Neuropsychological Functioning and Cerebral Perfusion Post Carotid Endarterectomy
Neuropsychological Functioning and Cerebral Perfusion Post Carotid Endarterectomy
The study aims to investigate the relationship between neuropsychological functioning and
 brain perfusion in patients undergoing carotid endarterectomy and control patients undergoing
 other peripheral vascular procedures.
Carotid endarterectomy (CEA) is a vascular surgical procedure that is aimed at reducing
 accumulated cholesterol and fats in carotid arteries. While some research indicates that CEA
 is associated with improvements in neuropsychological functioning, other studies have
 identified deficits in neuropsychological functioning following CEA. The factors associated
 with these different outcomes are unclear. Identification of the factors that mediate
 post-CEA neuropsychological functioning outcomes may allow for the development of
 interventions that would improve such outcomes. Recent research has identified a relationship
 between post-CEA neuropsychological deficits, and cerebral blood flow in certain areas of the
 brain, with some indication that brain cell loss following CEA may be a key factor. The
 proposed study will explore changes in cerebral blood flow through the use of
 diffusion-weighted magnetic resonance images (DW-MRI) to investigate the relationship between
 neuropsychological functioning and brain perfusion in 70 CEA patients and to compare
 neuropsychological functioning of the CEA patients to a control group of 30 patients
 undergoing other peripheral vascular surgical procedures. Patients' neuropsychological
 functioning will be assessed pre, post and six months after the CEA or peripheral vascular
 surgery. Additionally DW-MRI will be assessed pre and post surgery for the patients
 undergoing CEA.
Inclusion Criteria:

 -  Patients undergoing elective carotid endarterectomy or other peripheral vascular
 surgical procedures.

 -  Ages 40-90

 Exclusion Criteria:

 1. History of Substance Use:

 History of cocaine use within the past 12 months. Tetrahydrocannabinol use within the
 past 12 months.

 2. Conditions that affect brain MRI/contraindications for MRI:

 Diagnosis of HIV. History of any traumatic brain injury. History or current diagnosis
 with any form of brain tumor. Current normal pressure hydrocephalus. Patients with any
 implanted metallic medical device, or non-removable metallic material in their body

 3. Conditions that affect neuropsychological assessment:

 Diagnosis with Attention Deficit/Hyperactivity Disorder. Current major depressive
 episode. Current manic episode. Current psychotic episode. Diagnosis with any
 developmental disorder. Diagnosis with any form of dementia (MMSE<24). A score higher
 than 3 on the Modified Rankin Scale indicating a major stroke.

 4. General Contraindications:

 Diagnosis with or history of any medical condition that, based on reasonable clinical
 judgment, would clinically contraindicate the patient undergoing any of the study
 procedures.