THE RELATIONSHIP BETWEEN STRUCTURAL CHANGE OF NECK VESSELS AND COGNITIVE FUNCTIONS IN PATIENTS WITH METABOLIC SYNDROME

Background. Carotid atherosclerosis is closely connected with the development of stroke, cognitive deficits and dementia. The impact of the localization of carotid atherosclerosis on the development of cognitive deficits remains unclear.

Objective. To analyze the relationship between the indicators of cognitive functions and structural changes of the carotid arteries in patients with metabolic syndrome (MS).

 Design and methods. The study included 178 patients divided into 2 groups. The first group included 80 patients (44,94 %) with MS without cognitive impairment. The second group consisted of 98 patients (55,06 %) with MS and cognitive disorders. All patients underwent neuropsychological testing, cognitive evoked potential (EP) for the assessment of cognitive functions, and the thickness of intima-media (TIM) of the carotid arteries was determined.

Results. There was an increase in TIM of the internal carotid artery (p < 0,01) and bifurcations (p < 0,01) in the group of patients with MS and cognitive deficit compared to the group without cognitive disorders. The correlation was established between the TIM of the internal carotid artery and bifurcations and the results of Mini-Mental State Examination test (p < 0,01), as well as responsiveness and concentration (p<0.01), an indicator of memory, storage and display of information (p < 0,01). We also have found a significant relationship between TIM of the internal carotid artery, bifurcation and the cognitive EP latency period (p < 0,01).

Conclusions. According to the neuropsychological testing and cognitive evoked potentials the increase of TIM in the internal carotid artery and bifurcations is associated with the development of cognitive impairment.

1. Johnston S.C., O’Meara E.S., Manolio T.A. et al. Cognitive impairment and decline are associated with carotid artery disease in patients without clinically evident cerebrovascular disease // Ann. Intern. Med. — 2004. — Vol. 140, № 4. — P. 237–247.

2. Mathiesen E.B., Waterloo K., Joakimsen O. et al. Reduced neuropsychological test performance in asymptomatic carotid stenosis: the Tromsø study // Neurology. — 2004. — Vol. 62, № 5. — P. 695–701.

3. Van Oijen M., Witteman J.C., Hofman A. et al. Atherosclerosis and risk for dementia // Ann. Neurol. — 2007. — Vol. 61, № 5. — P. 403–410.

4. Romero J., Seshadri S., Wolf P. et al. Carotid artery atherosclerosis, MRI indices of brain ischemia and aging and cognitive impairment: the Framingham study // Stroke. — 2009. — Vol. 40, № 5. — P. 1590–1596.

5. Bo M., Massaia M., Speme S. et al. Cognitive function after carotid endarterectomy: Greater risk of decline in symptomatic patients with left internal carotid artery disease // J. Stroke Cerebrovasc. Dis. — 2005. — Vol. 14, № 5. — P. 221–228.

6. Mocco J., Wilson D., Komotar R.J. Predictors of neurocognitive decline after carotid endarterectomy // Neurosurgery. — 2006. — Vol. 58, № 5. — P. 844–850.

7. Harvey J. Leptin regulation of neuronal excitability and cognitive function // Curr. Opin. Pharmacol. — 2007. — Vol. 7, № 6. — P. 643–647.

8. Zhong W., Cruickshanks K.J., Huang J.H. Carotid atherosclerosis and cognitive function in midlife: the beaver dam offspring study // Atherosclerosis. — 2011. — Vol. 219, № 1. — P. 330–333.

9. Cerhan J.R., Folsom A.R., Mortimer J.L. et al. Correlates of cognitive function in middle-aged adults. Atherosclerosis risk in communities (Aric) study investigators // Gerontology. — 1998. — Vol. 44, № 2. — P. 95–105.

10. Knopman D., Boland L.L., Mosley T. Cardiovascular risk factors and cognitive decline in middle-aged adults // Neurology. — 2001. — Vol. 56, № 1. — P. 42–48.

11. Зуева И.Б., Ванаева К.И., Санец Е.Л. и др. Взаимосвязь факторов сердечнососудистого риска с когнитивными функциями у пациентов среднего возраста // Артериальная гипертензия. — 2011. — Т. 17, № 5. — С. 432–441. // Zueva I.B.,

12. Vanaeva K.I., Sanez E.L. et al. The relationship of cardiovascular risk factors with cognitive functions in patients of middle age // Arterial Hypertension [Arterialnaya Gipertenziya]. — 2011. — Vol. 17, № 5. — Р. 432–441 [Russian].

13. Johnson K.C., Margolis K.L., Espeland M.A. et al. A prospective study of the effect of hypertension and baseline blood pressure on cognitive decline and dementia in postmenopausal women: the Women’s Health Initiative Memory Study // J. Am. Geriatr. Soc. — 2008. — Vol. 56, № 8. — P. 1449–1458.

14. Dufouil C., de Kersaint-Gilly A., Besancon V. et al. Longitudinal study of blood pressure and white matter hyperintensities: The EVA MRI Cohort // Neurology. — 2001. — Vol. 56, № 7. — P. 921–926.

