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Executive dysfunction in adults with moyamoya disease is associated with increased diffusion in frontal white matter

Lionel Calviere1, Guillaume Ssi Yan Kai, Isabelle Catalaa

  • 1Department of Vascular Neurology, University of Toulouse, Toulouse, France. liocalviere@free.fr

Journal of Neurology, Neurosurgery, and Psychiatry
|March 2, 2012
PubMed
Abstract

Insights

In adults with moyamoya disease (MMD), elevated apparent diffusion coefficient (ADC) in white matter indicates reduced cerebrovascular reserve (CVR) and predicts executive dysfunction, suggesting ADC as a potential marker for cognitive impairment risk.

Area of Science:

  • Neuroimaging
  • Neurology
  • Vascular Neurology

Background:

  • Alterations in cerebrovascular reserve (CVR) in moyamoya disease (MMD) are linked to cognitive deficits.
  • Elevated apparent diffusion coefficient (ADC) in white matter may signal chronic hemodynamic failure.

Purpose of the Study:

  • To investigate the relationship between ADC, CVR, and cognitive dysfunction in adults with MMD.
  • To determine if ADC can predict executive dysfunction in MMD patients.

Main Methods:

  • ADC and CVR were measured in the frontal white matter using MRI with an acetazolamide challenge.
  • Neuropsychological tests assessed executive function in MMD patients.

Main Results:

  • A negative correlation was found between ADC and CVR (Spearman's rho = -0.46, p=0.015).
  • Elevated ADC significantly predicted executive dysfunction (AUC = 0.85, p=0.032).
  • Executive dysfunction was present in 7 of 13 tested patients.

Conclusions:

  • Increased ADC in normal-appearing frontal white matter is associated with reduced CVR and executive dysfunction in MMD.
  • ADC measurement may help identify MMD patients at risk for cerebral ischemia and cognitive impairment.

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