Abstract Details

Title Early Image Markers Correlate with Cognitive Impairment in Patients with Asymptomatic Carotid Stenosis

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P04 - (-)

Poster/Presentation
Number 048

Objective

Background BACKGROUND: We previously showed that patients with severe asymptomatic carotid stenosis have more dizziness, poorer memory and complex visuo-spatial performances accompanied by white matter disconnections particularly in the frontoparietal network (FPN) and the default mode network (DMN) utilizing a seed-based analysis of the resting-state functional connectivity magnetic resonance imaging (rs-fcMRI). It is still unknown whether distributed areas outside the predefined regions of interests or the grey matter may be affected as well.

Design/Methods DESIGN/METHODS: We compared 26 consecutive patients with asymptomatic, severe (>70%) stenosis of unilateral internal carotid artery with the age- and gender-matched healthy elderly for a battery of neuropsychiatric tests as well as voxel-wise comparisons of rs-fcMRI, voxel-based morphometry (VBM) and diffusion tensor imaging (DTI).

Results RESULTS: Compared with the controls, the patients had reduced whole-brain fractional anisotropy (FA) of the white matter, but no decrease of the grey matter volume. Notably, in addition to the affected FPN and the DMN, the patients had disrupted connectivity in the dorsal attention network (DAN) and the motor network (MN) as well. The most severely affected connections included those with the contralateral insula of the DAN, the middle frontal gyrus of the FPN and the primary somatosensory cortex of the MN. Furthermore, in the patients, the functional connectivity between the frontal eye field (ipsilateral to stenosis) and the contralateral insula positively correlated with the symbol digit test scores, whereas the functional connectivity between the primary motor cortex and the contralateral supplementary motor cortex correlated with the trail making A test scores.

Conclusions CONCLUSIONS: Patients with severe asymptomatic carotid stenosis have distributed disruption of the white matter even at a subclinical stage. The brain connectivity correlates with their cognitive status and may facilitate early decision of revascularization.

Authors/Disclosures
Chun-Jen Lin (National Yang-Ming University) PRESENTER	No disclosure on file
Cheng Hsienlin	No disclosure on file
	No disclosure on file
	No disclosure on file
Gavin Giovannoni, MD (QMUL)	Dr. Giovannoni has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Giovannoni has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sanofi. Dr. Giovannoni has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Merck KGaA. Dr. Giovannoni has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche-Genentech. Dr. Giovannoni has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Moderna. Dr. Giovannoni has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sandoz. Dr. Giovannoni has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Astoria Biologica. Dr. Giovannoni has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Zenas. Dr. Giovannoni has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Giovannoni has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Giovannoni has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Giovannoni has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Medscape.

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