A Cross-Sectional Investigation of Cognition and Ultrasound-Based Vascular Strain Indices

Overview

Journal Arch Clin Neuropsychol

Publisher Oxford University Press

Specialties Neurology
Psychology

Date 2019 Feb 27

PMID 30805597

Citations 4

Authors

N H Meshram

D Jackson

T Varghese

C C Mitchell

S M Wilbrand

R J Dempsey

B P Hermann

Affiliations

Soon will be listed here.

Abstract

Objective: We examine the relationship between variability in the plaque strain distribution estimated using ultrasound with multiple cognitive domains including executive, language, visuospatial reasoning, and memory function.

Method: Asymptomatic (n = 42) and symptomatic (n = 34) patients with significant (>60%) carotid artery stenosis were studied for plaque instability using ultrasound strain imaging and multiple cognitive domains including executive, language, visuospatial reasoning, and memory function. Correlation and ROC analyses were performed between ultrasound strain indices and cognitive function. Strain indices and cognition scores were also compared between symptomatic and asymptomatic patients to determine whether there are significant group differences.

Results: Association of high-strain distributions with dysexecutive function was observed in both asymptomatic and symptomatic patients. For memory, visuospatial, and language functions, the correlations between strain and cognition were weaker for the asymptomatic compared to symptomatic group.

Conclusions: Both asymptomatic and symptomatic patients demonstrate a relationship between vessel strain indices and executive function indicating that silent strokes and micro-emboli could initially contribute to a decline in executive function, whereas strokes and transient ischemic attacks may cause the further decline in other cognitive functions.

Citing Articles

Lumen segmentation using a Mask R-CNN in carotid arteries with stenotic atherosclerotic plaque.

Kiernan M, Mukaddim R, Mitchell C, Maybock J, Wilbrand S, Dempsey R Ultrasonics. 2023; 137:107193.

PMID: 37952384 PMC: 10841729. DOI: 10.1016/j.ultras.2023.107193.

Study of the Relationship Between Ultrasound Strain Indices and Cognitive Decline for Vulnerable Carotid Plaque.

Meshram N, Jackson D, Mitchell C, Wilbrand S, Dempsey R, Hermann B Annu Int Conf IEEE Eng Med Biol Soc. 2020; 2020:2088-2091.

PMID: 33018417 PMC: 8063208. DOI: 10.1109/EMBC44109.2020.9175911.

carotid strain imaging using principal strains in longitudinal view.

Meshram N, Mitchell C, Wilbrand S, Dempsey R, Varghese T Biomed Phys Eng Express. 2019; 5(3).

PMID: 31240113 PMC: 6592631. DOI: 10.1088/2057-1976/ab15c9.

Lagrangian carotid strain imaging indices normalized to blood pressure for vulnerable plaque.

Varghese T, Meshram N, Mitchell C, Wilbrand S, Hermann B, Dempsey R J Clin Ultrasound. 2019; 47(8):477-485.

PMID: 31168787 PMC: 6760247. DOI: 10.1002/jcu.22739.

References

Alexander M, Stuss D, Fansabedian N . California Verbal Learning Test: performance by patients with focal frontal and non-frontal lesions. Brain. 2003; 126(Pt 6):1493-503. DOI: 10.1093/brain/awg128. View

van Sloten T, Protogerou A, Henry R, Schram M, Launer L, Stehouwer C . Association between arterial stiffness, cerebral small vessel disease and cognitive impairment: A systematic review and meta-analysis. Neurosci Biobehav Rev. 2015; 53:121-30. PMC: 5314721. DOI: 10.1016/j.neubiorev.2015.03.011. View

Isaacs B, KENNIE A . The Set test as an aid to the detection of dementia in old people. Br J Psychiatry. 1973; 123(575):467-70. DOI: 10.1192/bjp.123.4.467. View

Wang X, Jackson D, Mitchell C, Varghese T, Wilbrand S, Rocque B . Classification of Symptomatic and Asymptomatic Patients with and without Cognitive Decline Using Non-invasive Carotid Plaque Strain Indices as Biomarkers. Ultrasound Med Biol. 2016; 42(4):909-18. PMC: 4775393. DOI: 10.1016/j.ultrasmedbio.2015.11.025. View

Ophir J, Cespedes I, Ponnekanti H, Yazdi Y, Li X . Elastography: a quantitative method for imaging the elasticity of biological tissues. Ultrason Imaging. 1991; 13(2):111-34. DOI: 10.1177/016173469101300201. View

