Correlation between cognitive impairment and cerebral hemodynamic disturbances on perfusion magnetic resonance imaging in European adults with moyamoya disease. Clinical article.
OBJECTIVE
Although cognitive impairment has been reported in adults with moyamoya disease (MMD), its relationship with cerebral hemodynamic disturbances has not been investigated. The aims of the present study were to confirm the presence of dysexecutive cognitive syndrome (DCS) in adults with MMD and to explore the relationship of DCS with frontal lobe perfusion as measured by perfusion MR imaging.


METHODS
Cerebral blood volume (CBV) ratio and mean transit time delay were measured in frontal and temporoparietal regions using the cerebellum as a reference region in 10 European adults with MMD. In addition, the authors calculated the cerebrovascular reserve (CVR) using the CBV ratio and the acetazolamide challenge. All patients underwent a standardized neuropsychological assessment test battery. The authors defined DCS as an impairment shown on 3 tests or more of executive function.


RESULTS
The authors found DCS in 6 patients. The frontal CVR was lower in patients with DCS than in patients without DCS (mean ± SD: -13.5 ± 13.2% and 20.3 ± 21.3%; p = 0.019, Mann-Whitney U-test). Other parameters of frontal perfusion and temporoparietal CVR were not correlated with DCS.


CONCLUSIONS
The authors' findings suggest that DCS is common in European adults with MMD and may be related to frontal perfusion impairment.
Calviere
Lionel
L
Department of Neurology, University of Toulouse, Rangueil Hospital, Toulouse, France. liocalviere@free.fr
Catalaa
Isabelle
I
Marlats
Fabienne
F
Viguier
Alain
A
Bonneville
Fabrice
F
Cognard
Christophe
C
Larrue
Vincent
V
D000086:Acetazolamide; D000328:Adult; D000368:Aged; D000927:Anticonvulsants; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003072:Cognition Disorders / Q000209:etiology / Q000523:psychology*; D056344:Executive Function / Q000502:physiology; D005260:Female; D005625:Frontal Lobe / Q000098:blood supply; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009072:Moyamoya Disease / Q000503:physiopathology* / Q000523:psychology*; D009483:Neuropsychological Tests
D000927:Anticonvulsants; D000086:Acetazolamide