Neuroimaging Correlates of Memory Decline Following Carotid Interventions
| Status: | Completed |
|---|---|
| Conditions: | Cardiology |
| Therapuetic Areas: | Cardiology / Vascular Diseases |
| Healthy: | No |
| Age Range: | 40 - Any |
| Updated: | 4/2/2016 |
| Start Date: | November 2012 |
| End Date: | May 2015 |
| Contact: | Wei Zhou, MD |
| Email: | weizhou@stanford.edu |
| Phone: | 650-493-5000 |
Carotid revascularization can significantly reduce the risk of stroke in patients with
severe carotid stenosis; however, it has been associated with cognitive decline in 25% of
the older adults who undergo the procedure. Characterizing risk factors for cognitive
decline following carotid interventions and individualizing treatment strategy based on
those risks can minimize procedure-associated cognitive dysfunction. Neuroimaging techniques
that characterize white matter integrity and regional hypoperfusion have the potential to
provide sensitive brain structure indicators that may be associated with memory decline
following revascularization procedures. In this protocol, we hope to determine how cerebral
blood flow and baseline white matter abnormality in the vulnerable region modify the
frequency and cognitive effect of microembolization following carotid revascularization
procedures.
severe carotid stenosis; however, it has been associated with cognitive decline in 25% of
the older adults who undergo the procedure. Characterizing risk factors for cognitive
decline following carotid interventions and individualizing treatment strategy based on
those risks can minimize procedure-associated cognitive dysfunction. Neuroimaging techniques
that characterize white matter integrity and regional hypoperfusion have the potential to
provide sensitive brain structure indicators that may be associated with memory decline
following revascularization procedures. In this protocol, we hope to determine how cerebral
blood flow and baseline white matter abnormality in the vulnerable region modify the
frequency and cognitive effect of microembolization following carotid revascularization
procedures.
Inclusion Criteria:
- Patient is male or female >40 yrs of age.
- Patient has occlusive extracranial carotid stenosis (≥70%)
- Patient is scheduled to undergo a carotid revascularization procedure
- Patient agrees to voluntarily participate in the study and signs an informed consent.
- Patient agrees to be available for follow-up and is able to participate in all study
testing procedures.
- Patient has sufficient visual and auditory acuity for cognitive testing.
Exclusion Criteria:
- Patient is unable to safely and comfortably undergo MR imaging procedures (e.g.,
claustrophobia, implanted medical devices that are MRI incompatible such as
pacemaker, defibrillator, neural stimulator etc)
- Patient has an untreated or unsuccessfully controlled psychiatric disease
(schizophrenia, bipolar disorder).
- Patient has prominent suicidal or homicidal ideation.
- Patient has acute illness or unstable chronic illness (e.g. uncontrolled
hypertension, hepatic encephalopathy, portal hypertension, ascites, and esophageal
varices, pancreatitis).
- Patient with a history of neurological (e.g., multiple sclerosis, seizure disorder,
Parkinson's disease) or systemic illness affecting central nervous system function.
- Patient has prior closed head injury with ≥24 hours of amnesia.
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