22. European Stroke Conference 404 Behavioral disorders and post-stroke dementia Withdrawn! 500 © 2013 S. Karger AG, Basel Scientific Programme 405 Behavioral disorders and post-stroke dementia Unilateral carotid occlusion affects global neurocognitive function more than focal, side-specif-ic cognition. R.M. Lazar1, J.R. Festa2, Y.C. Cheung3, M. Pavol4, C.P. Derdeyn5, W.J. Powers6, R.S. Marshall7 Columbia University Medical Center, New York NY, USA1, Columbia University Medical Cen-ter, NEW YORK NY, USA2, Columbia University Medical Center, NEW YORK NY, USA3, Co-lumbia University Medical Center, NEW YORK NY, USA4, Washington University School of Med-icine, St. Louis MO, USA5, University of North Carolina School of Medicine, Chapel NC, USA6, Columbia University Medical Center, NEW YORK NY, USA7 Background: RECON, ancillary trial to the Carotid Occlusion Surgery Study (COSS), tested wheth-er EC-IC bypass would preserve or improve cognition over 2 years compared to best medical ther-apy alone in patients with symptomatic ICA occlusion and unilateral hemodynamic failure by in-creased OEF on PET. We previously showed that hemodynamic failure at baseline was associated with a combination of hemisphere-specific (left vs right) plus global (speed-dependent, multimodal) cognitive tests but the relative contribution of side-specific versus global elements within this bat-tery has never been examined formally. Methods: Eighty-nine patients with recent symptomatic carotid artery occlusion underwent neu-rocognitive assessment at baseline screening in RECON. Patients had to be English-speaking, ed-ucation >4th grade, and no prior dementia. Patients with stroke or TIA were included. Each was given a battery of 14 different tests evaluating right hemisphere, left hemisphere or global cognitive function, with each measure yielding an age-normalized z-score. We used a principal components analysis (PCA) to determine which combination of the 14 tests explained the greatest proportion of variance in cognition status. Results: The first principal component explained 36% of the variance in the neurocognitive battery. Using a component loading of > 0.20 as a cutoff for a significant contribution, 5/6 of the global mea-sures exceeded this criterion but only 3/8 of the left or right hemisphere-specific tasks did so. Conclusions: A PCA of cognitive testing in patients with ICA occlusion showed that despite unilat-eral carotid disease, global tasks account for most cognitive changes compared to side-specific, lo-calized function, even with stroke as a qualifying event. Future studies assessing the clinical impact of carotid disease and treatment should therefore include global cognitive functions as outcomes.
Karger_ESC London_2013
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