Hachinski V, Iadecola C, Petersen R, Breteler M, Nyenhuis D, Black S . National Institute of Neurological Disorders and Stroke-Canadian Stroke Network vascular cognitive impairment harmonization standards. Stroke. 2006; 37(9):2220-41. DOI: 10.1161/01.STR.0000237236.88823.47. View

Dempsey R, Vemuganti R, Varghese T, Hermann B . A review of carotid atherosclerosis and vascular cognitive decline: a new understanding of the keys to symptomology. Neurosurgery. 2010; 67(2):484-93. PMC: 2908960. DOI: 10.1227/01.NEU.0000371730.11404.36. View

Ober B, Dronkers N, Koss E, Delis D, Friedland R . Retrieval from semantic memory in Alzheimer-type dementia. J Clin Exp Neuropsychol. 1986; 8(1):75-92. DOI: 10.1080/01688638608401298. View

Wang X, Jackson D, Varghese T, Mitchell C, Hermann B, Kliewer M . Correlation of cognitive function with ultrasound strain indices in carotid plaque. Ultrasound Med Biol. 2013; 40(1):78-89. PMC: 3849143. DOI: 10.1016/j.ultrasmedbio.2013.08.001. View

10.

Shi H, Varghese T . Two-dimensional multi-level strain estimation for discontinuous tissue. Phys Med Biol. 2007; 52(2):389-401. DOI: 10.1088/0031-9155/52/2/006. View

11.

Benjamin E, Virani S, Callaway C, Chamberlain A, Chang A, Cheng S . Heart Disease and Stroke Statistics-2018 Update: A Report From the American Heart Association. Circulation. 2018; 137(12):e67-e492. DOI: 10.1161/CIR.0000000000000558. View

12.

Jackson D, Sandoval-Garcia C, Rocque B, Wilbrand S, Mitchell C, Hermann B . Cognitive Deficits in Symptomatic and Asymptomatic Carotid Endarterectomy Surgical Candidates. Arch Clin Neuropsychol. 2015; 31(1):1-7. PMC: 4718190. DOI: 10.1093/arclin/acv082. View

13.

Varghese T . Quasi-Static Ultrasound Elastography. Ultrasound Clin. 2010; 4(3):323-338. PMC: 2927834. DOI: 10.1016/j.cult.2009.10.009. View

14.

Singer J, Trollor J, Baune B, Sachdev P, Smith E . Arterial stiffness, the brain and cognition: a systematic review. Ageing Res Rev. 2014; 15:16-27. DOI: 10.1016/j.arr.2014.02.002. View

15.

Dempsey R, Jackson D, Wilbrand S, Mitchell C, Berman S, Johnson S . The Preservation of Cognition 1 Year After Carotid Endarterectomy in Patients With Prior Cognitive Decline. Neurosurgery. 2017; 82(3):322-328. PMC: 5711632. DOI: 10.1093/neuros/nyx173. View

16.

McCormick M, Varghese T, Wang X, Mitchell C, Kliewer M, Dempsey R . Methods for robust in vivo strain estimation in the carotid artery. Phys Med Biol. 2012; 57(22):7329-53. PMC: 3740562. DOI: 10.1088/0031-9155/57/22/7329. View

17.

Haley A, Forman D, Poppas A, Hoth K, Gunstad J, Jefferson A . Carotid artery intima-media thickness and cognition in cardiovascular disease. Int J Cardiol. 2007; 121(2):148-54. PMC: 2042538. DOI: 10.1016/j.ijcard.2006.10.032. View

18.

Meshram N, Varghese T, Mitchell C, Jackson D, Wilbrand S, Hermann B . Quantification of carotid artery plaque stability with multiple region of interest based ultrasound strain indices and relationship with cognition. Phys Med Biol. 2017; 62(15):6341-6360. PMC: 5580244. DOI: 10.1088/1361-6560/aa781f. View

19.

Wang X, Mitchell C, Varghese T, Jackson D, Rocque B, Hermann B . Improved Correlation of Strain Indices with Cognitive Dysfunction with Inclusion of Adventitial Layer with Carotid Plaque. Ultrason Imaging. 2015; 38(3):194-208. PMC: 4662918. DOI: 10.1177/0161734615589252. View

20.

Bots M, Hoes A, Koudstaal P, Hofman A, Grobbee D . Common carotid intima-media thickness and risk of stroke and myocardial infarction: the Rotterdam Study. Circulation. 1997; 96(5):1432-7. DOI: 10.1161/01.cir.96.5.1432. View