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Neurocognitive impairment in adults with moyamoya disease without stroke

Peter Karzmark1, Penelope D Zeifert, Teresa E Bell-Stephens

  • 1Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California 94305-5235, USA.

Neurosurgery
|August 19, 2011
PubMed
Abstract

Insights

Cognitive impairment in moyamoya disease (MMD) can occur even without evidence of stroke on MRI scans. This study found that MMD patients without stroke still experienced significant deficits in executive function and mental processing.

Area of Science:

  • Neurology
  • Neuroscience
  • Radiology

Background:

  • Moyamoya disease (MMD) is known to cause cognitive impairment in adults.
  • The exact cause of this cognitive decline, specifically whether it stems from ischemic stroke, remains unclear.

Purpose of the Study:

  • To investigate cognitive function in adults diagnosed with MMD but without any MRI-confirmed evidence of stroke.
  • To determine if cognitive impairment exists independently of ischemic events in MMD patients.

Main Methods:

  • Neuropsychological assessments were conducted on 30 adult patients with angiographically confirmed MMD.
  • Brain MRI was used to exclude evidence of stroke in the study participants.

Main Results:

  • Despite the absence of stroke, 23% of MMD patients showed significant cognitive impairment.
  • Impaired cognitive domains included executive functioning, mental efficiency, and word finding; memory was relatively preserved.
  • Subtle white matter hyperintensities were observed in 67% of patients, but without gray matter damage.

Conclusions:

  • Cognitive impairment in moyamoya disease can manifest independently of ischemic stroke.
  • These findings suggest that MMD itself, or associated non-ischemic changes, contribute to cognitive deficits.

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