Narrowing of neck artery without warning may signal memory and thinking decline

For the first time, researchers have demonstrated that narrowing of the carotid artery in the neck without any symptoms may be linked to problems in learning, memory, thinking and decision-making, compared to people with similar risk factors but no narrowing in the neck artery, according to a study released today that will be presented at the American Academy of Neurology's 66th Annual Meeting in Philadelphia, April 26 to May 3, 2014.

"To date, the focus of diagnosis and management of blockages has been prevention of stroke since that was the only harm that these blockages were thought to cause to patients," said Brajesh K. Lal, MD, with the VA Maryland Health Care System's Baltimore VA Medical Center and the University of Maryland School of Medicine in Baltimore. "These results underscore the importance of assessing the status of memory and thinking in people with carotid artery narrowing."

Narrowing of arteries occurs when plaques build up in the artery, and they can harm the brain by restricting proper blood flow or by showering little pieces of plaque into the brain.

The study involved 67 people with the condition, called (ACS), with a 50-percent reduction in the diameter of the artery and 60 people with vascular but without the condition. Risk factors included diabetes, high blood pressure, high blood cholesterol and . The participants underwent extensive testing for overall thinking abilities, and for specific aspects of thinking such as: processing speed, learning, memory, decision-making and language.

The study found that the ACS group performed significantly worse on the overall memory and thinking tests. On testing of specific aspects of thinking, they performed worse on tests for motor and processing speed, and learning and memory. Language scores did not differ between the two groups.

"If these findings are confirmed in larger studies, they hold significant implications for new treatment targets and open the door for more questions such as: should these patients be treated more aggressively with medications, cognitive rehabilitation, or even surgery to open up the artery," said Lal. "I anticipate a large number of follow-up studies searching for causes and the best treatment option for this newly identified morbidity associated with carotid narrowing."

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