Asymptomatic cervicocerebral atherosclerosis, intracranial vascular resistance and cognition: The AsIA-Neuropsychology Study

• Published in: Atherosclerosis Vol. 230; no. 2; pp. 330 - 335
• Main Authors: López-Olóriz, Jorge, López-Cancio, Elena, Arenillas, Juan F., Hernández, María, Jiménez, Marta, Dorado, Laura, Barrios, Maite, Soriano-Raya, Juan José, Miralbell, Júlia, Cáceres, Cynthia, Forés, Rosa, Pera, Guillem, Dávalos, Antoni, Mataró, Maria
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.10.2013
• Subjects: Aged; Aged, 80 and over; Atherosclerosis; Cardiovascular; Carotid Arteries; Carotid Arteries - diagnostic imaging; Carotid Arteries - pathology; Carotid Artery Diseases; Carotid Artery Diseases - complications; Carotid Artery Diseases - pathology; Carotid Intima-Media Thickness; Carotid Stenosis; Carotid Stenosis - complications; Carotid Stenosis - pathology; cognition; Cognition - physiology; Cognition Disorders; Cognition Disorders - complications; Cognition Disorders - pathology; Cognitive impairment; complications; Cross-Sectional Studies; dementia; education; Female; Humans; Intima–media thickness; Intracranial Arteriosclerosis; Intracranial Arteriosclerosis - complications; Intracranial Arteriosclerosis - pathology; Intracranial stenosis; Male; memory; mental depression; Middle Aged; Multivariate Analysis; Neuropsychological Tests; Neuropsychology; pathology; physiology; Pulsatility index; risk; Risk Assessment; stroke; Stroke - complications; Stroke - pathology; ultrasonics; Ultrasonography; Vascular Resistance; Intracranial stenosis; Atherosclerosis; Cognitive impairment; Intima–media thickness; Pulsatility index
• ISSN: 0021-9150; 1879-1484; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2013.08.011

Carotid atherosclerosis has emerged as a relevant contributor to cognitive impairment and dementia whereas the role of intracranial stenosis and vascular resistance in cognition remains unknown. This study aims to assess the association of asymptomatic cervicocerebral atherosclerosis and intracranial vascular resistance with cognitive performance in a large dementia-free population. The Barcelona-AsIA (Asymptomatic Intracranial Atherosclerosis) Neuropsychology Study included 747 Caucasian subjects older than 50 with a moderate–high vascular risk (assessed by REGICOR score) and without history of neither symptomatic vascular disease nor dementia. Extracranial and transcranial color-coded duplex ultrasound examination was performed to assess carotid intima–media thickness (IMT), presence of carotid plaques (ECAD group), intracranial stenosis (ICAD group), and middle cerebral artery pulsatility index (MCA-PI) as a measure of intracranial vascular resistance. Neuropsychological assessment included tests in three cognitive domains: visuospatial skills and speed, verbal memory and verbal fluency. In univariate analyses, carotid IMT, ECAD and MCA-PI were associated with lower performance in almost all cognitive domains, and ICAD was associated with poor performance in some visuospatial and verbal cognitive tests. After adjustment for age, sex, vascular risk score, years of education and depressive symptoms, ECAD remained associated with poor performance in the three cognitive domains and elevated MCA-PI with worse performance in visuospatial skills and speed. Carotid plaques and increased intracranial vascular resistance are independently associated with low cognitive functioning in Caucasian stroke and dementia-free subjects. We failed to find an independent association of intracranial large vessel stenosis with cognitive performance. •We investigated predictors of low cognitive functioning in a large population sample.•Carotid plaques predicted poor cognitive function in all cognitive domains.•High intracranial vascular resistance also predicted poor cognitive functioning.•We found independent and non-invasive measures related to cognition.