A Recent Update of Clinical and Research Topics Concerning Adult Moyamoya Disease

Jeon, Jin Pyeong; Kim, Jeong Eun

doi:10.3340/jkns.2016.59.6.537

Cited by 15 publications

(10 citation statements)

References 58 publications

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“… 11) In particular, patients with risk factors of atherosclerosis (dyslipidemia, heavy smoking, alcoholics and hypertension) more than three were excluded in defining MMD patients. 11 , 17) Therefore, we think that our result could be derived from a more accurate method to estimate risk factors in adult MMD with thyroid abnormalities. Second, the distinction between definitive MMD and quasi-MMD with underlying autoimmune disease such as Graves disease is not clear when the angiographic and clinical features are fully compatible with those of MMD.…”

Section: Discussionmentioning

confidence: 90%

“…If I 2 < 50%, a fixed effect model was used. 17) Publication bias was determined using funnel plot, Egger’s test of the intercept, and the Begg and Mazumdar rank correlation test. 18) SAS, version 9.3 (SAS Institute, Cary, North Carolina), R software V3.00 and comprehensive meta-analysis (CMA) software (CMA v2.2.064; Biostat, Englewood, NJ) were utilized for all the above, with statistical significance indicated at P < 0.05.…”

Section: Methodsmentioning

confidence: 99%

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Association of Hyperthyroidism and Thyroid Autoantibodies with Moyamoya Disease and Its Stroke Event: A Population-based Case-control Study and Meta-analysis

Ahn

Jeon

Kim

et al. 2018

Neurol. Med. Chir.(Tokyo)

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The aim of this study was to investigate the specific thyroid condition and thyroid autoantibodies in adult moyamoya disease (MMD) according to clinical presentation (ischemia vs. hemorrhage stroke). In addition, a meta-analysis was performed to reveal the association between adult MMD and elevated thyroid function, or autoantibodies. Prospectively collected data on 169 consecutive patients with MMD at a single institution were analyzed. Community-based controls matched for age and sex were selected for comparison. Penalized multinomial logistic regression analysis was used for factors affecting stroke. For meta-analysis, heterogeneity was evaluated by using the I2 test. If I2 < 50%, a fixed effect model was used. Fifty-four cases (32.0%) presented with ischemic stroke and 37 cases (21.9%) with hemorrhage stroke. Hyperthyroidism had a marginally increased risk of MMD with ischemic stroke with reference value of MMD without stroke [odds ratio (OR), 2.53; P = 0.055]. Anti-thyroperoxidase antibody (TPOAb) increased the risk of MMD presenting with ischemic stroke significantly (OR, 2.99; P = 0.020). A meta-analysis revealed that adult MMD was significantly associated with elevated autoantibodies (OR, 7.663; P = 0.002) and hyperthyroidism (OR, 10.936; P < 0.001). Elevated TPOAb and hyperthyroidism may play important roles in adult MMD with ischemic stroke. Studies focusing on targeted hyperthyroidism and thyroid autoantibodies are necessary in treating adult MMD patients in the future.

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Section: Discussionmentioning

confidence: 90%

Section: Methodsmentioning

confidence: 99%

Association of Hyperthyroidism and Thyroid Autoantibodies with Moyamoya Disease and Its Stroke Event: A Population-based Case-control Study and Meta-analysis

Ahn

Jeon

Kim

et al. 2018

Neurol. Med. Chir.(Tokyo)

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“…Diagnostic criteria previously required that steno-occlusive change at the ICA should be evident bilaterally for the definitive diagnosis of moyamoya disease [6]. Recently, however, diagnostic criteria for definitive moyamoya disease were revised to include patients with unilateral terminal ICA steno-occlusion as well [7].…”

Section: Discussionmentioning

confidence: 99%

Moyamoya Disease: A Diagnostic Challenge

Abdullah¹,

Nausheen²,

Mehdi³

et al. 2018

Intern Med

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“…Heterogeneity was evaluated by using the I 2 test. If I 2 was less than 50%, a fixed effect model was used [ 21 ]. Publication bias was determined using Begg’s funnel plot and Egger’s test of the intercept [ 3 , 11 , 22 ].…”

Section: Methodsmentioning

confidence: 99%

Protected versus Unprotected Carotid Artery Stenting : Meta-Analysis of the Current Literature

Cho

Kim²,

Lim

et al. 2018

J Korean Neurosurg Soc

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ObjectiveTo compare peri-operative any symptomatic stroke after carotid angioplasty and stenting (CAS), based on the application or absence of a cerebral protection device.MethodsA systematic literature review using PubMed, Embase, and the Cochrane Central was done across an online data base from January 1995 to October 2016. Procedures which were performed due to carotid dissection or aneurysm, procedures using covered stents or conducted in an emergency, were excluded. The primary endpoint was perioperative any symptomatic stroke within 30 days after the procedure. A fixed effect model was used in cases of heterogeneity less than 50%.ResultsIn the 25 articles included in this study, the number of stroke events was 326 (2.0%) in protected CAS and 142 (3.4%) in unprotected CAS. The use of cerebral protection device significantly decreased stroke after CAS (odds ratio [OR] 0.633, 95% confidence interval [CI] 0.479–0.837, p=0.001). In the publication bias analysis, Egger’s regression test disclosed that the intercept was -0.317 (95% CI -1.015–0.382, p=0.358). Regarding symptomatic patients (four studies, 539 CAS procedures), the number of stroke was six (1.7%) in protected CAS and 11 (5.7%) in unprotected CAS. The protective effect against stroke events by cerebral protection device did not have a statistical significance (OR 0.455, 95% CI 0.151–1.366, p=0.160).ConclusionThe use of protection device significantly decreased stroke after CAS. However, its efficacy was not demonstrated in symptomatic patients. Routine use of protection device during CAS should be critically assessed before mandatory use.

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A Recent Update of Clinical and Research Topics Concerning Adult Moyamoya Disease

Cited by 15 publications

References 58 publications

Association of Hyperthyroidism and Thyroid Autoantibodies with Moyamoya Disease and Its Stroke Event: A Population-based Case-control Study and Meta-analysis

Association of Hyperthyroidism and Thyroid Autoantibodies with Moyamoya Disease and Its Stroke Event: A Population-based Case-control Study and Meta-analysis

Moyamoya Disease: A Diagnostic Challenge

Protected versus Unprotected Carotid Artery Stenting : Meta-Analysis of the Current Literature

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