The effect of non-significant internal carotid artery stenoses on the results of cognitive training and electroencephalographic indicators in cardiac surgery patients
https://doi.org/10.30629/2658-7947-2024-29-4-62-69
Abstract
The effect of atherosclerotic lesions of the carotid arteries (CA) on the success of the cognitive function recovery procedures in cardiac patients has not been sufficiently studied. This study aims to evaluate the effects of cognitive rehabilitation depending on the presence of CA stenosis in patients after coronary artery bypass grafting (CABG) using neurophysiological indicators.
Material and methods. The cohort prospective study involved 85 patients (16 of them women), aged 45 to 75 years, admitted for elective CABG. All patients underwent standard clinical and instrumental, neurological, extended neuropsychological and neurophysiological examination.
Results. After multi-task training, the patients with CA stenosis had higher levels of high-frequency beta power (13-30 Hz), while the spectral power of the alpha1 rhythm (8-10 Hz) in this group was lower compared to patients without stenosis. In the case of successful cognitive rehabilitation (absence of POCD) at 11–12 days after CABG, compared with the group with POCD, patients without stenoses had higher total power of alpha 1 power and lower — beta power than patients with stenoses CA.
Conclusion. The absence of CA stenosis in the patients with successful completion of multi-tasking training contributed to the optimization of brain activity with an increase of alpha power. Whereas the patients with CA stenosis were characterized by an increase in high-frequency brain activity, both in the case of successful multi-tasking training and in its absence, in the early postoperative period of CABG. This study may serve as a basis for the development of special cognitive rehabilitation programs for patients with atherosclerotic lesions of the carotid system.
Keywords
About the Authors
D. S. KupriyanovaRussian Federation
Kemerovo
I. V. Tarasova
Russian Federation
Kemerovo
I. N. Kuhareva
Russian Federation
Kemerovo
A. S. Sosnina
Russian Federation
Kemerovo
I. D. Syrova
Russian Federation
Kemerovo
O. A. Trubnikova
Russian Federation
Kemerovo
O. L. Barbarash
Russian Federation
Kemerovo
References
1. Khan AA, Patel J, Desikan S, Chrencik M, Martinez-Delcid J, Caraballo B, et al. Asymptomatic carotid artery stenosis is associated with cerebral hypoperfusion. J Vasc Surg. 2021;73(5):1611– 1621.e2. doi: 10.1016/j.jvs.2020.10.063
2. Viticchi G, Falsetti L, Potente E, Bartolini M, Silvestrini M. Impact of carotid stenosis on cerebral hemodynamic failure and cognitive impairment progression: a narrative review. Annals of Translational Medicin. 2021;9(14):1–10. https://doi.org/10.21037/atm-20-7226
3. Geiger MA, Flumignan RLG, Sobreira ML, Avelar WM, Fingerhut C, Stein S, Guillaumon AT. Carotid Plaque Composition and the Importance of Non-Invasive in Imaging Stroke Prevention. Front Cardiovasc Med. 2022;9:885483. doi: 10.3389/fcvm.2022.885483
4. Fedorina M.A., Davydkin I.L., Germanova O.A. Atherosclerosis of the carotid arteries: clinical signifi cance (a literature review). Bulletin of the Medical Institute “REAVIZ” (REHABILITATION, DOCTOR AND HEALTH). 2023;13(3):41–46. (In Russ.). https://doi.org/10.20340/vmi-rvz.2023.3.CLIN.2
5. Norling AM, Marshall RS, Pavol MA, Howard G, Howard V, Liebeskind D, et al. Is Hemispheric Hypoperfusion a Treatable Cause of Cognitive Impairment? Curr Cardiol Rep. 2019;21(1):4. doi: 10.1007/s11886-019-1089-9
6. Belov YuV, Medvedeva LA, Katunina EA, Zagorulko OI, Drakina OV, Oĭstrakh AS. Diff erential diagnosis of neurological conditions in cardiac patients on the fi rst day after cardiac, ascending aortic and aortic arch surgery and repair of internal carotid arteries. Pirogov Russian Journal of Surgery. 2019;(12):5-12. (In Russ.). https://doi.org/10.17116/hirurgia20191215
7. Matsumoto T, Hoshi H, Hirata Y, Ichikawa S, Fukasawa K, Gonda T, et al. The association between carotid blood fl ow and resting-state brain activity in patients with cerebrovascular diseases. Sci Rep. 2021;11(1):15225. doi: 10.1038/s41598-021-94717-0
8. Maleva O.V., Sosnina A.S., Uchasova E.G., Ivanov S.V., Trubnikova O.A., Barbarash O.L. Factors for early postoperative cognitive impairment in patients after coronary bypass surgery and carotid endarterectomy. Cardiovascular Therapy and Prevention. 2022;21(5):3166. (In Russ.). https://doi.org/10.15829/1728-8800-2022-3166
