stenting on cognitive performance
Although evidence is accumulating that age modifies the risk of carotid angioplasty and stenting (CAS) versus endarterectomy (CEA) for patients with significant carotid stenosis, the impact of age on cognition after either CEA or CAS remains unclear. In this study, we analyzed the effects of age on...
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| Veröffentlicht in: | Journal of neurology 2012-11, Vol.259 (11), p.2309-2318 |
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| creator | Wasser, Katrin Hildebrandt, Helmut Gröschel, Sonja Stojanovic, Tomislav Schmidt, Holger Gröschel, Klaus Pilgram-Pastor, Sara M. Knauth, Michael Kastrup, Andreas |
| description | Although evidence is accumulating that age modifies the risk of carotid angioplasty and stenting (CAS) versus endarterectomy (CEA) for patients with significant carotid stenosis, the impact of age on cognition after either CEA or CAS remains unclear. In this study, we analyzed the effects of age on cognitive performance after either CEA or CAS using a comprehensive neuropsychological test battery with parallel test forms and a control group to exclude a learning effect. The neuropsychological outcomes after revascularization were determined in 19 CAS and 27 CEA patients with severe carotid stenosis. The patients were subdivided according to their median age ( |
| doi_str_mv | 10.1007/s00415-012-6491-9 |
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p
= 0.001). Notably, this cognitive deterioration persisted in patients after CEA, whereas it was only transient in patients treated with CAS. These results demonstrate an age-dependent effect of CEA and CAS on cognitive functions. In contrast to the recently observed increased clinical complication rates in older subjects after CAS compared with CEA, CEA appears to be associated with a greater, persistent decline in cognitive performance than CAS in this subgroup of patients.</description><identifier>ISSN: 0340-5354</identifier><identifier>EISSN: 1432-1459</identifier><identifier>DOI: 10.1007/s00415-012-6491-9</identifier><identifier>PMID: 22527231</identifier><identifier>CODEN: JNRYA9</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Age ; Age Factors ; Aged ; Angioplasty ; Angioplasty, Balloon - adverse effects ; Angioplasty, Balloon - psychology ; Asymptomatic ; Biological and medical sciences ; Carcinoembryonic antigen ; Carotid arteries ; Carotid Stenosis - epidemiology ; Carotid Stenosis - psychology ; Carotid Stenosis - surgery ; Cognition & reasoning ; Cognition Disorders - epidemiology ; Cognition Disorders - psychology ; Cognitive ability ; Endarterectomy, Carotid - adverse effects ; Endarterectomy, Carotid - psychology ; Female ; Humans ; Ischemia ; Learning ; Magnetic resonance imaging ; Male ; Medical sciences ; Medicine ; Medicine & Public Health ; Middle Aged ; Neurology ; Neuropharmacology ; Neuroprotective agent ; Neuropsychological Tests ; Neuropsychology ; Neuroradiology ; Neurosciences ; Original Communication ; Pharmacology. Drug treatments ; Retrospective Studies ; Stenosis ; Stents - adverse effects ; Treatment Outcome ; Ultrasonic imaging ; Veins & arteries</subject><ispartof>Journal of neurology, 2012-11, Vol.259 (11), p.2309-2318</ispartof><rights>The Author(s) 2012</rights><rights>2015 INIST-CNRS</rights><rights>Springer-Verlag Berlin Heidelberg 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c533t-3e39aa91610b501128e501048049a62f336bfe7cfd72dca3df473e6cde66c5893</citedby><cites>FETCH-LOGICAL-c533t-3e39aa91610b501128e501048049a62f336bfe7cfd72dca3df473e6cde66c5893</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00415-012-6491-9$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00415-012-6491-9$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26625841$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22527231$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wasser, Katrin</creatorcontrib><creatorcontrib>Hildebrandt, Helmut</creatorcontrib><creatorcontrib>Gröschel, Sonja</creatorcontrib><creatorcontrib>Stojanovic, Tomislav</creatorcontrib><creatorcontrib>Schmidt, Holger</creatorcontrib><creatorcontrib>Gröschel, Klaus</creatorcontrib><creatorcontrib>Pilgram-Pastor, Sara M.