Postoperative change of neuropsychological function after indirect revascularization in childhood moyamoya disease: a correlation with cerebral perfusion study

Hsu, Yen-Hsuan; Chen, Ya-Fang; Yang, Chi‐Cheng; Kuo, Meng-Fai

doi:10.1007/s00381-019-04432-5

Cited by 8 publications

(5 citation statements)

References 19 publications

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“…Only a few retrospective Asian studies have assessed the correlation between cognitive and cerebrovascular changes exclusively in children. One showed that CBF increased in all hemispheres, and in some ROIs, this correlated with change in cognition [40]. However, there were also territories with a negative correlation between CBF and cognitive test results, making it more difficult to draw definite conclusions.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcome, Cognition, and Cerebrovascular Reactivity after Surgical Treatment for Moyamoya Vasculopathy: A Dutch Prospective, Single-Center Cohort Study

Deckers

Kronenburg

Berg

et al. 2022

JCM

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Background: It remains unclear whether revascularization of moyamoya vasculopathy (MMV) has a positive effect on cognitive function. In this prospective, single-center study, we investigated the effect of revascularization on cognitive function in patients with MMV. We report clinical and radiological outcome parameters and the associations between clinical determinants and change in neurocognitive functioning. Methods: We consecutively included all MMV patients at a Dutch tertiary referral hospital who underwent pre- and postoperative standardized neuropsychological evaluation, [15O]H2O-PET (including cerebrovascular reactivity (CVR)), MRI, cerebral angiography, and completed standardized questionnaires on clinical outcome and quality of life (QOL). To explore the association between patient characteristics, imaging findings, and change in the z-scores of the cognitive domains, we used multivariable linear- and Bayesian regression analysis. Results: We included 40 patients of whom 35 (27 females, 21 children) were treated surgically. One patient died after surgery, and two withdrew from the study. TIA- and headache frequency and modified Rankin scale (mRS) improved (resp. p = 0.001, 0.019, 0.039). Eleven patients (seven children) developed a new infarct during follow-up (31%), five of which were symptomatic. CVR-scores improved significantly (p < 0.0005). The language domain improved (p = 0.029); other domains remained stable. In adults, there was an improvement in QOL. We could not find an association between change in imaging and cognitive scores. Conclusion: In this cohort of Western MMV patients, TIA frequency, headache, CVR, and mRS improved significantly after revascularization. The language domain significantly improved, while others remained stable. We could not find an association between changes in CVR and cognitive scores.

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Section: Discussionmentioning

confidence: 99%

Clinical Outcome, Cognition, and Cerebrovascular Reactivity after Surgical Treatment for Moyamoya Vasculopathy: A Dutch Prospective, Single-Center Cohort Study

Deckers

Kronenburg

Berg

et al. 2022

JCM

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“…63 Significant improvement in verbal memory was observed following indirect revascularization in a third prospective study in children with MMD. 64 Improvement in frontal lobe functions, including attention, have also been observed following indirect revascularization in children with MMD. 65 Poor cognitive outcomes in children have been attributed to completed stroke prior to revascularization surgery and small Neuropsychiatric Disease and Treatment 2024:20 https://doi.org/10.2147/NDT.S440975 DovePress 665 craniotomy in indirect surgical bypass.…”

Section: Impact Of Revascularization On Neurocognitive Outcomesmentioning

confidence: 99%

“… Kazumata 70 25 Adults Japan STA-MCA bypass and EDAMS Intelligence, memory, verbal comprehension, perceptual organization, working memory, executive function, attention, and processing speed 12–44 months Significant improvement in the full-scale IQ, performance IQ, perceptual organization, processing speed, and attention-related cognition. Ando 57 17 Adults Japan STA-MCA bypass and EDMS Intelligence, memory, visuospatial function and visual memory 6 months Cognitive improvement – 35% Hsu 64 23 Children Taiwan Bilateral EDAS Intelligence, verbal comprehension, perceptual organization, working memory, progressing speed, verbal learning and memory, and executive function 6+ months (average 22 months) Significant improvement in verbal memory function. Deckers 63 32 Adults (11) and children (21) Netherlands STA-MCA bypass and EDMS Intelligence, memory, working memory, language, attention and executive function, processing speed, and visuospatial function 10–27 months Significant improvement in language in children.…”

