Evaluation of cerebrovascular reactivity in moyamoya disease using oxygen-dependent magnetic resonance imaging

Moyamoya disease (MMD) is a rare cerebrovascular disorder marked by progressive stenosis of the internal carotid arteries. Assessing cerebral hemodynamics, specifically cerebrovascular reactivity (CVR), is vital for MMD management and prognosis. In this study, fMRI was performed in a prospective cohort of 47 patients with MMD and 32 healthy controls to investigate its utility in evaluating CVR and to explore the influence of cerebral posterior circulation compensation on CVR in MMD. The regions where the CVR values of participants with MMD were lower than those of healthy controls were primarily concentrated in the frontal, parietal, and temporal lobes (p < 0.05). In certain regions mainly supplied by posterior circulation, the CVR values of compensatory-normal subgroup tended to exceed those of compensatory-poor subgroup. fMRI can detect a significant decrease in CVR values in patients with MMD compared to healthy controls. Compensation for the posterior cerebral circulation may affect cerebrovascular reactivity.