Moyamoya Disease With Initial Ischemic or Hemorrhagic Attack Shows Different Brain Structural and Functional...

Area of Science:

• Neuroimaging
• Neurology
• Radiology

Background:

• Moyamoya disease (MMD) presents with cerebral ischemia or intracranial hemorrhage, but underlying pathophysiology remains unclear.
• Understanding structural and functional brain differences between MMD subtypes is crucial for diagnosis and treatment.

Purpose of the Study:

• To investigate brain structural and functional variations between ischemic MMD, hemorrhagic MMD, and healthy controls (HCs) using multimodal neuroimaging.
• To explore correlations between neuroimaging findings and cognitive function in MMD patients.

Main Methods:

• Included 12 ischemic MMD, 10 hemorrhagic MMD, and 10 HCs undergoing MRI and cognitive assessment.
• Cortical thickness, cerebral blood flow (CBF) via arterial spin labeling (ASL), and white matter integrity via diffusion tensor imaging (DTI) were analyzed.
• Correlation analyses examined relationships between MRI metrics and cognitive scores.

Main Results:

• Hemorrhagic MMD exhibited significantly greater right middle temporal gyrus (MTG) cortical thickness compared to ischemic MMD and HCs.
• The right MTG showed higher ASL-CBF, and its associated arcuate fasciculus (AF) had higher fractional anisotropy (FA) in hemorrhagic MMD.
• Right MTG thickness correlated positively with ASL-CBF and right AF FA; right AF FA correlated with MMD cognitive performance.

Conclusions:

• Hemorrhagic MMD is characterized by increased right MTG cortical thickness, linked to elevated CBF and enhanced right AF integrity.
• These findings offer insights into MMD pathophysiology and clinical manifestations, potentially aiding clinical practice.