Departments of Neurosurgery, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1, Jigyo-hama, Chuo-ku, Fukuoka 810-8563, Japan.
Departments of Neurosurgery, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1, Jigyo-hama, Chuo-ku, Fukuoka 810-8563, Japan.
J Clin Neurosci. 2020 Jun;76:53-57. doi: 10.1016/j.jocn.2020.04.050. Epub 2020 Apr 17.
The relationship between ultrasonographic flow parameters and cognitive function has not been well studied. This study aimed to clarify associations between carotid flow velocity (FV) and cognitive function in patients with a history of carotid endarterectomy (CEA). Ninety-four patients who previously underwent CEA participated in this study. The Neurobehavioral Cognitive Status Examination (Cognistat) and Frontal Assessment Battery (FAB) were adopted to assess cognitive functions at a mean of 6.5 ± 3.2 years after CEA. End-diastolic flow velocity (EDV) of the left and right common carotid artery (CCA) was significantly associated with total Cognistat score (p < 0.001) and total FAB score (p < 0.05). Pulsatility index (PI) of the left CCA was significantly associated with total Cognistat score and total FAB score (p < 0.01). A cut-off right CCA EDV of 14.5 cm/s offered the most reliable predictor of the bottom 25th percentile of total Cognistat score (sensitivity 83.3%, specificity 61.0%, area under the curve (AUC) 0.731, p = 0.0060), while a cut-off left CCA PI of 1.83 was the most reliable predictor of the bottom 25th percentile of total FAB score (sensitivity 73.3%, specificity 60.0%, AUC 0.679, p = 0.0179). Left and right CCA EDV correlated with sub-components of comprehension, construction, judgment, programming (p < 0.01), and conceptualization (p < 0.05). Right CCA EDV correlated with similarity (p < 0.01), repetition, naming, and memory (p < 0.05). Left CCA PI correlated with attention, conceptualization (p < 0.01), repetition, construction, similarity, and mental flexibility (p < 0.05), while right CCA PI correlated with construction (p < 0.05). CCA FV may offer useful markers of cognitive functions in patients with a history of CEA.
超声血流参数与认知功能之间的关系尚未得到充分研究。本研究旨在阐明颈动脉内膜切除术（CEA）后患者颈动脉血流速度（FV）与认知功能之间的关系。94 例先前接受过 CEA 的患者参与了本研究。在 CEA 后平均 6.5±3.2 年，采用神经行为认知状态检查（Cognistat）和额叶评估量表（FAB）评估认知功能。左、右颈总动脉（CCA）的舒张末期流速（EDV）与总 Cognistat 评分（p<0.001）和总 FAB 评分（p<0.05）显著相关。左 CCA 的搏动指数（PI）与总 Cognistat 评分和总 FAB 评分显著相关（p<0.01）。右 CCA EDV 的截断值为 14.5cm/s，可作为总 Cognistat 评分最低 25%的最可靠预测指标（敏感性 83.3%，特异性 61.0%，曲线下面积（AUC）为 0.731，p=0.0060），而左 CCA PI 的截断值为 1.83 是总 FAB 评分最低 25%的最可靠预测指标（敏感性 73.3%，特异性 60.0%，AUC 为 0.679，p=0.0179）。左、右 CCA EDV 与理解、构建、判断、编程（p<0.01）和概念化（p<0.05）的亚成分相关。右 CCA EDV 与相似性（p<0.01）、重复、命名和记忆（p<0.05）相关。左 CCA PI 与注意力、概念化（p<0.01）、重复、构建、相似性和心理灵活性（p<0.05）相关，而右 CCA PI 与构建（p<0.05）相关。CCA FV 可能为 CEA 后患者的认知功能提供有用的标志物。