Section: Impact Of Revascularization On Neurocognitive Outcomesmentioning

confidence: 99%

Neuropsychiatric Symptoms of Moyamoya Disease: Considerations for the Clinician

Oakley,

Lanzino,

Klaas

2024

NDT

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Neurocognitive impairment in moyamoya disease is common, under recognized, and potentially devastating. The purpose of this paper is to provide an updated overview on this topic for the practicing clinician. We searched PubMed for keywords including cognitive impairment, neurocognitive dysfunction, and neuropsychological recovery in moyamoya disease. We summarized the literature to provide a concise review of the treatment and management of neuropsychiatric symptoms associated with moyamoya disease. Neuropsychiatric sequelae have conventionally been attributed to chronic cerebral hypoperfusion and/or stroke. Cognitive dysfunction in adults with moyamoya disease is most commonly in the form of impaired executive function, whereas intelligence is the predominant impairment in children with moyamoya disease. Pharmacotherapy for treatment of the neuropsychiatric symptoms associated with moyamoya disease is appropriate and can improve quality of life; however, careful consideration is needed to avoid adverse cerebrovascular events. It remains unclear as to whether surgical revascularization improves or stabilizes cognitive performance and outcomes. Additional prospective studies are warranted to better understand the long-term impact of revascularization on cognitive functioning in moyamoya disease.

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“…And speculated the rate of ischemic attacks in patients with MMD may be associated with the reduced ability of patients to cope with external stimuli after long-term vascular stenosis and reduced cerebral vascular reserve function. Vascular ischemia can occur when external factors affect vasomotor function (21). The most common predisposing factor was fever, accounting for 41.3% (26/63) of all predisposing factors.…”

Section: Patient Characteristicsmentioning

confidence: 99%

Common Inducing Factors of Ischemic Events Occurred in Pediatric with Ischemic Moyamoya Disease

Chen,

Gao,

Tang

et al. 2023

Preprint

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Objective: This study aims to investigate the inducing factors that cause ischemic events and summarize the clinical features between TIA and infarction in pediatrics with ischemic MMD. Methods: A retrospective analysis was conducted from September 2015 to September 2021 in-patients and out-patients admitted to Xiangya Hospital of Central South University. Results: The results indicated that 74.1% (63/85) of patients had obvious inducing factors before the ischemic attack, among which fever accounted for 41.3% (26/63). TIA patients with obvious inducing factors accounted for 83.3% (25/30) cases, and cerebral infarction patients with obvious inducing factors accounted for 69.1% (38/55). The inducing factorof fever is significantly higher in patients with infarction than in those with TIA (p=0.0023). The inducing factors of crying (p=0.0006) and consumption of irritating foods (p=0.0018) are significantly higher in patients with TIA than infarction. The age was younger in patients with infarction than TIA (8.8 ± 0.7 vs 5.8 ± 0.5, p=0.0011). The infarctions were more common in patients with PCA involvement than in patients present with TIA (p=0.0044). Multivariate analysis revealed that crying (p= 0.002) was independently associated with TIA. Conclusions: The occurrence of ischemic events in children with ischemic MMD tends to be associated with a clear inducing factor. Fever is more common in causing cerebral infarction, while crying and eating irritating foods are easy to cause TIA. Crying was identified as an independent risk factor for inducing TIA. The patients present with infarction are associated with younger age and PCA involvement in pediatric ischemic MMD.

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Postoperative change of neuropsychological function after indirect revascularization in childhood moyamoya disease: a correlation with cerebral perfusion study

Cited by 8 publications

References 19 publications

Clinical Outcome, Cognition, and Cerebrovascular Reactivity after Surgical Treatment for Moyamoya Vasculopathy: A Dutch Prospective, Single-Center Cohort Study

Clinical Outcome, Cognition, and Cerebrovascular Reactivity after Surgical Treatment for Moyamoya Vasculopathy: A Dutch Prospective, Single-Center Cohort Study

Neuropsychiatric Symptoms of Moyamoya Disease: Considerations for the Clinician

Common Inducing Factors of Ischemic Events Occurred in Pediatric with Ischemic Moyamoya Disease

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