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Connectometry evaluation in patients undergoing carotid endarterectomy: an exploratory study

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Abstract

This research investigated local brain connectivity changes following Carotid Endarterectomy (CEA) by connectometry. Seventeen subjects (15 males and 2 females, mean age 74.1 years), all eligible for CEA, were prospectively recruited in this exploratory study. On the same day within the week before the CEA, each patient underwent a cognitive evaluation with a Mini Mental State Examination (MMSE) and a Magnetic Resonance Imaging (MRI) exam that included a DTI sequence for the connectometry analysis. A second MMSE and the same MRI protocol were performed on follow-up, 3–6 months after CEA. The MMSE scores were analyzed using T-Student tests. The connectometry analysis was performed using a multiple regression model to consider the effect of CEA, choosing three different T-score threshold (T-threshold) values (1, 2 and 3). Results were considered statistically valid for p value adjusted for False Discovery Rate (p-FDR) < 0.05. Comparison of pre-CEA and post-CEA MMSE scores showed improvement of MMSE scores after CEA. Connectometry analysis revealed no areas of statistically significant increased connectivity related to CEA for T-threshold value = 1 and 2, but showed statistically significant increase of connectivity after CEA in both cerebellar hemispheres and corpus callosum for T-threshold value = 3 (p-FDR = 0.0106667). The network property analysis showed improved small worldness (2.14%), clustering coefficient (1.64%), local (1.94%) and global efficiency (0.56%), and reduced characteristic path length (−0.52%) after CEA. These results suggest that CEA is associated both with cognitive performance improvement and changes in interhemispheric local connectivity in the corpus callosum and cerebellum.

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  1. Michele Porcu and Davide Craboledda contributed equally: co-first authors.

Authors and Affiliations

  1. Department of Radiology, University Hospital of Cagliari, Cagliari, Italy

    Michele Porcu, Paolo Garofalo, Giulio Columbano & Luca Saba

  2. Department of Medical Sciences and Public Health, University of Cagliari, S.S: 554, km 4,500, CAP: 09042, Monserrato, Cagliari, Italy

    Michele Porcu

  3. Department of Vascular Surgery, University Hospital of Cagliari, Cagliari, Italy

    Davide Craboledda, Roberto Sanfilippo & Roberto Montisci

  4. Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy

    Luigi Barberini

  5. Department of Radiology, University of Cambridge School of Clinical Medicine, Cambridge, CB2 0QQ, UK

    Fulvio Zaccagna

  6. Department of Radiology, Neuroradiology Division, Stanford University, Stanford, CA, USA

    Max Wintermark

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  1. Michele Porcu
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Porcu, M., Craboledda, D., Garofalo, P. et al. Connectometry evaluation in patients undergoing carotid endarterectomy: an exploratory study. Brain Imaging and Behavior 13, 1708–1718 (2019). https://doi.org/10.1007/s11682-018-0024-9

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