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 ORIGINAL ARTICLE
Year : 2020  |  Volume : 68  |  Issue : 6  |  Page : 1409--1413

Neurocognitive Outcomes in Adult Quasi -Moyamoya Disease: A Prospective Analysis of Consecutive Cases


1 Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, People's Republic of China
2 School of Basic Medical Sciences and Forensic Medicine, Hangzhou Medical College, Hangzhou, Zhejiang Province, People's Republic of China
3 Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, People's Republic of China
4 Department of Neurosurgery, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, Sichuan Province, People's Republic of China

Correspondence Address:
Dr. Dongsheng Guo
Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province
People's Republic of China
Junjuan Wang
School of Basic Medical Sciences and Forensic Medicine, Hangzhou Medical College, Hangzhou, Zhejiang Province
People's Republic of China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.304116

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Background: This study aimed to evaluate and compare the neurocognitive outcomes of adult quasi-moyamoya disease (quasi-MMD) patients with autoimmune diseases (AIDs) to help better manage these patients. Methods: We performed a structured battery of neurocognitive tests to analyze and compare the neurocognitive outcomes of adult quasi-MMD patients with AID in our hospital from October 2000 to September 2015. Results: Overall, 27.3% of the neuropsychological test comparisons indicated a significant improvement in cognition, and a significant decline was found in 6%. In 47.4% of comparisons, the observed difference did significantly change the reliable change indices (RCI) before and after anti-autoimmune treatment. We found that the number of patients showing significant improvements, and no change in cognitive outcomes did differ between quasi-MMD and MMD (31.8% vs 14.9% with p = 0.006 and 50.0% vs 66.8% with p = 0.031, respectively; Chi-squared test). The incidence of cognitive decline in quasi-MMD patients (18.2%) did not significantly differ from that in MMD patients (18.3%) (p = 0.982). After adjusting for covariates, including sex, age, type 2 diabetes mellitus, risk factors, other comorbidities, and AID, multiple logistic regression analysis suggested that AID was more likely to aggravate the neurocognitive outcome of quasi-MMD patients (p = 0.042, odds ratio (OR) 6.78, 95% confidence interval (CI) 1.31–62.71). Conclusions: AID was more likely to aggravate the neurocognitive outcome of quasi-MMD patients, and anti-autoimmune treatment could improve long-term neurocognitive outcomes. These findings indicated that AID seemed to be an independent risk factor for the pathological and physiological mechanisms of quasi-MMD.






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