Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Neuropsy Chiatry

Background: Carotid artery disease is an important cause of cognitive impairment in patients with stroke. Carotid stenosis is an independent risk factor for mild cognitive impairment and it was not due to underlying vascular risk factors.Cerebral vasomotor reactivity (CVR) is a measure of the perfusion reserve reflecting the capacity of cerebral arterioles to dilate in response to vasomotor stimuli.Objective: To assess the relation between cognitive function and asymptomatic carotid disease and to investigate the pattern and possible mechanisms of cognitive impairment associated with asymptomatic carotid artery disease.Design/Methods:Thirty asymptomatic subjects with carotid stenosis and 30 matched healthy control subjects were included. All subjects were subjected to: complete neurovascular examination, laboratory investigations, carotid duplex and transcranialdoppler, vasomotor reactivity (using breath holding method) and cognitive assessment.Results: In comparison to the control group, subjects with carotid stenosis had significantly lower levels of performance in tests of memory, language, executive functions, verbal memory, attention, orientation and visuospatial functions. Subjects with bilateral carotid stenosis performed worse than those with unilateral stenosis in attention, orientation, registration, naming, verbal fluency, visuospatial and executive functions tests.There was a strong negative correlation between the degree of stenosis in the affected side and the vasomotor reactivity.There is a positive correlation between vasomotor reactivity and cognitive performance

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