Cognitive Change 1 Year after CEA or CAS Compared with Medication.

BACKGROUND: Whether improvement of cognitive function can be maintained remains controversial.

AIMS: This study aimed to investigate cognitive changes between before carotid endarterectomy (CEA) or carotid artery stenting (CAS) and 1 year after intervention using cognitive evaluation tools.

METHODS: Patients suspected as having carotid stenosis were prospectively registered for evaluation of cognitive function from October 2011 to December 2013 in the Department of Neurosurgery, Fukuoka University Hospital. Cognitive evaluation by the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) were performed before and 1 year after CEA or CAS. Cognitive changes were evaluated using the Wilcoxon signed rank test, whereas the subscores of MoCA and MMSE were also compared.

RESULTS: The MoCA score was significantly ameliorated from 21 to 23 at 1 year after CEA (P = .003), but the MMSE score did not significantly change (24 to 25, P = .56). Additionally, the MoCA score was improved 1 year after CAS (P = .04), but it was unchanged in those who were treated medically (P = .15). Regarding the analyses of subscores, patients who had CEA improved in the areas of executive and memory functions, whereas those with medical treatment only showed improvement in memory. CAS did not improve any subscores. There was no significant improvement in the subscores of the MMSE in patients with CEA, CAS, or medical treatment 1 year after treatment compared with before treatment.

CONCLUSIONS: CEA or CAS may be significantly associated with cognitive improvement as evaluated by the MoCA. However, patients treated medically do not show improvement in cognitive performance.