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J Cereb Blood Flow Metab. 2018 Nov 27:271678X18815790. doi: 10.1177/0271678X18815790. [Epub ahead of print]

The stronger one-sided relative hypoperfusion, the more pronounced ipsilateral spatial attentional bias in patients with asymptomatic carotid stenosis.

Author information

1
1 Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
2
2 TUM Neuroimaging Center (TUM-NIC), Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
3
3 Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
4
4 Magnetic Resonance Research Center, Yale University, New Haven, CT, USA.
5
5 Department of Psychology, Ludwig-Maximilians-Universität München, Munich, Germany.
6
6 Graduate School of Systemic Neurosciences, Ludwig-Maximilians-Universität München, Munich, Germany.
7
7 Department of Vascular and Endovascular Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
8
8 I. Medizinische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
9
9 Clinic for Neurology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
10
10 Hans-Berger-Department of Neurology, Jena University Hospital, Jena, Germany.
11
11 Department of Psychiatry, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.

Abstract

Patients with asymptomatic, high-grade internal carotid artery stenosis often suffer from subtle cognitive impairments with unclear underlying neuro-cognitive mechanisms. Thus, we hypothesized that stenosis-related unilateral cerebral hypoperfusion leads to an ipsilateral attentional bias; 22 patients with asymptomatic, one-sided high-grade carotid stenosis and 24 age-matched healthy controls underwent pseudo-continuous arterial spin labeling to assess brain perfusion in the territory of the carotid arteries. Furthermore, a parametric assessment of attention functions was carried out on the basis of the computational Theory of Visual Attention. Both patients' perfusion and spatial attention were significantly more lateralized than those of healthy controls. Critically, both asymmetry indices were significantly correlated in patients, i.e. the stronger one-sided relative hypoperfusion, the stronger ipsilateral bias of attention. This association was specifically pronounced in parietal cortices and independent of white matter hyperintensities as a surrogate for cerebrovascular brain damage. Results provide evidence for a link between lateralized hypoperfusion and lateralized attentional weighting in asymptomatic, high-grade carotid stenosis. Data suggest that lateralized hypoperfusion with simultaneous spatial attentional bias might serve as a potential therapeutic target in one-sided carotid stenosis.

KEYWORDS:

Cerebral blood flow; Theory of Visual Attention; asymptomatic carotid stenosis; hypoperfusion; spatial attentional bias

PMID:
30480463
DOI:
10.1177/0271678X18815790

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