Academic Journal

Cognitive improvement following endovascular embolization in patients with intracranial dural arteriovenous fistula: The Neuropsychology in dural ArterIal Fistula (NAIF) Study

التفاصيل البيبلوغرافية
العنوان: Cognitive improvement following endovascular embolization in patients with intracranial dural arteriovenous fistula: The Neuropsychology in dural ArterIal Fistula (NAIF) Study
المؤلفون: Gramegna, Laura Ludovica, Ortega, Gemma, Dinia, Lavinia, Aixut, Sonia, Rosati, Santiago, Vega, Pedro, Lüttich, Alex, Remollo, Sebastian, González, Alejandro, Murias, Eduardo, Chirife Chaparro, Oscar, Moreu, Manuel, Requena, Manuel, de Dios Lascuevas, Marta, Hernandez, David, Quintana, Manuel, Puig, Josep, Rovira, Alex, Tomasello, Alejandro
المساهمون: Medtronic Europe
المصدر: Journal of NeuroInterventional Surgery ; page jnis-2023-021033 ; ISSN 1759-8478 1759-8486
بيانات النشر: BMJ
سنة النشر: 2023
الوصف: Background Cognitive improvement after endovascular embolization of an intracranial dural arteriovenous fistula (dAVF) remains unexplored. We aim to investigate cognitive changes following endovascular embolization of dAVFs. Methods Neuropsychology in dural ArterIal Fistula (NAIF) was a prospective multicentric study including patients with an angiographic diagnosis of dAVF who underwent endovascular embolization over the course of 4 years. A complete neuropsychological evaluation comprising five cognitive domains (attention and executive functions, memory, language, praxis, gnosis) was performed at baseline and 3 months follow-up. Mean Z scores for cognitive tests were compared pre- and post-treatment using paired sample t-tests, where higher Z scores indicate better cognition. Effect sizes were computed as Cohen’s d. Results A total of 32 patients (mean age 61.1±15.4 years, 10 (31.3%) females) were included. Patients exhibited improved performance in attention and executive functions: executive functions–attention (+0.282, P=0.009, d=0.29), executive functions–fluencies (+0.283, P=0.029, d=0.4), and executive functions–processing speed (+0.471, P=0.039, d=0.41). There was an increase in memory: verbal learning and verbal delayed recall scores (+0.513, P<0.001, d=0.55, and +0.385, P=0.001, d=0.41, respectively), while verbal recognition parameters (+0.839, P=0.086, d=0.37) and visual memory (delayed recall) (+0.430, P=0.060, d=0.35) displayed trends toward improved performance. Regarding language, there was significant overall improvement (+0.300, P=0.014, d=0.24), but neither praxis nor gnosis changed significantly. These cognitive outcomes were independent of the severity (measured as Cognard classification), and no patient experienced cognitive worsening. Conclusion This study suggests that endovascular embolization confers cognitive benefits on dAVF patients undergoing endovascular embolization and may be beneficial even for patients with a low risk of hemorrhage.
نوع الوثيقة: article in journal/newspaper
اللغة: English
DOI: 10.1136/jnis-2023-021033
الاتاحة: http://dx.doi.org/10.1136/jnis-2023-021033
https://syndication.highwire.org/content/doi/10.1136/jnis-2023-021033
رقم الانضمام: edsbas.22610C0
قاعدة البيانات: BASE
الوصف
DOI:10.1136/jnis-2023-021033