Conference Coverage

Narrowing of Carotid Artery Without Warning May Signal Memory and Cognitive Decline


 

PHILADELPHIA—Narrowing of the carotid artery without any symptoms may be linked to problems in learning, memory, thinking, and decision-making, compared to people with similar risk factors but no narrowing of the carotid artery, according to a study presented by Moira Dux, PhD, at the 66th Annual Meeting of the American Academy of Neurology.

“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,” said principal investigator Brajesh K. Lal, MD, with the VA Maryland Health Care System’s Baltimore VA Medical Center and the University of Maryland School of Medicine in Baltimore. “These results underscore the importance of assessing the status of memory and thinking in people with carotid artery narrowing.”

The study involved 67 people with asymptomatic carotid stenosis (ACS), 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 ACS 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,” said Dr. 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.”

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