[Cognitive function in patients with severe carotid stenosis--evaluation of RBANS, WAIS-R and NART before treatment of carotid revascularization--].

No to shinkei = Brain and nerve Pub Date : 2006-08-01
Akiko Takaiwa, Naoya Kuwayama, Nakamasa Hayashi, Michiya Kubo, Mie Matsui, Shunro Endo
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Abstract

Purpose: To evaluate the cognitive function in preoperative patients with severe carotid stenosis.

Patients and method: Twenty-five patients with severe carotid stenosis were examined on their cognitive function by RBANS (Japanese version), WAIS-R (Japanese version), and NART (Japanese version) before treatment of carotid revascularization (endarterectomy or stenting). They had full activities of daily living without any hemiparesis, aphasia, agnosia, and apraxia at the time of the examinations.

Results: Mean intelligent quotient (IQ) measured by WAIS-R and NART was 104.0 +/- 10.7 and 101.3 +/- 13.4, (ns) respectively. Mean total scale of RBANS was 90.0 +/- 13.4, which was significantly lower than both the results of WAIS-R and NART. A mean value of each RBANS index was 91.3 +/- 11.7 in immediate memory, 102.0 +/- 18.2 in visuospatial/constructional, 93.2 +/- 8.7 in language, 84.6 +/- 14.7 in attention, and 92.1 +/- 14.4 in delayed memory. RBANS index significantly declined in immediate memory, language, attention and delayed memory than visuospatial/constructional.

Conclusions: Qualitative evaluation was available in RBANS, WAIS-R, and NART, which enabled the investigators to make a precise comparison between these methods. WAIS-R and NART showed a comparatively preserved function and were presumed to be useful for the evaluation of the baseline of cognitive function in preoperative patients. RBANS demonstrated a slight decrease in memory and attention in those patients and was expected to be useful to detect the cognitive dysfunction when compared with WAIS-R and NART.

[颈动脉严重狭窄患者的认知功能——颈动脉血运重建术前rban、WAIS-R和NART的评估]。
目的:评价术前重度颈动脉狭窄患者的认知功能。患者与方法:对25例重度颈动脉狭窄患者行颈动脉血管重建术(动脉内膜切除术或支架置入术)前的认知功能进行rban(日文版)、WAIS-R(日文版)和NART(日文版)检测。在检查时,他们的日常生活活动完全正常,没有偏瘫、失语、失认症和失用症。结果:WAIS-R和NART测得的平均智商(IQ)分别为104.0 +/- 10.7和101.3 +/- 13.4 (ns)。rban的平均总评分为90.0 +/- 13.4,显著低于WAIS-R和NART的结果。各RBANS指标的平均值分别为:即时记忆91.3 +/- 11.7、视觉空间/建构102.0 +/- 18.2、语言93.2 +/- 8.7、注意84.6 +/- 14.7、延迟记忆92.1 +/- 14.4。rban指数在即时记忆、语言、注意和延迟记忆方面明显低于视觉空间/结构记忆。结论:在rban、WAIS-R和NART中可以进行定性评价,这使得研究者能够对这些方法进行精确的比较。WAIS-R和NART显示了相对保存的功能,被认为是评估术前患者认知功能基线的有用方法。与WAIS-R和NART相比,rban在这些患者的记忆和注意力方面略有下降,有望用于检测认知功能障碍。
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