Cognitive Function and Brain Connectivity in CAS Patients:a Rs-fMRI Study

Study Overview
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Brief Summary
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This is a prospective study aimed to explore the changes of cognitive function after surgery for CAS and the correlation with brain connectivity, in order to look for the clinical biomarkers to predict the carotid stent implantation for patients which can effect the cognition

Detailed Description
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Carotid artery stenting (CAS) can significantly decrease the incidence of ischemic stroke in patients with severe carotid artery stenosis has been confirmed in large randomized controlled studies (1, 2).Previous studies showed carotid artery stenosis is closely related to cognitive dysfunction, including asymptomatic carotid artery stenosis(≥70%).Cognitive impairment is one of the most serious problem facing the elderly. The impact on cognitive function in patients with CAS has been discussed by many researchers, however the effect still remained conflicting. In past few years, several imaging techniques, such as resting-state functional MRI (R-fMRI), had been increasingly used to study cognitive impairment in humans. In this study, we evaluated the cognition performance in severe carotid artery stenosis patients undergoing CAS and explored the mechanisms underlying the cognition changes by the Rs-fMRI. Inclusion criteria: age between 55 years and 80 years unilateral internal carotid artery stenotic degree ≥ 70% right-hand-dominant free of dementia, and depression modified Rankin Scale: 0 or 1 education ≥6 years obtained written informed consent. Exclusion criteria: contralateral internal carotid artery stenosis ≥ 50% posterior circulation diseases MMSE < 26, which is a cut-off value for mild cognitive impairment severe systemic diseases and neuropsychiatric diseases (such as congestive heart failure) any contraindications for MRI scan (e.g., metal implants) Non atherosclerotic stenosis, such as dissection, vasculitis.

Official Title
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Cognitive Function and Brain Connectivity in Carotid Artery Stenting Patients:a Rs-fMRI Study

Conditions
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MRI, Functional, Carotid Artery Stenosis

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age between 55 years and 80 years unilateral internal carotid artery stenotic degree ≥ 70% right-hand-dominant free of stroke, TIA, dementia, and depression modified Rankin Scale: 0 or 1 education ≥6 years obtained written informed consent. Exclusion Criteria: contralateral internal carotid artery stenosis ≥ 50% posterior circulation diseases MMSE < 26, which is a cut-off value for mild cognitive impairment severe systemic diseases and neuropsychiatric diseases (such as congestive heart failure and history of stroke) any contraindications for MRI scan (e.g., metal implants)

Ages Eligible for Study
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Minimum Age: 55 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Montreal Cognitive Assessment, MOCA | use MOCA to assess the cognition before CAS | before CAS(within 1 week) | 
| Mini-mental State Examination，MMSE | use MMSE to assess the cognition before CAS | before CAS(within 1 week) | 
| Montreal Cognitive Assessment, MOCA | use MOCA to assess the cognition after CAS | 3 months after CAS | 
| Mini-mental State Examination，MMSE | use MMSE to assess the cognition after CAS | 3 months after CAS | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Digit Symbol Test | use to assess the cognition before CAS | before CAS(within 1 week) | 
| Digit Symbol Test | use to assess the cognition after CAS | 3 months after CAS | 
| Trail Making Test A/B | use to assess the cognition before CAS | before CAS(within 1 week) | 
| Trail Making Test A/B | use to assess the cognition after CAS | 3 months after CAS | 
| digital span test | use to assess the cognition before CAS | before CAS(within 1 week) | 
| digital span test | use to assess the cognition after CAS | 3 months after CAS | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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resting state, MRI, carotid artery stenting, cognition