Influence of stent-assisted angioplasty on cognitive function and affective disorder in elderly patients with symptomatic vertebrobasilar artery stenosis
Yongxing Yan, Lizhen Liang, Yanrong Yuan, Tao Chen, Yonghui Shen, Changyang Zhong
Department of Neurology, Third People’s Hospital, Hangzhou, China (mainland)
Med Sci Monit 2014; 20:1129-1136
We aimed to investigate cognitive function and affective disorder in elderly patients with symptomatic vertebrobasilar artery stenosis (SVAS) after stent-assisted angioplasty (SAA) and to explore the potential mechanism.
Material and Methods: The study subjects were 26 elderly SVAS patients who were non-responsive to pharmacotherapy and received SAA (study group) and 30 patients receiving intracoronary stent implantation (control group). Montreal cognitive assessment (MoCA), Hamilton depression rating scale (HAMD), and Hamilton anxiety rating scale (HAMA) were used.
Results: The total MoCA score, scores of line connection, copying cube, drawing clock, and delayed recall increased significantly in the study group after surgery (P<0.05, P<0.01). In addition, the MoCA score increased over time and the total MoCA score at 12 months was markedly higher than that at 1 month (P<0.05). The scores of HAMD and HAMA decreased dramatically after surgery compared with before surgery in these patients (P<0.01). A comparison at the corresponding period was performed between study group and control group, and it was found that the differences in total MoCA scores and scores of line connection, copying cube, drawing clock, and delayed recall before surgery and at 1 month after surgery were significant (P<0.05, P<0.01).
Conclusions: SAA may improve the visuospatial/executive abilities and delayed recall, as well as the depression and anxiety in patients with SVAS. Larger and controlled trails are needed to investigate the effect of SAA on cognition and affection in these patients.
Keywords: Arterial Occlusive Diseases - therapy, Angioplasty - adverse effects, Basilar Artery - physiopathology, Blood Flow Velocity, Case-Control Studies, Cognition - physiology, Constriction, Pathologic, Mood Disorders - physiopathology, Neuropsychological Tests, Postoperative Complications - etiology, Recurrence, Regional Blood Flow, Stents - adverse effects, Stroke - etiology, Vertebral Artery - physiopathology