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Association of cognitive function and hypoperfusion in Moyamoya disease patients without stroke

Xu-Xuan Shen1,2, Hou-Di Zhang2, He-Guan Fu1,2

  • 1Department of Neurosurgery, The Fifth School of Clinical Medicine, Anhui Medical University, Beijing, China.

Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism
|November 18, 2022
PubMed

Insights

Hypoperfusion, or reduced blood flow, impairs cognition in Moyamoya disease (MMD) patients even without stroke. Specific brain region perfusion is linked to cognitive deficits, aiding in patient evaluation and treatment.

Area of Science:

  • Neuroscience
  • Neurology
  • Radiology

Background:

  • Moyamoya disease (MMD) is a rare cerebrovascular disorder.
  • The impact of hypoperfusion on cognitive function in MMD patients without stroke remains poorly understood.

Purpose of the Study:

  • To investigate cognitive function changes in MMD patients without prior stroke.
  • To explore the relationship between cognitive impairment and cerebral hypoperfusion in this population.

Main Methods:

  • Prospective study involving 115 adult MMD patients (no stroke) and 82 healthy controls.
  • Neurocognitive assessment using seven standardized tests (e.g., MoCA, TMT-A/B, CDT, CAVLT).
  • Hemodynamic evaluation via dynamic susceptibility contrast-enhanced MRI to measure cerebral blood flow (CBF).
  • Best subset regression (BSR) applied to identify cognitive impairment risk factors.

Main Results:

  • MMD patients without stroke exhibited significantly poorer global cognition, processing speed, executive function, visuospatial function, and verbal memory compared to controls.
  • Executive function (TMT-B) correlated with CBF in bilateral lateral frontal lobes, centrum semiovale, and temporal lobes.
  • Processing speed (TMT-A) and verbal memory (CAVLT) correlated with CBF in the left centrum semiovale (L-CSO) and temporal lobes.
  • BSR identified age, education, white matter lesions, and L-CSO hypoperfusion as risk factors for cognitive impairment.

Conclusions:

  • Hypoperfusion contributes to diverse cognitive impairments in MMD patients, even in the absence of overt stroke.
  • Assessing perfusion in specific brain regions may aid in evaluating cognitive status and guiding therapeutic strategies for MMD patients.
Keywords:
Cognitive impairmentMoyamoya diseasehypoperfusionnon-strokerisk factor

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