A Cross-Sectional Investigation of Cognition and Ultrasound-Based Vascular Strain Indices.

OBJECTIVE We examine the relationship between variability in the plaque strain distribution estimated using ultrasound with multiple cognitive domains including executive, language, visuospatial reasoning, and memory function. METHOD Asymptomatic (n = 42) and symptomatic (n = 34) patients with significant (>60%) carotid artery stenosis were studied for plaque instability using ultrasound strain imaging and multiple cognitive domains including executive, language, visuospatial reasoning, and memory function. Correlation and ROC analyses were performed between ultrasound strain indices and cognitive function. Strain indices and cognition scores were also compared between symptomatic and asymptomatic patients to determine whether there are significant group differences. RESULTS Association of high-strain distributions with dysexecutive function was observed in both asymptomatic and symptomatic patients. For memory, visuospatial, and language functions, the correlations between strain and cognition were weaker for the asymptomatic compared to symptomatic group. CONCLUSIONS Both asymptomatic and symptomatic patients demonstrate a relationship between vessel strain indices and executive function indicating that silent strokes and micro-emboli could initially contribute to a decline in executive function, whereas strokes and transient ischemic attacks may cause the further decline in other cognitive functions.

[1]  S. Black,et al.  National Institute of Neurological Disorders and Stroke–Canadian Stroke Network Vascular Cognitive Impairment Harmonization Standards , 2006, Stroke.

[2]  D. Wechsler,et al.  Wechsler Adult Intelligence Scale—Fourth Edition (WAIS-IV) , 2010 .

[3]  P. Osterrieth,et al.  Le test de copie d'une figure complexe; contribution à l'étude de la perception et de la mémoire. , 1944 .

[4]  Tomy Varghese,et al.  The Preservation of Cognition 1 Year After Carotid Endarterectomy in Patients With Prior Cognitive Decline , 2018, Neurosurgery.

[5]  Tomy Varghese,et al.  In vivo carotid strain imaging using principal strains in longitudinal view , 2019, Biomedical physics & engineering express.

[6]  T. Varghese,et al.  Two-dimensional multi-level strain estimation for discontinuous tissue , 2007, Physics in medicine and biology.

[7]  B Isaacs,et al.  The Set Test as an Aid to the Detection of Dementia in Old People , 1973, British Journal of Psychiatry.

[8]  Tomy Varghese,et al.  Classification of Symptomatic and Asymptomatic Patients with and without Cognitive Decline Using Non-invasive Carotid Plaque Strain Indices as Biomarkers. , 2016, Ultrasound in medicine & biology.

[9]  Tomy Varghese,et al.  A Review of Carotid Atherosclerosis and Vascular Cognitive Decline: A New Understanding of the Keys to Symptomology , 2010, Neurosurgery.

[10]  Nirvedh H. Meshram,et al.  Lagrangian carotid strain imaging indices normalized to blood pressure for vulnerable plaque , 2019, Journal of clinical ultrasound : JCU.

[11]  Francesca N. Delling,et al.  Heart Disease and Stroke Statistics—2018 Update: A Report From the American Heart Association , 2018, Circulation.

[12]  A. Rey.  L'examen psychologique dans les cas d'encéphalopathie traumatique. (Les problems.). , 1941 .

[13]  Tomy Varghese,et al.  Quantification of carotid artery plaque stability with multiple region of interest based ultrasound strain indices and relationship with cognition , 2017, Physics in medicine and biology.

[14]  D. Delis,et al.  Retrieval from semantic memory in Alzheimer-type dementia. , 1986, Journal of clinical and experimental neuropsychology.

[15]  R. Paul,et al.  Carotid artery intima-media thickness and cognition in cardiovascular disease. , 2007, International journal of cardiology.

[16]  B. Hermann,et al.  Cognitive Deficits in Symptomatic and Asymptomatic Carotid Endarterectomy Surgical Candidates. , 2016, Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists.

[17]  Michael D. Franzen,et al.  Empirical comparison of alternate forms of the Boston Naming Test , 1995 .

[18]  T. Varghese,et al.  Correlation of cognitive function with ultrasound strain indices in carotid plaque. , 2014, Ultrasound in medicine & biology.

[19]  T. Varghese.  Quasi-Static Ultrasound Elastography. , 2009, Ultrasound clinics.

[20]  Perminder S. Sachdev,et al.  Arterial stiffness, the brain and cognition: A systematic review , 2014, Ageing Research Reviews.

[21]  Arno W. Hoes,et al.  Common carotid intima-media thickness and risk of stroke and myocardial infarction: the Rotterdam Study. , 1997, Circulation.

[22]  P. Osterrieth.  Le test de copie d'une figure complexe , 1944 .

[23]  T. Varghese,et al.  Methods for robust in vivo strain estimation in the carotid artery , 2012, Physics in medicine and biology.

[24]  J. Meyers,et al.  Rey complex figure test under four different administration procedures , 1995 .

[25]  J. Ophir,et al.  Elastography: A Quantitative Method for Imaging the Elasticity of Biological Tissues , 1991, Ultrasonic imaging.

[26]  T. Varghese,et al.  Improved Correlation of Strain Indices with Cognitive Dysfunction with Inclusion of Adventitial Layer with Carotid Plaque , 2016, Ultrasonic imaging.

[27]  L. Launer,et al.  Association between arterial stiffness, cerebral small vessel disease and cognitive impairment: A systematic review and meta-analysis , 2015, Neuroscience & Biobehavioral Reviews.

[28]  D. Stuss,et al.  California Verbal Learning Test: performance by patients with focal frontal and non-frontal lesions. , 2003, Brain : a journal of neurology.