Correlation Between Cognitive Impairment And Cerebral Hemodynamics In Adults With Moyamoya Disease

Objective:This study used three-dimentional pulsed continuous arterial spin labeling(3D-p CASL)technique to investigate the correlation between cerebral hemodynamics and cognitive function in adults moyamoya disease.Methods:Collected 40 MMD patients diagnosed by head MRI and MRA in the second affiliated hospital of nanchang university from march 2018 to december 2019.The case group was divided into vascular cognitive disorders(VCDs)group and non VCDs group according to the Mo CA score,matching 40 healthy adults in the same period as the health control group.All subjects were assessed and recorded by professional assessors for cognitive function,signed informed consent,performed routine MRI scans,and routine scan sequences included T1WI、T2WI、T2FLAIR、DWI 、 MRA,the CBF value of bilateral dorsolateral prefrontal lobe(DLPF),supplemental motor area(SMA),inferior parietal lobe(IPL),superior temporal gyrus(STG)and anterior cingulate gyrus(ACG)were obtained by scanning the whole brain3D-p CASL.To analyze the characteristics of each CBF value between VCDs group,non-VCDs group and control group,to explore the correlation between the CBF value of each brain area and cognitive function in the VCDs、healthy control group;Apply to SPSS 24.0 statistics to process the data.Results:1.In this study,there were 40 cases in case group and 40 cases in health control group.The case group was divided into VCDs group(28 cases in total)and non VCDs group(12 cases in total).The two groups were compared with the health control group in terms of basic information such as gender,age and education years.The results showed that there was no statistical significance and comparability between the groups.2.For Mo CA score,the score of VCDs group was significantly lower than that of non VCDs group and healthy control group(P < 0.05);for TMTA and TMTB scores,the score of VCDs group was significantly higher than that of non VCDs group and healthy control group(P < 0.05);in the cognitive evaluation of the three groups,there was no significant difference in the scores of non VCDs group and healthy control group.3.The results showed that the case group could be divided into stroke group and non-stroke group according to the clinical symptoms,and there was no significant difference between stroke group and non-stroke group in Mo CA score(P>0.05).4.The results showed that the CBF value of the right dorsolateral prefrontal lobe,the right inferior parietal lobe,the right supplemental motor area,the right superior temporal gyrus,the left dorsolateral prefrontal lobe were significantly higher in the control group than in the non VCDs group than in the VCDs group(P < 0.05);The CBF value in the left superior temporal gyrus and left anterior cingulate gyrus were higher than those in the control group VCDs group was more than non VCDs group,and the difference was statistically significant(P < 0.05);In the right anterior cingulate gyrus and the left supplemental motor area,the CBF value was higher in the healthy control group than in the VCDs group and non VCDs group,and there was no statistically significant difference between the VCDs group and non VCDs group;There was no statistically significant difference between the three groups in the CBF value of the left inferior parietal lobe.5.The analysis between relative the CBF value and cognitive function in healthy controls: a two-factor correlation analysis showed that there was no correlation between the CBF value and Mo CA、TMTA 、TMTB score in 10 brain regions(right dorsolateral prefrontal lobe,right supplemental motor area,right superior temporal gyrus,right inferior parietal lobule,right anterior cingulate gyrus,left dorsolateral prefrontal lobe,left supplemental motor area,left superior temporal gyrus,left inferior parietal lobe,left anterior cingulate gyrus)(P>0.05).6.The results of the analysis of the data between the CBF value and the cognitive function score in the VCDs group: The CBF of the right dorsolateral prefrontal lobe,the right inferior parietal lobe,the right supplemental motor area,the right superior temporal gyrus and the right anterior cingulate gyrus was significantly correlated with the Mo CA score(P < 0.05),the difference was statistically significant,positive correlation.There was no significant correlation between Mo CA score and the CBF value in left dorsolateral prefrontal lobe,left inferior parietal lobe,left supplemental motor area,left superior temporal gyrus and left anterior cingulate gyrus(P > 0.05);There was a negative correlation between TMTA score and the CBF value in the right anterior cingulate gyrus(P < 0.05);There was no significant correlation between TMTA score and the CBF value in the right dorsolateral prefrontal lobe,the right supplemental motor area,the right superior temporal gyrus,the right inferior parietal lobe,the left inferior parietal lobe,the left supplemental motor area,the left superior temporal gyrus and the left anterior cingulate gyrus(P >0.05);There was a negative correlation between TMTB score and the CBF value in right dorsolateral prefrontal lobe,right inferior parietal lobe,right superior temporal gyrus and right anterior cingulate gyrus(P < 0.05);There was no significant correlation between TMTB score and the CBF value in right supplemental motor area,left dorsolateral prefrontal lobe,left supplemental motor area,left superior temporal gyrus and left anterior cingulate gyrus(P > 0.05).Conclusion:1.3D-p CASL can find MMD cerebral hypoperfusion area,which can be combined with cognitive score to provide diagnostic basis for MMD early cognitive impairment.2.Mo CA score was correlated with the CBF of MMD,and it was speculated that the CBF value could reflect cognitive function to some extent.3.TMTB score was correlated with the CBF of MMD,speculating that higher baseline MMD might have better executive cognitive function.