9. Razumnikova O.M., Tarasova I.V., Trubnikova O.A., Barbarash O.L. The changes in the structure of cognitive functions and anxiety in cardiac surgery patients depending on the severity of carotid arteries. Complex Issues of Cardiovascular Diseases. 2022;11(1):36–48. (In Russ.) https://doi.org/10.17802/2306-1278-2022-11-1-36-48
10. Lineback CM, Stamm B, Sorond F, Caprio FZ. Carotid disease, cognition, and aging: time to redefi ne asymptomatic disease? Geroscience. 2023;45(2):719–725. doi: 10.1007/s11357-022-00688-z
11. Hess NR, Killic A, Serna-Gallegos DR, Navid F, Wang Y, Thoma F, Sultan I. Eff ect of untreated carotid artery stenosis at the time of isolated coronary artery bypass grafting. JTCVS Open. 2021;7:182–190. doi: 10.1016/j.xjon.2021.07.001
12. Syrova ID, Kovalenko AV, Trubnikova OA, Maleva OV, Chernobai AG, Lozhkin IS, Barbarash OL. Cerebrovascular complications in patients with moderate and small stenosis of the carotid arteries in the hospital period of coronary artery bypass grafting using cardiopulmonary bypass. S.S. Korsakov Journal of Neurology and Psychiatry. 2022;122(8):73-79 (In Russ.) https://doi.org/10.17116/jnevro202212208173
13. Relander K, Hietanen M, Rämö J, Vento A, Tikkala I, Roine RO, et al. Diff erential Cognitive Functioning and Benefi t From Surgery in Patients Undergoing Coronary Artery Bypass Grafting and Carotid Endarterectomy. Front Neurol. 2022;13:824486. doi: 10.3389/fneur.2022.824486
14. He J, Duan R, Qiu P, Zhang H, Zhang M, Liu M, et al. The risk factors of postoperative cognitive dysfunction in patients undergoing carotid endarterectomy: an updated meta-analysis. J Cardiothorac Surg. 2023;18(1):309. doi: 10.1186/s13019-023-02428-6
15. Lee B, Kim KS, Shim JK, Kim HB, Jun B, Kwak YL. Increased Carotid Intima-Media Thickness was not Associated With Cognitive Dysfunction After Off -Pump Coronary Surgery in Older Adult Patients Without Carotid Stenosis. Semin Thorac Cardiovasc Surg. 2022;34(1):112–121. doi: 10.1053/j.semtcvs.2021.03.004
16. Butz M, Gerriets T, Sammer G, El-Shazly J, Tschernatsch M, Schramm P, et al. The impact of postoperative cognitive training on health-related quality of life and cognitive failures in daily living after heart valve surgery: A randomized clinical trial. Brain Behav. 2023;13(3):e2915. doi: 10.1002/brb3.2915
17. Bogolepova AN. Postoperative cognitive dysfunction. S.S. Korsakov Journal of Neurology and Psychiatry. 2022;122(8):7-11. (In Russ.). https://doi.org/10.17116/jnevro20221220817
18. Neimark M.I., Shmelev V.V., Rakhmonov A.A., Titova Z.A. Etiology and Pathogenesis of Postoperative Cognitive Dysfunction (Review). General Reanimatology. 2023;19(1):60–71. (In Russ.). https://doi.org/10.15360/1813-9779-2023-1-2202
19. Rublev V.Yu., Geltser B.I., Sergeev E.A., Kotelnikov V.N., Karpov R.S. Comorbidity of coronary artery disease and its signifi cance in predicting the results of coronary artery bypass grafting. Bulletin of Siberian Medicine. 2022;21(1):152–161. (In Russ.). https://doi.org/10.20538/1682-0363-2022-1-152-161
20. Pillai L. Asymptomatic carotid atherosclerosis stenosis, infl ammation, and cognitive impairment. J Vasc Surg. 2022;75(5):1651. doi: 10.1016/j.jvs.2021.11.078
21. Dan B. Neuroscience underlying rehabilitation: what is neuroplasticity? Dev Med Child Neurol. 2019;61(11):1240. doi: 10.1111/dmcn.14341
22. Johnson BP, Cohen LG. Applied strategies of neuroplasticity. Handb Clin Neurol. 2023;196:599–609. doi: 10.1016/B978-0-323-98817-9.00011-9
23. Salihu AT, Hill KD, Jaberzadeh S. Eff ect of cognitive task complexity on dual task postural stability: a systematic review and meta-analysis. Exp Brain Res. 2022 Mar;240(3):703–731. doi: 10.1007/s00221-021-06299-y
24. Trubnikova O.A., Tarasova I.V., Kukhareva I.N., Temnikova T.B., Sosnina A.S., Syrova I.D., et al. Eff ectiveness of dual-task computerized cognitive training in the prevention of postoperative cognitive dysfunction in coronary bypass surgery. Cardiovascular Therapy and Prevention. 2022;21(8):3320. (In Russ.). https://doi.org/10.15829/1728-8800-2022-3320
25. Greaves D, Psaltis PJ, Lampit A, Davis DHJ, Smith AE, Bourke A, et al. Computerised cognitive training to improve cognition including delirium following coronary artery bypass grafting surgery: protocol for a blinded randomised controlled trial. BMJ Open. 2020;10(2):e034551. doi: 10.1136/bmjo-pen-2019-034551
26. Butz M, Gerriets T, Sammer G, El-Shazly J, Tschernatsch M, Huttner HB, et al. Eff ects of postoperative cognitive trainingon neurocognitive decline after heart surgery: a randomized clinical trial. Eur J Cardiothorac Surg. 2022;62(5):ezac251. doi: 10.1093/ejcts/ezac251. PMID: 35415742.
