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Cognitive Performance Profile in Pediatric Moyamoya Disease Patients and Its Relationship With Regional Cerebral
Jiaxi Li1,2,3, Xingju Liu1,2,3, Dong Zhang1,2,3
1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Insights
Pediatric moyamoya disease often impairs cognitive function, with reduced cerebral blood flow linked to deficits. Specifically, cerebral infarction impacts perceptual reasoning, while left temporal lobe blood flow correlates with processing speed.
Area of Science:
- Neurology
- Pediatric Neurology
- Neuroimaging
Background:
- Moyamoya disease is a progressive cerebrovascular disorder.
- Cognitive impairment is a known complication in pediatric moyamoya disease.
- Reduced cerebral blood flow is suspected to underlie cognitive deficits.
Purpose of the Study:
- To investigate the correlation between cognitive function and regional cerebral perfusion in pediatric moyamoya disease patients.
- To identify specific cognitive deficits associated with moyamoya disease.
- To explore the relationship between cerebral infarction, Suzuki stage, and cognitive performance.
Main Methods:
- Prospective enrollment of pediatric moyamoya disease patients.
- Assessment of cognitive function using the Wechsler Intelligence Scale for Children (4th edition).
- Evaluation of regional cerebral perfusion using arterial spin-labeling magnetic resonance imaging.
Main Results:
- 71.4% of patients exhibited cognitive deficits, with 42.9% showing overall impairment.
- Lower Perceptual Reasoning Index scores were associated with cerebral infarction (p=0.019).
- Left hemisphere Suzuki stage negatively correlated with Full-scale Intelligence Quotient (r=-0.452, p=0.039).
- Left temporal lobe cerebral blood flow positively associated with Processing Speed Index (β=0.535, p=0.041).
Conclusions:
- Pediatric moyamoya disease patients present with varying degrees of cognitive impairment.
- Cerebral infarction is linked to diminished perceptual reasoning abilities.
- Cerebral blood flow in the left temporal lobe is a significant predictor of processing speed.
Abstract:
Object: Moyamoya disease affects the cognitive function of pediatric patients, and compromised cerebral blood flow might be the potential cause. We aimed to explore the specific correlation between cognitive impairment and regional perfusion status in pediatric moyamoya disease patients. Methods: We prospectively enrolled consecutive pediatric moyamoya disease patients admitted to Beijing Tiantan Hospital from July 2017 to March 2019. Arterial spin-labeling magnetic resonance and the Wechsler Intelligence Scale for Children (the 4th edition) were performed on all participants. The cognitive performance of patients was analyzed, and its correlation to cerebral perfusion status was also investigated in the region of interest-based analysis. Results: A total of 21 patients met the inclusion criteria (mean aged 11.14 ± 2.82, male: female = 11:10). Six patients (28.6%) showed no cognitive deficits in any index score, while 15 (71.4%) showed cognitive deficits with differing severity. Nine (42.9%) patients showed overall cognitive impairment, and all cognitive index scores except for Verbal Comprehension Index were significantly lower than the mean scores of normative data with corresponding age. Perceptual Reasoning Index (p = 0.019) were statistically lower in patients with radiologically confirmed cerebral infarction. Suzuki stage of the left hemisphere negatively correlated to Full-scale Intelligence Quotient (r = -0.452, p = 0.039). Region of Interest analysis showed that cerebral blood flow of the left temporal lobe independently associated with the Processing Speed Index (β = 0.535, p = 0.041). Conclusion: Pediatric moyamoya disease patients exhibited different levels of cognitive impairment. Cerebral infarction is related to poorer perceptual reasoning ability. Cerebral blood flow in the left temporal lobe positively correlates with processing speed.
