Association of cognitive function with cerebral blood flow in children with moyamoya disease

被引：23

作者：

Kazumata, Ken ^{[1
]}

Tokairin, Kikutaro ^{[1
]}

Sugiyama, Taku ^{[1
]}

Ito, Masaki ^{[1
]}

Uchino, Haruto ^{[1
]}

Osanai, Toshiya ^{[1
]}

Kawabori, Masahito ^{[1
]}

Nakayama, Naoki ^{[1
]}

Houkin, Kiyohiro ^{[1
]}

机构：

[1] Hokkaido Univ, Grad Sch Med, Dept Neurosurg, Sapporo, Hokkaido, Japan

来源：

JOURNAL OF NEUROSURGERY-PEDIATRICS | 2020年 / 25卷 / 01期

关键词：

moyamoya disease; cognitive disorders; cerebral blood flow; intellectual ability; vascular disorders; BRAIN; INTELLIGENCE; DECLINE; ADULTS; CONNECTIVITY; IMPAIRMENT; PERFUSION; ISCHEMIA; NETWORK; SURGERY;

D O I：

10.3171/2019.7.PEDS19312

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

OBJECTIVE The cognitive effects of main cerebral artery occlusive lesions are unclear in children with moyamoya disease (MMD). The authors aimed to investigate cognitive function in the presurgical phase of pediatric patients with MMD with no apparent brain lesions. METHODS In this prospective, observational, single-center study, 21 children (mean age 10 +/- 3.0 years, range 5-14 years) diagnosed with MMD at Hokkaido University Hospital between 2012 and 2018 were enrolled. A cross-sectional evaluation of intellectual ability was performed using the Wechsler Intelligence Scale for Children-Fourth Edition at the initial diagnosis. rCBF was measured using [I-123] N-isopropyl p-iodoamphetamine/SPECT. The associations among clinical factors, disease severity, regional cerebral blood flow (rCBF), and intelligence test scores were also examined. RESULTS The mean full-scale intelligence quotient (FIQ) was 101.8 +/- 12.5 (range 76-125) in children with no apparent brain lesions. A significant difference in the intelligence scale index score was observed, most frequently (42.9%) between working memory index (WMI) and verbal comprehension index (VCI; VCI - WMI > 11 points). Regional CBF was significantly reduced both in the left and right medial frontal cortices (left: 61.3 +/- 5.3 ml/100 g/min, right 65.3 +/- 5.3 ml/100 g/min; p < 0.001) compared to the cerebellum (77.8 +/- 6.8 ml/100 g/min). There was a significant association of rCBF in the left dorsolateral prefrontal cortex (DLPFC) with FIQ (r = 0.46, p = 0.034), perceptual reasoning index (PRI; r = 0.44, p = 0.045), and processing speed index (PSI; r = 0.44, p = 0.045). There was an association between rCBF of the left medial frontal cortex and PSI (r = 0.49, p = 0.026). Age of onset, family history, ischemic symptoms, and angiographic severity were not associated with poor cognitive performance. CONCLUSIONS Although average intellectual ability was not reduced in children with MMD, the association of reduced rCBF in the left DLPFC and medial frontal cortex with FIQ, PRI, and PSI suggests mild cognitive dysfunction due to cerebral hypoperfusion.

引用

页码：62 / 68

页数：7