{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T15:25:07Z","timestamp":1794324307768,"version":"4.9.0"},"reference-count":41,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>This article describes the use of ultrasound measurements of physical strain within carotid atherosclerotic plaques as a measure of instability and the potential for vascular cognitive decline, microemboli, and white matter changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Asymptomatic patients with significant (&gt; 60%) carotid artery stenosis were studied for dynamic measures of plaque instability, presence of microemboli, white matter changes, and vascular cognitive decline in comparison with normative controls and premorbid state.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Although classically asymptomatic, these patients showed vascular cognitive decline. The degree of strain instability measured within the atherosclerotic plaque directly predicted vascular cognitive decline in these patients thought previously to be asymptomatic according to classic criteria. Furthermore, 26% of patients showed microemboli, and patients had twice as much white matter hyperintensity as controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>These data show that physical measures of plaque instability are possible through interpretation of ultrasound strain data during pulsation, which may be more clinically relevant than solely measuring degree of stenosis. The data also highlight the importance of understanding that the definition of symptoms should not be limited to motor, speech, and vision function but underscore the role of vascular cognitive decline in the pathophysiology of carotid atherosclerotic disease.<\/jats:p>\n                    <jats:p>Clinical trial registration no.: NCT02476396 (clinicaltrials.gov)<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2016.10.jns161299","type":"journal-article","created":{"date-parts":[[2017,3,10]],"date-time":"2017-03-10T10:04:38Z","timestamp":1489140278000},"page":"111-119","source":"Crossref","is-referenced-by-count":57,"title":["Carotid atherosclerotic plaque instability and cognition determined by ultrasound-measured plaque strain in asymptomatic patients with significant stenosis"],"prefix":"10.3171","volume":"128","author":[{"given":"Robert J.","family":"Dempsey","sequence":"first","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomy","family":"Varghese","sequence":"additional","affiliation":[{"name":"Medical Physics, University of Wisconsin School of Medicine and Public Health;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daren C.","family":"Jackson","sequence":"additional","affiliation":[{"name":"Wisconsin Surgical Outcomes Research Program, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Wang","sequence":"additional","affiliation":[{"name":"Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nirvedh H.","family":"Meshram","sequence":"additional","affiliation":[{"name":"Medical Physics, University of Wisconsin School of Medicine and Public Health;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol C.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Department of Medicine, Cardiovascular Medicine Division;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce P.","family":"Hermann","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Wisconsin School of Medicine and Public Health; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sterling C.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Waisman Laboratory for Brain Injury and Behavior, University of Wisconsin\u2013Madison & Geriatric Research Education & Clinical Center, William S. 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