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Brain Structure, Connectivity, and Cognitive Changes Following Revascularization Surgery in Adult Moyamoya Disease

Ken Kazumata1, Khin Khin Tha2, Kikutaro Tokairin1

  • 1Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Japan.

Neurosurgery
|June 4, 2019
PubMed
Abstract

Insights

Revascularization surgery improved cognitive processing speed and attention in Moyamoya disease (MMD) patients. Multimodal MRI revealed postsurgical brain structure and connectivity changes, aiding in detecting these subtle alterations.

Area of Science:

  • Neurology
  • Neurosurgery
  • Neuroimaging

Background:

  • Moyamoya disease (MMD) requires surgical intervention to restore cerebral blood flow.
  • The impact of revascularization surgery on cognitive function and brain changes in MMD is not fully understood.

Purpose of the Study:

  • To investigate cognitive, structural, and functional brain changes after revascularization surgery in MMD patients.
  • To utilize multimodal neuroimaging and neurobehavioral data for a comprehensive analysis.

Main Methods:

  • 25 adult MMD patients underwent neurobehavioral and neuroimaging assessments pre- and post-surgery (>12 months).
  • Cognitive function was evaluated using standard neuropsychological tests.
  • Brain imaging included diffusion tensor imaging (DTI) for white matter integrity, morphometry, and resting-state functional MRI (fMRI) for connectivity.

Main Results:

  • Significant improvements were observed in full-scale IQ, performance IQ (PIQ), perceptual organization (PO), processing speed, and Stroop test scores post-surgery.
  • Brain imaging revealed lateral ventricle enlargement, reduced corpus callosum and subcortical volumes, and prefrontal cortical thinning.
  • Increased white matter fractional anisotropy and enhanced fronto-cerebellar connectivity correlated with cognitive improvements.

Conclusions:

  • Revascularization surgery shows potential to enhance processing speed and attention in adult MMD patients.
  • Multimodal MRI is valuable for detecting subtle postsurgical brain structural and connectivity alterations in MMD.
Keywords:
Cerebrovascular disordersCognitive functionEC-IC bypassIntracranial artery diseaseMoyamoya disease

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