Artikel
Quality of life and neuropsychological outcome after EC-IC bypass revascularisation in adult Moyamoya patients
Lebensqualität und neuropsychologisches Outcome nach EC-IC-Bypassanlage bei erwachsenen Moyamoya-Patienten
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Veröffentlicht: | 25. Mai 2022 |
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Gliederung
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Objective: Patients with Moyamoya angiopathy (MMA) have an above-average incidence of neuropsychological impairment and psychiatric comorbidities such as depression. A prevalence and correlation to preoperative imaging findings was identified in previous studies and a relation to a reduced quality of life (QoL) was proven. This study investigates changes in neuropsychological performance after revascularization by extracranial-intracranial (EC-IC) bypass.
Methods: Neuropsychological and QoL data were analyzed in 30 adult patients pre- and 1-year postoperatively (SCL-90, SF-36, BDI). In addition, executive function performance was obtained via a standardized test battery as part of the routine neuropsychological assessment (TMTA/B, D2, Ch-L).
Results: 86 complete questionnaires and 88 executive function tests were available for analysis in total. Scores for anxiety, psychoticism and phobic anxiety showed significant improvement postoperatively (p < .01). QoL parameters like vitality, psychological well-being and social functioning (p < .01) as well as general health and physical role function (p < .05) were also significantly increased, especially if there were already limitations preoperatively. If depression was present preoperatively, its severity was also significantly reduced after revascularization (mean difference 7.7 ±1.3; p < .001). A significant improvement in executive function was observed in neuropsychological performance testing regarding psychomotor processing speed after revascularization (p < .01).
Conclusion: Insufficient intracerebral blood flow in Moyamoya patients leads not only to possible physical deficits, but also to neuropsychological impairment with correspondingly reduced QoL indicators. The results of this study show an improved outcome in various parameters after revascularization by EC-IC bypass. Neuropsychological performance should be tested and kept in mind when planning therapeutic concepts for patients with Moyamoya Angiopathy.