15. Fine-Edelstein J.S., Wolf P.A., O’Leary D.H. Precursors of extracranial carotid atherosclerosis in the Framingham study // Neurology. — 1994. — Vol. 44, № 6. — P. 1046–1050.

16. Dempsey R.J., Diana A.L., Moore R.V. Thickness of carotid artery atherosclerotic plaque and ischemic risk // Neurosurgery. — 1990. — Vol. 27, № 3. — P. 343–348.

17. O’Leary D.H., Polak J.F., Kronmal R.A. et al. Carotidartery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular health study collaborative research group// N. Engl. J. Med. — 1999. — Vol. 340, № 1. — P. 14–22.

18. Goldstein L.B., Adams R., Becker K. et al. Primary prevention of ischemic stroke. A statement for healthcare professionals from the stroke council of the American heart Association // Stroke. — 2001. — Vol. 32, № 1. — P. 280–299.

19. Breteler M.M., Claus J.J., Grobbee D.E., Hofman A. Cardiovascular disease and distribution of cognitive function in elderly people: the Rotterdam study // Br. Med. J. — 1994. — Vol. 308, № 6944. — P. 1604–1608.

20. Heiss G., Sharrett A.R., Barnes R. Carotid atherosclerosis measured by b-mode ultrasound in populations: Associations with cardiovascular risk factors in the ARIC study // Am. J. Epidemiol. — 1991. — Vol. 134, № 3. — P. 250–256.

21. Rubba P., Bond M.G., Covetti G. Site-specific atherosclerotic plaques in the carotid arteries of middle-aged women from southern Italy: Associations with traditional risk factors and oxidation markers // Stroke. — 2001. — Vol. 32, № 9. — P. 1953–1959.

22. Yanez N.D., Kronmal R.A., Shemanski L.R. A regression model for longitudinal change in the presence of measurement error // Ann. Epidemiol. — 2002. — Vol. 12, № 1. — P. 34–38.

23. Pignoli P., Tremoli E., Poli A., Oreste P., Paoletti R. Intimal plus medial thickness of the arterial wall: a direct measurement with ultrasound imaging // Circulation. — 1986. — Vol. 74, № 6. — P. 1399–1406.

24. Newman A.B., Fitzpatrick A.L., Lopez O. et al. Dementia and Alzheimer’s disease incidence in relationship to cardiovascular disease in the Cardiovascular Health Study cohort // J. Am. Geriatr.

25. Soc. — 2005. — Vol. 53, № 7. — P. 1101–1107.

26. Savva G.M., Stephan. B.C. Epidemiological studies of the effect of stroke on incident dementia: a systematic review // Stroke. — 2010. — Vol. 41, № 1. — P. 41–46.

27. Sojkova J., Beason-Held L.L, Metter E.J. Intima-media thickness and regional cerebral blood flow in older adults // Stroke. — 2010. — Vol. 41, № 2. — P. 273–279.

28. Cabeza R., Nyberg L. Imaging cognition II: an empirical review of 275 pet and fMRI studies // J. Cogn. Neurosci. — 2000. — Vol. 12, № 1. — P. 1–47.

29. Grady C.L. Functional brain imaging and age-related changes in cognition // Biol. Psychol. — 2000. — Vol. 54, № 1–3. — P. 259–281.

30. Komulainen P., Kivipelto M., Lakka T.A. Carotid intimamedia thickness and cognitive function in elderly women: a population-based study // Neuroepidemiology. — 2007. — Vol. 28, № 4. — P. 207–213.

31. Tell G.S., Howard G., McKinney W. Risk factors for site specific extracranial carotid artery plaque distribution as measured by B-mode ultrasound // J. Clin. Epidemiol. — 1989. — Vol. 42, № 6. — P. 551–559.

32. Espeland M., Tang R., Terry J.G. Associations of risk factors with segment-specific intimal-medial thickness of the extracranial carotid artery // Stroke. — 1999. — Vol. 30, № 5. — P. 1047–1055.

33. Frodl-Bauch T., Bottlender R., Hegerl U. Neurochemical substrates and neuroanatomical generators of the event-related P300 // Neuropsychobiology. — 1999. — Vol. 40, № 2. — P. 86–94.

34. Hénon H., Pasquier F., Leys D. Poststroke dementia // Cerebrovasc. Dis. — 2006. — Vol. 22, № 1. — P. 61–70.

35. Polich J. Cognitive brain potentials // Curr. Direct. Psychol. Sci. — 1993. — Vol. 2. — 175 p.

36. Polich J. P300 clinical utility and control of variability // J. Clin. Neurophysiol. — 1998. — Vol. 15, № 1. — P. 14–33.

37. Kǘgler C.F., Vlajic P. Funk H., Raithel D., Platt D. The event-related P300 potential approach to cognitive functions of nondemented patients with cerebral and peripheral arteriosclerosis // J. Am. Ceriatr. Soc. — 1995. — Vol. 43, № 11. — P. 1228–1236.