27. Rollnik JD. Clinical neurophysiology of neurologic rehabilitation. Handb Clin Neurol. 2019;161:187–194. doi: 10.1016/B978-0-444-64142-7.00048-5
28. Tarasova IV, Razumnikova OA, Trubnikova OA, Mezentsev YuA, Kupriyanova DS, Barbarash OL. Neurophysiological correlates of postoperative cognitive disorders. S.S. Korsakov Journal of Neurology and Psychiatry. 2021;121(2):18-23. (In Russ.). https://doi.org/10.17116/jnevro202112102118
29. Tarasova I, Trubnikova O, Kupriyanova DS, Maleva O, Syrova I, Kukhareva I, et al. Cognitive functions and patterns of brain activity in patients after simultaneous coronary and carotid artery revascularization. Front Hum Neurosci. 2023;17:996359. doi: 10.3389/fnhum.2023.996359
30. Chu Z, Cheng L, Tong Q. Carotid artery calcifi cation score and its association with cognitive impairment. Clin Interv Aging. 2019;14:167–177. doi: 10.2147/CIA.S192586
31. Lattanzi S, Carbonari L, Pagliariccio G, Bartolini M, Cagnetti C, Viticchi G, et al. Neurocognitive functioning and cerebrovascular reactivity after carotid endarterectomy. Neurology. 2018;90(4):e307-e315. doi: 10.1212/WNL.0000000000004862
32. Piegza M, Więckiewicz G, Wierzba D, Piegza J. Cognitive Functions in Patients after Carotid Artery Revascularization-A Narrative Review. Brain Sci. 2021;11(10):1307. doi: 10.3390/brain-sci11101307
33. Razumnikova OM, Mezentsev YuA, Pavlov PS, Tarasova IV, Trubnikova OA. Diff erentiation of cognitive status in patients with coronary artery disease using EEG clusterization by discrete optimization with a minimax criterion. Opera Med Physiol. 2021;8(3): 42–51. doi: 10.24412/2500-2295-2021-3-42-51
34. Gongora M, Bittencourt J, Teixeira S, Basile LF, Pompeu F, Droguett EL, et al. Low-frequency rTMS over the Parietofrontal network during a sensorimotor task: The role of absolute beta power in the sensorimotor integration. Neurosci Lett. 2016;611:1–5. doi: 10.1016/j.neulet.2015.11.025
35. Palacios-García I, Silva J, Villena-González M, Campos-Arteaga G, Artigas-Vergara C, Luarte N, et al. Increase in Beta Power Refl ects Attentional Top-Down Modulation After Psychosocial Stress Induction. Front Hum Neurosci. 2021;15:630813. doi: 10.3389/fnhum.2021.630813
36. Schmidt-Kassow M, White TN, Abel C, Kaiser J. Pre-stimulus beta power varies as a function of auditory-motor synchronization and temporal predictability. Front Neurosci. 2023;17:1128197. doi: 10.3389/fnins.2023.1128197
37. Gangemi A, De Luca R, Fabio RA, Lauria P, Rifi ci C, Pollicino P, et al. Eff ects of Virtual Reality Cognitive Training on Neuroplasticity: A Quasi-Randomized Clinical Trial in Patients with Stroke. Biomedicines. 2023;11(12):3225. doi: 10.3390/biomedicines11123225
38. Wang Y, Xu X, Wang R. Intrinsic sodium currents and excitatory synaptic transmission infl uence spontaneous fi ring in up and down activities. Neural Netw. 2018;98:42–50. doi: 10.1016/j.neunet.2017.10.008
Review
For citations:
Kupriyanova D.S., Tarasova I.V., Kuhareva I.N., Sosnina A.S., Syrova I.D., Trubnikova O.A., Barbarash O.L. The effect of non-significant internal carotid artery stenoses on the results of cognitive training and electroencephalographic indicators in cardiac surgery patients. Russian neurological journal. 2024;29(4):62-69. (In Russ.) https://doi.org/10.30629/2658-7947-2024-29-4-62-69