Abstract
Object: Moyamoya disease affects the cognitive function of pediatric patients, and compromised cerebral blood flow might be the potential cause. We aimed to explore the specific correlation between cognitive impairment and regional perfusion status in pediatric moyamoya disease patients.Methods: We prospectively enrolled consecutive pediatric moyamoya disease patients admitted to Beijing Tiantan Hospital from July 2017 to March 2019. Arterial spin-labeling magnetic resonance and the Wechsler Intelligence Scale for Children (the 4th edition) were performed on all participants. The cognitive performance of patients was analyzed, and its correlation to cerebral perfusion status was also investigated in the region of interest-based analysis.Results: A total of 21 patients met the inclusion criteria (mean aged 11.14 ± 2.82, male: female = 11:10). Six patients (28.6%) showed no cognitive deficits in any index score, while 15 (71.4%) showed cognitive deficits with differing severity. Nine (42.9%) patients showed overall cognitive impairment, and all cognitive index scores except for Verbal Comprehension Index were significantly lower than the mean scores of normative data with corresponding age. Perceptual Reasoning Index (p = 0.019) were statistically lower in patients with radiologically confirmed cerebral infarction. Suzuki stage of the left hemisphere negatively correlated to Full-scale Intelligence Quotient (r = −0.452, p = 0.039). Region of Interest analysis showed that cerebral blood flow of the left temporal lobe independently associated with the Processing Speed Index (β = 0.535, p = 0.041).Conclusion: Pediatric moyamoya disease patients exhibited different levels of cognitive impairment. Cerebral infarction is related to poorer perceptual reasoning ability. Cerebral blood flow in the left temporal lobe positively correlates with processing speed.
Highlights
Moyamoya disease (MMD) is a cerebrovascular disease characterized by idiopathic stenosis or occlusion of the end of internal carotid arteries [1, 2]
Arterial spin-labeling magnetic resonance imaging (ASL-MRI) is a novel technique that uses labeled intraarterial blood as the contrast substance to acquire perfusion images, with the radiation-free nature being ideal for children [7, 8]
Consecutive pediatric moyamoya disease (MMD) patients who were admitted to Beijing Tiantan Hospital from July 2017 to March 2019 and met the inclusion criteria were prospectively enrolled in the current study
Summary
Moyamoya disease (MMD) is a cerebrovascular disease characterized by idiopathic stenosis or occlusion of the end of internal carotid arteries [1, 2]. Single-photon emission computed topography (SPECT) and perfusion CT are widely adopted to evaluate cerebral hemodynamics of MMD patients. These methods are radioactive and potentially hazardous, especially for pediatric patients [5, 6]. Arterial spin-labeling magnetic resonance imaging (ASL-MRI) is a novel technique that uses labeled intraarterial blood as the contrast substance to acquire perfusion images, with the radiation-free nature being ideal for children [7, 8]. Several studies had adopted this technique to evaluate surgical effectiveness in both adult and pediatric MMD patients [9, 10]. The application of ASL would facilitate the research about cognition in pediatric MMD
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
