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Vasc Spec Int. 2017 Dec;33(4):146-155. English. Original Article. https://doi.org/10.5758/vsi.2017.33.4.146
Casas-Hernanz L , Garolera M , Badenes D , Quintana S , Millán S , Calzado N , de Francisco J , Royo J , Aguilar M .
Servei de Neurologia, Hospital Universitari Mútua Terrassa, Barcelona, Spain. lauracasass@gmail.com
Departament de Psiquiatria i de Medicina Legal, Universitat Autònoma de Barcelona, Barcelona, Spain.
Neuropsychological Unit, Hospital of Terrassa-Consorci Sanitari de Terrassa, Barcelona, Spain.
Servei de Medicina Intensiva, Hospital Universitari Mútua Terrassa, Barcelona, Spain.
Unitat d’Urgències, Hospital Plató, Barcelona, Spain.
Servei de Cirurgia Vascular, Hospital Universitari Mútua Terrassa, Barcelona, Spain.
Abstract

Purpose

The aim of our study was to determine the clinical profile of patients considered cognitive ‘responders’ to surgery in order to establish clinical variables associated with a favorable cognitive performance.

Materials and Methods

A total of 70 patients were included in the study. A well-validated, comprehensive standardized neurocognitive battery of tests of about 2 hours was administered. Patients were examined twice, 1-week before surgery and 1-year postoperatively. The criterion to be included in the ‘responder’ group was the following: to obtain a positive difference between post-revascularization and pre-revascularization neuropsychological assessment ≥1 standard deviation in ≥2 tests.

Results

Twenty-seven patients (38.6%) were cognitive responders to treatment. In bivariate analysis between responders and non-responders, presence of atrophy (P=0.003), small vessels (P=0.577), symptoms (P=0.046), and age (P=0.030) were the factors statistically significant. When comparing cognitive performance before and after carotid revascularization, significant differences were observed in semantic fluency with a lower performance after 12 months (P=0.004, d=0.29), and in the Language index (Repeatable Battery for the Assessment of Neuropsychological Status) (P=0.005, d=0.34).

Conclusion

Patients without neurological symptoms, of a younger age and without atrophy and white matter small vessel lesions are better cognitive responders 1-year after carotid revascularization.

Copyright © 2019. Korean Association of Medical Journal Editors.