Carotid stenosis without warning may signal memory and thinking decline

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For the first time, researchers have demonstrated that asymptomatic carotid stenosis may be linked to problems in learning, memory, thinking and decision-making, compared to people with similar risk factors but no carotid stenosis.

The study results were presented at the American Academy of Neurology’s 66th Annual Meeting in Philadelphia, USA, 26 April–3 May 2014.

“To date, the focus of diagnosis and management of carotid artery blockages has been prevention of stroke since that was the only harm that these blockages were thought to cause to patients,” says Brajesh K Lal, Baltimore VA Medical Center and the University of Maryland School of Medicine, Baltimore, USA. “These results underscore the importance of assessing the status of memory and thinking in people with carotid artery narrowing.”

The study involved 67 patients with asymptomatic carotid stenosis with a 50% reduction in the diameter of the artery and 60 people with vascular risk factors but without the condition. Risk factors included diabetes, high blood pressure, high blood cholesterol and coronary artery disease. The participants underwent extensive testing for overall thinking abilities, and for specific aspects of thinking, such as processing speed, learning, memory, decision-making and language.

The study found that the asymptomatic group performed significantly worse on the overall memory and thinking tests. On testing of specific aspects of thinking, they performed worse on tests for motor and processing speed, and learning and memory. Language scores did not differ between the two groups.

“If these findings are confirmed in larger studies, they hold significant implications for new treatment targets and open the door for more questions such as: should these patients be treated more aggressively with medications, cognitive rehabilitation, or even surgery to open up the artery,” says Lal. “I anticipate a large number of follow-up studies searching for causes and the best treatment option for this newly identified morbidity associated with carotid narrowing.”

The study was supported by the US Department of Veterans Affairs.

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