title: Preliminary study of neurocognitive dysfunction in adult moyamoya disease and improvement after superficial temporal artery-middle cerebral artery bypass.
abstract: OBJECTIVE
  Moyamoya disease (MMD) is a chronic cerebrovascular occlusive disease of unknown etiology. In addition, the neurocognitive impairment of adults with MMD is infrequently reported and, to date, has not been well described. We attempted to determine both the neurocognitive profile of adult moyamoya disease and whether a superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis can improve the neurocognitive impairment in exhibiting hemodynamic disturbance without stroke.
  
  
  METHODS
  From September 2010 through November 2012, 12 patients with angiographically diagnosed MMD underwent STA-MCA anastomosis for hemodynamic impairment. Patients with hypoperfusion and impaired cerebrovascular reserve (CVR) capacity but without evidence of ischemic stroke underwent a cognitive function test, the Seoul Neuropsychological Screening Battery (SNSB). Five patients agreed to undergo a follow-up SNSB test. Data from preoperative and postoperative neurocognitive function tests were compared and analyzed.
  
  
  RESULTS
  Five of 12 patients were enrolled. The median age was 45 years (range, 24-55 years). A comparison of preoperative to postoperative status of SNSB, memory domain, especially delayed recall showed significant improvement. Although most of the domains showed improvement after surgery, the results were not statistically significant.
  
  
  CONCLUSIONS
  In our preliminary study, large proportions of adult patients with MMD demonstrate disruption of cognitive function. This suggests the possibility of chronic hypoperfusion as a primary cause of the neurocognitive impairment. When preoperative and postoperative status of cognitive function was compared, memory domain showed remarkable improvement. Although further study is needed, neurocognitive impairment may be an indication for earlier intervention with reperfusion procedures that can improve cognitive function.
authors.affiliation: Department of Neurosurgery, Eulji University Hospital, College of Medicine, Eulji University, Daejeon, Korea.
authors.forename: Hyun Joo
authors.initials: HJ
authors.lastname: Baek
authors.affiliation: Department of Neurosurgery, Eulji University Hospital, College of Medicine, Eulji University, Daejeon, Korea.
authors.forename: Seung Young
authors.initials: SY
authors.lastname: Chung
authors.affiliation: Department of Neurosurgery, Eulji University Hospital, College of Medicine, Eulji University, Daejeon, Korea.
authors.forename: Moon Sun
authors.initials: MS
authors.lastname: Park
authors.affiliation: Department of Neurosurgery, Eulji University Hospital, College of Medicine, Eulji University, Daejeon, Korea.
authors.forename: Seong Min
authors.initials: SM
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Eulji University Hospital, College of Medicine, Eulji University, Daejeon, Korea.
authors.forename: Ki Suk
authors.initials: KS
authors.lastname: Park
authors.affiliation: Department of Neurosurgery, Eulji University Hospital, College of Medicine, Eulji University, Daejeon, Korea.
authors.forename: Hee Un
authors.initials: HU
authors.lastname: Son
keywords: Moyamoya disease; Neurocognitive impairment; STA-MCA anastomosis