COGNITIVE OUTCOMES ON STENTING WITH MEDICAL TREATMENT VESUS MEDICAL TREATMENT ALONE FOR SYMPTOMATIC MIDDLE CEREBRAL ARTERY STENOSIS COMPANIED WITH COGNITIVE IMPAIRMENT

Wentao Gong¹, Feifei Liu², Juan Xiao³, Xianjun Zhang¹, Tonghui Liu¹, Jian Ding⁴, Yong Zhang^{1, *}

¹Department of Neurological Intervention, the Affiliated Hospital of Qingdao University, Qingdao, PR China - ²Department of General Medicine, the Affiliated Hospital of Qingdao University, Qingdao, PR China - ³Department of Evidence-based Medicine, the Second Hospital of Shandong University, Jinan, PR China - ⁴Department of Neurology, the Affiliated Hospital of Qingdao University, Qingdao, PR China

Objective: The effects of intensive drug therapy and stenting combined drug therapy on cognitive function in patients with symptomatic middle cerebral artery stenosis accompanied by cognitive impairment were compared during follow-up periods of 1 month and 6 months. 

Methods: A single-centre retrospective cohort study was conducted in 77 patients with symptomatic middle cerebral artery stenosis accompanied by cognitive impairment. Patients were divided into an intensive drug treatment group and a stenting combined drug treatment group. The MoCA scores before the two treatments, at one month of follow-up and at six months of follow-up were compared, and subgroup analysis of different perfusion states before stenting combined with drug therapy was carried out.

Results: In the stenting combined drug treatment group, the total MoCA score, language repetition and delayed recall score were higher than those scores in the intensive drug treatment group at one month and six months of follow-up (P<0.05), and the attention score was also improved at six months follow-up. There was no change in the total MoCA score in the intensive drug treatment group compared with the baseline during the follow-up period, but the total MoCA score, clock drawing test, attention and delayed recall in the stenting combined with drug treatment group showed benefits compared to those in the baseline at the one month follow-up (P<0.05). During the one-month follow-up period, the normal perfusion group could only benefit from delayed recall (1.11±0.963 VS 1.61±1.037, P<0.05). The abnormal perfusion group benefited from the total MoCA score, clock drawing experiment, attention, delayed recall and orientation. After six months follow-up, the total MoCA score in the abnormal perfusion group was more beneficial than that in normal perfusion group (3.875 vs 1.222, P<0.05).

Conclusion: For patients with symptomatic middle cerebral artery stenosis with cognitive impairment, stenting combined with drug therapy can improve cognitive impairment, but intensive drug therapy cannot benefit from cognitive function.