Cognitive Functions in Carotid Artery Disease before Endarterectomy

Abstract

Restorative effects of carotid endarterectomy (CEA) on cognitive functioning in patients with severe atherosclerotic disease presuppose the existence of cognitive deficits prior to the intervention. Thorough examination of this premise received only minor attention. The present study assessed symptomatic and asymptomatic patients with severe unilateral or bilateral stenosis of the carotid arteries one day before CEA. Healthy volunteers with similar demographic characteristics served as control subjects. Patients overall showed decreased functioning on tests of attention, verbal and visual memory, verbal fluency, and psychomotor speed and executive functioning, even after correction for the effects of mood. Simple motor skills and visuospatial functioning were not affected. Patients grouped according to presence and type of previous clinical symptoms and severity of contralateral stenosis only slightly differed from each other. The findings leave open the potential of improving cognitive function after CEA.

We thank the staff of the Department of Vascular Surgery from the St. Antonius Hospital for help in the arrangement of meetings with patients, and Nicole Dreessen, Christi-Anne van Hattum, Cindy de Graag, Lindsey Ossewaarde, Greet Huisman, Roeland van der Zouwen, and Ingrid Verkerk for their help in data collection.

Notes

We thank the staff of the Department of Vascular Surgery from the St. Antonius Hospital for help in the arrangement of meetings with patients, and Nicole Dreessen, Christi-Anne van Hattum, Cindy de Graag, Lindsey Ossewaarde, Greet Huisman, Roeland van der Zouwen, and Ingrid Verkerk for their help in data collection.

¹Missing values on the Dichotic Listening Test (11 patients, 4 controls), as a result of serious hearing problems, were imputed for patients and controls separately by using linear regression analysis on the basis of related variables and an additive error term (Streiner, 2002). Missing scores on the Trail Making Test B (3 patients), due to difficulty with the test, were replaced by arbitrary high scores. Post-hoc ANOVA on the data without these corrections did not change the pattern of the statistical outcomes.