</creatorcontrib><creatorcontrib>Knauth, Michael</creatorcontrib><creatorcontrib>Kastrup, Andreas</creatorcontrib><title>Age-dependent effects of carotid endarterectomy or stenting on cognitive performance</title><title>Journal of neurology</title><addtitle>J Neurol</addtitle><addtitle>J Neurol</addtitle><description>Although evidence is accumulating that age modifies the risk of carotid angioplasty and stenting (CAS) versus endarterectomy (CEA) for patients with significant carotid stenosis, the impact of age on cognition after either CEA or CAS remains unclear. In this study, we analyzed the effects of age on cognitive performance after either CEA or CAS using a comprehensive neuropsychological test battery with parallel test forms and a control group to exclude a learning effect. The neuropsychological outcomes after revascularization were determined in 19 CAS and 27 CEA patients with severe carotid stenosis. The patients were subdivided according to their median age (<68 years and ≥68 years); 27 healthy subjects served as a control group. In all patients clinical examinations, MRI scans and a neuropsychological test battery that assessed four major cognitive domains were performed immediately before, within 72 h, and 3 months after CEA or CAS. While patients <68 years of age showed no significant cognitive alteration after either CEA or CAS, a significant cognitive decline was observed in patients ≥68 years in both treatment groups (
p
= 0.001). Notably, this cognitive deterioration persisted in patients after CEA, whereas it was only transient in patients treated with CAS. These results demonstrate an age-dependent effect of CEA and CAS on cognitive functions. In contrast to the recently observed increased clinical complication rates in older subjects after CAS compared with CEA, CEA appears to be associated with a greater, persistent decline in cognitive performance than CAS in this subgroup of patients.</description><subject>Age</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Angioplasty</subject><subject>Angioplasty, Balloon - adverse effects</subject><subject>Angioplasty, Balloon - psychology</subject><subject>Asymptomatic</subject><subject>Biological and medical sciences</subject><subject>Carcinoembryonic antigen</subject><subject>Carotid arteries</subject><subject>Carotid Stenosis - epidemiology</subject><subject>Carotid Stenosis - psychology</subject><subject>Carotid Stenosis - surgery</subject><subject>Cognition & reasoning</subject><subject>Cognition Disorders - epidemiology</subject><subject>Cognition Disorders - psychology</subject><subject>Cognitive ability</subject><subject>Endarterectomy, Carotid - adverse effects</subject><subject>Endarterectomy, Carotid - psychology</subject><subject>Female</subject><subject>Humans</subject><subject>Ischemia</subject><subject>Learning</subject><subject>Magnetic resonance imaging</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neurology</subject><subject>Neuropharmacology</subject><subject>Neuroprotective agent</subject><subject>Neuropsychological Tests</subject><subject>Neuropsychology</subject><subject>Neuroradiology</subject><subject>Neurosciences</subject><subject>Original Communication</subject><subject>Pharmacology. Drug treatments</subject><subject>Retrospective Studies</subject><subject>Stenosis</subject><subject>Stents - adverse effects</subject><subject>Treatment Outcome</subject><subject>Ultrasonic imaging</subject><subject>Veins & arteries</subject><issn>0340-5354</issn><issn>1432-1459</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkV1rFDEUhoNY7Lb6A7yRgAi9ic13Zm6EUvyCQm_qdchmTsaUmWRNZgv992bdba2C4NWBvE_Oec95EXrN6HtGqTmvlEqmCGWcaNkz0j9DKyYFJ0yq_jlaUSEpUULJY3RS6y2ltGvCC3TMueKGC7ZCNxcjkAE2kAZIC4YQwC8V54C9K3mJA26KKwuU9p7ne5wLrktDYxpxTtjnMcUl3gHeQAm5zC55eImOgpsqvDrUU_Tt08ebyy_k6vrz18uLK-KVEAsRIHrneqYZXSvKGO-gFSo7KnuneRBCrwMYHwbDB-_EEKQRoP0AWnvV9eIUfdj33WzXMwy-2SpuspsSZ1fubXbR_qmk-N2O-c4K2Uluutbg7NCg5B9bqIudY_UwTS5B3lbLmGFtTk_pf6Dtps2-ZA19-xd6m7cltUvsKC6lVMY0iu0pX3KtBcKjb0btLl67j9e2eO0uXrtb-M3ThR9_POTZgHcHwFXvplBaHLH-5rTmqvtlke-52qQ0Qnli8Z_TfwL7Jb0P</recordid><startdate>20121101</startdate><enddate>20121101</enddate><creator>Wasser, Katrin</creator><creator>Hildebrandt, Helmut</creator><creator>Gröschel, Sonja</creator><creator>Stojanovic, Tomislav</creator><creator>Schmidt, Holger</creator><creator>Gröschel, Klaus</creator><creator>Pilgram-Pastor, Sara M.</creator><creator>Knauth, Michael</creator><creator>Kastrup, Andreas</creator><general>Springer-Verlag</general><general>Springer</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20121101</creationdate><title>Age-dependent effects of carotid endarterectomy or stenting on cognitive performance</title><author>Wasser, Katrin ; Hildebrandt, Helmut ; Gröschel, Sonja ; Stojanovic, Tomislav ; Schmidt, Holger ; Gröschel, Klaus ; Pilgram-Pastor, Sara M. ; Knauth, Michael ; Kastrup, Andreas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c533t-3e39aa91610b501128e501048049a62f336bfe7cfd72dca3df473e6cde66c5893</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Age</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Angioplasty</topic><topic>Angioplasty, Balloon - adverse effects</topic><topic>Angioplasty, Balloon - psychology</topic><topic>Asymptomatic</topic><topic>Biological and medical sciences</topic><topic>Carcinoembryonic antigen</topic><topic>Carotid arteries</topic><topic>Carotid Stenosis - epidemiology</topic><topic>Carotid Stenosis - psychology</topic><topic>Carotid Stenosis - surgery</topic><topic>Cognition & reasoning</topic><topic>Cognition Disorders - epidemiology</topic><topic>Cognition Disorders - psychology</topic><topic>Cognitive ability</topic><topic>Endarterectomy, Carotid - adverse effects</topic><topic>Endarterectomy, Carotid - psychology</topic><topic>Female</topic><topic>Humans</topic><topic>Ischemia</topic><topic>Learning</topic><topic>Magnetic resonance imaging</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neurology</topic><topic>Neuropharmacology</topic><topic>Neuroprotective agent</topic><topic>Neuropsychological Tests</topic><topic>Neuropsychology</topic><topic>Neuroradiology</topic><topic>Neurosciences</topic><topic>Original Communication</topic><topic>Pharmacology. Drug treatments</topic><topic>Retrospective Studies</topic><topic>Stenosis</topic><topic>Stents - adverse effects</topic><topic>Treatment Outcome</topic><topic>Ultrasonic imaging</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wasser, Katrin</creatorcontrib><creatorcontrib>Hildebrandt, Helmut</creatorcontrib><creatorcontrib>Gröschel, Sonja</creatorcontrib><creatorcontrib>Stojanovic, Tomislav</creatorcontrib><creatorcontrib>Schmidt, Holger</creatorcontrib><creatorcontrib>Gröschel, Klaus</creatorcontrib><creatorcontrib>Pilgram-Pastor, Sara M.</creatorcontrib><creatorcontrib>Knauth, Michael</creatorcontrib><creatorcontrib>Kastrup, Andreas</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wasser, Katrin</au><au>Hildebrandt, Helmut</au><au>Gröschel, Sonja</au><au>Stojanovic, Tomislav</au><au>Schmidt, Holger</au><au>Gröschel, Klaus</au><au>Pilgram-Pastor, Sara M.</au><au>Knauth, Michael</au><au>Kastrup, Andreas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Age-dependent effects of carotid endarterectomy or stenting on cognitive performance</atitle><jtitle>Journal of neurology</jtitle><stitle>J Neurol</stitle><addtitle>J Neurol</addtitle><date>2012-11-01</date><risdate>2012</risdate><volume>259</volume><issue>11</issue><spage>2309</spage><epage>2318</epage><pages>2309-2318</pages><issn>0340-5354</issn><eissn>1432-1459</eissn><coden>JNRYA9</coden><abstract>Although evidence is accumulating that age modifies the risk of carotid angioplasty and stenting (CAS) versus endarterectomy (CEA) for patients with significant carotid stenosis, the impact of age on cognition after either CEA or CAS remains unclear. In this study, we analyzed the effects of age on cognitive performance after either CEA or CAS using a comprehensive neuropsychological test battery with parallel test forms and a control group to exclude a learning effect. The neuropsychological outcomes after revascularization were determined in 19 CAS and 27 CEA patients with severe carotid stenosis. The patients were subdivided according to their median age (<68 years and ≥68 years); 27 healthy subjects served as a control group. In all patients clinical examinations, MRI scans and a neuropsychological test battery that assessed four major cognitive domains were performed immediately before, within 72 h, and 3 months after CEA or CAS. While patients <68 years of age showed no significant cognitive alteration after either CEA or CAS, a significant cognitive decline was observed in patients ≥68 years in both treatment groups (
p
= 0.001). Notably, this cognitive deterioration persisted in patients after CEA, whereas it was only transient in patients treated with CAS. These results demonstrate an age-dependent effect of CEA and CAS on cognitive functions. In contrast to the recently observed increased clinical complication rates in older subjects after CAS compared with CEA, CEA appears to be associated with a greater, persistent decline in cognitive performance than CAS in this subgroup of patients.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>22527231</pmid><doi>10.1007/s00415-012-6491-9</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Age Age Factors Aged Angioplasty Angioplasty, Balloon - adverse effects Angioplasty, Balloon - psychology Asymptomatic Biological and medical sciences Carcinoembryonic antigen Carotid arteries Carotid Stenosis - epidemiology Carotid Stenosis - psychology Carotid Stenosis - surgery Cognition & reasoning Cognition Disorders - epidemiology Cognition Disorders - psychology Cognitive ability Endarterectomy, Carotid - adverse effects Endarterectomy, Carotid - psychology Female Humans Ischemia Learning Magnetic resonance imaging Male Medical sciences Medicine Medicine & Public Health Middle Aged Neurology Neuropharmacology Neuroprotective agent Neuropsychological Tests Neuropsychology Neuroradiology Neurosciences Original Communication Pharmacology. Drug treatments Retrospective Studies Stenosis Stents - adverse effects Treatment Outcome Ultrasonic imaging Veins & arteries |
| title | Age-dependent effects of carotid endarterectomy or stenting on cognitive performance |
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