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01-12-2020 | Positron Emission Tomography | Original Article

Neuropsychological impairment in adults with moyamoya angiopathy: preoperative assessment and correlation to MRI and H₂¹⁵O PET

Authors: Constantin Roder, Patrick Haas, Monika Fudali, Monika Milian, Ulrike Ernemann, Philipp T. Meyer, Marcos Tatagiba, Nadia Khan

Published in: Neurosurgical Review | Issue 6/2020

Abstract

Patients with moyamoya angiopathy (MMA) are known to have an increased risk of impaired executive function (dysexecutive cognitive syndrome (DCS)). Numbers of moyamoya patients with DCS vary strongly in the literature; evidence of a correlation to affected vascular territories is low. This study aims to identify cognitive impairment in adult moyamoya patients and to correlate findings with imaging results. In addition, the predictive value of individual tests for the identification of DCS was analyzed. Neuropsychological test data of 41 adult moyamoya patients was analyzed for a possible correlation with territorial hypoperfusion on H₂¹⁵O PET with acetazolamide (ACZ) challenge (cerebrovascular reserve—CVR) and infarction patterns observed in MRI. Each vascular territory was analyzed separately and correlated to neuropsychological test results and to the presence of DCS. In total, 41.5% of patients presented with DCS. Significant association of DCS and affection of the right middle cerebral artery (MCA) territory was seen for insufficient CVR in PET (p = 0.030) and for patients with infarctions seen in MRI (p = 0.014). Analysis of individual neuropsychological test results confirmed the main association with the right MCA territory, as well as some association with the right anterior cerebral artery (ACA) territory. Analysis of a subgroup of patients with chronic disease on MRI (presence of large post-infarction gliosis and brain atrophy in affected territories) revealed a significantly higher risk for DCS (85% affected) than non-chronic patients (21% affected) (p < 0.001). Analysis of neuropsychological test data in this moyamoya cohort reveals DCS in 41.5% of all patients. Correlation between DCS and an impairment of CVR seen in PET and/or infarctions seen in MRI was significant for the right MCA territory. Patients with chronic disease had a significantly higher risk for DCS than non-chronic patients (p < 0.001).

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Title: Neuropsychological impairment in adults with moyamoya angiopathy: preoperative assessment and correlation to MRI and H215O PET
Authors: Constantin Roder
Patrick Haas
Monika Fudali
Monika Milian
Ulrike Ernemann
Philipp T. Meyer
Marcos Tatagiba
Nadia Khan
Publication date: 01-12-2020
Publisher: Springer Berlin Heidelberg
Keywords: Positron Emission Tomography
Acetazolamide
Published in: Neurosurgical Review / Issue 6/2020
Print ISSN: 0344-5607
Electronic ISSN: 1437-2320
DOI: https://doi.org/10.1007/s10143-019-01192-3

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Springer Medicine

Neuropsychological impairment in adults with moyamoya angiopathy: preoperative assessment and correlation to MRI and H₂¹⁵O PET

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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