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Abstract #0594

Using Structural Connectivity Graph Analysis to Predict Cognitive Decline in Patients After Carotid Endarterectomy

Salil Soman 1,2 , Gautam Prasad 3,4 , Elizabeth Hitchner 5 , Wei Zhou 5,6 , Michael Moseley 7 , and Allyson Rosen 8,9

1 Radiology, Stanford University, Menlo Park, CA, United States, 2 California War Related Illness and Injury Study Center, Palo Alto Veteras Affairs Hospital, Palo Alto, CA, United States, 3 LONI, University of Southern California, Los Angeles, CA, United States, 4 Psychology, Stanford University, CA, United States, 5 Vascular Surgery, Stanford University, CA, United States, 6 Vascular Surgery, Veterans Affairs Palo Alto Health Care System, CA, United States, 7 Radiology, Stanford University, CA, United States, 8 Pschology, Stanford University, CA, United States, 9 Pscychology, Veterans Affairs Palo Alto Health Care System, CA, United States

Some patients with carotid stenosis that undergo carotid surgery afterwards experience cognitive decline. Identifying these patients before surgery would allow targeting of therapies to minimize disability. We hypothesized that structural connectivity graphs could identify these patients. We performed T1, DTI, and neuropsychological testing prior to surgery. Repeat neuropsychological testing was then performed 1 month later. FreeSurfer 5.3 whole brain segmentation, whole brain HARDI tractography, and connectivity analysis were then performed. The graph analysis methods weighted optimal community structure & binary connected component sizes metrics both predicted patients that would experience cognitive decline with 81% sensitivity 83% and specificity (FDR .05).

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