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73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

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

Meeting Abstract

  • presenting/speaker Patrick Haas - Universitätsklinikum Tübingen, Klinik für Neurochirurgie, Tübingen, Deutschland; Universitätsklinikum Tübingen, Zentrum für Moyamoya und cerebrale Revaskularisation, Tübingen, Deutschland
  • Monika Fudali - Universitätsklinikum Tübingen, Klinik für Neurochirurgie, Tübingen, Deutschland; Universitätsklinikum Tübingen, Zentrum für Moyamoya und cerebrale Revaskularisation, Tübingen, Deutschland
  • Helene Hurth - Universitätsklinikum Tübingen, Klinik für Neurochirurgie, Tübingen, Deutschland; Universitätsklinikum Tübingen, Zentrum für Moyamoya und cerebrale Revaskularisation, Tübingen, Deutschland
  • Sophie Wang - Universitätsklinikum Tübingen, Klinik für Neurochirurgie, Tübingen, Deutschland; Universitätsklinikum Tübingen, Zentrum für Moyamoya und cerebrale Revaskularisation, Tübingen, Deutschland
  • Marcos Tatagiba - Universitätsklinikum Tübingen, Klinik für Neurochirurgie, Tübingen, Deutschland; Universitätsklinikum Tübingen, Zentrum für Moyamoya und cerebrale Revaskularisation, Tübingen, Deutschland
  • Nadia Khan - Universitätskinderspital Zürich, Moyamoya Center, Zürich, Schweiz
  • Constantin Roder - Universitätsklinikum Tübingen, Klinik für Neurochirurgie, Tübingen, Deutschland; Universitätsklinikum Tübingen, Zentrum für Moyamoya und cerebrale Revaskularisation, Tübingen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocV314

doi: 10.3205/22dgnc301, urn:nbn:de:0183-22dgnc3018

Published: May 25, 2022

© 2022 Haas et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

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.