Association between white matter impairment and cognitive dysfunction in patients with ischemic Moyamoya disease

Ziqi Liu,Ziqi Liu,Ran Duan,Ran Duan,Rong Wang,Rong Wang,Rong Wang,Rong Wang,Rong Wang,Zhe Yi,Zhe Yi,Zongsheng Xu,Zongsheng Xu,Li Yuan,Chu Xiao,Shihao He,Shihao He

doi:10.1186/s12883-020-01876-0

Abstract

BackgroundIschemic Moyamoya disease is one of the important causes of stroke, which leads to severe impairment in cognitive functions. This cognitive impairment occurs prior to stroke. However, the cognitive functions that are impaired and the mechanisms of these impairments have not been determined.MethodsWe analyzed 12 patients with Moyamoya disease and 12 controls. All participants underwent cognitive tests and magnetic resonance imaging (MRI) scans. The diffusion tensor imaging (DTI) data was processed using Tract-Based Spatial Statistics (TBSS). Significantly different white matter areas were correlated with different cognitive functions.ResultsThere were significant differences in intelligence and subtraction between the patients and controls (p < 0.05). The parameters of DTI such as fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) have different changes in anterior thalamic radiation, inferior fronto-occipital fasciculus (IFO), superior longitudinal fasciculus (SLF), uncinate fasciculus (UF), inferior longitudinal fasciculus, forceps minor, and other regions between the two groups.ConclusionLeft UF and IFO may be the key brain regions affecting arithmetic function, while bilateral IFO has an effect on intelligence. RD and AD may be better indicators for early prediction of chronic white matter damage than FA, while MD tends to have a comprehensive indirect change. There is cognitive impairment in ischemic MMD, which is closely related to white matter impairment.Trial registrationClinical Trial Registration, Unique identifier: ChiCTR1900023610. Registered 4 June 2019 – Prospective study registered.

Highlights

Ischemic Moyamoya disease is one of the important causes of stroke, which leads to severe impairment in cognitive functions
We aimed to study white matter fiber bundle damage in Moyamoya Disease (MMD) patients without stroke by diffusion tensor imaging (DTI) to investigate whether the site of damage in white matter fiber bundles is associated with certain cognitive impairment and determine the cause of cognitive impairment in patients without stroke
Cognition result Cognitive tests were performed on 12 MMD patients and 12 controls, and it was found that the function of Raven’s Standard Progressive Matrices (SPM), Mental rotation (ROT), verbal working memory 2(VWM2), Simple subtraction (SUB), Complex subtraction (COMSUB), and word-memory (WORDM) in the patient group were all significantly lower than that in the control group (p < 0.05)

Summary

Introduction

Ischemic Moyamoya disease is one of the important causes of stroke, which leads to severe impairment in cognitive functions. This cognitive impairment occurs prior to stroke. In a small sample study, about two-thirds of patients with MMD have cognitive impairment [4], not all patients with cognitive dysfunction suffer from stroke. Previous studies have found that MMD patients have significantly lower executive function, attention, and shortterm memory than controls [5,6,7], but the difference in the structure of the brain between patients and controls is not known. We used neuroimaging to find a link between different parts of the brain and cognitive functions

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