Neurocognitive Dysfunction According to Hypoperfusion Territory in Patients With Moyamoya Disease
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Objective To demonstrate the prevalence of cerebral hypoperfusion without focal cerebral lesions in patients with Moyamoya disease (MMD), and the relationship between areas of hypoperfusion and cognitive impairment.Methods Twenty-six MMD patients were included. Patients were categorized according to the presence/absence of hypoperfusion in the frontal, parietal, temporal, and occipital lobes on brain single-photon-emission computed tomography (SPECT) after acetazolamide challenge. Computerized neuropsychological test (CNT) results were compared between groups.Results Only 3 patients showed normal cerebral perfusion. Baseline characteristics were similar between groups. Patients with frontal lobe hypoperfusion showed lower scores in visual continuous performance test (CPT), auditory CPT, forward digit span test, backward digit span test, verbal learning test, and trail-making test. Patients with parietal lobe hypoperfusion showed lower backward digit span test, visual learning test, and trail-making test scores. Related to temporal and occipital lobes, there were no significant differences in CNT results between the hypoperfusion and normal groups.Conclusion MMD patients without focal cerebral lesion frequently exhibit cerebral hypoperfusion. MMD patients with frontal and parietal hypoperfusion had abnormal CNT profiles, similar to those with frontal and parietal lesions. It is suggested that the hypoperfusion territory on brain SPECT without focal lesion may affect the characteristics of neurocognitive dysfunction in MMD patients.
Abstract
Objective To demonstrate the prevalence of cerebral hypoperfusion without focal cerebral lesions in patients with Moyamoya disease (MMD), and the relationship between areas of hypoperfusion and cognitive impairment.Methods Twenty-six MMD patients were included. Patients were categorized according to the presence/absence of hypoperfusion in the frontal, parietal, temporal, and occipital lobes on brain single-photon-emission computed tomography (SPECT) after acetazolamide challenge. Computerized neuropsychological test (CNT) results were compared between groups.Results Only 3 patients showed normal cerebral perfusion. Baseline characteristics were similar between groups. Patients with frontal lobe hypoperfusion showed lower scores in visual continuous performance test (CPT), auditory CPT, forward digit span test, backward digit span test, verbal learning test, and trail-making test. Patients with parietal lobe hypoperfusion showed lower backward digit span test, visual learning test, and trail-making test scores. Related to temporal and occipital lobes, there were no significant differences in CNT results between the hypoperfusion and normal groups.Conclusion MMD patients without focal cerebral lesion frequently exhibit cerebral hypoperfusion. MMD patients with frontal and parietal hypoperfusion had abnormal CNT profiles, similar to those with frontal and parietal lesions. It is suggested that the hypoperfusion territory on brain SPECT without focal lesion may affect the characteristics of neurocognitive dysfunction in MMD patients.
참고문헌 (25)
- Scott RM, "Moyamoya disease and moyamoya syndrome", N Engl J Med, 360, pp.1226~1237 (2009)
- Takeuchi K, "Hypogenesis of bilateral internal carotid artery", Shinkei, 9, pp.37~43 (1957)
- Cho HJ, "The different infarct patterns between adulthood-onset and childhood-onset moyamoya disease", J Neurol Neurosurg Psychiatr, 82, pp.38~40 (2011)
- Ikezaki K, "Cerebral circulation and oxygen metabolism in childhood moyamoya disease: a perioperative positron emission tomography study", J Neurosurg, 81, pp.843~850 (1994)
- Abete P, "Cognitive impairment and cardiovascular diseases in the elderly: a heart-brain continuum hypothesis", Ageing Res Rev, 18, pp.41~52 (2014)
- Hynes SM, "Intensive working memory training: a single case experimental design in a patient following hypoxic brain damage", Brain Inj, 28, pp.1766~1775 (2014)
- Kim JM, "Changing ischaemic lesion patterns in adult moyamoya disease", J Neurol Neurosurg Psychiatr, 80, pp.36~40 (2009)
- Kuroda S, "Moyamoya disease: current concepts and future perspectives", Lancet Neurol, 7, pp.1056~1066 (2008)
- Williams TS, "Intellectual ability and executive function in pediatric moyamoya vasculopathy", Dev Med Child Neurol, 54, pp.30~37 (2012)
- Festa JR, "Neurocognitive dysfunction in adult moyamoya disease", J Neurol, 257, pp.806~815 (2010)
- Calviere L, "Improvement in cognitive function and cerebral perfusion after bur hole surgery in an adult with moyamoya disease: case report", J Neurosurg, 115, pp.347~349 (2011)
- 정한영, "한글판 수정바델지수(K-MBI)의 개발: 뇌졸중 환자 대상의 다기관 연구", Annals of Rehabilitation Medicine, 31(3), pp.283~297 (2007), 대한재활의학회
- 김연희, "뇌손상 환자의 인지기능 평가를 위한 전산화 신경심리검사의 유용성", Annals of Rehabilitation Medicine, 25(2), pp.209~216 (2001), 대한재활의학회
- Weinberg DG, "Moyamoya disease: a review of histopathology, biochemistry, and genetics", Neurosurg Focus, 30, pp.E20~ (2011)
- Hayashi K, "A nationwide survey on unilateral moyamoya disease in Japan", Clin Neurol Neurosurg, 124, pp.1~5 (2014)
- Milner B, "Some cognitive effects of frontal-lobe lesions in man", Philos Trans R Soc Lond B Biol Sci, 298, pp.211~226 (1982)
- Gitelman DR, "A large-scale distributed network for covert spatial attention: further anatomical delineation based on stringent behavioural and cognitive controls", Brain, 122(Pt 6), pp.1093~1106 (1999)
- Black S, "Understanding white matter disease: imaging-pathological correlations in vascular cognitive impairment", Stroke, 40(3 Suppl), pp.S48~52 (2009)
- Kurumatani T, "White matter changes in the gerbil brain under chronic cerebral hypoperfusion", Stroke, 29, pp.1058~1062 (1998)
- Riddle A, "Histopathological correlates of magnetic resonance imaging-defined chronic perinatal white matter injury", Ann Neurol, 70, pp.493~507 (2011)
- Shibata M, "White matter lesions and glial activation in a novel mouse model of chronic cerebral hypoperfusion", Stroke, 35, pp.2598~2603 (2004)
- Volkan-Salanci B, "The role of brain perfusion SPECT in moyamoya disease", Rev Esp Med Nucl Imagen Mol, 31, pp.216~218 (2012)
- Kim SK, "Neurobehavioral cognitive status examination in stroke patients", J Korean Acad Rehabil Med, 21, pp.259~263 (1997)
- Adamski N, "A pilot study on the benefit of cognitive rehabilitation in Parkinson’s disease", Ther Adv Neurol Disord, 9, pp.153~164 (2016)
- Feng H, "Training rehabilitation as an effective treatment for patients with vascular cognitive impairment with no dementia", Rehabil Nurs (2016)