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Carotid artery stenosis as a risk factor for Alzheimer’s disease
Author(s) -
Vitali Francesca,
Beach Thomas G.,
Alexander Gene,
Reiman Eric M.,
Arias Juan Aristizabal,
Brinton Roberta Diaz,
Altbach Maria,
Weinkauf Craig
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.046162
Subject(s) - medicine , dementia , carotid endarterectomy , disease , pathological , autopsy , carotid artery disease , risk factor , stenosis , pathology
Background The role of extra‐cranial carotid artery disease (ECAD) in Alzheimer’s disease (AD) is not clear but of significance because treatments including carotid endarterectomy (CEA) are available yet not offered for the indication of dementia prevention. Here, we conducted a preliminary study to elucidate if ECAD can be considered a risk factor for Alzheimer’s disease (AD) and if CEA can improve cognitive impairment and dementia opening new views on possible treatment intervention options. Method Using Banner Alzheimer’s Brain Bank, post‐mortem pathological analyses were conducted on 48 patients with ECAD treated with CEA and 92 subjects with ECAD without CEA. Neurofibrillary tangles and white matter lesion burden were quantified by post‐mortem histology and scored at autopsy by pathologists. Student’s t‐test was performed to compare patients with ECAD with and without carotid endarterectomy (CEA). Result Preliminary results indicate that patients with CEA had significantly lower burden of white matter lesions (P = .05) and neurofibrillary tangles (P = .04). Additional analyses will evaluate whether CEA improves cognition in a cohort of patients with ECAD. Conclusion Outcomes of these analyses provide proof of concept indicating impact of ECAD on changes in brain structure associated with dementia. These outcomes provide a foundation on which to test hypotheses regarding the mechanisms contributing to ECAD associated AD.