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71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21.06. - 24.06.2020

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

Neuropsychologische Beeinträchtigung bei erwachsenen Moyamoyapatienten mit Moyamoya-Angiopathie – präoperative Beurteilung und Korrelation zu MRT und H215O-PET

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  • presenting/speaker Patrick Haas - Universitätsklinikum Tübingen, Klinik für Neurochirurgie, Tübingen, Deutschland
  • Monika Fudali - Universitätsklinikum Tübingen, Klinik für Neurochirurgie, Tübingen, Deutschland
  • Monika Milian - Universitätsklinikum Tübingen, Klinik für Neurochirurgie, Tübingen, Deutschland
  • Ulrike Ernemann - Universitätsklinikum Tübingen, Diagnostische und Interventionelle Neuroradiologie, Tübingen, Deutschland
  • Philipp Meyer - Universitätsklinikum Freiburg, Klinik für Nuklearmedizin, Freiburg, Deutschland
  • Marcos Tatagiba - Universitätsklinikum Tübingen, Klinik für Neurochirurgie, Tübingen, Deutschland
  • Nadia Khan - Universitätsklinikum Tübingen, Klinik für Neurochirurgie, Tübingen, Deutschland; Universitätsspital Zürich, Moyamoya Center, Zürich, Switzerland
  • Constantin Roder - Universitätsklinikum Tübingen, Klinik für Neurochirurgie, Tübingen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. sine loco [digital], 21.-24.06.2020. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocV207

doi: 10.3205/20dgnc203, urn:nbn:de:0183-20dgnc2034

Veröffentlicht: 26. Juni 2020

© 2020 Haas et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objective: Patients with moyamoya angiopathy (MMA) are known to have an increased risk of impaired executive function (dysexecutive cognitive syndrome (DCS). Number 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.

Methods: 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 presence of DCS.

Results: 41.5% of patients presented with DCS. Significant association of DCS and affection of the right 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 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).

Conclusion: 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).