PMID- 18574546
OWN - NLM
STAT- MEDLINE
DCOM- 20080925
LR  - 20230612
IS  - 0942-0940 (Electronic)
IS  - 0001-6268 (Print)
IS  - 0001-6268 (Linking)
VI  - 150
IP  - 8
DP  - 2008 Aug
TI  - Elevation of monocyte chemoattractant protein-1 in patients experiencing 
      neurocognitive decline following carotid endarterectomy.
PG  - 779-84; discussion 784
LID - 10.1007/s00701-008-1618-6 [doi]
AB  - BACKGROUND: Previous studies have demonstrated that elevated pre-operative 
      monocyte count is an independent predictor of acute neurocognitive decline 
      following carotid endarterectomy (CEA). Monocyte chemoattractant protein-1 
      (MCP-1), secreted by human endothelial and monocyte-like cells, is a potent 
      mediator of inflammation and mononuclear cell trafficking. This study examines 
      the relationship between peri-operative serum MCP-1 elevation and post-operative 
      neurocognitive injury following CEA. METHODS: Fifty-two patients undergoing CEA 
      and 67 lumbar laminectomy (LL) controls were administered a battery of five 
      neuropsychological tests pre-operatively and on post-operative day 1 (POD 1). 
      Change in individual test scores from baseline to POD 1 were converted into 
      Z-score and used to develop a point system quantifying the degree of 
      neurocognitive dysfunction relative to change within the LL group. Neurocognitive 
      injury following CEA was defined as a score greater than 2 standard deviations 
      above mean total deficit scores of LL controls. Serum MCP-1 levels were measured 
      pre-operatively and on POD 1 by enzyme-linked immunosorbent assay. FINDINGS: Mean 
      percent MCP-1 elevation was higher for the 13 injured CEA patients (147.7 +/- 
      32.4%) in our cohort compared to 39 age- and sex-matched uninjured CEA patients 
      (76.0 +/- 16.5%). In unconditional multivariate logistic regression analysis, 
      percent elevation in serum MCP-1 level was associated with neurocognitive injury 
      one day after CEA (OR = 2.19, 95% CI = 1.13-4.26, P = 0.021, for a 100% elevation 
      from pre-operative levels). CONCLUSIONS: Peri-operative elevations in serum MCP-1 
      levels correlate with acute neurocognitive dysfunction following CEA. These data 
      implicate an inflammatory mechanism in the pathogenesis of Ischaemic 
      neurocognitive decline.
FAU - Mack, W J
AU  - Mack WJ
AD  - Department of Neurological Surgery, Columbia University Medical Center, New York, 
      NY 10032, USA.
FAU - Ducruet, A F
AU  - Ducruet AF
FAU - Hickman, Z L
AU  - Hickman ZL
FAU - Zurica, J
AU  - Zurica J
FAU - Starke, R M
AU  - Starke RM
FAU - Garrett, M C
AU  - Garrett MC
FAU - Komotar, R J
AU  - Komotar RJ
FAU - Quest, D O
AU  - Quest DO
FAU - Solomon, R A
AU  - Solomon RA
FAU - Heyer, E J
AU  - Heyer EJ
FAU - Sander Connolly, E
AU  - Sander Connolly E
LA  - eng
GR  - M01 RR000645/RR/NCRR NIH HHS/United States
GR  - RR00645/RR/NCRR NIH HHS/United States
GR  - R01 AG017604/AG/NIA NIH HHS/United States
GR  - R01 AG017604-05A2/AG/NIA NIH HHS/United States
GR  - R01AG17604/AG/NIA NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20080623
PL  - Austria
TA  - Acta Neurochir (Wien)
JT  - Acta neurochirurgica
JID - 0151000
RN  - 0 (Chemokine CCL2)
SB  - IM
MH  - Aged
MH  - Chemokine CCL2/*blood
MH  - Cognition Disorders/diagnosis/*immunology
MH  - *Endarterectomy, Carotid
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Laminectomy
MH  - Lumbar Vertebrae/surgery
MH  - Male
MH  - Neuropsychological Tests
MH  - Postoperative Complications/diagnosis/*immunology
MH  - Prospective Studies
MH  - Reference Values
PMC - PMC2698290
MID - NIHMS114030
EDAT- 2008/06/25 09:00
MHDA- 2008/09/26 09:00
PMCR- 2009/06/18
CRDT- 2008/06/25 09:00
PHST- 2007/12/20 00:00 [received]
PHST- 2008/05/28 00:00 [accepted]
PHST- 2008/06/25 09:00 [pubmed]
PHST- 2008/09/26 09:00 [medline]
PHST- 2008/06/25 09:00 [entrez]
PHST- 2009/06/18 00:00 [pmc-release]
AID - 10.1007/s00701-008-1618-6 [doi]
PST - ppublish
SO  - Acta Neurochir (Wien). 2008 Aug;150(8):779-84; discussion 784. doi: 
      10.1007/s00701-008-1618-6. Epub 2008 Jun 23.