Postoperative change of neuropsychological function after indirect revascularization in childhood moyamoya disease: a correlation with cerebral perfusion study
Journal
Child's Nervous System
Journal Volume
36
Journal Issue
6
Pages
1245-1253
Date Issued
2020
Author(s)
Abstract
Purpose: The relationships between postoperative functional improvement in various cognitive domains and regional hemodynamic change have not been sufficiently studied in childhood moyamoya disease (MMD). The present study aimed to examine the cognitive benefit of indirect revascularization, the underlying biological mechanism, and factors affecting surgical outcome in childhood MMD.
Methods: Twenty-three patients with MMD aged under 20 years received neuropsychological examinations before and after indirect revascularization surgery, evaluating intellectual function, verbal and visual memory, and executive function. Among them, 13 patients had magnetic resonance perfusion (MRP) studies, in which regional cerebral perfusion was rated.
Results: Postoperative improvement was observed in verbal memory performances (p = 0.02-0.03) and in cerebral perfusion at all 26 cerebral hemispheres (p = 0.003-0.005), especially in the middle cerebral artery (MCA) territories (p = 0.001-0.003). Hemodynamic improvement in the left MCA territories was significantly correlated with improvement of both verbal new learning (p = 0.01) and intellectual function (p = 0.004). Postoperative cognitive improvement of immediate recall and verbal intellectual function was associated with female sex (r = - 0.42) and symptom duration (p = - 0.03), respectively. Hemodynamic improvement in the MCA territories was related to longer follow-up intervals (p = 0.02).
Conclusion: The findings revealed that the selective postoperative cognitive improvement was associated with increased regional perfusion in the MCA territories, and indicate the importance of early intervention and the potential of indirect revascularization regarding long-term outcome.
Subjects
Cerebral revascularization
Hemodynamics
Moyamoya disease
Stroke
Treatment
SDGs
Other Subjects
Article; brain perfusion; cerebral revascularization; child; childhood disease; clinical article; cognition; disease duration; executive function; female; human; intelligence; left hemisphere; male; middle cerebral artery; moyamoya disease; neuroimaging; neuropsychological test; nuclear magnetic resonance imaging; priority journal; recall; right hemisphere; school child; treatment outcome; verbal memory; visual memory
Publisher
Springer
Type
journal article