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Comparative Study
. 2007 Oct 1;121(2):148-54.
doi: 10.1016/j.ijcard.2006.10.032. Epub 2006 Dec 28.

Carotid artery intima-media thickness and cognition in cardiovascular disease

Andreana P Haley  1 , Daniel E Forman, Athena Poppas, Karin F Hoth, John Gunstad, Angela L Jefferson, Robert H Paul, Albert S H Ler, Lawrence H Sweet, Ronald A Cohen
Affiliations
Comparative Study

Carotid artery intima-media thickness and cognition in cardiovascular disease

Andreana P Haley et al. Int J Cardiol. .

Abstract

Background: Increased carotid artery intima-media thickness (IMT) is a non-invasive marker of systemic arterial disease. Increased IMT has been associated with atherosclerosis, abnormal arterial mechanics, myocardial infarction, and stroke. Given evidence of a relationship between cardiovascular health and attention-executive-psychomotor functioning, the purpose of this study was to examine IMT in relation to neuropsychological test performance in patients with a variety of cardiovascular diagnoses.

Methods: One hundred and nine participants, ages 55 to 85, underwent neuropsychological assessment and B-mode ultrasound of the left common carotid artery. IMT was calculated using an automated algorithm based on a validated edge-detection technique. The relationship between IMT and measures of language, memory, visual-spatial abilities and attention-executive-psychomotor functioning was modeled using hierarchical linear regression analyses adjusted for age, education, sex, cardiovascular risk, current systolic blood pressure, and history of coronary artery disease (CAD).

Results: Increased IMT was associated with significantly lower performance in the attention-executive-psychomotor domain (IMT beta=-0.26, p<.01), independent of age, education, sex, cardiovascular risk, current systolic blood pressure, and CAD (F(10,100)=3.61, p<.001). IMT was not significantly related to language, memory, or visual-spatial abilities.

Conclusions: Our findings suggest that, in patients with cardiovascular disease, IMT may be associated with the integrity of frontal subcortical networks responsible for attention-executive-psychomotor performance. Future studies are needed to clarify the mechanisms by which IMT affects cognition and examine potential interactions between increased IMT and other measures of cardiovascular health such as blood pressure variability, cardiac systolic performance, and systemic perfusion.

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Figures

Figure 1
Figure 1
Carotid image of a selected frame of a typical participant. The white arrows mark the lumen-intima and media-adventitia interfaces. The dotted line represents the selected region for analysis.
Figure 2
Figure 2
Automated IMT detection. The image represents the signal intensity of the region selected for analysis on far wall of the left common carotid artery for all frames of a typical subject. The orange color indicates high intensity values, and blue color indicates low intensity values. The pink circles represent the estimated boundaries for the carotid diameter. The black ‘x’s represent the estimated lumen-intima and media-adventitia interfaces.
Figure 3
Figure 3
Bland-Altman plot of the agreement between the manual and automated measurements of IMT.
Figure 4
Figure 4
Bland-Altman plot of the agreement between two automated measurements of IMT.
See this image and copyright information in PMC

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