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Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism
Oct, 2024;44 (10): 1787-1800.

Decreased diffusivity along the perivascular space and cerebral hemodynamic disturbance in adult moyamoya disease.

Shoko Hara, Junko Kikuta, Kaito Takabayashi, Koji Kamagata, Shihori Hayashi, Motoki Inaji, Yoji Tanaka, Masaaki Hori, Kenji Ishii, Tadashi Nariai, Toshiaki Taoka, Shinji Naganawa, Shigeki Aoki, Taketoshi Maehara
Author Information
  1. Shoko Hara: Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan. ORCID
  2. Junko Kikuta: Department of Radiology, Juntendo University, Tokyo, Japan.
  3. Kaito Takabayashi: Department of Radiology, Juntendo University, Tokyo, Japan.
  4. Koji Kamagata: Department of Radiology, Juntendo University, Tokyo, Japan.
  5. Shihori Hayashi: Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan.
  6. Motoki Inaji: Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan.
  7. Yoji Tanaka: Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan.
  8. Masaaki Hori: Department of Radiology, Juntendo University, Tokyo, Japan.
  9. Kenji Ishii: Research Team for Neuroimaging, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
  10. Tadashi Nariai: Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan.
  11. Toshiaki Taoka: Department of Innovative Biomedical Visualization, Nagoya University Graduate School of Medicine, Aichi, Japan.
  12. Shinji Naganawa: Department of Radiology, Nagoya University, Aichi, Japan.
  13. Shigeki Aoki: Department of Radiology, Juntendo University, Tokyo, Japan.
  14. Taketoshi Maehara: Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan.
PMID: 38574287 DOI: 10.1177/0271678X241245492

Abstract

Moyamoya disease (MMD) causes cerebral arterial stenosis and hemodynamic disturbance, the latter of which may disrupt glymphatic system activity, the waste clearance system. We evaluated 46 adult patients with MMD and 33 age- and sex-matched controls using diffusivity along the perivascular space (ALPS) measured with diffusion tensor imaging (ALPS index), which may partly reflect glymphatic system activity, and multishell diffusion MRI to generate freewater maps. Twenty-three patients were also evaluated via O-gas positron emission tomography (PET), and all patients underwent cognitive tests. Compared to controls, patients (38.4 (13.2) years old, 35 females) had lower ALPS indices in the left and right hemispheres (1.94 (0.27) vs. 1.65 (0.25) and 1.94 (0.22) vs. 1.65 (0.19), 0.001). While the right ALPS index showed no correlation, the left ALPS index was correlated with parenchymal freewater (���=���-0.47, 0.001); perfusion measured with PET (cerebral blood flow, ���=���0.70, 0.001; mean transit time, ���=���-0.60, 0.003; and oxygen extraction fraction, ���=���-0.52, 0.003); and cognitive tests (trail making test part B for executive function; ���=���-0.37, 0.01). Adult patients with MMD may exhibit decreased glymphatic system activity, which is correlated with the degree of hemodynamic disturbance, increased interstitial freewater, and cognitive dysfunction, but further investigation is needed.

Keywords

Diffusion tensor image analysis along the perivascular space extracellular fluid glymphatic system ischemia moyamoya disease

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MeSH Term

Humans
Moyamoya Disease
Female
Male
Adult
Glymphatic System
Middle Aged
Positron-Emission Tomography
Hemodynamics
Cerebrovascular Circulation
Diffusion Tensor Imaging
Journal Article
Article has an altmetric score of 9

Word Cloud

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